Daily Papers

X-ray is medicine's most widely used imaging modality, yet remains among its least quantitative. Unlike volumetric modalities like CT or MRI, X-ray collapses 3D anatomy into a 2D projection, causing structures to overlap and anatomical boundaries to be ambiguous, even to experts. As a result, labeling X-ray databases for training general-purpose segmentation systems is impractical, leaving morphometric and functional X-ray analysis confined to narrow anatomical regions and applications. To this end, we present FleXray, a generalist model for anatomical segmentation across the entire body in clinical X-rays. Instead of curating large, manually annotated X-ray datasets, we build a scalable, physics-based generative X-ray data engine. Using existing 3D whole-body CT segmentation datasets and generative image-editing models, we simulate fully-annotated 2D X-rays with diverse appearances, physiological properties, and imaging geometries. Trained on these simulations, FleXray accurately segments 60 anatomical structures across unseen research datasets and in-the-wild X-rays. We further show that FleXray makes X-rays directly amenable to quantitative analysis, enabling automated measurements for disease grading, robust navigation during X-ray-guided interventions, and data-efficient learning of pathological targets. We release the model, code, a full-body X-ray segmentation dataset, and a local, easy-to-use browser-based tool at https://flexray.csail.mit.edu .

Chest X-ray imaging (CXR) is an important diagnostic tool used in hospitals to assess patient conditions and monitor changes over time. Generative models, specifically diffusion-based models, have shown promise in generating realistic synthetic X-rays. However, these models mainly focus on conditional generation using single-time-point data, i.e., typically CXRs taken at a specific time with their corresponding reports, limiting their clinical utility, particularly for capturing temporal changes. To address this limitation, we propose a novel framework, EHRXDiff, which predicts future CXR images by integrating previous CXRs with subsequent medical events, e.g., prescriptions, lab measures, etc. Our framework dynamically tracks and predicts disease progression based on a latent diffusion model, conditioned on the previous CXR image and a history of medical events. We comprehensively evaluate the performance of our framework across three key aspects, including clinical consistency, demographic consistency, and visual realism. We demonstrate that our framework generates high-quality, realistic future images that capture potential temporal changes, suggesting its potential for further development as a clinical simulation tool. This could offer valuable insights for patient monitoring and treatment planning in the medical field.

Recent advances in generative AI have brought incredible breakthroughs in several areas, including medical imaging. These generative models have tremendous potential not only to help safely share medical data via synthetic datasets but also to perform an array of diverse applications, such as anomaly detection, image-to-image translation, denoising, and MRI reconstruction. However, due to the complexity of these models, their implementation and reproducibility can be difficult. This complexity can hinder progress, act as a use barrier, and dissuade the comparison of new methods with existing works. In this study, we present MONAI Generative Models, a freely available open-source platform that allows researchers and developers to easily train, evaluate, and deploy generative models and related applications. Our platform reproduces state-of-art studies in a standardised way involving different architectures (such as diffusion models, autoregressive transformers, and GANs), and provides pre-trained models for the community. We have implemented these models in a generalisable fashion, illustrating that their results can be extended to 2D or 3D scenarios, including medical images with different modalities (like CT, MRI, and X-Ray data) and from different anatomical areas. Finally, we adopt a modular and extensible approach, ensuring long-term maintainability and the extension of current applications for future features.

X-ray images play a vital role in the intraoperative processes due to their high resolution and fast imaging speed and greatly promote the subsequent segmentation, registration and reconstruction. However, over-dosed X-rays superimpose potential risks to human health to some extent. Data-driven algorithms from volume scans to X-ray images are restricted by the scarcity of paired X-ray and volume data. Existing methods are mainly realized by modelling the whole X-ray imaging procedure. In this study, we propose a learning-based approach termed CT2X-GAN to synthesize the X-ray images in an end-to-end manner using the content and style disentanglement from three different image domains. Our method decouples the anatomical structure information from CT scans and style information from unpaired real X-ray images/ digital reconstructed radiography (DRR) images via a series of decoupling encoders. Additionally, we introduce a novel consistency regularization term to improve the stylistic resemblance between synthesized X-ray images and real X-ray images. Meanwhile, we also impose a supervised process by computing the similarity of computed real DRR and synthesized DRR images. We further develop a pose attention module to fully strengthen the comprehensive information in the decoupled content code from CT scans, facilitating high-quality multi-view image synthesis in the lower 2D space. Extensive experiments were conducted on the publicly available CTSpine1K dataset and achieved 97.8350, 0.0842 and 3.0938 in terms of FID, KID and defined user-scored X-ray similarity, respectively. In comparison with 3D-aware methods (pi-GAN, EG3D), CT2X-GAN is superior in improving the synthesis quality and realistic to the real X-ray images.

Synthetic medical data generation has opened up new possibilities in the healthcare domain, offering a powerful tool for simulating clinical scenarios, enhancing diagnostic and treatment quality, gaining granular medical knowledge, and accelerating the development of unbiased algorithms. In this context, we present a novel approach called ViewXGen, designed to overcome the limitations of existing methods that rely on general domain pipelines using only radiology reports to generate frontal-view chest X-rays. Our approach takes into consideration the diverse view positions found in the dataset, enabling the generation of chest X-rays with specific views, which marks a significant advancement in the field. To achieve this, we introduce a set of specially designed tokens for each view position, tailoring the generation process to the user's preferences. Furthermore, we leverage multi-view chest X-rays as input, incorporating valuable information from different views within the same study. This integration rectifies potential errors and contributes to faithfully capturing abnormal findings in chest X-ray generation. To validate the effectiveness of our approach, we conducted statistical analyses, evaluating its performance in a clinical efficacy metric on the MIMIC-CXR dataset. Also, human evaluation demonstrates the remarkable capabilities of ViewXGen, particularly in producing realistic view-specific X-rays that closely resemble the original images.

Synthetic data generated by generative models can enhance the performance and capabilities of data-hungry deep learning models in medical imaging. However, there is (1) limited availability of (synthetic) datasets and (2) generative models are complex to train, which hinders their adoption in research and clinical applications. To reduce this entry barrier, we propose medigan, a one-stop shop for pretrained generative models implemented as an open-source framework-agnostic Python library. medigan allows researchers and developers to create, increase, and domain-adapt their training data in just a few lines of code. Guided by design decisions based on gathered end-user requirements, we implement medigan based on modular components for generative model (i) execution, (ii) visualisation, (iii) search & ranking, and (iv) contribution. The library's scalability and design is demonstrated by its growing number of integrated and readily-usable pretrained generative models consisting of 21 models utilising 9 different Generative Adversarial Network architectures trained on 11 datasets from 4 domains, namely, mammography, endoscopy, x-ray, and MRI. Furthermore, 3 applications of medigan are analysed in this work, which include (a) enabling community-wide sharing of restricted data, (b) investigating generative model evaluation metrics, and (c) improving clinical downstream tasks. In (b), extending on common medical image synthesis assessment and reporting standards, we show Fréchet Inception Distance variability based on image normalisation and radiology-specific feature extraction.

Scaling robust driving policies is fundamentally bottlenecked by the scarcity of edge cases in curated datasets. While the real world continuously captures these critical events, such long-tail events remain underutilized when collected from heterogeneous sources. Specifically, diverse but valuable in-the-wild long-tail videos lack the full view coverage required for training policy models, often missing multi-view poses or originating solely from monocular dash cameras. This modality gap prevents these ubiquitous observations from being converted into scalable training data for long-tail generalization. We introduce OpenLongTail, an open-source generative data engine for scaling autonomous driving policies under long-tail events. To transform heterogeneous data sources into view-aligned and temporally coherent multi-view assets that are useful for policy learning, we develop a pose-informed extrapolative view synthesis pipeline that generates the missing views. We further enhance cross-view consistency and the temporal alignment for the newly generated views by injecting Plücker ray geometry into the scalable generation engine. By synthesizing heterogeneous long-tail data, we observe a significant improvement in closed-loop driving robustness in handling long-tail events. By measuring the extrapolative view synthesis and pose metrics, we validate the effectiveness of OpenLongTail in visual fidelity, cross-view consistency, and ego-trajectory recovery.

Generative models, particularly text-to-image (T2I) diffusion models, play a crucial role in medical image analysis. However, these models are prone to training data memorization, posing significant risks to patient privacy. Synthetic chest X-ray generation is one of the most common applications in medical image analysis with the MIMIC-CXR dataset serving as the primary data repository for this task. This study adopts a data-driven approach and presents the first systematic attempt to identify prompts and text tokens in MIMIC-CXR that contribute the most to training data memorization. Our analysis reveals an unexpected finding: prompts containing traces of de-identification procedures are among the most memorized, with de-identification markers contributing the most. Furthermore, we also find existing inference-time memorization mitigation strategies are ineffective and fail to sufficiently reduce the model's reliance on memorized text tokens highlighting a broader issue in T2I synthesis with MIMIC-CXR. On this front, we propose actionable strategies to enhance privacy and improve the reliability of generative models in medical imaging. Finally, our results provide a foundation for future work on developing and benchmarking memorization mitigation techniques for synthetic chest X-ray generation using the MIMIC-CXR dataset.

Medical image synthesis presents unique challenges due to the inherent complexity and high-resolution details required in clinical contexts. Traditional generative architectures such as Generative Adversarial Networks (GANs) or Variational Auto Encoder (VAEs) have shown great promise for high-resolution image generation but struggle with preserving fine-grained details that are key for accurate diagnosis. To address this issue, we introduce Pixel Perfect MegaMed, the first vision-language foundation model to synthesize images at resolutions of 1024x1024. Our method deploys a multi-scale transformer architecture designed specifically for ultra-high resolution medical image generation, enabling the preservation of both global anatomical context and local image-level details. By leveraging vision-language alignment techniques tailored to medical terminology and imaging modalities, Pixel Perfect MegaMed bridges the gap between textual descriptions and visual representations at unprecedented resolution levels. We apply our model to the CheXpert dataset and demonstrate its ability to generate clinically faithful chest X-rays from text prompts. Beyond visual quality, these high-resolution synthetic images prove valuable for downstream tasks such as classification, showing measurable performance gains when used for data augmentation, particularly in low-data regimes. Our code is accessible through the project website - https://tehraninasab.github.io/pixelperfect-megamed.

Multimodal models trained on large natural image-text pair datasets have exhibited astounding abilities in generating high-quality images. Medical imaging data is fundamentally different to natural images, and the language used to succinctly capture relevant details in medical data uses a different, narrow but semantically rich, domain-specific vocabulary. Not surprisingly, multi-modal models trained on natural image-text pairs do not tend to generalize well to the medical domain. Developing generative imaging models faithfully representing medical concepts while providing compositional diversity could mitigate the existing paucity of high-quality, annotated medical imaging datasets. In this work, we develop a strategy to overcome the large natural-medical distributional shift by adapting a pre-trained latent diffusion model on a corpus of publicly available chest x-rays (CXR) and their corresponding radiology (text) reports. We investigate the model's ability to generate high-fidelity, diverse synthetic CXR conditioned on text prompts. We assess the model outputs quantitatively using image quality metrics, and evaluate image quality and text-image alignment by human domain experts. We present evidence that the resulting model (RoentGen) is able to create visually convincing, diverse synthetic CXR images, and that the output can be controlled to a new extent by using free-form text prompts including radiology-specific language. Fine-tuning this model on a fixed training set and using it as a data augmentation method, we measure a 5% improvement of a classifier trained jointly on synthetic and real images, and a 3% improvement when trained on a larger but purely synthetic training set. Finally, we observe that this fine-tuning distills in-domain knowledge in the text-encoder and can improve its representation capabilities of certain diseases like pneumothorax by 25%.

We introduce CheXGenBench, a rigorous and multifaceted evaluation framework for synthetic chest radiograph generation that simultaneously assesses fidelity, privacy risks, and clinical utility across state-of-the-art text-to-image generative models. Despite rapid advancements in generative AI for real-world imagery, medical domain evaluations have been hindered by methodological inconsistencies, outdated architectural comparisons, and disconnected assessment criteria that rarely address the practical clinical value of synthetic samples. CheXGenBench overcomes these limitations through standardised data partitioning and a unified evaluation protocol comprising over 20 quantitative metrics that systematically analyse generation quality, potential privacy vulnerabilities, and downstream clinical applicability across 11 leading text-to-image architectures. Our results reveal critical inefficiencies in the existing evaluation protocols, particularly in assessing generative fidelity, leading to inconsistent and uninformative comparisons. Our framework establishes a standardised benchmark for the medical AI community, enabling objective and reproducible comparisons while facilitating seamless integration of both existing and future generative models. Additionally, we release a high-quality, synthetic dataset, SynthCheX-75K, comprising 75K radiographs generated by the top-performing model (Sana 0.6B) in our benchmark to support further research in this critical domain. Through CheXGenBench, we establish a new state-of-the-art and release our framework, models, and SynthCheX-75K dataset at https://raman1121.github.io/CheXGenBench/

This paper presents a comprehensive systematic review of generative models (GANs, VAEs, DMs, and LLMs) used to synthesize various medical data types, including imaging (dermoscopic, mammographic, ultrasound, CT, MRI, and X-ray), text, time-series, and tabular data (EHR). Unlike previous narrowly focused reviews, our study encompasses a broad array of medical data modalities and explores various generative models. Our search strategy queries databases such as Scopus, PubMed, and ArXiv, focusing on recent works from January 2021 to November 2023, excluding reviews and perspectives. This period emphasizes recent advancements beyond GANs, which have been extensively covered previously. The survey reveals insights from three key aspects: (1) Synthesis applications and purpose of synthesis, (2) generation techniques, and (3) evaluation methods. It highlights clinically valid synthesis applications, demonstrating the potential of synthetic data to tackle diverse clinical requirements. While conditional models incorporating class labels, segmentation masks and image translations are prevalent, there is a gap in utilizing prior clinical knowledge and patient-specific context, suggesting a need for more personalized synthesis approaches and emphasizing the importance of tailoring generative approaches to the unique characteristics of medical data. Additionally, there is a significant gap in using synthetic data beyond augmentation, such as for validation and evaluation of downstream medical AI models. The survey uncovers that the lack of standardized evaluation methodologies tailored to medical images is a barrier to clinical application, underscoring the need for in-depth evaluation approaches, benchmarking, and comparative studies to promote openness and collaboration.

Generating 3D images of complex objects conditionally from a few 2D views is a difficult synthesis problem, compounded by issues such as domain gap and geometric misalignment. For instance, a unified framework such as Generative Adversarial Networks cannot achieve this unless they explicitly define both a domain-invariant and geometric-invariant joint latent distribution, whereas Neural Radiance Fields are generally unable to handle both issues as they optimize at the pixel level. By contrast, we propose a simple and novel 2D to 3D synthesis approach based on conditional diffusion with vector-quantized codes. Operating in an information-rich code space enables high-resolution 3D synthesis via full-coverage attention across the views. Specifically, we generate the 3D codes (e.g. for CT images) conditional on previously generated 3D codes and the entire codebook of two 2D views (e.g. 2D X-rays). Qualitative and quantitative results demonstrate state-of-the-art performance over specialized methods across varied evaluation criteria, including fidelity metrics such as density, coverage, and distortion metrics for two complex volumetric imagery datasets from in real-world scenarios.

The latest breakthroughs in large vision-language models, such as Bard and GPT-4, have showcased extraordinary abilities in performing a wide range of tasks. Such models are trained on massive datasets comprising billions of public image-text pairs with diverse tasks. However, their performance on task-specific domains, such as radiology, is still under-investigated and potentially limited due to a lack of sophistication in understanding biomedical images. On the other hand, conversational medical models have exhibited remarkable success but have mainly focused on text-based analysis. In this paper, we introduce XrayGPT, a novel conversational medical vision-language model that can analyze and answer open-ended questions about chest radiographs. Specifically, we align both medical visual encoder (MedClip) with a fine-tuned large language model (Vicuna), using a simple linear transformation. This alignment enables our model to possess exceptional visual conversation abilities, grounded in a deep understanding of radiographs and medical domain knowledge. To enhance the performance of LLMs in the medical context, we generate ~217k interactive and high-quality summaries from free-text radiology reports. These summaries serve to enhance the performance of LLMs through the fine-tuning process. Our approach opens up new avenues the research for advancing the automated analysis of chest radiographs. Our open-source demos, models, and instruction sets are available at: https://github.com/mbzuai-oryx/XrayGPT.

With the growing availability of data within various scientific domains, generative models hold enormous potential to accelerate scientific discovery. They harness powerful representations learned from datasets to speed up the formulation of novel hypotheses with the potential to impact material discovery broadly. We present the Generative Toolkit for Scientific Discovery (GT4SD). This extensible open-source library enables scientists, developers, and researchers to train and use state-of-the-art generative models to accelerate scientific discovery focused on material design.

Generative modeling has experienced substantial progress in recent years, particularly in text-to-image and text-to-video synthesis. However, the medical field has not yet fully exploited the potential of large-scale foundational models for synthetic data generation. In this paper, we introduce GenerateCT, the first method for text-conditional computed tomography (CT) generation, addressing the limitations in 3D medical imaging research and making our entire framework open-source. GenerateCT consists of a pre-trained large language model, a transformer-based text-conditional 3D chest CT generation architecture, and a text-conditional spatial super-resolution diffusion model. We also propose CT-ViT, which efficiently compresses CT volumes while preserving auto-regressiveness in-depth, enabling the generation of 3D CT volumes with variable numbers of axial slices. Our experiments demonstrate that GenerateCT can produce realistic, high-resolution, and high-fidelity 3D chest CT volumes consistent with medical language text prompts. We further investigate the potential of GenerateCT by training a model using generated CT volumes for multi-abnormality classification of chest CT volumes. Our contributions provide a valuable foundation for future research in text-conditional 3D medical image generation and have the potential to accelerate advancements in medical imaging research. Our code, pre-trained models, and generated data are available at https://github.com/ibrahimethemhamamci/GenerateCT.

Prostate cancer, a growing global health concern, necessitates precise diagnostic tools, with Magnetic Resonance Imaging (MRI) offering high-resolution soft tissue imaging that significantly enhances diagnostic accuracy. Recent advancements in explainable AI and representation learning have significantly improved prostate cancer diagnosis by enabling automated and precise lesion classification. However, existing explainable AI methods, particularly those based on frameworks like generative adversarial networks (GANs), are predominantly developed for natural image generation, and their application to medical imaging often leads to suboptimal performance due to the unique characteristics and complexity of medical image. To address these challenges, our paper introduces three key contributions. First, we propose ProjectedEx, a generative framework that provides interpretable, multi-attribute explanations, effectively linking medical image features to classifier decisions. Second, we enhance the encoder module by incorporating feature pyramids, which enables multiscale feedback to refine the latent space and improves the quality of generated explanations. Additionally, we conduct comprehensive experiments on both the generator and classifier, demonstrating the clinical relevance and effectiveness of ProjectedEx in enhancing interpretability and supporting the adoption of AI in medical settings. Code will be released at https://github.com/Richardqiyi/ProjectedEx

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

Scientific user facilities, such as synchrotron beamlines, are equipped with a wide array of hardware and software tools that require a codebase for human-computer-interaction. This often necessitates developers to be involved to establish connection between users/researchers and the complex instrumentation. The advent of generative AI presents an opportunity to bridge this knowledge gap, enabling seamless communication and efficient experimental workflows. Here we present a modular architecture for the Virtual Scientific Companion (VISION) by assembling multiple AI-enabled cognitive blocks that each scaffolds large language models (LLMs) for a specialized task. With VISION, we performed LLM-based operation on the beamline workstation with low latency and demonstrated the first voice-controlled experiment at an X-ray scattering beamline. The modular and scalable architecture allows for easy adaptation to new instrument and capabilities. Development on natural language-based scientific experimentation is a building block for an impending future where a science exocortex -- a synthetic extension to the cognition of scientists -- may radically transform scientific practice and discovery.

Medical imaging is frequently used in clinical practice and trials for diagnosis and treatment. Writing imaging reports is time-consuming and can be error-prone for inexperienced radiologists. Therefore, automatically generating radiology reports is highly desired to lighten the workload of radiologists and accordingly promote clinical automation, which is an essential task to apply artificial intelligence to the medical domain. In this paper, we propose to generate radiology reports with memory-driven Transformer, where a relational memory is designed to record key information of the generation process and a memory-driven conditional layer normalization is applied to incorporating the memory into the decoder of Transformer. Experimental results on two prevailing radiology report datasets, IU X-Ray and MIMIC-CXR, show that our proposed approach outperforms previous models with respect to both language generation metrics and clinical evaluations. Particularly, this is the first work reporting the generation results on MIMIC-CXR to the best of our knowledge. Further analyses also demonstrate that our approach is able to generate long reports with necessary medical terms as well as meaningful image-text attention mappings.

Biomedical imaging datasets are often small and biased, meaning that real-world performance of predictive models can be substantially lower than expected from internal testing. This work proposes using generative image editing to simulate dataset shifts and diagnose failure modes of biomedical vision models; this can be used in advance of deployment to assess readiness, potentially reducing cost and patient harm. Existing editing methods can produce undesirable changes, with spurious correlations learned due to the co-occurrence of disease and treatment interventions, limiting practical applicability. To address this, we train a text-to-image diffusion model on multiple chest X-ray datasets and introduce a new editing method RadEdit that uses multiple masks, if present, to constrain changes and ensure consistency in the edited images. We consider three types of dataset shifts: acquisition shift, manifestation shift, and population shift, and demonstrate that our approach can diagnose failures and quantify model robustness without additional data collection, complementing more qualitative tools for explainable AI.

Training prohibited item detection models requires a large amount of X-ray security images, but collecting and annotating these images is time-consuming and laborious. To address data insufficiency, X-ray security image synthesis methods composite images to scale up datasets. However, previous methods primarily follow a two-stage pipeline, where they implement labor-intensive foreground extraction in the first stage and then composite images in the second stage. Such a pipeline introduces inevitable extra labor cost and is not efficient. In this paper, we propose a one-stage X-ray security image synthesis pipeline (Xsyn) based on text-to-image generation, which incorporates two effective strategies to improve the usability of synthetic images. The Cross-Attention Refinement (CAR) strategy leverages the cross-attention map from the diffusion model to refine the bounding box annotation. The Background Occlusion Modeling (BOM) strategy explicitly models background occlusion in the latent space to enhance imaging complexity. To the best of our knowledge, compared with previous methods, Xsyn is the first to achieve high-quality X-ray security image synthesis without extra labor cost. Experiments demonstrate that our method outperforms all previous methods with 1.2% mAP improvement, and the synthetic images generated by our method are beneficial to improve prohibited item detection performance across various X-ray security datasets and detectors. Code is available at https://github.com/pILLOW-1/Xsyn/.

The deep learning revolution, kicked off by AlexNet, taught us that end-to-end training beats decomposing a problem into hand-designed stages. Generative modeling, however, has remained the exception-despite generative models being remarkably capable, they are still not trained end-to-end. This is because, at its core, generative modeling is about handling distributions with many modes, and existing scalable approaches handle this the same way, by factoring the generation procedure, which prevents end-to-end generation. In this work, we introduce Explorative Modeling, a new paradigm that instead factors the training loop, exploring K candidate matches between model generations and data, and training on the best, so predictions commit to modes rather than blurring them. We find Explorative Models (XMs) useful in two settings. First, increasing exploration adds a third pretraining axis beyond parameters and data for existing generative models-where scaling exploration monotonically improves performance across both continuous and discrete domains (images, video, and language). Notably, gains from exploration increase with scale, climbing from 7% to 36% as data scales and from 13% to 23% as models grow, with efficiency gains more than doubling at 3x the compute. Concretely, exploration improves FLOP efficiency by 4.1x, sample efficiency by 6.2x, parameter efficiency by 47%, lifts the strongest of image-generation recipes to a near-state-of-the-art 1.43 FID on ImageNet without guidance, enables scaling how end-to-end existing models are, and unlocks scaling generalization. Second, XMs enable end-to-end reconstructive generative modeling, matching diffusion on control tasks with 16-256x fewer inference steps. Together, these results establish XMs as both a new pretraining axis for existing generative models and a standalone end-to-end generative modeling paradigm.

AI models for lung cancer screening are limited by data scarcity, impacting generalizability and clinical applicability. Generative models address this issue but are constrained by training data variability. We introduce SYN-LUNGS, a framework for generating high-quality 3D CT images with detailed annotations. SYN-LUNGS integrates XCAT3 phantoms for digital twin generation, X-Lesions for nodule simulation (varying size, location, and appearance), and DukeSim for CT image formation with vendor and parameter variability. The dataset includes 3,072 nodule images from 1,044 simulated CT scans, with 512 lesions and 174 digital twins. Models trained on clinical + simulated data outperform clinical only models, achieving 10% improvement in detection, 2-9% in segmentation and classification, and enhanced synthesis. By incorporating anatomy-informed simulations, SYN-LUNGS provides a scalable approach for AI model development, particularly in rare disease representation and improving model reliability.

Recent medical multimodal foundation models are built as multimodal LLMs (MLLMs) by connecting a CLIP-pretrained vision encoder to an LLM using LLaVA-style finetuning. This two-stage, decoupled approach introduces a projection layer that can distort visual features. This is especially concerning in medical imaging where subtle cues are essential for accurate diagnoses. In contrast, early-fusion generative approaches such as Chameleon eliminate the projection bottleneck by processing image and text tokens within a single unified sequence, enabling joint representation learning that leverages the inductive priors of language models. We present CheXmix, a unified early-fusion generative model trained on a large corpus of chest X-rays paired with radiology reports. We expand on Chameleon's autoregressive framework by introducing a two-stage multimodal generative pretraining strategy that combines the representational strengths of masked autoencoders with MLLMs. The resulting models are highly flexible, supporting both discriminative and generative tasks at both coarse and fine-grained scales. Our approach outperforms well-established generative models across all masking ratios by 6.0% and surpasses CheXagent by 8.6% on AUROC at high image masking ratios on the CheXpert classification task. We further inpaint images over 51.0% better than text-only generative models and outperform CheXagent by 45% on the GREEN metric for radiology report generation. These results demonstrate that CheXmix captures fine-grained information across a broad spectrum of chest X-ray tasks. Our code is at: https://github.com/StanfordMIMI/CheXmix.

Automated radiology report generation holds immense potential to alleviate the heavy workload of radiologists. Despite the formidable vision-language capabilities of recent Multimodal Large Language Models (MLLMs), their clinical deployment is severely constrained by inherent limitations: their "black-box" decision-making renders the generated reports untraceable due to the lack of explicit visual evidence to support the diagnosis, and they struggle to access external domain knowledge. To address these challenges, we propose the Evidence-driven Radiology Report Generation Agent (EviAgent). Unlike opaque end-to-end paradigms, EviAgent coordinates a transparent reasoning trajectory by breaking down the complex generation process into granular operational units. We integrate multi-dimensional visual experts and retrieval mechanisms as external support modules, endowing the system with explicit visual evidence and high-quality clinical priors. Extensive experiments on MIMIC-CXR, CheXpert Plus, and IU-Xray datasets demonstrate that EviAgent outperforms both large-scale generalist models and specialized medical models, providing a robust and trustworthy solution for automated radiology report generation.

This paper introduces an innovative methodology for producing high-quality 3D lung CT images guided by textual information. While diffusion-based generative models are increasingly used in medical imaging, current state-of-the-art approaches are limited to low-resolution outputs and underutilize radiology reports' abundant information. The radiology reports can enhance the generation process by providing additional guidance and offering fine-grained control over the synthesis of images. Nevertheless, expanding text-guided generation to high-resolution 3D images poses significant memory and anatomical detail-preserving challenges. Addressing the memory issue, we introduce a hierarchical scheme that uses a modified UNet architecture. We start by synthesizing low-resolution images conditioned on the text, serving as a foundation for subsequent generators for complete volumetric data. To ensure the anatomical plausibility of the generated samples, we provide further guidance by generating vascular, airway, and lobular segmentation masks in conjunction with the CT images. The model demonstrates the capability to use textual input and segmentation tasks to generate synthesized images. The results of comparative assessments indicate that our approach exhibits superior performance compared to the most advanced models based on GAN and diffusion techniques, especially in accurately retaining crucial anatomical features such as fissure lines, airways, and vascular structures. This innovation introduces novel possibilities. This study focuses on two main objectives: (1) the development of a method for creating images based on textual prompts and anatomical components, and (2) the capability to generate new images conditioning on anatomical elements. The advancements in image generation can be applied to enhance numerous downstream tasks.

The advent of large language models (LLMs) has ushered in a new paradigm of search engines that use generative models to gather and summarize information to answer user queries. This emerging technology, which we formalize under the unified framework of generative engines (GEs), can generate accurate and personalized responses, rapidly replacing traditional search engines like Google and Bing. Generative Engines typically satisfy queries by synthesizing information from multiple sources and summarizing them using LLMs. While this shift significantly improves user utility and generative search engine traffic, it poses a huge challenge for the third stakeholder - website and content creators. Given the black-box and fast-moving nature of generative engines, content creators have little to no control over when and how their content is displayed. With generative engines here to stay, we must ensure the creator economy is not disadvantaged. To address this, we introduce Generative Engine Optimization (GEO), the first novel paradigm to aid content creators in improving their content visibility in GE responses through a flexible black-box optimization framework for optimizing and defining visibility metrics. We facilitate systematic evaluation by introducing GEO-bench, a large-scale benchmark of diverse user queries across multiple domains, along with relevant web sources to answer these queries. Through rigorous evaluation, we demonstrate that GEO can boost visibility by up to 40\% in GE responses. Moreover, we show the efficacy of these strategies varies across domains, underscoring the need for domain-specific optimization methods. Our work opens a new frontier in information discovery systems, with profound implications for both developers of GEs and content creators.

During their formative years, radiology trainees are required to interpret hundreds of mammograms per month, with the objective of becoming apt at discerning the subtle patterns differentiating benign from malignant lesions. Unfortunately, medico-legal and technical hurdles make it difficult to access and query medical images for training. In this paper we train a generative adversarial network (GAN) to synthesize 512 x 512 high-resolution mammograms. The resulting model leads to the unsupervised separation of high-level features (e.g. the standard mammography views and the nature of the breast lesions), with stochastic variation in the generated images (e.g. breast adipose tissue, calcification), enabling user-controlled global and local attribute-editing of the synthesized images. We demonstrate the model's ability to generate anatomically and medically relevant mammograms by achieving an average AUC of 0.54 in a double-blind study on four expert mammography radiologists to distinguish between generated and real images, ascribing to the high visual quality of the synthesized and edited mammograms, and to their potential use in advancing and facilitating medical education.

Due to the three-dimensional nature of CT- or MR-scans, generative modeling of medical images is a particularly challenging task. Existing approaches mostly apply patch-wise, slice-wise, or cascaded generation techniques to fit the high-dimensional data into the limited GPU memory. However, these approaches may introduce artifacts and potentially restrict the model's applicability for certain downstream tasks. This work presents WDM, a wavelet-based medical image synthesis framework that applies a diffusion model on wavelet decomposed images. The presented approach is a simple yet effective way of scaling diffusion models to high resolutions and can be trained on a single 40 GB GPU. Experimental results on BraTS and LIDC-IDRI unconditional image generation at a resolution of 128 times 128 times 128 show state-of-the-art image fidelity (FID) and sample diversity (MS-SSIM) scores compared to GANs, Diffusion Models, and Latent Diffusion Models. Our proposed method is the only one capable of generating high-quality images at a resolution of 256 times 256 times 256.

Automatic radiology report generation is a promising application of multimodal deep learning, aiming to reduce reporting workload and improve consistency. However, current state-of-the-art (SOTA) systems - such as Multimodal AI for Radiology Applications (MAIRA-2) and Medical Pathways Language Model-Multimodal (MedPaLM-M) - depend on large-scale multimodal training, clinical metadata, and multiple imaging views, making them resource-intensive and inaccessible for most settings. We introduce a compact image-to-text architecture that generates the Findings section of chest X-ray reports from a single frontal image. The model combines a frozen Self-Distillation with No Labels v3 (DINOv3) Vision Transformer (ViT) encoder with a Generative Pre-trained Transformer 2 (GPT-2) decoder enhanced by layer-wise anatomical attention. This mechanism integrates lung and heart segmentation masks through hierarchical Gaussian smoothing, biasing attention toward clinically relevant regions without adding trainable parameters. Evaluated on the official Medical Information Mart for Intensive Care-Chest X-ray (MIMIC-CXR) dataset using Chest Radiograph Expert (CheXpert) and Radiology Graph (RadGraph) metrics, our approach achieved substantial gains: CheXpert Macro-F1 for five key pathologies increased by 168% (0.083 -> 0.238) and Micro-F1 by 146% (0.137 -> 0.337), while broader performance across 14 observations improved by 86% (0.170 -> 0.316). Structural coherence also improved, with RadGraph F1 rising by 9.7%. Despite its small size and purely image-conditioned design, the model demonstrates that decoder-level anatomical guidance improves spatial grounding and enhances coherence in clinically relevant regions. The source code is publicly available at: https://github.com/devMuniz02/UDEM-CXR-Reporting-Thesis-2025.

Developing an interpretable system for generating reports in chest X-ray (CXR) analysis is becoming increasingly crucial in Computer-aided Diagnosis (CAD) systems, enabling radiologists to comprehend the decisions made by these systems. Despite the growth of diverse datasets and methods focusing on report generation, there remains a notable gap in how closely these models' generated reports align with the interpretations of real radiologists. In this study, we tackle this challenge by initially introducing Fine-Grained CXR (FG-CXR) dataset, which provides fine-grained paired information between the captions generated by radiologists and the corresponding gaze attention heatmaps for each anatomy. Unlike existing datasets that include a raw sequence of gaze alongside a report, with significant misalignment between gaze location and report content, our FG-CXR dataset offers a more grained alignment between gaze attention and diagnosis transcript. Furthermore, our analysis reveals that simply applying black-box image captioning methods to generate reports cannot adequately explain which information in CXR is utilized and how long needs to attend to accurately generate reports. Consequently, we propose a novel explainable radiologist's attention generator network (Gen-XAI) that mimics the diagnosis process of radiologists, explicitly constraining its output to closely align with both radiologist's gaze attention and transcript. Finally, we perform extensive experiments to illustrate the effectiveness of our method. Our datasets and checkpoint is available at https://github.com/UARK-AICV/FG-CXR.

Objective: While recent advances in text-conditioned generative models have enabled the synthesis of realistic medical images, progress has been largely confined to 2D modalities such as chest X-rays. Extending text-to-image generation to volumetric Computed Tomography (CT) remains a significant challenge, due to its high dimensionality, anatomical complexity, and the absence of robust frameworks that align vision-language data in 3D medical imaging. Methods: We introduce a novel architecture for Text-to-CT generation that combines a latent diffusion model with a 3D contrastive vision-language pretraining scheme. Our approach leverages a dual-encoder CLIP-style model trained on paired CT volumes and radiology reports to establish a shared embedding space, which serves as the conditioning input for generation. CT volumes are compressed into a low-dimensional latent space via a pretrained volumetric VAE, enabling efficient 3D denoising diffusion without requiring external super-resolution stages. Results: We evaluate our method on the CT-RATE dataset and conduct a comprehensive assessment of image fidelity, clinical relevance, and semantic alignment. Our model achieves competitive performance across all tasks, significantly outperforming prior baselines for text-to-CT generation. Moreover, we demonstrate that CT scans synthesized by our framework can effectively augment real data, improving downstream diagnostic performance. Conclusion: Our results show that modality-specific vision-language alignment is a key component for high-quality 3D medical image generation. By integrating contrastive pretraining and volumetric diffusion, our method offers a scalable and controllable solution for synthesizing clinically meaningful CT volumes from text, paving the way for new applications in data augmentation, medical education, and automated clinical simulation.

Medical image segmentation has recently demonstrated impressive progress with deep neural networks, yet the heterogeneous modalities and scarcity of mask annotations limit the development of segmentation models on unannotated modalities. This paper investigates a new paradigm for leveraging generative models in medical applications: controllably synthesizing data for unannotated modalities, without requiring registered data pairs. Specifically, we make the following contributions in this paper: (i) we collect and curate a large-scale radiology image-text dataset, MedGen-1M, comprising modality labels, attributes, region, and organ information, along with a subset of organ mask annotations, to support research in controllable medical image generation; (ii) we propose a diffusion-based data engine, termed MRGen, which enables generation conditioned on text prompts and masks, synthesizing MR images for diverse modalities lacking mask annotations, to train segmentation models on unannotated modalities; (iii) we conduct extensive experiments across various modalities, illustrating that our data engine can effectively synthesize training samples and extend MRI segmentation towards unannotated modalities.

Recent developments in 2D visual generation have been remarkably successful. However, 3D and 4D generation remain challenging in real-world applications due to the lack of large-scale 4D data and effective model design. In this paper, we propose to jointly investigate general 3D and 4D generation by leveraging camera and object movements commonly observed in daily life. Due to the lack of real-world 4D data in the community, we first propose a data curation pipeline to obtain camera poses and object motion strength from videos. Based on this pipeline, we introduce a large-scale real-world 4D scene dataset: CamVid-30K. By leveraging all the 3D and 4D data, we develop our framework, GenXD, which allows us to produce any 3D or 4D scene. We propose multiview-temporal modules, which disentangle camera and object movements, to seamlessly learn from both 3D and 4D data. Additionally, GenXD employs masked latent conditions to support a variety of conditioning views. GenXD can generate videos that follow the camera trajectory as well as consistent 3D views that can be lifted into 3D representations. We perform extensive evaluations across various real-world and synthetic datasets, demonstrating GenXD's effectiveness and versatility compared to previous methods in 3D and 4D generation.

Medical image data is less accessible than in other domains due to privacy and regulatory constraints. In addition, labeling requires costly, time-intensive manual image annotation by clinical experts. To overcome these challenges, synthetic medical data generation offers a promising solution. Generative AI (GenAI), employing generative deep learning models, has proven effective at producing realistic synthetic images. This study proposes a novel mask-guided GenAI approach using diffusion models to generate synthetic fetal head ultrasound images paired with segmentation masks. These synthetic pairs augment real datasets for supervised fine-tuning of the Segment Anything Model (SAM). Our results show that the synthetic data captures real image features effectively, and this approach reaches state-of-the-art fetal head segmentation, especially when trained with a limited number of real image-mask pairs. In particular, the segmentation reaches Dice Scores of 94.66\% and 94.38\% using a handful of ultrasound images from the Spanish and African cohorts, respectively. Our code, models, and data are available on GitHub.

Deep learning algorithms produces state-of-the-art results for different machine learning and computer vision tasks. To perform well on a given task, these algorithms require large dataset for training. However, deep learning algorithms lack generalization and suffer from over-fitting whenever trained on small dataset, especially when one is dealing with medical images. For supervised image analysis in medical imaging, having image data along with their corresponding annotated ground-truths is costly as well as time consuming since annotations of the data is done by medical experts manually. In this paper, we propose a new Generative Adversarial Network for Medical Imaging (MI-GAN). The MI-GAN generates synthetic medical images and their segmented masks, which can then be used for the application of supervised analysis of medical images. Particularly, we present MI-GAN for synthesis of retinal images. The proposed method generates precise segmented images better than the existing techniques. The proposed model achieves a dice coefficient of 0.837 on STARE dataset and 0.832 on DRIVE dataset which is state-of-the-art performance on both the datasets.

Despite recent progress, medical foundation models still struggle to unify visual understanding and generation, as these tasks have inherently conflicting goals: semantic abstraction versus pixel-level reconstruction. Existing approaches, typically based on parameter-shared autoregressive architectures, frequently lead to compromised performance in one or both tasks. To address this, we present UniX, a next-generation unified medical foundation model for chest X-ray understanding and generation. UniX decouples the two tasks into an autoregressive branch for understanding and a diffusion branch for high-fidelity generation. Crucially, a cross-modal self-attention mechanism is introduced to dynamically guide the generation process with understanding features. Coupled with a rigorous data cleaning pipeline and a multi-stage training strategy, this architecture enables synergistic collaboration between tasks while leveraging the strengths of diffusion models for superior generation. On two representative benchmarks, UniX achieves a 46.1% improvement in understanding performance (Micro-F1) and a 24.2% gain in generation quality (FD-RadDino), using only a quarter of the parameters of LLM-CXR. By achieving performance on par with task-specific models, our work establishes a scalable paradigm for synergistic medical image understanding and generation. Codes and models are available at https://github.com/ZrH42/UniX.

Novel architectures have recently improved generative image synthesis leading to excellent visual quality in various tasks. Much of this success is due to the scalability of these architectures and hence caused by a dramatic increase in model complexity and in the computational resources invested in training these models. Our work questions the underlying paradigm of compressing large training data into ever growing parametric representations. We rather present an orthogonal, semi-parametric approach. We complement comparably small diffusion or autoregressive models with a separate image database and a retrieval strategy. During training we retrieve a set of nearest neighbors from this external database for each training instance and condition the generative model on these informative samples. While the retrieval approach is providing the (local) content, the model is focusing on learning the composition of scenes based on this content. As demonstrated by our experiments, simply swapping the database for one with different contents transfers a trained model post-hoc to a novel domain. The evaluation shows competitive performance on tasks which the generative model has not been trained on, such as class-conditional synthesis, zero-shot stylization or text-to-image synthesis without requiring paired text-image data. With negligible memory and computational overhead for the external database and retrieval we can significantly reduce the parameter count of the generative model and still outperform the state-of-the-art.

We present a radiology-specific multimodal model for the task for generating radiological reports from chest X-rays (CXRs). Our work builds on the idea that large language model(s) can be equipped with multimodal capabilities through alignment with pre-trained vision encoders. On natural images, this has been shown to allow multimodal models to gain image understanding and description capabilities. Our proposed model (MAIRA-1) leverages a CXR-specific image encoder in conjunction with a fine-tuned large language model based on Vicuna-7B, and text-based data augmentation, to produce reports with state-of-the-art quality. In particular, MAIRA-1 significantly improves on the radiologist-aligned RadCliQ metric and across all lexical metrics considered. Manual review of model outputs demonstrates promising fluency and accuracy of generated reports while uncovering failure modes not captured by existing evaluation practices. More information and resources can be found on the project website: https://aka.ms/maira.

Deep learning models have emerged as a powerful tool for various medical applications. However, their success depends on large, high-quality datasets that are challenging to obtain due to privacy concerns and costly annotation. Generative models, such as diffusion models, offer a potential solution by synthesizing medical images, but their practical adoption is hindered by long inference times. In this paper, we propose the use of an optimal transport flow matching approach to accelerate image generation. By introducing a straighter mapping between the source and target distribution, our method significantly reduces inference time while preserving and further enhancing the quality of the outputs. Furthermore, this approach is highly adaptable, supporting various medical imaging modalities, conditioning mechanisms (such as class labels and masks), and different spatial dimensions, including 2D and 3D. Beyond image generation, it can also be applied to related tasks such as image enhancement. Our results demonstrate the efficiency and versatility of this framework, making it a promising advancement for medical imaging applications. Code with checkpoints and a synthetic dataset (beneficial for classification and segmentation) is now available on: https://github.com/milad1378yz/MOTFM.

X-ray is widely applied for transmission imaging due to its stronger penetration than natural light. When rendering novel view X-ray projections, existing methods mainly based on NeRF suffer from long training time and slow inference speed. In this paper, we propose a 3D Gaussian splatting-based framework, namely X-Gaussian, for X-ray novel view synthesis. Firstly, we redesign a radiative Gaussian point cloud model inspired by the isotropic nature of X-ray imaging. Our model excludes the influence of view direction when learning to predict the radiation intensity of 3D points. Based on this model, we develop a Differentiable Radiative Rasterization (DRR) with CUDA implementation. Secondly, we customize an Angle-pose Cuboid Uniform Initialization (ACUI) strategy that directly uses the parameters of the X-ray scanner to compute the camera information and then uniformly samples point positions within a cuboid enclosing the scanned object. Experiments show that our X-Gaussian outperforms state-of-the-art methods by 6.5 dB while enjoying less than 15% training time and over 73x inference speed. The application on sparse-view CT reconstruction also reveals the practical values of our method. Code and models will be publicly available at https://github.com/caiyuanhao1998/X-Gaussian . A video demo of the training process visualization is at https://www.youtube.com/watch?v=gDVf_Ngeghg .

The advancement of visual intelligence is intrinsically tethered to the availability of large-scale data. In parallel, generative Artificial Intelligence (AI) has unlocked the potential to create synthetic images that closely resemble real-world photographs. This prompts a compelling inquiry: how much visual intelligence could benefit from the advance of generative AI? This paper explores the innovative concept of harnessing these AI-generated images as new data sources, reshaping traditional modeling paradigms in visual intelligence. In contrast to real data, AI-generated data exhibit remarkable advantages, including unmatched abundance and scalability, the rapid generation of vast datasets, and the effortless simulation of edge cases. Built on the success of generative AI models, we examine the potential of their generated data in a range of applications, from training machine learning models to simulating scenarios for computational modeling, testing, and validation. We probe the technological foundations that support this groundbreaking use of generative AI, engaging in an in-depth discussion on the ethical, legal, and practical considerations that accompany this transformative paradigm shift. Through an exhaustive survey of current technologies and applications, this paper presents a comprehensive view of the synthetic era in visual intelligence. A project associated with this paper can be found at https://github.com/mwxely/AIGS .

Medical report generation has achieved remarkable advancements yet has still been faced with several challenges. First, the inherent imbalance in the distribution of normal and abnormal cases may lead models to exhibit a biased focus on normal samples, resulting in unreliable diagnoses. Second, the frequent occurrence of common template sentences in the reports may overwhelm the critical abnormal information. Moreover, existing works focus on 2D chest X-rays, leaving CT report generation underexplored due to the high-dimensional nature of CT images and the limited availability of CT-report pairs. Recently, LLM has shown a great ability to generate reliable answers with appropriate prompts, which shed light on addressing the aforementioned challenges. In this paper, we propose Dia-LLaMA, a framework to adapt the LLaMA2-7B for CT report generation by incorporating diagnostic information as guidance prompts. Considering the high dimension of CT, we leverage a pre-trained ViT3D with perceiver to extract the visual information. To tailor the LLM for report generation and emphasize abnormality, we extract additional diagnostic information by referring to a disease prototype memory bank, which is updated during training to capture common disease representations. Furthermore, we introduce disease-aware attention to enable the model to adjust attention for different diseases. Experiments on the chest CT dataset demonstrated that our proposed method outperformed previous methods and achieved state-of-the-art on both clinical efficacy performance and natural language generation metrics. The code will be made publically available.

In this study, we aim to initiate the development of Radiology Foundation Model, termed as RadFM.We consider the construction of foundational models from the perspectives of data, model design, and evaluation thoroughly. Our contribution can be concluded as follows: (i), we construct a large-scale Medical Multi-modal Dataset, MedMD, consisting of 16M 2D and 3D medical scans. To the best of our knowledge, this is the first multi-modal dataset containing 3D medical scans. (ii), We propose an architecture that enables visually conditioned generative pre-training, allowing for the integration of text input interleaved with 2D or 3D medical scans to generate response for diverse radiologic tasks. The model was initially pre-trained on MedMD and subsequently domain-specific fine-tuned on RadMD, a radiologic cleaned version of MedMD, containing 3M radiologic visual-language pairs. (iii), we propose a new evaluation benchmark that comprises five tasks, aiming to comprehensively assess the capability of foundation models in handling practical clinical problems. Our experimental results confirm that RadFM significantly outperforms existing multi-modal foundation models. The codes, data, and model checkpoint will all be made publicly available to promote further research and development in the field.

While generative modeling has become prevalent across numerous research fields, its integration into the realm of image retrieval remains largely unexplored and underjustified. In this paper, we present a novel methodology, reframing image retrieval as a variant of generative modeling and employing a sequence-to-sequence model. This approach is harmoniously aligned with the current trend towards unification in research, presenting a cohesive framework that allows for end-to-end differentiable searching. This, in turn, facilitates superior performance via direct optimization techniques. The development of our model, dubbed IRGen, addresses the critical technical challenge of converting an image into a concise sequence of semantic units, which is pivotal for enabling efficient and effective search. Extensive experiments demonstrate that our model achieves state-of-the-art performance on three widely-used image retrieval benchmarks as well as two million-scale datasets, yielding significant improvement compared to prior competitive retrieval methods. In addition, the notable surge in precision scores facilitated by generative modeling presents the potential to bypass the reranking phase, which is traditionally indispensable in practical retrieval workflows.

The progress in generative models, particularly Generative Adversarial Networks (GANs), opened new possibilities for image generation but raised concerns about potential malicious uses, especially in sensitive areas like medical imaging. This study introduces MITS-GAN, a novel approach to prevent tampering in medical images, with a specific focus on CT scans. The approach disrupts the output of the attacker's CT-GAN architecture by introducing finely tuned perturbations that are imperceptible to the human eye. Specifically, the proposed approach involves the introduction of appropriate Gaussian noise to the input as a protective measure against various attacks. Our method aims to enhance tamper resistance, comparing favorably to existing techniques. Experimental results on a CT scan demonstrate MITS-GAN's superior performance, emphasizing its ability to generate tamper-resistant images with negligible artifacts. As image tampering in medical domains poses life-threatening risks, our proactive approach contributes to the responsible and ethical use of generative models. This work provides a foundation for future research in countering cyber threats in medical imaging. Models and codes are publicly available on https://iplab.dmi.unict.it/MITS-GAN-2024/.

For equitable deployment of AI tools in hospitals and healthcare facilities, we need Deep Segmentation Networks that offer high performance and can be trained on cost-effective GPUs with limited memory and large batch sizes. In this work, we propose Wave-GMS, a lightweight and efficient multi-scale generative model for medical image segmentation. Wave-GMS has a substantially smaller number of trainable parameters, does not require loading memory-intensive pretrained vision foundation models, and supports training with large batch sizes on GPUs with limited memory. We conducted extensive experiments on four publicly available datasets (BUS, BUSI, Kvasir-Instrument, and HAM10000), demonstrating that Wave-GMS achieves state-of-the-art segmentation performance with superior cross-domain generalizability, while requiring only ~2.6M trainable parameters. Code is available at https://github.com/ATPLab-LUMS/Wave-GMS.

The rapid development of generative AI (GenAI) models in computer vision necessitates effective evaluation methods to ensure their quality and fairness. Existing tools primarily focus on dataset quality assurance and model explainability, leaving a significant gap in GenAI output evaluation during model development. Current practices often depend on developers' subjective visual assessments, which may lack scalability and generalizability. This paper bridges this gap by conducting a formative study with GenAI model developers in an industrial setting. Our findings led to the development of GenLens, a visual analytic interface designed for the systematic evaluation of GenAI model outputs during the early stages of model development. GenLens offers a quantifiable approach for overviewing and annotating failure cases, customizing issue tags and classifications, and aggregating annotations from multiple users to enhance collaboration. A user study with model developers reveals that GenLens effectively enhances their workflow, evidenced by high satisfaction rates and a strong intent to integrate it into their practices. This research underscores the importance of robust early-stage evaluation tools in GenAI development, contributing to the advancement of fair and high-quality GenAI models.

Despite the success of Large Language Models (LLMs) in general image tasks, a gap persists in the medical field for a multimodal large model adept at handling the nuanced diversity of medical images. Addressing this, we propose MedXChat, a unified multimodal large model designed for seamless interactions between medical assistants and users. MedXChat encompasses three key functionalities: CXR(Chest X-ray)-to-Report generation, CXR-based visual question-answering (VQA), and Text-to-CXR synthesis. Our contributions are as follows. Firstly, our model showcases exceptional cross-task adaptability, displaying adeptness across all three defined tasks and outperforming the benchmark models on the MIMIC dataset in medical multimodal applications. Secondly, we introduce an innovative Text-to-CXR synthesis approach that utilizes instruction-following capabilities within the Stable Diffusion (SD) architecture. This technique integrates smoothly with the existing model framework, requiring no extra parameters, thereby maintaining the SD's generative strength while also bestowing upon it the capacity to render fine-grained medical images with high fidelity. Comprehensive experiments validate MedXChat's synergistic enhancement across all tasks. Our instruction data and model will be open-sourced.

This paper presents a proof-of-concept approach for learned synergistic reconstruction of medical images using multi-branch generative models. Leveraging variational autoencoders (VAEs) and generative adversarial networks (GANs), our models learn from pairs of images simultaneously, enabling effective denoising and reconstruction. Synergistic image reconstruction is achieved by incorporating the trained models in a regularizer that evaluates the distance between the images and the model, in a similar fashion to multichannel dictionary learning (DiL). We demonstrate the efficacy of our approach on both Modified National Institute of Standards and Technology (MNIST) and positron emission tomography (PET)/computed tomography (CT) datasets, showcasing improved image quality and information sharing between modalities. Despite challenges such as patch decomposition and model limitations, our results underscore the potential of generative models for enhancing medical imaging reconstruction.

Generating accurate and clinically meaningful radiology reports from chest X-ray images remains a significant challenge in medical AI. While recent vision-language models achieve strong results in general radiology report generation, they often fail to adequately describe rare but clinically important pathologies like fractures. This work addresses this gap by developing specialized models for fracture pathology detection and description. We train fracture-specific vision-language models with encoders from MAIRA-2 and CheXagent, demonstrating significant improvements over general-purpose models in generating accurate fracture descriptions. Analysis of model outputs by fracture type, location, and age reveals distinct strengths and limitations of current vision-language model architectures. We publicly release our best-performing fracture-reporting model, facilitating future research in accurate reporting of rare pathologies.

Achieving robust performance and fairness across diverse patient populations remains a challenge in developing clinically deployable deep learning models for diagnostic imaging. Synthetic data generation has emerged as a promising strategy to address limitations in dataset scale and diversity. We introduce RoentGen-v2, a text-to-image diffusion model for chest radiographs that enables fine-grained control over both radiographic findings and patient demographic attributes, including sex, age, and race/ethnicity. RoentGen-v2 is the first model to generate clinically plausible images with demographic conditioning, facilitating the creation of a large, demographically balanced synthetic dataset comprising over 565,000 images. We use this large synthetic dataset to evaluate optimal training pipelines for downstream disease classification models. In contrast to prior work that combines real and synthetic data naively, we propose an improved training strategy that leverages synthetic data for supervised pretraining, followed by fine-tuning on real data. Through extensive evaluation on over 137,000 chest radiographs from five institutions, we demonstrate that synthetic pretraining consistently improves model performance, generalization to out-of-distribution settings, and fairness across demographic subgroups. Across datasets, synthetic pretraining led to a 6.5% accuracy increase in the performance of downstream classification models, compared to a modest 2.7% increase when naively combining real and synthetic data. We observe this performance improvement simultaneously with the reduction of the underdiagnosis fairness gap by 19.3%. These results highlight the potential of synthetic imaging to advance equitable and generalizable medical deep learning under real-world data constraints. We open source our code, trained models, and synthetic dataset at https://github.com/StanfordMIMI/RoentGen-v2 .

The rapid advancement of generative AI has revolutionized image creation, enabling high-quality synthesis from text prompts while raising critical challenges for media authenticity. We present Ai-GenBench, a novel benchmark designed to address the urgent need for robust detection of AI-generated images in real-world scenarios. Unlike existing solutions that evaluate models on static datasets, Ai-GenBench introduces a temporal evaluation framework where detection methods are incrementally trained on synthetic images, historically ordered by their generative models, to test their ability to generalize to new generative models, such as the transition from GANs to diffusion models. Our benchmark focuses on high-quality, diverse visual content and overcomes key limitations of current approaches, including arbitrary dataset splits, unfair comparisons, and excessive computational demands. Ai-GenBench provides a comprehensive dataset, a standardized evaluation protocol, and accessible tools for both researchers and non-experts (e.g., journalists, fact-checkers), ensuring reproducibility while maintaining practical training requirements. By establishing clear evaluation rules and controlled augmentation strategies, Ai-GenBench enables meaningful comparison of detection methods and scalable solutions. Code and data are publicly available to ensure reproducibility and to support the development of robust forensic detectors to keep pace with the rise of new synthetic generators.

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

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.

We introduce a radiology-focused visual language model designed to generate radiology reports from chest X-rays. Building on previous findings that large language models (LLMs) can acquire multimodal capabilities when aligned with pretrained vision encoders, we demonstrate similar potential with chest X-ray images. This integration enhances the ability of model to understand and describe chest X-ray images. Our model combines an image encoder with a fine-tuned LLM based on the Vicuna-7B architecture, enabling it to generate different sections of a radiology report with notable accuracy. The training process involves a two-stage approach: (i) initial alignment of chest X-ray features with the LLM (ii) followed by fine-tuning for radiology report generation.

Generative engines (GEs) are reshaping information access by replacing ranked links with citation-grounded answers, yet current Generative Engine Optimization (GEO) methods optimize each instance in isolation, unable to accumulate or transfer effective strategies across tasks and engines. We reframe GEO as a strategy learning problem and propose MAGEO, a multi-agent framework in which coordinated planning, editing, and fidelity-aware evaluation serve as the execution layer, while validated editing patterns are progressively distilled into reusable, engine-specific optimization skills. To enable controlled assessment, we introduce a Twin Branch Evaluation Protocol for causal attribution of content edits and DSV-CF, a dual-axis metric that unifies semantic visibility with attribution accuracy. We further release MSME-GEO-Bench, a multi-scenario, multi-engine benchmark grounded in real-world queries. Experiments on three mainstream engines show that MAGEO substantially outperforms heuristic baselines in both visibility and citation fidelity, with ablations confirming that engine-specific preference modeling and strategy reuse are central to these gains, suggesting a scalable learning-driven paradigm for trustworthy GEO. Code is available at https://github.com/Wu-beining/MAGEO

Chest Xray imaging is a widely used diagnostic tool in modern medicine, and its high utilization creates substantial workloads for radiologists. To alleviate this burden, vision language models are increasingly applied to automate Chest Xray radiology report generation (CXRRRG), aiming for clinically accurate descriptions while reducing manual effort. Conventional approaches, however, typically rely on single images, failing to capture the longitudinal context necessary for producing clinically faithful comparison statements. Recently, growing attention has been directed toward incorporating longitudinal data into CXR RRG, enabling models to leverage historical studies in ways that mirror radiologists diagnostic workflows. Nevertheless, existing surveys primarily address single image CXRRRG and offer limited guidance for longitudinal settings, leaving researchers without a systematic framework for model design. To address this gap, this survey provides the first comprehensive review of longitudinal radiology report generation (LRRG). Specifically, we examine dataset construction strategies, report generation architectures alongside longitudinally tailored designs, and evaluation protocols encompassing both longitudinal specific measures and widely used benchmarks. We further summarize LRRG methods performance, alongside analyses of different ablation studies, which collectively highlight the critical role of longitudinal information and architectural design choices in improving model performance. Finally, we summarize five major limitations of current research and outline promising directions for future development, aiming to lay a foundation for advancing this emerging field.

Generative models trained at scale can now produce text, video, and more recently, scientific data such as crystal structures. In applications of generative approaches to materials science, and in particular to crystal structures, the guidance from the domain expert in the form of high-level instructions can be essential for an automated system to output candidate crystals that are viable for downstream research. In this work, we formulate end-to-end language-to-structure generation as a multi-objective optimization problem, and propose Generative Hierarchical Materials Search (GenMS) for controllable generation of crystal structures. GenMS consists of (1) a language model that takes high-level natural language as input and generates intermediate textual information about a crystal (e.g., chemical formulae), and (2) a diffusion model that takes intermediate information as input and generates low-level continuous value crystal structures. GenMS additionally uses a graph neural network to predict properties (e.g., formation energy) from the generated crystal structures. During inference, GenMS leverages all three components to conduct a forward tree search over the space of possible structures. Experiments show that GenMS outperforms other alternatives of directly using language models to generate structures both in satisfying user request and in generating low-energy structures. We confirm that GenMS is able to generate common crystal structures such as double perovskites, or spinels, solely from natural language input, and hence can form the foundation for more complex structure generation in near future.

Solving parametric partial differential equations (PDEs) and associated PDE-based, inverse problems is a central task in engineering and physics, yet existing neural operator methods struggle with high-dimensional, discontinuous inputs and require large amounts of {\em labeled} training data. We propose the Deep Generative Neural Operator (DGNO), a physics-aware framework that addresses these challenges by leveraging a deep, generative, probabilistic model in combination with a set of lower-dimensional, latent variables that simultaneously encode PDE-inputs and PDE-outputs. This formulation can make use of unlabeled data and significantly improves inverse problem-solving, particularly for discontinuous or discrete-valued input functions. DGNO enforces physics constraints without labeled data by incorporating as virtual observables, weak-form residuals based on compactly supported radial basis functions (CSRBFs). These relax regularity constraints and eliminate higher-order derivatives from the objective function. We also introduce MultiONet, a novel neural operator architecture, which is a more expressive generalization of the popular DeepONet that significantly enhances the approximating power of the proposed model. These innovations make DGNO particularly effective for challenging forward and inverse, PDE-based problems, such as those involving multi-phase media. Numerical experiments demonstrate that DGNO achieves higher accuracy across multiple benchmarks while exhibiting robustness to noise and strong generalization to out-of-distribution cases. Its adaptability, and the ability to handle sparse, noisy data while providing probabilistic estimates, make DGNO a powerful tool for scientific and engineering applications.

We present a large-scale synthetic dataset for novel view synthesis consisting of ~300k images rendered from nearly 2000 complex scenes using high-quality ray tracing at high resolution (1600 x 1600 pixels). The dataset is orders of magnitude larger than existing synthetic datasets for novel view synthesis, thus providing a large unified benchmark for both training and evaluation. Using 4 distinct sources of high-quality 3D meshes, the scenes of our dataset exhibit challenging variations in camera views, lighting, shape, materials, and textures. Because our dataset is too large for existing methods to process, we propose Sparse Voxel Light Field (SVLF), an efficient voxel-based light field approach for novel view synthesis that achieves comparable performance to NeRF on synthetic data, while being an order of magnitude faster to train and two orders of magnitude faster to render. SVLF achieves this speed by relying on a sparse voxel octree, careful voxel sampling (requiring only a handful of queries per ray), and reduced network structure; as well as ground truth depth maps at training time. Our dataset is generated by NViSII, a Python-based ray tracing renderer, which is designed to be simple for non-experts to use and share, flexible and powerful through its use of scripting, and able to create high-quality and physically-based rendered images. Experiments with a subset of our dataset allow us to compare standard methods like NeRF and mip-NeRF for single-scene modeling, and pixelNeRF for category-level modeling, pointing toward the need for future improvements in this area.

Solar activity is one of the main drivers of variability in our solar system and the key source of space weather phenomena that affect Earth and near Earth space. The extensive record of high resolution extreme ultraviolet (EUV) observations from the Solar Dynamics Observatory (SDO) offers an unprecedented, very large dataset of solar images. In this work, we make use of this comprehensive dataset to investigate capabilities of current state-of-the-art generative models to accurately capture the data distribution behind the observed solar activity states. Starting from StyleGAN-based methods, we uncover severe deficits of this model family in handling fine-scale details of solar images when training on high resolution samples, contrary to training on natural face images. When switching to the diffusion based generative model family, we observe strong improvements of fine-scale detail generation. For the GAN family, we are able to achieve similar improvements in fine-scale generation when turning to ProjectedGANs, which uses multi-scale discriminators with a pre-trained frozen feature extractor. We conduct ablation studies to clarify mechanisms responsible for proper fine-scale handling. Using distributed training on supercomputers, we are able to train generative models for up to 1024x1024 resolution that produce high quality samples indistinguishable to human experts, as suggested by the evaluation we conduct. We make all code, models and workflows used in this study publicly available at https://github.com/SLAMPAI/generative-models-for-highres-solar-images.

Controllable generative models of 3D medical images can synthesize volumes with specified clinical attributes, but this demands samples that are simultaneously high-fidelity, natively 3D, and faithful to the requested conditioning. We present CONFLUX, a latent diffusion model for chest computed tomography (CT): a 3D variational autoencoder compresses each volume, and a rectified-flow transformer generates in the latent space. Generation is conditioned on structured radiological metadata (18 abnormality findings, sex, age, and reconstruction kernel) through adaptive layer normalization. The model leads strong volumetric baselines on tri-planar Frechet distance (FID 32.3 vs. 74.6 for MAISI) while exposing direct control over clinical attributes. To strengthen that control we add an online reinforcement-learning post-training stage (group-relative policy optimization) that rewards how reliably a classifier recovers the requested findings from each generated volume. Judged by a separate, independent classifier, post-training removes 47% of the shortfall relative to real-scan reliability. We release the model and a ~200k synthetic chest-CT dataset with conditioning metadata spanning a wide variety of clinical findings.

Medical imaging plays a crucial role in diagnosis, with radiology reports serving as vital documentation. Automating report generation has emerged as a critical need to alleviate the workload of radiologists. While machine learning has facilitated report generation for 2D medical imaging, extending this to 3D has been unexplored due to computational complexity and data scarcity. We introduce the first method to generate radiology reports for 3D medical imaging, specifically targeting chest CT volumes. Given the absence of comparable methods, we establish a baseline using an advanced 3D vision encoder in medical imaging to demonstrate our method's effectiveness, which leverages a novel auto-regressive causal transformer. Furthermore, recognizing the benefits of leveraging information from previous visits, we augment CT2Rep with a cross-attention-based multi-modal fusion module and hierarchical memory, enabling the incorporation of longitudinal multimodal data. Access our code at https://github.com/ibrahimethemhamamci/CT2Rep

Radiology report generation (RRG) has attracted significant attention due to its potential to reduce the workload of radiologists. Current RRG approaches are still unsatisfactory against clinical standards. This paper introduces a novel RRG method, LM-RRG, that integrates large models (LMs) with clinical quality reinforcement learning to generate accurate and comprehensive chest X-ray radiology reports. Our method first designs a large language model driven feature extractor to analyze and interpret different regions of the chest X-ray image, emphasizing specific regions with medical significance. Next, based on the large model's decoder, we develop a multimodal report generator that leverages multimodal prompts from visual features and textual instruction to produce the radiology report in an auto-regressive way. Finally, to better reflect the clinical significant and insignificant errors that radiologists would normally assign in the report, we introduce a novel clinical quality reinforcement learning strategy. It utilizes the radiology report clinical quality (RadCliQ) metric as a reward function in the learning process. Extensive experiments on the MIMIC-CXR and IU-Xray datasets demonstrate the superiority of our method over the state of the art.

After being collected for patient care, Observational Health Data (OHD) can further benefit patient well-being by sustaining the development of health informatics and medical research. Vast potential is unexploited because of the fiercely private nature of patient-related data and regulations to protect it. Generative Adversarial Networks (GANs) have recently emerged as a groundbreaking way to learn generative models that produce realistic synthetic data. They have revolutionized practices in multiple domains such as self-driving cars, fraud detection, digital twin simulations in industrial sectors, and medical imaging. The digital twin concept could readily apply to modelling and quantifying disease progression. In addition, GANs posses many capabilities relevant to common problems in healthcare: lack of data, class imbalance, rare diseases, and preserving privacy. Unlocking open access to privacy-preserving OHD could be transformative for scientific research. In the midst of COVID-19, the healthcare system is facing unprecedented challenges, many of which of are data related for the reasons stated above. Considering these facts, publications concerning GAN applied to OHD seemed to be severely lacking. To uncover the reasons for this slow adoption, we broadly reviewed the published literature on the subject. Our findings show that the properties of OHD were initially challenging for the existing GAN algorithms (unlike medical imaging, for which state-of-the-art model were directly transferable) and the evaluation synthetic data lacked clear metrics. We find more publications on the subject than expected, starting slowly in 2017, and since then at an increasing rate. The difficulties of OHD remain, and we discuss issues relating to evaluation, consistency, benchmarking, data modelling, and reproducibility.

Recent advances in generative medical models are constrained by modality-specific scenarios that hinder the integration of complementary evidence from imaging, pathology, and clinical notes. This fragmentation limits their evolution into foundation models that can learn and reason across the full spectrum of biomedical data. We propose MeDiM, the first medical discrete diffusion model that learns shared distributions across modalities without modality-specific components. MeDiM unifies multiple generative tasks: translating between images and text, and jointly producing image-report pairs across domains in response to prompts. Built on a discrete diffusion framework, MeDiM bridges vision and language representations through a shared probabilistic space. To enable unified and flexible medical generation, we employ a multimodal large language model (MLLM) as the diffusion backbone, leveraging its prior knowledge and cross-modal reasoning. Two key designs are introduced: (1) removing the causal attention mask for bidirectional context, and (2) injecting continuous timestep embeddings for diffusion awareness. Experiments demonstrate high-fidelity medical generation (FID 16.60 on MIMIC-CXR and FID 24.19 on PathGen) and accurate report generation (METEOR 0.2650 and 0.2580). Jointly generated image-report pairs further enhance downstream performance (plus6.43 percent BLEU-1, plus18.57 percent BLEU-2, plus31.58 percent BLEU-3, plus4.80 percent METEOR), showing that MeDiM supports coherent and clinically grounded multimodal outputs.

Content generation modeling has emerged as a promising direction in computational pathology, offering capabilities such as data-efficient learning, synthetic data augmentation, and task-oriented generation across diverse diagnostic tasks. This review provides a comprehensive synthesis of recent progress in the field, organized into four key domains: image generation, text generation, molecular profile-morphology generation, and other specialized generation applications. By analyzing over 150 representative studies, we trace the evolution of content generation architectures -- from early generative adversarial networks to recent advances in diffusion models and generative vision-language models. We further examine the datasets and evaluation protocols commonly used in this domain and highlight ongoing limitations, including challenges in generating high-fidelity whole slide images, clinical interpretability, and concerns related to the ethical and legal implications of synthetic data. The review concludes with a discussion of open challenges and prospective research directions, with an emphasis on developing integrated and clinically deployable generation systems. This work aims to provide a foundational reference for researchers and practitioners developing content generation models in computational pathology.

Medical imaging plays a significant role in clinical practice of medical diagnosis, where the text reports of the images are essential in understanding them and facilitating later treatments. By generating the reports automatically, it is beneficial to help lighten the burden of radiologists and significantly promote clinical automation, which already attracts much attention in applying artificial intelligence to medical domain. Previous studies mainly follow the encoder-decoder paradigm and focus on the aspect of text generation, with few studies considering the importance of cross-modal mappings and explicitly exploit such mappings to facilitate radiology report generation. In this paper, we propose a cross-modal memory networks (CMN) to enhance the encoder-decoder framework for radiology report generation, where a shared memory is designed to record the alignment between images and texts so as to facilitate the interaction and generation across modalities. Experimental results illustrate the effectiveness of our proposed model, where state-of-the-art performance is achieved on two widely used benchmark datasets, i.e., IU X-Ray and MIMIC-CXR. Further analyses also prove that our model is able to better align information from radiology images and texts so as to help generating more accurate reports in terms of clinical indicators.

Despite the ever-increasing interest in applying deep learning (DL) models to medical imaging, the typical scarcity and imbalance of medical datasets can severely impact the performance of DL models. The generation of synthetic data that might be freely shared without compromising patient privacy is a well-known technique for addressing these difficulties. Inpainting algorithms are a subset of DL generative models that can alter one or more regions of an input image while matching its surrounding context and, in certain cases, non-imaging input conditions. Although the majority of inpainting techniques for medical imaging data use generative adversarial networks (GANs), the performance of these algorithms is frequently suboptimal due to their limited output variety, a problem that is already well-known for GANs. Denoising diffusion probabilistic models (DDPMs) are a recently introduced family of generative networks that can generate results of comparable quality to GANs, but with diverse outputs. In this paper, we describe a DDPM to execute multiple inpainting tasks on 2D axial slices of brain MRI with various sequences, and present proof-of-concept examples of its performance in a variety of evaluation scenarios. Our model and a public online interface to try our tool are available at: https://github.com/Mayo-Radiology-Informatics-Lab/MBTI

Recent advancements in generative models have unlocked the capabilities to render photo-realistic data in a controllable fashion. Trained on the real data, these generative models are capable of producing realistic samples with minimal to no domain gap, as compared to the traditional graphics rendering. However, using the data generated using such models for training downstream tasks remains under-explored, mainly due to the lack of 3D consistent annotations. Moreover, controllable generative models are learned from massive data and their latent space is often too vast to obtain meaningful sample distributions for downstream task with limited generation. To overcome these challenges, we extract 3D consistent annotations from an existing controllable generative model, making the data useful for downstream tasks. Our experiments show competitive performance against state-of-the-art models using only generated synthetic data, demonstrating potential for solving downstream tasks. Project page: https://synth-forge.github.io

The standard approach to tackling computer vision problems is to train deep convolutional neural network (CNN) models using large-scale image datasets which are representative of the target task. However, in many scenarios, it is often challenging to obtain sufficient image data for the target task. Data augmentation is a way to mitigate this challenge. A common practice is to explicitly transform existing images in desired ways so as to create the required volume and variability of training data necessary to achieve good generalization performance. In situations where data for the target domain is not accessible, a viable workaround is to synthesize training data from scratch--i.e., synthetic data augmentation. This paper presents an extensive review of synthetic data augmentation techniques. It covers data synthesis approaches based on realistic 3D graphics modeling, neural style transfer (NST), differential neural rendering, and generative artificial intelligence (AI) techniques such as generative adversarial networks (GANs) and variational autoencoders (VAEs). For each of these classes of methods, we focus on the important data generation and augmentation techniques, general scope of application and specific use-cases, as well as existing limitations and possible workarounds. Additionally, we provide a summary of common synthetic datasets for training computer vision models, highlighting the main features, application domains and supported tasks. Finally, we discuss the effectiveness of synthetic data augmentation methods. Since this is the first paper to explore synthetic data augmentation methods in great detail, we are hoping to equip readers with the necessary background information and in-depth knowledge of existing methods and their attendant issues.

The term "generative AI" refers to computational techniques that are capable of generating seemingly new, meaningful content such as text, images, or audio from training data. The widespread diffusion of this technology with examples such as Dall-E 2, GPT-4, and Copilot is currently revolutionizing the way we work and communicate with each other. In this article, we provide a conceptualization of generative AI as an entity in socio-technical systems and provide examples of models, systems, and applications. Based on that, we introduce limitations of current generative AI and provide an agenda for Business & Information Systems Engineering (BISE) research. Different from previous works, we focus on generative AI in the context of information systems, and, to this end, we discuss several opportunities and challenges that are unique to the BISE community and make suggestions for impactful directions for BISE research.

Our approach, which we call Embeddings for Language/Image-aligned X-Rays, or ELIXR, leverages a language-aligned image encoder combined or grafted onto a fixed LLM, PaLM 2, to perform a broad range of tasks. We train this lightweight adapter architecture using images paired with corresponding free-text radiology reports from the MIMIC-CXR dataset. ELIXR achieved state-of-the-art performance on zero-shot chest X-ray (CXR) classification (mean AUC of 0.850 across 13 findings), data-efficient CXR classification (mean AUCs of 0.893 and 0.898 across five findings (atelectasis, cardiomegaly, consolidation, pleural effusion, and pulmonary edema) for 1% (~2,200 images) and 10% (~22,000 images) training data), and semantic search (0.76 normalized discounted cumulative gain (NDCG) across nineteen queries, including perfect retrieval on twelve of them). Compared to existing data-efficient methods including supervised contrastive learning (SupCon), ELIXR required two orders of magnitude less data to reach similar performance. ELIXR also showed promise on CXR vision-language tasks, demonstrating overall accuracies of 58.7% and 62.5% on visual question answering and report quality assurance tasks, respectively. These results suggest that ELIXR is a robust and versatile approach to CXR AI.

Sparse-view 3D CT reconstruction aims to recover volumetric structures from a limited number of 2D X-ray projections. Existing feedforward methods are constrained by the scarcity of large-scale training datasets and the absence of direct and consistent 3D representations. In this paper, we propose an X-ray Large Reconstruction Model (X-LRM) for extremely sparse-view (<10 views) CT reconstruction. X-LRM consists of two key components: X-former and X-triplane. X-former can handle an arbitrary number of input views using an MLP-based image tokenizer and a Transformer-based encoder. The output tokens are then upsampled into our X-triplane representation, which models the 3D radiodensity as an implicit neural field. To support the training of X-LRM, we introduce Torso-16K, a large-scale dataset comprising over 16K volume-projection pairs of various torso organs. Extensive experiments demonstrate that X-LRM outperforms the state-of-the-art method by 1.5 dB and achieves 27times faster speed with better flexibility. Furthermore, the evaluation of lung segmentation tasks also suggests the practical value of our approach. Our code and dataset will be released at https://github.com/Richard-Guofeng-Zhang/X-LRM

The success of Deep Learning applications critically depends on the quality and scale of the underlying training data. Generative adversarial networks (GANs) can generate arbitrary large datasets, but diversity and fidelity are limited, which has recently been addressed by denoising diffusion probabilistic models (DDPMs) whose superiority has been demonstrated on natural images. In this study, we propose Medfusion, a conditional latent DDPM for medical images. We compare our DDPM-based model against GAN-based models, which constitute the current state-of-the-art in the medical domain. Medfusion was trained and compared with (i) StyleGan-3 on n=101,442 images from the AIROGS challenge dataset to generate fundoscopies with and without glaucoma, (ii) ProGAN on n=191,027 from the CheXpert dataset to generate radiographs with and without cardiomegaly and (iii) wGAN on n=19,557 images from the CRCMS dataset to generate histopathological images with and without microsatellite stability. In the AIROGS, CRMCS, and CheXpert datasets, Medfusion achieved lower (=better) FID than the GANs (11.63 versus 20.43, 30.03 versus 49.26, and 17.28 versus 84.31). Also, fidelity (precision) and diversity (recall) were higher (=better) for Medfusion in all three datasets. Our study shows that DDPM are a superior alternative to GANs for image synthesis in the medical domain.

Generative models trained on internet-scale data are capable of generating novel and realistic texts, images, and videos. A natural next question is whether these models can advance science, for example by generating novel stable materials. Traditionally, models with explicit structures (e.g., graphs) have been used in modeling structural relationships in scientific data (e.g., atoms and bonds in crystals), but generating structures can be difficult to scale to large and complex systems. Another challenge in generating materials is the mismatch between standard generative modeling metrics and downstream applications. For instance, common metrics such as the reconstruction error do not correlate well with the downstream goal of discovering stable materials. In this work, we tackle the scalability challenge by developing a unified crystal representation that can represent any crystal structure (UniMat), followed by training a diffusion probabilistic model on these UniMat representations. Our empirical results suggest that despite the lack of explicit structure modeling, UniMat can generate high fidelity crystal structures from larger and more complex chemical systems, outperforming previous graph-based approaches under various generative modeling metrics. To better connect the generation quality of materials to downstream applications, such as discovering novel stable materials, we propose additional metrics for evaluating generative models of materials, including per-composition formation energy and stability with respect to convex hulls through decomposition energy from Density Function Theory (DFT). Lastly, we show that conditional generation with UniMat can scale to previously established crystal datasets with up to millions of crystals structures, outperforming random structure search (the current leading method for structure discovery) in discovering new stable materials.

A very recent trend in generative modeling is building 3D-aware generators from 2D image collections. To induce the 3D bias, such models typically rely on volumetric rendering, which is expensive to employ at high resolutions. During the past months, there appeared more than 10 works that address this scaling issue by training a separate 2D decoder to upsample a low-resolution image (or a feature tensor) produced from a pure 3D generator. But this solution comes at a cost: not only does it break multi-view consistency (i.e. shape and texture change when the camera moves), but it also learns the geometry in a low fidelity. In this work, we show that it is possible to obtain a high-resolution 3D generator with SotA image quality by following a completely different route of simply training the model patch-wise. We revisit and improve this optimization scheme in two ways. First, we design a location- and scale-aware discriminator to work on patches of different proportions and spatial positions. Second, we modify the patch sampling strategy based on an annealed beta distribution to stabilize training and accelerate the convergence. The resulted model, named EpiGRAF, is an efficient, high-resolution, pure 3D generator, and we test it on four datasets (two introduced in this work) at 256^2 and 512^2 resolutions. It obtains state-of-the-art image quality, high-fidelity geometry and trains {approx} 2.5 times faster than the upsampler-based counterparts. Project website: https://universome.github.io/epigraf.

Integrating multi-modal clinical data, such as electronic health records (EHR) and chest X-ray images (CXR), is particularly beneficial for clinical prediction tasks. However, in a temporal setting, multi-modal data are often inherently asynchronous. EHR can be continuously collected but CXR is generally taken with a much longer interval due to its high cost and radiation dose. When clinical prediction is needed, the last available CXR image might have been outdated, leading to suboptimal predictions. To address this challenge, we propose DDL-CXR, a method that dynamically generates an up-to-date latent representation of the individualized CXR images. Our approach leverages latent diffusion models for patient-specific generation strategically conditioned on a previous CXR image and EHR time series, providing information regarding anatomical structures and disease progressions, respectively. In this way, the interaction across modalities could be better captured by the latent CXR generation process, ultimately improving the prediction performance. Experiments using MIMIC datasets show that the proposed model could effectively address asynchronicity in multimodal fusion and consistently outperform existing methods.

The availability of high-quality paired data is essential for training learning-based image demoiréing models. However, it remains challenging for existing datasets to encompass the complex moiré patterns captured in uncontrolled real-world scenarios. Such degradations typically manifest as large-scale, multicolored moiré patterns. Moreover, these patterns frequently occur in images for which clean counterparts are difficult to obtain, such as photographs acquired from public displays or existing online resources. In this work, we propose a novel data engine designed to improve the removal of complex moiré patterns by generating training supervision. Specifically, we initially collect real-world images containing complex moiré patterns and localize the corresponding screen regions. Multiple image-conditioned generative foundation models are subsequently deployed to produce candidate references. To establish reliable supervision, these candidates are subjected to patch-level quality control to filter and select the optimal results. Based on this systematic paradigm, we construct the WildMoiré dataset, which contains 6.8K moiré-GT training pairs. For evaluation, we additionally build an independent test set comprising sim250 pairs with captured clean ground truth. Extensive experiments on ESDNet, SDXL, and Qwen-Image-Edit demonstrate that the proposed generative supervision consistently improves the performance of complex moiré removal.

In image generation, Multiple Latent Variable Generative Models (MLVGMs) employ multiple latent variables to gradually shape the final images, from global characteristics to finer and local details (e.g., StyleGAN, NVAE), emerging as powerful tools for diverse applications. Yet their generative dynamics remain only empirically observed, without a systematic understanding of each latent variable's impact. In this work, we propose a novel framework that quantifies the contribution of each latent variable using Mutual Information (MI) as a metric. Our analysis reveals that current MLVGMs often underutilize some latent variables, and provides actionable insights for their use in downstream applications. With this foundation, we introduce a method for generating synthetic data for Self-Supervised Contrastive Representation Learning (SSCRL). By leveraging the hierarchical and disentangled variables of MLVGMs, our approach produces diverse and semantically meaningful views without the need for real image data. Additionally, we introduce a Continuous Sampling (CS) strategy, where the generator dynamically creates new samples during SSCRL training, greatly increasing data variability. Our comprehensive experiments demonstrate the effectiveness of these contributions, showing that MLVGMs' generated views compete on par with or even surpass views generated from real data. This work establishes a principled approach to understanding and exploiting MLVGMs, advancing both generative modeling and self-supervised learning. Code and pre-trained models at: https://github.com/SerezD/mi_ml_gen.

Generative modelling of entire CT volumes conditioned on clinical reports has the potential to accelerate research through data augmentation, privacy-preserving synthesis and reducing regulator-constraints on patient data while preserving diagnostic signals. With the recent release of CT-RATE, a large-scale collection of 3D CT volumes paired with their respective clinical reports, training large text-conditioned CT volume generation models has become achievable. In this work, we introduce CTFlow, a 0.5B latent flow matching transformer model, conditioned on clinical reports. We leverage the A-VAE from FLUX to define our latent space, and rely on the CT-Clip text encoder to encode the clinical reports. To generate consistent whole CT volumes while keeping the memory constraints tractable, we rely on a custom autoregressive approach, where the model predicts the first sequence of slices of the volume from text-only, and then relies on the previously generated sequence of slices and the text, to predict the following sequence. We evaluate our results against state-of-the-art generative CT model, and demonstrate the superiority of our approach in terms of temporal coherence, image diversity and text-image alignment, with FID, FVD, IS scores and CLIP score.

The landscape of image generation has rapidly evolved, from early GAN-based approaches to diffusion models and, most recently, to unified generative architectures that seek to bridge understanding and generation tasks. Recent advances, especially the GPT-4o, have demonstrated the feasibility of high-fidelity multimodal generation, their architectural design remains mysterious and unpublished. This prompts the question of whether image and text generation have already been successfully integrated into a unified framework for those methods. In this work, we conduct an empirical study of GPT-4o's image generation capabilities, benchmarking it against leading open-source and commercial models. Our evaluation covers four main categories, including text-to-image, image-to-image, image-to-3D, and image-to-X generation, with more than 20 tasks. Our analysis highlights the strengths and limitations of GPT-4o under various settings, and situates it within the broader evolution of generative modeling. Through this investigation, we identify promising directions for future unified generative models, emphasizing the role of architectural design and data scaling.

Generative models have recently made remarkable progress in the field of 3D objects. However, their practical application in fields like engineering remains limited since they fail to deliver the accuracy, quality, and controllability needed for domain-specific tasks. Fine-tuning large generative models is a promising perspective for making these models available in these fields. Creating high-quality, domain-specific 3D datasets is crucial for fine-tuning large generative models, yet the data filtering and annotation process remains a significant bottleneck. We present MeshFleet, a filtered and annotated 3D vehicle dataset extracted from Objaverse-XL, the most extensive publicly available collection of 3D objects. Our approach proposes a pipeline for automated data filtering based on a quality classifier. This classifier is trained on a manually labeled subset of Objaverse, incorporating DINOv2 and SigLIP embeddings, refined through caption-based analysis and uncertainty estimation. We demonstrate the efficacy of our filtering method through a comparative analysis against caption and image aesthetic score-based techniques and fine-tuning experiments with SV3D, highlighting the importance of targeted data selection for domain-specific 3D generative modeling.

Synthetic medical data offers a scalable solution for training robust models, but significant domain gaps limit its generalizability to real-world clinical settings. This paper addresses the challenge of cross-domain translation between synthetic and real X-ray images of the head, focusing on bridging discrepancies in attenuation behavior, noise characteristics, and soft tissue representation. We propose MedShift, a unified class-conditional generative model based on Flow Matching and Schrodinger Bridges, which enables high-fidelity, unpaired image translation across multiple domains. Unlike prior approaches that require domain-specific training or rely on paired data, MedShift learns a shared domain-agnostic latent space and supports seamless translation between any pair of domains seen during training. We introduce X-DigiSkull, a new dataset comprising aligned synthetic and real skull X-rays under varying radiation doses, to benchmark domain translation models. Experimental results demonstrate that, despite its smaller model size compared to diffusion-based approaches, MedShift offers strong performance and remains flexible at inference time, as it can be tuned to prioritize either perceptual fidelity or structural consistency, making it a scalable and generalizable solution for domain adaptation in medical imaging. The code and dataset are available at https://caetas.github.io/medshift.html

Deep generative models have achieved promising results in image generation, and various generative model hubs, e.g., Hugging Face and Civitai, have been developed that enable model developers to upload models and users to download models. However, these model hubs lack advanced model management and identification mechanisms, resulting in users only searching for models through text matching, download sorting, etc., making it difficult to efficiently find the model that best meets user requirements. In this paper, we propose a novel setting called Generative Model Identification (GMI), which aims to enable the user to identify the most appropriate generative model(s) for the user's requirements from a large number of candidate models efficiently. To our best knowledge, it has not been studied yet. In this paper, we introduce a comprehensive solution consisting of three pivotal modules: a weighted Reduced Kernel Mean Embedding (RKME) framework for capturing the generated image distribution and the relationship between images and prompts, a pre-trained vision-language model aimed at addressing dimensionality challenges, and an image interrogator designed to tackle cross-modality issues. Extensive empirical results demonstrate the proposal is both efficient and effective. For example, users only need to submit a single example image to describe their requirements, and the model platform can achieve an average top-4 identification accuracy of more than 80%.

The widespread adoption of electronic health records and digital healthcare data has created a demand for data-driven insights to enhance patient outcomes, diagnostics, and treatments. However, using real patient data presents privacy and regulatory challenges, including compliance with HIPAA and GDPR. Synthetic data generation, using generative AI models like GANs and VAEs offers a promising solution to balance valuable data access and patient privacy protection. In this paper, we examine generative AI models for creating realistic, anonymized patient data for research and training, explore synthetic data applications in healthcare, and discuss its benefits, challenges, and future research directions. Synthetic data has the potential to revolutionize healthcare by providing anonymized patient data while preserving privacy and enabling versatile applications.

Digitally reconstructed radiographs (DRRs) are simulated 2D X-ray images generated from 3D CT volumes, widely used in preoperative settings but limited in intraoperative applications due to computational bottlenecks, especially for accurate but heavy physics-based Monte Carlo methods. While analytical DRR renderers offer greater efficiency, they overlook anisotropic X-ray image formation phenomena, such as Compton scattering. We present a novel approach that marries realistic physics-inspired X-ray simulation with efficient, differentiable DRR generation using 3D Gaussian splatting (3DGS). Our direction-disentangled 3DGS (DDGS) method separates the radiosity contribution into isotropic and direction-dependent components, approximating complex anisotropic interactions without intricate runtime simulations. Additionally, we adapt the 3DGS initialization to account for tomography data properties, enhancing accuracy and efficiency. Our method outperforms state-of-the-art techniques in image accuracy. Furthermore, our DDGS shows promise for intraoperative applications and inverse problems such as pose registration, delivering superior registration accuracy and runtime performance compared to analytical DRR methods.

In this work, we present MedImageInsight, an open-source medical imaging embedding model. MedImageInsight is trained on medical images with associated text and labels across a diverse collection of domains, including X-Ray, CT, MRI, dermoscopy, OCT, fundus photography, ultrasound, histopathology, and mammography. Rigorous evaluations demonstrate MedImageInsight's ability to achieve state-of-the-art (SOTA) or human expert level performance across classification, image-image search, and fine-tuning tasks. Specifically, on public datasets, MedImageInsight achieves SOTA in CT 3D medical image retrieval, as well as SOTA in disease classification and search for chest X-ray, dermatology, and OCT imaging. Furthermore, MedImageInsight achieves human expert performance in bone age estimation (on both public and partner data), as well as AUC above 0.9 in most other domains. When paired with a text decoder, MedImageInsight achieves near SOTA level single image report findings generation with less than 10\% the parameters of other models. Compared to fine-tuning GPT-4o with only MIMIC-CXR data for the same task, MedImageInsight outperforms in clinical metrics, but underperforms on lexical metrics where GPT-4o sets a new SOTA. Importantly for regulatory purposes, MedImageInsight can generate ROC curves, adjust sensitivity and specificity based on clinical need, and provide evidence-based decision support through image-image search (which can also enable retrieval augmented generation). In an independent clinical evaluation of image-image search in chest X-ray, MedImageInsight outperformed every other publicly available foundation model evaluated by large margins (over 6 points AUC), and significantly outperformed other models in terms of AI fairness (across age and gender). We hope releasing MedImageInsight will help enhance collective progress in medical imaging AI research and development.

The remarkable success of deep learning in recent years has prompted applications in medical image classification and diagnosis tasks. While classification models have demonstrated robustness in classifying simpler datasets like MNIST or natural images such as ImageNet, this resilience is not consistently observed in complex medical image datasets where data is more scarce and lacks diversity. Moreover, previous findings on natural image datasets have indicated a potential trade-off between data likelihood and classification accuracy. In this study, we explore the use of score-based generative models as classifiers for medical images, specifically mammographic images. Our findings suggest that our proposed generative classifier model not only achieves superior classification results on CBIS-DDSM, INbreast and Vin-Dr Mammo datasets, but also introduces a novel approach to image classification in a broader context. Our code is publicly available at https://github.com/sushmitasarker/sgc_for_medical_image_classification

In machine learning, generative modeling aims to learn to generate new data statistically similar to the training data distribution. In this paper, we survey learning generative models under limited data, few shots and zero shot, referred to as Generative Modeling under Data Constraint (GM-DC). This is an important topic when data acquisition is challenging, e.g. healthcare applications. We discuss background, challenges, and propose two taxonomies: one on GM-DC tasks and another on GM-DC approaches. Importantly, we study interactions between different GM-DC tasks and approaches. Furthermore, we highlight research gaps, research trends, and potential avenues for future exploration. Project website: https://gmdc-survey.github.io.

Generative models are increasingly used to augment medical imaging datasets for fairer AI, yet a key assumption often goes unexamined: that generators produce equally high-quality images across demographic groups. Models trained on imbalanced data inherit these imbalances, degrading synthesis for rare subgroups and struggling with intersections absent from training: the imbalanced generator problem. Remedies such as loss reweighting operate at the optimization level and provide limited benefit when training signal is scarce or absent. We propose CompDiff, a hierarchical compositional diffusion framework that addresses this at the representation level. A dedicated Hierarchical Conditioner Network (HCN) decomposes demographic conditioning into single-attribute, pairwise, and composed representations, producing a demographic token concatenated with CLIP embeddings as cross-attention context. This structured factorization encourages parameter sharing across subgroups and supports compositional generalization to rare or unseen intersections. On chest X-rays (MIMIC-CXR) and fundus images (FairGenMed), CompDiff compares favorably against standard fine-tuning and FairDiffusion across image quality (FID 64.3 vs. 75.1), subgroup equity (ES-FID), and zero-shot intersectional generalization (up to 21% FID improvement on held-out intersections). Downstream classifiers trained on CompDiff data show improved AUROC and reduced demographic bias, suggesting that the architectural design of demographic conditioning is an important and underexplored factor in fair medical image generation. Code: https://github.com/mahmoudibrahim98/CompDiff.

The power of DNNs relies heavily on the quantity and quality of training data. However, collecting and annotating data on a large scale is often expensive and time-consuming. To address this issue, we explore a new task, termed dataset expansion, aimed at expanding a ready-to-use small dataset by automatically creating new labeled samples. To this end, we present a Guided Imagination Framework (GIF) that leverages cutting-edge generative models like DALL-E2 and Stable Diffusion (SD) to "imagine" and create informative new data from the input seed data. Specifically, GIF conducts data imagination by optimizing the latent features of the seed data in the semantically meaningful space of the prior model, resulting in the creation of photo-realistic images with new content. To guide the imagination towards creating informative samples for model training, we introduce two key criteria, i.e., class-maintained information boosting and sample diversity promotion. These criteria are verified to be essential for effective dataset expansion: GIF-SD obtains 13.5% higher model accuracy on natural image datasets than unguided expansion with SD. With these essential criteria, GIF successfully expands small datasets in various scenarios, boosting model accuracy by 36.9% on average over six natural image datasets and by 13.5% on average over three medical datasets. The source code is available at https://github.com/Vanint/DatasetExpansion.

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

Generative AI has made remarkable strides to revolutionize fields such as image and video generation. These advancements are driven by innovative algorithms, architecture, and data. However, the rapid proliferation of generative models has highlighted a critical gap: the absence of trustworthy evaluation metrics. Current automatic assessments such as FID, CLIP, FVD, etc often fail to capture the nuanced quality and user satisfaction associated with generative outputs. This paper proposes an open platform GenAI-Arena to evaluate different image and video generative models, where users can actively participate in evaluating these models. By leveraging collective user feedback and votes, GenAI-Arena aims to provide a more democratic and accurate measure of model performance. It covers three arenas for text-to-image generation, text-to-video generation, and image editing respectively. Currently, we cover a total of 27 open-source generative models. GenAI-Arena has been operating for four months, amassing over 6000 votes from the community. We describe our platform, analyze the data, and explain the statistical methods for ranking the models. To further promote the research in building model-based evaluation metrics, we release a cleaned version of our preference data for the three tasks, namely GenAI-Bench. We prompt the existing multi-modal models like Gemini, GPT-4o to mimic human voting. We compute the correlation between model voting with human voting to understand their judging abilities. Our results show existing multimodal models are still lagging in assessing the generated visual content, even the best model GPT-4o only achieves a Pearson correlation of 0.22 in the quality subscore, and behaves like random guessing in others.

Vision-language models (VLMs) have shown strong performance on text-to-image retrieval benchmarks. However, bridging this success to real-world applications remains a challenge. In practice, human search behavior is rarely a one-shot action. Instead, it is often a multi-round process guided by clues in mind, that is, a mental image ranging from vague recollections to vivid mental representations of the target image. Motivated by this gap, we study the task of Mental Image Retrieval (MIR), which targets the realistic yet underexplored setting where users refine their search for a mentally envisioned image through multi-round interactions with an image search engine. Central to successful interactive retrieval is the capability of machines to provide users with clear, actionable feedback; however, existing methods rely on indirect or abstract verbal feedback, which can be ambiguous, misleading, or ineffective for users to refine the query. To overcome this, we propose GenIR, a generative multi-round retrieval paradigm leveraging diffusion-based image generation to explicitly reify the AI system's understanding at each round. These synthetic visual representations provide clear, interpretable feedback, enabling users to refine their queries intuitively and effectively. We further introduce a fully automated pipeline to generate a high-quality multi-round MIR dataset. Experimental results demonstrate that GenIR significantly outperforms existing interactive methods in the MIR scenario. This work establishes a new task with a dataset and an effective generative retrieval method, providing a foundation for future research in this direction.

The landscape of high-performance image generation models is currently dominated by proprietary systems, such as Nano Banana Pro and Seedream 4.0. Leading open-source alternatives, including Qwen-Image, Hunyuan-Image-3.0 and FLUX.2, are characterized by massive parameter counts (20B to 80B), making them impractical for inference, and fine-tuning on consumer-grade hardware. To address this gap, we propose Z-Image, an efficient 6B-parameter foundation generative model built upon a Scalable Single-Stream Diffusion Transformer (S3-DiT) architecture that challenges the "scale-at-all-costs" paradigm. By systematically optimizing the entire model lifecycle -- from a curated data infrastructure to a streamlined training curriculum -- we complete the full training workflow in just 314K H800 GPU hours (approx. $630K). Our few-step distillation scheme with reward post-training further yields Z-Image-Turbo, offering both sub-second inference latency on an enterprise-grade H800 GPU and compatibility with consumer-grade hardware (<16GB VRAM). Additionally, our omni-pre-training paradigm also enables efficient training of Z-Image-Edit, an editing model with impressive instruction-following capabilities. Both qualitative and quantitative experiments demonstrate that our model achieves performance comparable to or surpassing that of leading competitors across various dimensions. Most notably, Z-Image exhibits exceptional capabilities in photorealistic image generation and bilingual text rendering, delivering results that rival top-tier commercial models, thereby demonstrating that state-of-the-art results are achievable with significantly reduced computational overhead. We publicly release our code, weights, and online demo to foster the development of accessible, budget-friendly, yet state-of-the-art generative models.

One of the key impediments for developing and assessing robust medical imaging algorithms is limited access to large-scale datasets with suitable annotations. Synthetic data generated with plausible physical and biological constraints may address some of these data limitations. We propose the use of physics simulations to generate synthetic images with pixel-level segmentation annotations, which are notoriously difficult to obtain. Specifically, we apply this approach to breast imaging analysis and release T-SYNTH, a large-scale open-source dataset of paired 2D digital mammography (DM) and 3D digital breast tomosynthesis (DBT) images. Our initial experimental results indicate that T-SYNTH images show promise for augmenting limited real patient datasets for detection tasks in DM and DBT. Our data and code are publicly available at https://github.com/DIDSR/tsynth-release.

Simulating showers of particles in highly-granular calorimeters is a key frontier in the application of machine learning to particle physics. Achieving high accuracy and speed with generative machine learning models can enable them to augment traditional simulations and alleviate a major computing constraint. Recent developments have shown how diffusion based generative shower simulation approaches that do not rely on a fixed structure, but instead generate geometry-independent point clouds, are very efficient. We present a transformer-based extension to previous architectures which were developed for simulating electromagnetic showers in the highly granular electromagnetic calorimeter of the International Large Detector, ILD. The attention mechanism now allows us to generate complex hadronic showers with more pronounced substructure across both the electromagnetic and hadronic calorimeters. This is the first time that machine learning methods are used to holistically generate showers across the electromagnetic and hadronic calorimeter in highly granular imaging calorimeter systems.

Automated radiology report generation from 3D CT volumes often suffers from incomplete pathology coverage. We provide empirical evidence that this limitation stems from a representational bottleneck: contrastive 3D CT embeddings encode discriminative pathology signals, yet exhibit severe dimensional concentration, with as few as 2 effective dimensions out of 512. Corroborating this, scaling the language model yields no measurable improvement, suggesting that the bottleneck lies in the visual representation rather than the generator. This bottleneck limits both generation and retrieval; naive static retrieval fails to improve clinical efficacy and can even degrade performance. We propose AdaRAG-CT, an adaptive augmentation framework that compensates for this visual bottleneck by introducing supplementary textual information through controlled retrieval and selectively integrating it during generation. On the CT-RATE benchmark, AdaRAG-CT achieves state-of-the-art clinical efficacy, improving Clinical F1 from 0.420 (CT-Agent) to 0.480 (+6 points); ablation studies confirm that both the retrieval and generation components contribute to the improvement. Code is available at https://github.com/renjie-liang/Adaptive-RAG-for-3DCT-Report-Generation.

We propose a new approach for generative modeling based on training a neural network to be idempotent. An idempotent operator is one that can be applied sequentially without changing the result beyond the initial application, namely f(f(z))=f(z). The proposed model f is trained to map a source distribution (e.g, Gaussian noise) to a target distribution (e.g. realistic images) using the following objectives: (1) Instances from the target distribution should map to themselves, namely f(x)=x. We define the target manifold as the set of all instances that f maps to themselves. (2) Instances that form the source distribution should map onto the defined target manifold. This is achieved by optimizing the idempotence term, f(f(z))=f(z) which encourages the range of f(z) to be on the target manifold. Under ideal assumptions such a process provably converges to the target distribution. This strategy results in a model capable of generating an output in one step, maintaining a consistent latent space, while also allowing sequential applications for refinement. Additionally, we find that by processing inputs from both target and source distributions, the model adeptly projects corrupted or modified data back to the target manifold. This work is a first step towards a ``global projector'' that enables projecting any input into a target data distribution.

Flow-based generative models (Dinh et al., 2014) are conceptually attractive due to tractability of the exact log-likelihood, tractability of exact latent-variable inference, and parallelizability of both training and synthesis. In this paper we propose Glow, a simple type of generative flow using an invertible 1x1 convolution. Using our method we demonstrate a significant improvement in log-likelihood on standard benchmarks. Perhaps most strikingly, we demonstrate that a generative model optimized towards the plain log-likelihood objective is capable of efficient realistic-looking synthesis and manipulation of large images. The code for our model is available at https://github.com/openai/glow

A common and fundamental limitation of Generative AI (GenAI) is its propensity to hallucinate. While large language models (LLM) have taken the world by storm, without eliminating or at least reducing hallucinations, real-world GenAI systems may face challenges in user adoption. In the process of deploying an enterprise application that produces workflows based on natural language requirements, we devised a system leveraging Retrieval Augmented Generation (RAG) to greatly improve the quality of the structured output that represents such workflows. Thanks to our implementation of RAG, our proposed system significantly reduces hallucinations in the output and improves the generalization of our LLM in out-of-domain settings. In addition, we show that using a small, well-trained retriever encoder can reduce the size of the accompanying LLM, thereby making deployments of LLM-based systems less resource-intensive.

Transforming two-dimensional (2D) images into three-dimensional (3D) volumes is a well-known yet challenging problem for the computer vision community. In the medical domain, a few previous studies attempted to convert two or more input radiographs into computed tomography (CT) volumes. Following their effort, we introduce a diffusion model-based technology that can rotate the anatomical content of any input radiograph in 3D space, potentially enabling the visualization of the entire anatomical content of the radiograph from any viewpoint in 3D. Similar to previous studies, we used CT volumes to create Digitally Reconstructed Radiographs (DRRs) as the training data for our model. However, we addressed two significant limitations encountered in previous studies: 1. We utilized conditional diffusion models with classifier-free guidance instead of Generative Adversarial Networks (GANs) to achieve higher mode coverage and improved output image quality, with the only trade-off being slower inference time, which is often less critical in medical applications; and 2. We demonstrated that the unreliable output of style transfer deep learning (DL) models, such as Cycle-GAN, to transfer the style of actual radiographs to DRRs could be replaced with a simple yet effective training transformation that randomly changes the pixel intensity histograms of the input and ground-truth imaging data during training. This transformation makes the diffusion model agnostic to any distribution variations of the input data pixel intensity, enabling the reliable training of a DL model on input DRRs and applying the exact same model to conventional radiographs (or DRRs) during inference.

In this paper, we address a key scientific problem in machine learning: Given a training set for an image classification task, can we train a generative model on this dataset to enhance the classification performance? (i.e., closed-set generative data augmentation). We start by exploring the distinctions and similarities between real images and closed-set synthetic images generated by advanced generative models. Through extensive experiments, we offer systematic insights into the effective use of closed-set synthetic data for augmentation. Notably, we empirically determine the equivalent scale of synthetic images needed for augmentation. In addition, we also show quantitative equivalence between the real data augmentation and open-set generative augmentation (generative models trained using data beyond the given training set). While it aligns with the common intuition that real images are generally preferred, our empirical formulation also offers a guideline to quantify the increased scale of synthetic data augmentation required to achieve comparable image classification performance. Our results on natural and medical image datasets further illustrate how this effect varies with the baseline training set size and the amount of synthetic data incorporated.

In subject-driven text-to-image generation, recent works have achieved superior performance by training the model on synthetic datasets containing numerous image pairs. Trained on these datasets, generative models can produce text-aligned images for specific subject from arbitrary testing image in a zero-shot manner. They even outperform methods which require additional fine-tuning on testing images. However, the cost of creating such datasets is prohibitive for most researchers. To generate a single training pair, current methods fine-tune a pre-trained text-to-image model on the subject image to capture fine-grained details, then use the fine-tuned model to create images for the same subject based on creative text prompts. Consequently, constructing a large-scale dataset with millions of subjects can require hundreds of thousands of GPU hours. To tackle this problem, we propose Toffee, an efficient method to construct datasets for subject-driven editing and generation. Specifically, our dataset construction does not need any subject-level fine-tuning. After pre-training two generative models, we are able to generate infinite number of high-quality samples. We construct the first large-scale dataset for subject-driven image editing and generation, which contains 5 million image pairs, text prompts, and masks. Our dataset is 5 times the size of previous largest dataset, yet our cost is tens of thousands of GPU hours lower. To test the proposed dataset, we also propose a model which is capable of both subject-driven image editing and generation. By simply training the model on our proposed dataset, it obtains competitive results, illustrating the effectiveness of the proposed dataset construction framework.

In order to fully harness the potential of machine learning, it is crucial to establish a system that renders the field more accessible and less daunting for individuals who may not possess a comprehensive understanding of its intricacies. The paper describes the design of a system that integrates AutoML, XAI, and synthetic data generation to provide a great UX design for users. The system allows users to navigate and harness the power of machine learning while abstracting its complexities and providing high usability. The paper proposes two novel classifiers, Logistic Regression Forest and Support Vector Tree, for enhanced model performance, achieving 96\% accuracy on a diabetes dataset and 93\% on a survey dataset. The paper also introduces a model-dependent local interpreter called MEDLEY and evaluates its interpretation against LIME, Greedy, and Parzen. Additionally, the paper introduces LLM-based synthetic data generation, library-based data generation, and enhancing the original dataset with GAN. The findings on synthetic data suggest that enhancing the original dataset with GAN is the most reliable way to generate synthetic data, as evidenced by KS tests, standard deviation, and feature importance. The authors also found that GAN works best for quantitative datasets.

For a fixed parameter size, the capabilities of large models are primarily determined by the quality and quantity of its training data. Consequently, training datasets now grow faster than the rate at which new data is indexed on the web, leading to projected data exhaustion over the next decade. Much more data exists as user-generated content that is not publicly indexed, but incorporating such data comes with considerable risks, such as leaking private information and other undesirable content. We introduce a framework, Generative Data Refinement (GDR), for using pretrained generative models to transform a dataset with undesirable content into a refined dataset that is more suitable for training. Our experiments show that GDR can outperform industry-grade solutions for dataset anonymization, as well as enable direct detoxification of highly unsafe datasets. Moreover, we show that by generating synthetic data that is conditioned on each example in the real dataset, GDR's refined outputs naturally match the diversity of web scale datasets, and thereby avoid the often challenging task of generating diverse synthetic data via model prompting. The simplicity and effectiveness of GDR make it a powerful tool for scaling up the total stock of training data for frontier models.

Image retrieval methods based on CNN descriptors rely on metric learning from a large number of diverse examples of positive and negative image pairs. Domains, such as night-time images, with limited availability and variability of training data suffer from poor retrieval performance even with methods performing well on standard benchmarks. We propose to train a GAN-based synthetic-image generator, translating available day-time image examples into night images. Such a generator is used in metric learning as a form of augmentation, supplying training data to the scarce domain. Various types of generators are evaluated and analyzed. We contribute with a novel light-weight GAN architecture that enforces the consistency between the original and translated image through edge consistency. The proposed architecture also allows a simultaneous training of an edge detector that operates on both night and day images. To further increase the variability in the training examples and to maximize the generalization of the trained model, we propose a novel method of diverse anchor mining. The proposed method improves over the state-of-the-art results on a standard Tokyo 24/7 day-night retrieval benchmark while preserving the performance on Oxford and Paris datasets. This is achieved without the need of training image pairs of matching day and night images. The source code is available at https://github.com/mohwald/gandtr .

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

We present X^3 (pronounced XCube), a novel generative model for high-resolution sparse 3D voxel grids with arbitrary attributes. Our model can generate millions of voxels with a finest effective resolution of up to 1024^3 in a feed-forward fashion without time-consuming test-time optimization. To achieve this, we employ a hierarchical voxel latent diffusion model which generates progressively higher resolution grids in a coarse-to-fine manner using a custom framework built on the highly efficient VDB data structure. Apart from generating high-resolution objects, we demonstrate the effectiveness of XCube on large outdoor scenes at scales of 100mtimes100m with a voxel size as small as 10cm. We observe clear qualitative and quantitative improvements over past approaches. In addition to unconditional generation, we show that our model can be used to solve a variety of tasks such as user-guided editing, scene completion from a single scan, and text-to-3D. More results and details can be found at https://research.nvidia.com/labs/toronto-ai/xcube/.

This large scale study focuses on quantifying what X-rays diagnostic prediction tasks generalize well across multiple different datasets. We present evidence that the issue of generalization is not due to a shift in the images but instead a shift in the labels. We study the cross-domain performance, agreement between models, and model representations. We find interesting discrepancies between performance and agreement where models which both achieve good performance disagree in their predictions as well as models which agree yet achieve poor performance. We also test for concept similarity by regularizing a network to group tasks across multiple datasets together and observe variation across the tasks. All code is made available online and data is publicly available: https://github.com/mlmed/torchxrayvision

We introduce Seedream 4.0, an efficient and high-performance multimodal image generation system that unifies text-to-image (T2I) synthesis, image editing, and multi-image composition within a single framework. We develop a highly efficient diffusion transformer with a powerful VAE which also can reduce the number of image tokens considerably. This allows for efficient training of our model, and enables it to fast generate native high-resolution images (e.g., 1K-4K). Seedream 4.0 is pretrained on billions of text-image pairs spanning diverse taxonomies and knowledge-centric concepts. Comprehensive data collection across hundreds of vertical scenarios, coupled with optimized strategies, ensures stable and large-scale training, with strong generalization. By incorporating a carefully fine-tuned VLM model, we perform multi-modal post-training for training both T2I and image editing tasks jointly. For inference acceleration, we integrate adversarial distillation, distribution matching, and quantization, as well as speculative decoding. It achieves an inference time of up to 1.8 seconds for generating a 2K image (without a LLM/VLM as PE model). Comprehensive evaluations reveal that Seedream 4.0 can achieve state-of-the-art results on both T2I and multimodal image editing. In particular, it demonstrates exceptional multimodal capabilities in complex tasks, including precise image editing and in-context reasoning, and also allows for multi-image reference, and can generate multiple output images. This extends traditional T2I systems into an more interactive and multidimensional creative tool, pushing the boundary of generative AI for both creativity and professional applications. Seedream 4.0 is now accessible on https://www.volcengine.com/experience/ark?launch=seedream.

With the rise of multimodal applications, instruction data has become critical for training multimodal language models capable of understanding complex image-based queries. Existing practices rely on powerful but costly large language models (LLMs) or multimodal language models (MLMs) to produce instruction data. These are often prone to hallucinations, licensing issues and the generation process is often hard to scale and interpret. In this work, we present a programmatic approach that employs scene graphs as symbolic representations of images and human-written programs to systematically synthesize vision-centric instruction data. Our approach ensures the interpretability and controllability of the data generation process and scales efficiently while maintaining factual accuracy. By implementing a suite of 24 single-image, 14 multi-image instruction generators, and a scene graph generation pipeline, we build a scalable, cost-effective system: ProVision which produces diverse question-answer pairs concerning objects, attributes, relations, depth, etc., for any given image. Applied to Visual Genome and DataComp datasets, we generate over 10 million instruction data points, ProVision-10M, and leverage them in both pretraining and instruction tuning stages of MLMs. When adopted in the instruction tuning stage, our single-image instruction data yields up to a 7% improvement on the 2D split and 8% on the 3D split of CVBench, along with a 3% increase in performance on QBench2, RealWorldQA, and MMMU. Our multi-image instruction data leads to an 8% improvement on Mantis-Eval. Incorporation of our data in both pre-training and fine-tuning stages of xGen-MM-4B leads to an averaged improvement of 1.6% across 11 benchmarks.

Recent advances in generative vision-language models (VLMs) have exciting potential implications for AI in radiology, yet VLMs are also known to produce hallucinations, nonsensical text, and other unwanted behaviors that can waste clinicians' time and cause patient harm. Drawing on recent work on direct preference optimization (DPO), we propose a simple method for modifying the behavior of pretrained VLMs performing radiology report generation by suppressing unwanted types of generations. We apply our method to the prevention of hallucinations of prior exams, addressing a long-established problem behavior in models performing chest X-ray report generation. Across our experiments, we find that DPO fine-tuning achieves a 3.2-4.8x reduction in lines hallucinating prior exams while maintaining model performance on clinical accuracy metrics. Our work is, to the best of our knowledge, the first work to apply DPO to medical VLMs, providing a data- and compute- efficient way to suppress problem behaviors while maintaining overall clinical accuracy.

Following the impressive development of LLMs, vision-language alignment in LLMs is actively being researched to enable multimodal reasoning and visual IO. This direction of research is particularly relevant to medical imaging because medical image analysis and generation consist of reasoning based on a combination of visual features and prior knowledge. Many recent works have focused on training adapter networks that serve as an information bridge between image processing networks and LLMs; but presumably, in order to achieve maximum reasoning potential of LLMs on visual information as well, visual and language features should be allowed to interact more freely. This is especially important in the medical domain because understanding and generating medical images such as chest X-rays (CXR) require not only accurate visual and language-based reasoning but also a more intimate mapping between the two modalities. Thus, taking inspiration from previous work on the transformer and VQ-GAN combination for bidirectional image and text generation, we build upon this approach and develop a method for instruction-tuning an LLM pre-trained only on text to gain vision-language capabilities for medical images. Specifically, we leverage a pretrained LLM's existing question-answering and instruction-following abilities to teach it to understand visual inputs by instructing it to answer questions about image inputs and, symmetrically, output both text and image responses appropriate to a given query by tuning the LLM with diverse tasks that encompass image-based text-generation and text-based image-generation. We show that our model, LLM-CXR, trained in this approach shows better image-text alignment in both CXR understanding and generation tasks while being smaller in size compared to previously developed models that perform a narrower range of tasks. The code is at https://github.com/hyn2028/llm-cxr.

Earth observation is fundamentally multi-scale; geospatial tasks span varied resolutions, and satellite imagery is organized into cascading tile pyramids that nest fine detail within wide coverage. Current generative models of satellite imagery, however, operate along a single axis: they either zoom to enhance a single tile's resolution or pan to extend imagery at a fixed scale. As a result, no existing method produces a complete pyramid that stays consistent across both scale and space, where a high-zoom tile must agree with the coarse context it refines and with the neighbors it meets. Motivated by this gap, we introduce a new task, multi-scale tile completion: given a sparse set of seed tiles at arbitrary zoom levels and positions, synthesize a complete, uniform quadtree that is globally consistent across both scale and space. We approach this task with Genesis, a generative engine that brings both axes together by composing two specialized operators over the quadtree: a vertical super-resolution model and a horizontal mask-based outpainting model, producing pyramids that are consistent across zoom levels and seamless across neighboring tiles. Each operator achieves state-of-the-art results on its subtask, and the engine propagates sparse seeds into seamless, multi-resolution maps from any initial configuration. To evaluate the task and benchmark Genesis, we introduce dense500, a fully observed multi-scale pyramid dataset spanning diverse geographic regions, together with a suite of pyramid-level metrics. Code, models, and our dataset are available at https://github.com/mvrl/genesis.

Ensuring the quality and integrity of medical images is crucial for maintaining diagnostic accuracy in deep learning-based Computer-Aided Diagnosis and Computer-Aided Detection (CAD) systems. Covariate shifts are subtle variations in the data distribution caused by different imaging devices or settings and can severely degrade model performance, similar to the effects of adversarial attacks. Therefore, it is vital to have a lightweight and fast method to assess the quality of these images prior to using CAD models. AdverX-Ray addresses this need by serving as an image-quality assessment layer, designed to detect covariate shifts effectively. This Adversarial Variational Autoencoder prioritizes the discriminator's role, using the suboptimal outputs of the generator as negative samples to fine-tune the discriminator's ability to identify high-frequency artifacts. Images generated by adversarial networks often exhibit severe high-frequency artifacts, guiding the discriminator to focus excessively on these components. This makes the discriminator ideal for this approach. Trained on patches from X-ray images of specific machine models, AdverX-Ray can evaluate whether a scan matches the training distribution, or if a scan from the same machine is captured under different settings. Extensive comparisons with various OOD detection methods show that AdverX-Ray significantly outperforms existing techniques, achieving a 96.2% average AUROC using only 64 random patches from an X-ray. Its lightweight and fast architecture makes it suitable for real-time applications, enhancing the reliability of medical imaging systems. The code and pretrained models are publicly available.

Observational astronomy relies on visual feature identification to detect critical astrophysical phenomena. While machine learning (ML) increasingly automates this process, models often struggle with generalization in large-scale surveys due to the limited representativeness of labeled datasets -- whether from simulations or human annotation -- a challenge pronounced for rare yet scientifically valuable objects. To address this, we propose a conditional diffusion model to synthesize realistic galaxy images for augmenting ML training data. Leveraging the Galaxy Zoo 2 dataset which contains visual feature -- galaxy image pairs from volunteer annotation, we demonstrate that our model generates diverse, high-fidelity galaxy images closely adhere to the specified morphological feature conditions. Moreover, this model enables generative extrapolation to project well-annotated data into unseen domains and advancing rare object detection. Integrating synthesized images into ML pipelines improves performance in standard morphology classification, boosting completeness and purity by up to 30\% across key metrics. For rare object detection, using early-type galaxies with prominent dust lane features ( sim0.1\% in GZ2 dataset) as a test case, our approach doubled the number of detected instances from 352 to 872, compared to previous studies based on visual inspection. This study highlights the power of generative models to bridge gaps between scarce labeled data and the vast, uncharted parameter space of observational astronomy and sheds insight for future astrophysical foundation model developments. Our project homepage is available at https://galaxysd-webpage.streamlit.app/.