Daily Papers

Operating rooms (ORs) demand precise coordination among surgeons, nurses, and equipment in a fast-paced, occlusion-heavy environment, necessitating advanced perception models to enhance safety and efficiency. Existing datasets either provide partial egocentric views or sparse exocentric multi-view context, but do not explore the comprehensive combination of both. We introduce EgoExOR, the first OR dataset and accompanying benchmark to fuse first-person and third-person perspectives. Spanning 94 minutes (84,553 frames at 15 FPS) of two emulated spine procedures, Ultrasound-Guided Needle Insertion and Minimally Invasive Spine Surgery, EgoExOR integrates egocentric data (RGB, gaze, hand tracking, audio) from wearable glasses, exocentric RGB and depth from RGB-D cameras, and ultrasound imagery. Its detailed scene graph annotations, covering 36 entities and 22 relations (568,235 triplets), enable robust modeling of clinical interactions, supporting tasks like action recognition and human-centric perception. We evaluate the surgical scene graph generation performance of two adapted state-of-the-art models and offer a new baseline that explicitly leverages EgoExOR's multimodal and multi-perspective signals. This new dataset and benchmark set a new foundation for OR perception, offering a rich, multimodal resource for next-generation clinical perception.

Understanding the intricate workflows of cataract surgery requires modeling complex interactions between surgical tools, anatomical structures, and procedural techniques. Existing datasets primarily address isolated aspects of surgical analysis, such as tool detection or phase segmentation, but lack comprehensive representations that capture the semantic relationships between entities over time. This paper introduces the Cataract Surgery Scene Graph (CAT-SG) dataset, the first to provide structured annotations of tool-tissue interactions, procedural variations, and temporal dependencies. By incorporating detailed semantic relations, CAT-SG offers a holistic view of surgical workflows, enabling more accurate recognition of surgical phases and techniques. Additionally, we present a novel scene graph generation model, CatSGG, which outperforms current methods in generating structured surgical representations. The CAT-SG dataset is designed to enhance AI-driven surgical training, real-time decision support, and workflow analysis, paving the way for more intelligent, context-aware systems in clinical practice.

Operating rooms (ORs) are complex, high-stakes environments requiring precise understanding of interactions among medical staff, tools, and equipment for enhancing surgical assistance, situational awareness, and patient safety. Current datasets fall short in scale, realism and do not capture the multimodal nature of OR scenes, limiting progress in OR modeling. To this end, we introduce MM-OR, a realistic and large-scale multimodal spatiotemporal OR dataset, and the first dataset to enable multimodal scene graph generation. MM-OR captures comprehensive OR scenes containing RGB-D data, detail views, audio, speech transcripts, robotic logs, and tracking data and is annotated with panoptic segmentations, semantic scene graphs, and downstream task labels. Further, we propose MM2SG, the first multimodal large vision-language model for scene graph generation, and through extensive experiments, demonstrate its ability to effectively leverage multimodal inputs. Together, MM-OR and MM2SG establish a new benchmark for holistic OR understanding, and open the path towards multimodal scene analysis in complex, high-stakes environments. Our code, and data is available at https://github.com/egeozsoy/MM-OR.

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

Surgical simulation offers a promising addition to conventional surgical training. However, available simulation tools lack photorealism and rely on hardcoded behaviour. Denoising Diffusion Models are a promising alternative for high-fidelity image synthesis, but existing state-of-the-art conditioning methods fall short in providing precise control or interactivity over the generated scenes. We introduce SurGrID, a Scene Graph to Image Diffusion Model, allowing for controllable surgical scene synthesis by leveraging Scene Graphs. These graphs encode a surgical scene's components' spatial and semantic information, which are then translated into an intermediate representation using our novel pre-training step that explicitly captures local and global information. Our proposed method improves the fidelity of generated images and their coherence with the graph input over the state-of-the-art. Further, we demonstrate the simulation's realism and controllability in a user assessment study involving clinical experts. Scene Graphs can be effectively used for precise and interactive conditioning of Denoising Diffusion Models for simulating surgical scenes, enabling high fidelity and interactive control over the generated content.

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

Surgical simulation plays a pivotal role in training novice surgeons, accelerating their learning curve and reducing intra-operative errors. However, conventional simulation tools fall short in providing the necessary photorealism and the variability of human anatomy. In response, current methods are shifting towards generative model-based simulators. Yet, these approaches primarily focus on using increasingly complex conditioning for precise synthesis while neglecting the fine-grained human control aspect. To address this gap, we introduce SG2VID, the first diffusion-based video model that leverages Scene Graphs for both precise video synthesis and fine-grained human control. We demonstrate SG2VID's capabilities across three public datasets featuring cataract and cholecystectomy surgery. While SG2VID outperforms previous methods both qualitatively and quantitatively, it also enables precise synthesis, providing accurate control over tool and anatomy's size and movement, entrance of new tools, as well as the overall scene layout. We qualitatively motivate how SG2VID can be used for generative augmentation and present an experiment demonstrating its ability to improve a downstream phase detection task when the training set is extended with our synthetic videos. Finally, to showcase SG2VID's ability to retain human control, we interact with the Scene Graphs to generate new video samples depicting major yet rare intra-operative irregularities.

Scene graph generation has emerged as a prominent research field in computer vision, witnessing significant advancements in the recent years. However, despite these strides, precise and thorough definitions for the metrics used to evaluate scene graph generation models are lacking. In this paper, we address this gap in the literature by providing a review and precise definition of commonly used metrics in scene graph generation. Our comprehensive examination clarifies the underlying principles of these metrics and can serve as a reference or introduction to scene graph metrics. Furthermore, to facilitate the usage of these metrics, we introduce a standalone Python package called SGBench that efficiently implements all defined metrics, ensuring their accessibility to the research community. Additionally, we present a scene graph benchmarking web service, that enables researchers to compare scene graph generation methods and increase visibility of new methods in a central place. All of our code can be found at https://lorjul.github.io/sgbench/.

In this paper, we present a novel generative task: joint scene graph - image generation. While previous works have explored image generation conditioned on scene graphs or layouts, our task is distinctive and important as it involves generating scene graphs themselves unconditionally from noise, enabling efficient and interpretable control for image generation. Our task is challenging, requiring the generation of plausible scene graphs with heterogeneous attributes for nodes (objects) and edges (relations among objects), including continuous object bounding boxes and discrete object and relation categories. We introduce a novel diffusion model, DiffuseSG, that jointly models the adjacency matrix along with heterogeneous node and edge attributes. We explore various types of encodings for the categorical data, relaxing it into a continuous space. With a graph transformer being the denoiser, DiffuseSG successively denoises the scene graph representation in a continuous space and discretizes the final representation to generate the clean scene graph. Additionally, we introduce an IoU regularization to enhance the empirical performance. Our model significantly outperforms existing methods in scene graph generation on the Visual Genome and COCO-Stuff datasets, both on standard and newly introduced metrics that better capture the problem complexity. Moreover, we demonstrate the additional benefits of our model in two downstream applications: 1) excelling in a series of scene graph completion tasks, and 2) improving scene graph detection models by using extra training samples generated from DiffuseSG.

The lack of labeled datasets in 3D vision for surgical scenes inhibits the development of robust 3D reconstruction algorithms in the medical domain. Despite the popularity of Neural Radiance Fields and 3D Gaussian Splatting in the general computer vision community, these systems have yet to find consistent success in surgical scenes due to challenges such as non-stationary lighting and non-Lambertian surfaces. As a result, the need for labeled surgical datasets continues to grow. In this work, we introduce a differentiable rendering framework for material and lighting estimation from endoscopic images and known geometry. Compared to previous approaches that model lighting and material jointly as radiance, we explicitly disentangle these scene properties for robust and photorealistic novel view synthesis. To disambiguate the training process, we formulate domain-specific properties inherent in surgical scenes. Specifically, we model the scene lighting as a simple spotlight and material properties as a bidirectional reflectance distribution function, parameterized by a neural network. By grounding color predictions in the rendering equation, we can generate photorealistic images at arbitrary camera poses. We evaluate our method with various sequences from the Colonoscopy 3D Video Dataset and show that our method produces competitive novel view synthesis results compared with other approaches. Furthermore, we demonstrate that synthetic data can be used to develop 3D vision algorithms by finetuning a depth estimation model with our rendered outputs. Overall, we see that the depth estimation performance is on par with fine-tuning with the original real images.

3D indoor scenes are widely used in computer graphics, with applications ranging from interior design to gaming to virtual and augmented reality. They also contain rich information, including room layout, as well as furniture type, geometry, and placement. High-quality 3D indoor scenes are highly demanded while it requires expertise and is time-consuming to design high-quality 3D indoor scenes manually. Existing research only addresses partial problems: some works learn to generate room layout, and other works focus on generating detailed structure and geometry of individual furniture objects. However, these partial steps are related and should be addressed together for optimal synthesis. We propose SCENEHGN, a hierarchical graph network for 3D indoor scenes that takes into account the full hierarchy from the room level to the object level, then finally to the object part level. Therefore for the first time, our method is able to directly generate plausible 3D room content, including furniture objects with fine-grained geometry, and their layout. To address the challenge, we introduce functional regions as intermediate proxies between the room and object levels to make learning more manageable. To ensure plausibility, our graph-based representation incorporates both vertical edges connecting child nodes with parent nodes from different levels, and horizontal edges encoding relationships between nodes at the same level. Extensive experiments demonstrate that our method produces superior generation results, even when comparing results of partial steps with alternative methods that can only achieve these. We also demonstrate that our method is effective for various applications such as part-level room editing, room interpolation, and room generation by arbitrary room boundaries.

Advancements in generative models have sparked significant interest in generating images while adhering to specific structural guidelines. Scene graph to image generation is one such task of generating images which are consistent with the given scene graph. However, the complexity of visual scenes poses a challenge in accurately aligning objects based on specified relations within the scene graph. Existing methods approach this task by first predicting a scene layout and generating images from these layouts using adversarial training. In this work, we introduce a novel approach to generate images from scene graphs which eliminates the need of predicting intermediate layouts. We leverage pre-trained text-to-image diffusion models and CLIP guidance to translate graph knowledge into images. Towards this, we first pre-train our graph encoder to align graph features with CLIP features of corresponding images using a GAN based training. Further, we fuse the graph features with CLIP embedding of object labels present in the given scene graph to create a graph consistent CLIP guided conditioning signal. In the conditioning input, object embeddings provide coarse structure of the image and graph features provide structural alignment based on relationships among objects. Finally, we fine tune a pre-trained diffusion model with the graph consistent conditioning signal with reconstruction and CLIP alignment loss. Elaborate experiments reveal that our method outperforms existing methods on standard benchmarks of COCO-stuff and Visual Genome dataset.

We propose an end-to-end variational generative model for scene layout synthesis conditioned on scene graphs. Unlike unconditional scene layout generation, we use scene graphs as an abstract but general representation to guide the synthesis of diverse scene layouts that satisfy relationships included in the scene graph. This gives rise to more flexible control over the synthesis process, allowing various forms of inputs such as scene layouts extracted from sentences or inferred from a single color image. Using our conditional layout synthesizer, we can generate various layouts that share the same structure of the input example. In addition to this conditional generation design, we also integrate a differentiable rendering module that enables layout refinement using only 2D projections of the scene. Given a depth and a semantics map, the differentiable rendering module enables optimizing over the synthesized layout to fit the given input in an analysis-by-synthesis fashion. Experiments suggest that our model achieves higher accuracy and diversity in conditional scene synthesis and allows exemplar-based scene generation from various input forms.

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

Vision foundation models (VFMs) have emerged as powerful tools for surgical scene understanding. However, current approaches predominantly rely on unimodal RGB pre-training, overlooking the complex 3D geometry inherent to surgical environments. Although several architectures support multimodal or geometry-aware inputs in general computer vision, the benefits of incorporating depth information in surgical settings remain underexplored. We conduct a large-scale empirical study comparing eight ViT-based VFMs that differ in pre-training domain, learning objective, and input modality (RGB vs. RGB-D). For pre-training, we use a curated dataset of 1.4 million robotic surgical images paired with depth maps generated from an off-the-shelf network. We evaluate these models under both frozen-backbone and end-to-end fine-tuning protocols across eight surgical datasets spanning object detection, segmentation, depth estimation, and pose estimation. Our experiments yield several consistent findings. Models incorporating explicit geometric tokenization, such as MultiMAE, substantially outperform unimodal baselines across all tasks. Notably, geometric-aware pre-training enables remarkable data efficiency: models fine-tuned on just 25% of labeled data consistently surpass RGB-only models trained on the full dataset. Importantly, these gains require no architectural or runtime changes at inference; depth is used only during pre-training, making adoption straightforward. These findings suggest that multimodal pre-training offers a viable path towards building more capable surgical vision systems.

Foundation models in video generation are demonstrating remarkable capabilities as potential world models for simulating the physical world. However, their application in high-stakes domains like surgery, which demand deep, specialized causal knowledge rather than general physical rules, remains a critical unexplored gap. To systematically address this challenge, we present SurgVeo, the first expert-curated benchmark for video generation model evaluation in surgery, and the Surgical Plausibility Pyramid (SPP), a novel, four-tiered framework tailored to assess model outputs from basic appearance to complex surgical strategy. On the basis of the SurgVeo benchmark, we task the advanced Veo-3 model with a zero-shot prediction task on surgical clips from laparoscopic and neurosurgical procedures. A panel of four board-certified surgeons evaluates the generated videos according to the SPP. Our results reveal a distinct "plausibility gap": while Veo-3 achieves exceptional Visual Perceptual Plausibility, it fails critically at higher levels of the SPP, including Instrument Operation Plausibility, Environment Feedback Plausibility, and Surgical Intent Plausibility. This work provides the first quantitative evidence of the chasm between visually convincing mimicry and causal understanding in surgical AI. Our findings from SurgVeo and the SPP establish a crucial foundation and roadmap for developing future models capable of navigating the complexities of specialized, real-world healthcare domains.

In this paper, we propose a novel text promptable surgical instrument segmentation approach to overcome challenges associated with diversity and differentiation of surgical instruments in minimally invasive surgeries. We redefine the task as text promptable, thereby enabling a more nuanced comprehension of surgical instruments and adaptability to new instrument types. Inspired by recent advancements in vision-language models, we leverage pretrained image and text encoders as our model backbone and design a text promptable mask decoder consisting of attention- and convolution-based prompting schemes for surgical instrument segmentation prediction. Our model leverages multiple text prompts for each surgical instrument through a new mixture of prompts mechanism, resulting in enhanced segmentation performance. Additionally, we introduce a hard instrument area reinforcement module to improve image feature comprehension and segmentation precision. Extensive experiments on EndoVis2017 and EndoVis2018 datasets demonstrate our model's superior performance and promising generalization capability. To our knowledge, this is the first implementation of a promptable approach to surgical instrument segmentation, offering significant potential for practical application in the field of robotic-assisted surgery.

Surgical video-language pretraining (VLP) faces unique challenges due to the knowledge domain gap and the scarcity of multi-modal data. This study aims to bridge the gap by addressing issues regarding textual information loss in surgical lecture videos and the spatial-temporal challenges of surgical VLP. We propose a hierarchical knowledge augmentation approach and a novel Procedure-Encoded Surgical Knowledge-Augmented Video-Language Pretraining (PeskaVLP) framework to tackle these issues. The knowledge augmentation uses large language models (LLM) for refining and enriching surgical concepts, thus providing comprehensive language supervision and reducing the risk of overfitting. PeskaVLP combines language supervision with visual self-supervision, constructing hard negative samples and employing a Dynamic Time Warping (DTW) based loss function to effectively comprehend the cross-modal procedural alignment. Extensive experiments on multiple public surgical scene understanding and cross-modal retrieval datasets show that our proposed method significantly improves zero-shot transferring performance and offers a generalist visual representation for further advancements in surgical scene understanding.The code is available at https://github.com/CAMMA-public/SurgVLP

With the growing volume of CT examinations, there is an increasing demand for automated tools such as organ segmentation, abnormality detection, and report generation to support radiologists in managing their clinical workload. Multi-label classification of 3D Chest CT scans remains a critical yet challenging problem due to the complex spatial relationships inherent in volumetric data and the wide variability of abnormalities. Existing methods based on 3D convolutional neural networks struggle to capture long-range dependencies, while Vision Transformers often require extensive pre-training on large-scale, domain-specific datasets to perform competitively. In this work of academic research, we propose a 2.5D alternative by introducing a new graph-based framework that represents 3D CT volumes as structured graphs, where axial slice triplets serve as nodes processed through spectral graph convolution, enabling the model to reason over inter-slice dependencies while maintaining complexity compatible with clinical deployment. Our method, trained and evaluated on 3 datasets from independent institutions, achieves strong cross-dataset generalization, and shows competitive performance compared to state-of-the-art visual encoders. We further conduct comprehensive ablation studies to evaluate the impact of various aggregation strategies, edge-weighting schemes, and graph connectivity patterns. Additionally, we demonstrate the broader applicability of our approach through transfer experiments on automated radiology report generation and abdominal CT data.

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

Surgical future prediction, driven by real-time AI analysis of surgical video, is critical for operating room safety and efficiency. It provides actionable insights into upcoming events, their timing, and risks-enabling better resource allocation, timely instrument readiness, and early warnings for complications (e.g., bleeding, bile duct injury). Despite this need, current surgical AI research focuses on understanding what is happening rather than predicting future events. Existing methods target specific tasks in isolation, lacking unified approaches that span both short-term (action triplets, events) and long-term horizons (remaining surgery duration, phase transitions). These methods rely on coarse-grained supervision while fine-grained surgical action triplets and steps remain underexplored. Furthermore, methods based only on future feature prediction struggle to generalize across different surgical contexts and procedures. We address these limits by reframing surgical future prediction as state-change learning. Rather than forecasting raw observations, our approach classifies state transitions between current and future timesteps. We introduce SurgFUTR, implementing this through a teacher-student architecture. Video clips are compressed into state representations via Sinkhorn-Knopp clustering; the teacher network learns from both current and future clips, while the student network predicts future states from current videos alone, guided by our Action Dynamics (ActDyn) module. We establish SFPBench with five prediction tasks spanning short-term (triplets, events) and long-term (remaining surgery duration, phase and step transitions) horizons. Experiments across four datasets and three procedures show consistent improvements. Cross-procedure transfer validates generalizability.

Surgical instrument segmentation under Federated Learning (FL) is a promising direction, which enables multiple surgical sites to collaboratively train the model without centralizing datasets. However, there exist very limited FL works in surgical data science, and FL methods for other modalities do not consider inherent characteristics in surgical domain: i) different scenarios show diverse anatomical backgrounds while highly similar instrument representation; ii) there exist surgical simulators which promote large-scale synthetic data generation with minimal efforts. In this paper, we propose a novel Personalized FL scheme, Spatio-Temporal Representation Decoupling and Enhancement (FedST), which wisely leverages surgical domain knowledge during both local-site and global-server training to boost segmentation. Concretely, our model embraces a Representation Separation and Cooperation (RSC) mechanism in local-site training, which decouples the query embedding layer to be trained privately, to encode respective backgrounds. Meanwhile, other parameters are optimized globally to capture the consistent representations of instruments, including the temporal layer to capture similar motion patterns. A textual-guided channel selection is further designed to highlight site-specific features, facilitating model adapta tion to each site. Moreover, in global-server training, we propose Synthesis-based Explicit Representation Quantification (SERQ), which defines an explicit representation target based on synthetic data to synchronize the model convergence during fusion for improving model generalization.

Controllable 3D scene generation has extensive applications in virtual reality and interior design, where the generated scenes should exhibit high levels of realism and controllability in terms of geometry. Scene graphs provide a suitable data representation that facilitates these applications. However, current graph-based methods for scene generation are constrained to text-based inputs and exhibit insufficient adaptability to flexible user inputs, hindering the ability to precisely control object geometry. To address this issue, we propose MMGDreamer, a dual-branch diffusion model for scene generation that incorporates a novel Mixed-Modality Graph, visual enhancement module, and relation predictor. The mixed-modality graph allows object nodes to integrate textual and visual modalities, with optional relationships between nodes. It enhances adaptability to flexible user inputs and enables meticulous control over the geometry of objects in the generated scenes. The visual enhancement module enriches the visual fidelity of text-only nodes by constructing visual representations using text embeddings. Furthermore, our relation predictor leverages node representations to infer absent relationships between nodes, resulting in more coherent scene layouts. Extensive experimental results demonstrate that MMGDreamer exhibits superior control of object geometry, achieving state-of-the-art scene generation performance. Project page: https://yangzhifeio.github.io/project/MMGDreamer.

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

This paper presents the Holistic and Multi-Granular Surgical Scene Understanding of Prostatectomies (GraSP) dataset, a curated benchmark that models surgical scene understanding as a hierarchy of complementary tasks with varying levels of granularity. Our approach encompasses long-term tasks, such as surgical phase and step recognition, and short-term tasks, including surgical instrument segmentation and atomic visual actions detection. To exploit our proposed benchmark, we introduce the Transformers for Actions, Phases, Steps, and Instrument Segmentation (TAPIS) model, a general architecture that combines a global video feature extractor with localized region proposals from an instrument segmentation model to tackle the multi-granularity of our benchmark. Through extensive experimentation in ours and alternative benchmarks, we demonstrate TAPIS's versatility and state-of-the-art performance across different tasks. This work represents a foundational step forward in Endoscopic Vision, offering a novel framework for future research towards holistic surgical scene understanding.

Data scarcity remains a fundamental barrier to achieving fully autonomous surgical robots. While large scale vision language action (VLA) models have shown impressive generalization in household and industrial manipulation by leveraging paired video action data from diverse domains, surgical robotics suffers from the paucity of datasets that include both visual observations and accurate robot kinematics. In contrast, vast corpora of surgical videos exist, but they lack corresponding action labels, preventing direct application of imitation learning or VLA training. In this work, we aim to alleviate this problem by learning policy models from SurgWorld, a world model designed for surgical physical AI. We curated the Surgical Action Text Alignment (SATA) dataset with detailed action description specifically for surgical robots. Then we built SurgeWorld based on the most advanced physical AI world model and SATA. It's able to generate diverse, generalizable and realistic surgery videos. We are also the first to use an inverse dynamics model to infer pseudokinematics from synthetic surgical videos, producing synthetic paired video action data. We demonstrate that a surgical VLA policy trained with these augmented data significantly outperforms models trained only on real demonstrations on a real surgical robot platform. Our approach offers a scalable path toward autonomous surgical skill acquisition by leveraging the abundance of unlabeled surgical video and generative world modeling, thus opening the door to generalizable and data efficient surgical robot policies.

This paper explores the advancements and applications of large-scale models in the medical field, with a particular focus on Medical Large Models (MedLMs). These models, encompassing Large Language Models (LLMs), Vision Models, 3D Large Models, and Multimodal Models, are revolutionizing healthcare by enhancing disease prediction, diagnostic assistance, personalized treatment planning, and drug discovery. The integration of graph neural networks in medical knowledge graphs and drug discovery highlights the potential of Large Graph Models (LGMs) in understanding complex biomedical relationships. The study also emphasizes the transformative role of Vision-Language Models (VLMs) and 3D Large Models in medical image analysis, anatomical modeling, and prosthetic design. Despite the challenges, these technologies are setting new benchmarks in medical innovation, improving diagnostic accuracy, and paving the way for personalized healthcare solutions. This paper aims to provide a comprehensive overview of the current state and future directions of large models in medicine, underscoring their significance in advancing global health.

The concept of 3D scene graphs is increasingly recognized as a powerful semantic and hierarchical representation of the environment. Current approaches often address this at a coarse, object-level resolution. In contrast, our goal is to develop a representation that enables robots to directly interact with their environment by identifying both the location of functional interactive elements and how these can be used. To achieve this, we focus on detecting and storing objects at a finer resolution, focusing on affordance-relevant parts. The primary challenge lies in the scarcity of data that extends beyond instance-level detection and the inherent difficulty of capturing detailed object features using robotic sensors. We leverage currently available 3D resources to generate 2D data and train a detector, which is then used to augment the standard 3D scene graph generation pipeline. Through our experiments, we demonstrate that our approach achieves functional element segmentation comparable to state-of-the-art 3D models and that our augmentation enables task-driven affordance grounding with higher accuracy than the current solutions. See our project page at https://fungraph.github.io.

Recent advancements in surgical computer vision have been driven by vision-only models, which lack language semantics, relying on manually annotated videos to predict fixed object categories. This limits their generalizability to unseen surgical procedures and tasks. We propose leveraging surgical video lectures from e-learning platforms to provide effective vision and language supervisory signals for multi-modal representation learning, bypassing manual annotations. We address surgery-specific linguistic challenges using multiple automatic speech recognition systems for text transcriptions. We introduce SurgVLP - Surgical Vision Language Pre-training - a novel method for multi-modal representation learning. SurgVLP employs a new contrastive learning objective, aligning video clip embeddings with corresponding multiple text embeddings in a joint latent space. We demonstrate the representational capability of this space through several vision-and-language surgical tasks and vision-only tasks specific to surgery. Unlike current fully supervised approaches, SurgVLP adapts to different surgical procedures and tasks without specific fine-tuning, achieving zero-shot adaptation to tasks such as surgical tool, phase, and triplet recognition without manual annotation. These results highlight the transferability and versatility of the learned multi-modal representations in surgical video analysis. The code is available at https://github.com/CAMMA-public/SurgVLP

Scene graphs offer a structured, hierarchical representation of images, with nodes and edges symbolizing objects and the relationships among them. It can serve as a natural interface for image editing, dramatically improving precision and flexibility. Leveraging this benefit, we introduce a new framework that integrates large language model (LLM) with Text2Image generative model for scene graph-based image editing. This integration enables precise modifications at the object level and creative recomposition of scenes without compromising overall image integrity. Our approach involves two primary stages: 1) Utilizing a LLM-driven scene parser, we construct an image's scene graph, capturing key objects and their interrelationships, as well as parsing fine-grained attributes such as object masks and descriptions. These annotations facilitate concept learning with a fine-tuned diffusion model, representing each object with an optimized token and detailed description prompt. 2) During the image editing phase, a LLM editing controller guides the edits towards specific areas. These edits are then implemented by an attention-modulated diffusion editor, utilizing the fine-tuned model to perform object additions, deletions, replacements, and adjustments. Through extensive experiments, we demonstrate that our framework significantly outperforms existing image editing methods in terms of editing precision and scene aesthetics.

Natural language could play an important role in developing generalist surgical models by providing a broad source of supervision from raw texts. This flexible form of supervision can enable the model's transferability across datasets and tasks as natural language can be used to reference learned visual concepts or describe new ones. In this work, we present HecVL, a novel hierarchical video-language pretraining approach for building a generalist surgical model. Specifically, we construct a hierarchical video-text paired dataset by pairing the surgical lecture video with three hierarchical levels of texts: at clip-level, atomic actions using transcribed audio texts; at phase-level, conceptual text summaries; and at video-level, overall abstract text of the surgical procedure. Then, we propose a novel fine-to-coarse contrastive learning framework that learns separate embedding spaces for the three video-text hierarchies using a single model. By disentangling embedding spaces of different hierarchical levels, the learned multi-modal representations encode short-term and long-term surgical concepts in the same model. Thanks to the injected textual semantics, we demonstrate that the HecVL approach can enable zero-shot surgical phase recognition without any human annotation. Furthermore, we show that the same HecVL model for surgical phase recognition can be transferred across different surgical procedures and medical centers. The code is available at https://github.com/CAMMA-public/SurgVLP

Surgical scene perception via videos are critical for advancing robotic surgery, telesurgery, and AI-assisted surgery, particularly in ophthalmology. However, the scarcity of diverse and richly annotated video datasets has hindered the development of intelligent systems for surgical workflow analysis. Existing datasets for surgical workflow analysis, which typically face challenges such as small scale, a lack of diversity in surgery and phase categories, and the absence of time-localized annotations, limit the requirements for action understanding and model generalization validation in complex and diverse real-world surgical scenarios. To address this gap, we introduce OphNet, a large-scale, expert-annotated video benchmark for ophthalmic surgical workflow understanding. OphNet features: 1) A diverse collection of 2,278 surgical videos spanning 66 types of cataract, glaucoma, and corneal surgeries, with detailed annotations for 102 unique surgical phases and 150 granular operations; 2) It offers sequential and hierarchical annotations for each surgery, phase, and operation, enabling comprehensive understanding and improved interpretability; 3) Moreover, OphNet provides time-localized annotations, facilitating temporal localization and prediction tasks within surgical workflows. With approximately 205 hours of surgical videos, OphNet is about 20 times larger than the largest existing surgical workflow analysis benchmark. Our dataset and code have been made available at: https://github.com/minghu0830/OphNet-benchmark.

We present a system for generating indoor scenes in response to text prompts. The prompts are not limited to a fixed vocabulary of scene descriptions, and the objects in generated scenes are not restricted to a fixed set of object categories -- we call this setting indoor scene generation. Unlike most prior work on indoor scene generation, our system does not require a large training dataset of existing 3D scenes. Instead, it leverages the world knowledge encoded in pre-trained large language models (LLMs) to synthesize programs in a domain-specific layout language that describe objects and spatial relations between them. Executing such a program produces a specification of a constraint satisfaction problem, which the system solves using a gradient-based optimization scheme to produce object positions and orientations. To produce object geometry, the system retrieves 3D meshes from a database. Unlike prior work which uses databases of category-annotated, mutually-aligned meshes, we develop a pipeline using vision-language models (VLMs) to retrieve meshes from massive databases of un-annotated, inconsistently-aligned meshes. Experimental evaluations show that our system outperforms generative models trained on 3D data for traditional, closed-universe scene generation tasks; it also outperforms a recent LLM-based layout generation method on open-universe scene generation.

Generating images from scene graphs is a challenging task that attracted substantial interest recently. Prior works have approached this task by generating an intermediate layout description of the target image. However, the representation of each object in the layout was generated independently, which resulted in high overlap, low coverage, and an overall blurry layout. We propose a novel method that alleviates these issues by generating the entire layout description gradually to improve inter-object dependency. We empirically show on the COCO-STUFF dataset that our approach improves the quality of both the intermediate layout and the final image. Our approach improves the layout coverage by almost 20 points and drops object overlap to negligible amounts.

Understanding a visual scene goes beyond recognizing individual objects in isolation. Relationships between objects also constitute rich semantic information about the scene. In this work, we explicitly model the objects and their relationships using scene graphs, a visually-grounded graphical structure of an image. We propose a novel end-to-end model that generates such structured scene representation from an input image. The model solves the scene graph inference problem using standard RNNs and learns to iteratively improves its predictions via message passing. Our joint inference model can take advantage of contextual cues to make better predictions on objects and their relationships. The experiments show that our model significantly outperforms previous methods for generating scene graphs using Visual Genome dataset and inferring support relations with NYU Depth v2 dataset.

There is a surge of interest in image scene graph generation (object, attribute and relationship detection) due to the need of building fine-grained image understanding models that go beyond object detection. Due to the lack of a good benchmark, the reported results of different scene graph generation models are not directly comparable, impeding the research progress. We have developed a much-needed scene graph generation benchmark based on the maskrcnn-benchmark and several popular models. This paper presents main features of our benchmark and a comprehensive ablation study of scene graph generation models using the Visual Genome and OpenImages Visual relationship detection datasets. Our codebase is made publicly available at https://github.com/microsoft/scene_graph_benchmark.

Graph-structured scene descriptions can be efficiently used in generative models to control the composition of the generated image. Previous approaches are based on the combination of graph convolutional networks and adversarial methods for layout prediction and image generation, respectively. In this work, we show how employing multi-head attention to encode the graph information, as well as using a transformer-based model in the latent space for image generation can improve the quality of the sampled data, without the need to employ adversarial models with the subsequent advantage in terms of training stability. The proposed approach, specifically, is entirely based on transformer architectures both for encoding scene graphs into intermediate object layouts and for decoding these layouts into images, passing through a lower dimensional space learned by a vector-quantized variational autoencoder. Our approach shows an improved image quality with respect to state-of-the-art methods as well as a higher degree of diversity among multiple generations from the same scene graph. We evaluate our approach on three public datasets: Visual Genome, COCO, and CLEVR. We achieve an Inception Score of 13.7 and 12.8, and an FID of 52.3 and 60.3, on COCO and Visual Genome, respectively. We perform ablation studies on our contributions to assess the impact of each component. Code is available at https://github.com/perceivelab/trf-sg2im

Scene graph generation (SGG) is a fundamental task aimed at detecting visual relations between objects in an image. The prevailing SGG methods require all object classes to be given in the training set. Such a closed setting limits the practical application of SGG. In this paper, we introduce open-vocabulary scene graph generation, a novel, realistic and challenging setting in which a model is trained on a set of base object classes but is required to infer relations for unseen target object classes. To this end, we propose a two-step method that firstly pre-trains on large amounts of coarse-grained region-caption data and then leverages two prompt-based techniques to finetune the pre-trained model without updating its parameters. Moreover, our method can support inference over completely unseen object classes, which existing methods are incapable of handling. On extensive experiments on three benchmark datasets, Visual Genome, GQA, and Open-Image, our method significantly outperforms recent, strong SGG methods on the setting of Ov-SGG, as well as on the conventional closed SGG.

Surgical scene segmentation is critical in computer-assisted surgery and is vital for enhancing surgical quality and patient outcomes. Recently, referring surgical segmentation is emerging, given its advantage of providing surgeons with an interactive experience to segment the target object. However, existing methods are limited by low efficiency and short-term tracking, hindering their applicability in complex real-world surgical scenarios. In this paper, we introduce ReSurgSAM2, a two-stage surgical referring segmentation framework that leverages Segment Anything Model 2 to perform text-referred target detection, followed by tracking with reliable initial frame identification and diversity-driven long-term memory. For the detection stage, we propose a cross-modal spatial-temporal Mamba to generate precise detection and segmentation results. Based on these results, our credible initial frame selection strategy identifies the reliable frame for the subsequent tracking. Upon selecting the initial frame, our method transitions to the tracking stage, where it incorporates a diversity-driven memory mechanism that maintains a credible and diverse memory bank, ensuring consistent long-term tracking. Extensive experiments demonstrate that ReSurgSAM2 achieves substantial improvements in accuracy and efficiency compared to existing methods, operating in real-time at 61.2 FPS. Our code and datasets will be available at https://github.com/jinlab-imvr/ReSurgSAM2.

Purpose: Foundation models, trained on multitudes of public datasets, often require additional fine-tuning or re-prompting mechanisms to be applied to visually distinct target domains such as surgical videos. Further, without domain knowledge, they cannot model the specific semantics of the target domain. Hence, when applied to surgical video segmentation, they fail to generalise to sections where previously tracked objects leave the scene or new objects enter. Methods: We propose SASVi, a novel re-prompting mechanism based on a frame-wise Mask R-CNN Overseer model, which is trained on a minimal amount of scarcely available annotations for the target domain. This model automatically re-prompts the foundation model SAM2 when the scene constellation changes, allowing for temporally smooth and complete segmentation of full surgical videos. Results: Re-prompting based on our Overseer model significantly improves the temporal consistency of surgical video segmentation compared to similar prompting techniques and especially frame-wise segmentation, which neglects temporal information, by at least 1.5%. Our proposed approach allows us to successfully deploy SAM2 to surgical videos, which we quantitatively and qualitatively demonstrate for three different cholecystectomy and cataract surgery datasets. Conclusion: SASVi can serve as a new baseline for smooth and temporally consistent segmentation of surgical videos with scarcely available annotation data. Our method allows us to leverage scarce annotations and obtain complete annotations for full videos of the large-scale counterpart datasets. We make those annotations publicly available, providing extensive annotation data for the future development of surgical data science models.

Data diversity and volume are crucial to the success of training deep learning models, while in the medical imaging field, the difficulty and cost of data collection and annotation are especially huge. Specifically in robotic surgery, data scarcity and imbalance have heavily affected the model accuracy and limited the design and deployment of deep learning-based surgical applications such as surgical instrument segmentation. Considering this, we rethink the surgical instrument segmentation task and propose a one-to-many data generation solution that gets rid of the complicated and expensive process of data collection and annotation from robotic surgery. In our method, we only utilize a single surgical background tissue image and a few open-source instrument images as the seed images and apply multiple augmentations and blending techniques to synthesize amounts of image variations. In addition, we also introduce the chained augmentation mixing during training to further enhance the data diversities. The proposed approach is evaluated on the real datasets of the EndoVis-2018 and EndoVis-2017 surgical scene segmentation. Our empirical analysis suggests that without the high cost of data collection and annotation, we can achieve decent surgical instrument segmentation performance. Moreover, we also observe that our method can deal with novel instrument prediction in the deployment domain. We hope our inspiring results will encourage researchers to emphasize data-centric methods to overcome demanding deep learning limitations besides data shortage, such as class imbalance, domain adaptation, and incremental learning. Our code is available at https://github.com/lofrienger/Single_SurgicalScene_For_Segmentation.

We present a unified representation for actionable spatial perception: 3D Dynamic Scene Graphs. Scene graphs are directed graphs where nodes represent entities in the scene (e.g. objects, walls, rooms), and edges represent relations (e.g. inclusion, adjacency) among nodes. Dynamic scene graphs (DSGs) extend this notion to represent dynamic scenes with moving agents (e.g. humans, robots), and to include actionable information that supports planning and decision-making (e.g. spatio-temporal relations, topology at different levels of abstraction). Our second contribution is to provide the first fully automatic Spatial PerceptIon eNgine(SPIN) to build a DSG from visual-inertial data. We integrate state-of-the-art techniques for object and human detection and pose estimation, and we describe how to robustly infer object, robot, and human nodes in crowded scenes. To the best of our knowledge, this is the first paper that reconciles visual-inertial SLAM and dense human mesh tracking. Moreover, we provide algorithms to obtain hierarchical representations of indoor environments (e.g. places, structures, rooms) and their relations. Our third contribution is to demonstrate the proposed spatial perception engine in a photo-realistic Unity-based simulator, where we assess its robustness and expressiveness. Finally, we discuss the implications of our proposal on modern robotics applications. 3D Dynamic Scene Graphs can have a profound impact on planning and decision-making, human-robot interaction, long-term autonomy, and scene prediction. A video abstract is available at https://youtu.be/SWbofjhyPzI

We present EchoScene, an interactive and controllable generative model that generates 3D indoor scenes on scene graphs. EchoScene leverages a dual-branch diffusion model that dynamically adapts to scene graphs. Existing methods struggle to handle scene graphs due to varying numbers of nodes, multiple edge combinations, and manipulator-induced node-edge operations. EchoScene overcomes this by associating each node with a denoising process and enables collaborative information exchange, enhancing controllable and consistent generation aware of global constraints. This is achieved through an information echo scheme in both shape and layout branches. At every denoising step, all processes share their denoising data with an information exchange unit that combines these updates using graph convolution. The scheme ensures that the denoising processes are influenced by a holistic understanding of the scene graph, facilitating the generation of globally coherent scenes. The resulting scenes can be manipulated during inference by editing the input scene graph and sampling the noise in the diffusion model. Extensive experiments validate our approach, which maintains scene controllability and surpasses previous methods in generation fidelity. Moreover, the generated scenes are of high quality and thus directly compatible with off-the-shelf texture generation. Code and trained models are open-sourced.

Purpose: Accurate 3D hand pose estimation supports surgical applications such as skill assessment, robot-assisted interventions, and geometry-aware workflow analysis. However, surgical environments pose severe challenges, including intense and localized lighting, frequent occlusions by instruments or staff, and uniform hand appearance due to gloves, combined with a scarcity of annotated datasets for reliable model training. Method: We propose a robust multi-view pipeline for 3D hand pose estimation in surgical contexts that requires no domain-specific fine-tuning and relies solely on off-the-shelf pretrained models. The pipeline integrates reliable person detection, whole-body pose estimation, and state-of-the-art 2D hand keypoint prediction on tracked hand crops, followed by a constrained 3D optimization. In addition, we introduce a novel surgical benchmark dataset comprising over 68,000 frames and 3,000 manually annotated 2D hand poses with triangulated 3D ground truth, recorded in a replica operating room under varying levels of scene complexity. Results: Quantitative experiments demonstrate that our method consistently outperforms baselines, achieving a 31% reduction in 2D mean joint error and a 76% reduction in 3D mean per-joint position error. Conclusion: Our work establishes a strong baseline for 3D hand pose estimation in surgery, providing both a training-free pipeline and a comprehensive annotated dataset to facilitate future research in surgical computer vision.

Image manipulation can be considered a special case of image generation where the image to be produced is a modification of an existing image. Image generation and manipulation have been, for the most part, tasks that operate on raw pixels. However, the remarkable progress in learning rich image and object representations has opened the way for tasks such as text-to-image or layout-to-image generation that are mainly driven by semantics. In our work, we address the novel problem of image manipulation from scene graphs, in which a user can edit images by merely applying changes in the nodes or edges of a semantic graph that is generated from the image. Our goal is to encode image information in a given constellation and from there on generate new constellations, such as replacing objects or even changing relationships between objects, while respecting the semantics and style from the original image. We introduce a spatio-semantic scene graph network that does not require direct supervision for constellation changes or image edits. This makes it possible to train the system from existing real-world datasets with no additional annotation effort.

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

Graph generation is integral to various engineering and scientific disciplines. Nevertheless, existing methodologies tend to overlook the generation of edge attributes. However, we identify critical applications where edge attributes are essential, making prior methods potentially unsuitable in such contexts. Moreover, while trivial adaptations are available, empirical investigations reveal their limited efficacy as they do not properly model the interplay among graph components. To address this, we propose a joint score-based model of nodes and edges for graph generation that considers all graph components. Our approach offers two key novelties: (i) node and edge attributes are combined in an attention module that generates samples based on the two ingredients; and (ii) node, edge and adjacency information are mutually dependent during the graph diffusion process. We evaluate our method on challenging benchmarks involving real-world and synthetic datasets in which edge features are crucial. Additionally, we introduce a new synthetic dataset that incorporates edge values. Furthermore, we propose a novel application that greatly benefits from the method due to its nature: the generation of traffic scenes represented as graphs. Our method outperforms other graph generation methods, demonstrating a significant advantage in edge-related measures.

Scene graph generation (SGG) aims to predict graph-structured descriptions of input images, in the form of objects and relationships between them. This task is becoming increasingly useful for progress at the interface of vision and language. Here, it is important - yet challenging - to perform well on novel (zero-shot) or rare (few-shot) compositions of objects and relationships. In this paper, we identify two key issues that limit such generalization. Firstly, we show that the standard loss used in this task is unintentionally a function of scene graph density. This leads to the neglect of individual edges in large sparse graphs during training, even though these contain diverse few-shot examples that are important for generalization. Secondly, the frequency of relationships can create a strong bias in this task, such that a blind model predicting the most frequent relationship achieves good performance. Consequently, some state-of-the-art models exploit this bias to improve results. We show that such models can suffer the most in their ability to generalize to rare compositions, evaluating two different models on the Visual Genome dataset and its more recent, improved version, GQA. To address these issues, we introduce a density-normalized edge loss, which provides more than a two-fold improvement in certain generalization metrics. Compared to other works in this direction, our enhancements require only a few lines of code and no added computational cost. We also highlight the difficulty of accurately evaluating models using existing metrics, especially on zero/few shots, and introduce a novel weighted metric.

Scene Graph Generation (SGG) converts visual scenes into structured graph representations, providing deeper scene understanding for complex vision tasks. However, existing SGG models often overlook essential spatial relationships and struggle with generalization in open-vocabulary contexts. To address these limitations, we propose LLaVA-SpaceSGG, a multimodal large language model (MLLM) designed for open-vocabulary SGG with enhanced spatial relation modeling. To train it, we collect the SGG instruction-tuning dataset, named SpaceSGG. This dataset is constructed by combining publicly available datasets and synthesizing data using open-source models within our data construction pipeline. It combines object locations, object relations, and depth information, resulting in three data formats: spatial SGG description, question-answering, and conversation. To enhance the transfer of MLLMs' inherent capabilities to the SGG task, we introduce a two-stage training paradigm. Experiments show that LLaVA-SpaceSGG outperforms other open-vocabulary SGG methods, boosting recall by 8.6% and mean recall by 28.4% compared to the baseline. Our codebase, dataset, and trained models are publicly accessible on GitHub at the following URL: https://github.com/Endlinc/LLaVA-SpaceSGG.

Integration of Vision-Language Models (VLMs) in surgical intelligence is hindered by hallucinations, domain knowledge gaps, and limited understanding of task interdependencies within surgical scenes, undermining clinical reliability. While recent VLMs demonstrate strong general reasoning and thinking capabilities, they still lack the domain expertise and task-awareness required for precise surgical scene interpretation. Although Chain-of-Thought (CoT) can structure reasoning more effectively, current approaches rely on self-generated CoT steps, which often exacerbate inherent domain gaps and hallucinations. To overcome this, we present SurgRAW, a CoT-driven multi-agent framework that delivers transparent, interpretable insights for most tasks in robotic-assisted surgery. By employing specialized CoT prompts across five tasks: instrument recognition, action recognition, action prediction, patient data extraction, and outcome assessment, SurgRAW mitigates hallucinations through structured, domain-aware reasoning. Retrieval-Augmented Generation (RAG) is also integrated to external medical knowledge to bridge domain gaps and improve response reliability. Most importantly, a hierarchical agentic system ensures that CoT-embedded VLM agents collaborate effectively while understanding task interdependencies, with a panel discussion mechanism promotes logical consistency. To evaluate our method, we introduce SurgCoTBench, the first reasoning-based dataset with structured frame-level annotations. With comprehensive experiments, we demonstrate the effectiveness of proposed SurgRAW with 29.32% accuracy improvement over baseline VLMs on 12 robotic procedures, achieving the state-of-the-art performance and advancing explainable, trustworthy, and autonomous surgical assistance.

Surgical robotics holds much promise for improving patient safety and clinician experience in the Operating Room (OR). However, it also comes with new challenges, requiring strong team coordination and effective OR management. Automatic detection of surgical activities is a key requirement for developing AI-based intelligent tools to tackle these challenges. The current state-of-the-art surgical activity recognition methods however operate on image-based representations and depend on large-scale labeled datasets whose collection is time-consuming and resource-expensive. This work proposes a new sample-efficient and object-based approach for surgical activity recognition in the OR. Our method focuses on the geometric arrangements between clinicians and surgical devices, thus utilizing the significant object interaction dynamics in the OR. We conduct experiments in a low-data regime study for long video activity recognition. We also benchmark our method againstother object-centric approaches on clip-level action classification and show superior performance.

Conversation agents powered by large language models are revolutionizing the way we interact with visual data. Recently, large vision-language models (LVLMs) have been extensively studied for both images and videos. However, these studies typically focus on common scenarios. In this work, we introduce an LVLM specifically designed for surgical scenarios. We integrate visual representations of surgical images and videos into the language feature space. Consequently, we establish a LVLM model, Surgical-LLaVA, fine-tuned on instruction following data of surgical scenarios. Our experiments demonstrate that Surgical-LLaVA exhibits impressive multi-modal chat abilities in surgical contexts, occasionally displaying multi-modal behaviors on unseen instructions. We conduct a quantitative evaluation of visual question-answering datasets for surgical scenarios. The results show superior performance compared to previous works, indicating the potential of our model to tackle more complex surgery scenarios.

We introduce the task of predicting functional 3D scene graphs for real-world indoor environments from posed RGB-D images. Unlike traditional 3D scene graphs that focus on spatial relationships of objects, functional 3D scene graphs capture objects, interactive elements, and their functional relationships. Due to the lack of training data, we leverage foundation models, including visual language models (VLMs) and large language models (LLMs), to encode functional knowledge. We evaluate our approach on an extended SceneFun3D dataset and a newly collected dataset, FunGraph3D, both annotated with functional 3D scene graphs. Our method significantly outperforms adapted baselines, including Open3DSG and ConceptGraph, demonstrating its effectiveness in modeling complex scene functionalities. We also demonstrate downstream applications such as 3D question answering and robotic manipulation using functional 3D scene graphs. See our project page at https://openfungraph.github.io

Dynamic reconstruction of deformable tissues in endoscopic video is a key technology for robot-assisted surgery. Recent reconstruction methods based on neural radiance fields (NeRFs) have achieved remarkable results in the reconstruction of surgical scenes. However, based on implicit representation, NeRFs struggle to capture the intricate details of objects in the scene and cannot achieve real-time rendering. In addition, restricted single view perception and occluded instruments also propose special challenges in surgical scene reconstruction. To address these issues, we develop SurgicalGaussian, a deformable 3D Gaussian Splatting method to model dynamic surgical scenes. Our approach models the spatio-temporal features of soft tissues at each time stamp via a forward-mapping deformation MLP and regularization to constrain local 3D Gaussians to comply with consistent movement. With the depth initialization strategy and tool mask-guided training, our method can remove surgical instruments and reconstruct high-fidelity surgical scenes. Through experiments on various surgical videos, our network outperforms existing method on many aspects, including rendering quality, rendering speed and GPU usage. The project page can be found at https://surgicalgaussian.github.io.

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

This paper explores the task of radiology report generation, which aims at generating free-text descriptions for a set of radiographs. One significant challenge of this task is how to correctly maintain the consistency between the images and the lengthy report. Previous research explored solving this issue through planning-based methods, which generate reports only based on high-level plans. However, these plans usually only contain the major observations from the radiographs (e.g., lung opacity), lacking much necessary information, such as the observation characteristics and preliminary clinical diagnoses. To address this problem, the system should also take the image information into account together with the textual plan and perform stronger reasoning during the generation process. In this paper, we propose an observation-guided radiology report generation framework (ORGAN). It first produces an observation plan and then feeds both the plan and radiographs for report generation, where an observation graph and a tree reasoning mechanism are adopted to precisely enrich the plan information by capturing the multi-formats of each observation. Experimental results demonstrate that our framework outperforms previous state-of-the-art methods regarding text quality and clinical efficacy

We introduce a method for the generation of images from an input scene graph. The method separates between a layout embedding and an appearance embedding. The dual embedding leads to generated images that better match the scene graph, have higher visual quality, and support more complex scene graphs. In addition, the embedding scheme supports multiple and diverse output images per scene graph, which can be further controlled by the user. We demonstrate two modes of per-object control: (i) importing elements from other images, and (ii) navigation in the object space, by selecting an appearance archetype. Our code is publicly available at https://www.github.com/ashual/scene_generation

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

Panoptic Scene Graph generation (PSG) is a recently proposed task in image scene understanding that aims to segment the image and extract triplets of subjects, objects and their relations to build a scene graph. This task is particularly challenging for two reasons. First, it suffers from a long-tail problem in its relation categories, making naive biased methods more inclined to high-frequency relations. Existing unbiased methods tackle the long-tail problem by data/loss rebalancing to favor low-frequency relations. Second, a subject-object pair can have two or more semantically overlapping relations. While existing methods favor one over the other, our proposed HiLo framework lets different network branches specialize on low and high frequency relations, enforce their consistency and fuse the results. To the best of our knowledge we are the first to propose an explicitly unbiased PSG method. In extensive experiments we show that our HiLo framework achieves state-of-the-art results on the PSG task. We also apply our method to the Scene Graph Generation task that predicts boxes instead of masks and see improvements over all baseline methods. Code is available at https://github.com/franciszzj/HiLo.

Medical video generation has transformative potential for enhancing surgical understanding and pathology insights through precise and controllable visual representations. However, current models face limitations in controllability and authenticity. To bridge this gap, we propose SurgSora, a motion-controllable surgical video generation framework that uses a single input frame and user-controllable motion cues. SurgSora consists of three key modules: the Dual Semantic Injector (DSI), which extracts object-relevant RGB and depth features from the input frame and integrates them with segmentation cues to capture detailed spatial features of complex anatomical structures; the Decoupled Flow Mapper (DFM), which fuses optical flow with semantic-RGB-D features at multiple scales to enhance temporal understanding and object spatial dynamics; and the Trajectory Controller (TC), which allows users to specify motion directions and estimates sparse optical flow, guiding the video generation process. The fused features are used as conditions for a frozen Stable Diffusion model to produce realistic, temporally coherent surgical videos. Extensive evaluations demonstrate that SurgSora outperforms state-of-the-art methods in controllability and authenticity, showing its potential to advance surgical video generation for medical education, training, and research.

Recent advances in multimodal large language models (LLMs) have highlighted their potential for medical and surgical applications. However, existing surgical datasets predominantly adopt a Visual Question Answering (VQA) format with heterogeneous taxonomies and lack support for pixel-level segmentation, limiting consistent evaluation and applicability. We present SurgMLLMBench, a unified multimodal benchmark explicitly designed for developing and evaluating interactive multimodal LLMs for surgical scene understanding, including the newly collected Micro-surgical Artificial Vascular anastomosIS (MAVIS) dataset. It integrates pixel-level instrument segmentation masks and structured VQA annotations across laparoscopic, robot-assisted, and micro-surgical domains under a unified taxonomy, enabling comprehensive evaluation beyond traditional VQA tasks and richer visual-conversational interactions. Extensive baseline experiments show that a single model trained on SurgMLLMBench achieves consistent performance across domains and generalizes effectively to unseen datasets. SurgMLLMBench will be publicly released as a robust resource to advance multimodal surgical AI research, supporting reproducible evaluation and development of interactive surgical reasoning models.

Scene Graph Generation(SGG) is a scene understanding task that aims at identifying object entities and reasoning their relationships within a given image. In contrast to prevailing two-stage methods based on a large object detector (e.g., Faster R-CNN), one-stage methods integrate a fixed-size set of learnable queries to jointly reason relational triplets <subject, predicate, object>. This paradigm demonstrates robust performance with significantly reduced parameters and computational overhead. However, the challenge in one-stage methods stems from the issue of weak entanglement, wherein entities involved in relationships require both coupled features shared within triplets and decoupled visual features. Previous methods either adopt a single decoder for coupled triplet feature modeling or multiple decoders for separate visual feature extraction but fail to consider both. In this paper, we introduce UniQ, a Unified decoder with task-specific Queries architecture, where task-specific queries generate decoupled visual features for subjects, objects, and predicates respectively, and unified decoder enables coupled feature modeling within relational triplets. Experimental results on the Visual Genome dataset demonstrate that UniQ has superior performance to both one-stage and two-stage methods.

Existing research addresses scene graph generation (SGG) -- a critical technology for scene understanding in images -- from a detection perspective, i.e., objects are detected using bounding boxes followed by prediction of their pairwise relationships. We argue that such a paradigm causes several problems that impede the progress of the field. For instance, bounding box-based labels in current datasets usually contain redundant classes like hairs, and leave out background information that is crucial to the understanding of context. In this work, we introduce panoptic scene graph generation (PSG), a new problem task that requires the model to generate a more comprehensive scene graph representation based on panoptic segmentations rather than rigid bounding boxes. A high-quality PSG dataset, which contains 49k well-annotated overlapping images from COCO and Visual Genome, is created for the community to keep track of its progress. For benchmarking, we build four two-stage baselines, which are modified from classic methods in SGG, and two one-stage baselines called PSGTR and PSGFormer, which are based on the efficient Transformer-based detector, i.e., DETR. While PSGTR uses a set of queries to directly learn triplets, PSGFormer separately models the objects and relations in the form of queries from two Transformer decoders, followed by a prompting-like relation-object matching mechanism. In the end, we share insights on open challenges and future directions.

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.

Inferring objects and their relationships from an image in the form of a scene graph is useful in many applications at the intersection of vision and language. We consider a challenging problem of compositional generalization that emerges in this task due to a long tail data distribution. Current scene graph generation models are trained on a tiny fraction of the distribution corresponding to the most frequent compositions, e.g. <cup, on, table>. However, test images might contain zero- and few-shot compositions of objects and relationships, e.g. <cup, on, surfboard>. Despite each of the object categories and the predicate (e.g. 'on') being frequent in the training data, the models often fail to properly understand such unseen or rare compositions. To improve generalization, it is natural to attempt increasing the diversity of the training distribution. However, in the graph domain this is non-trivial. To that end, we propose a method to synthesize rare yet plausible scene graphs by perturbing real ones. We then propose and empirically study a model based on conditional generative adversarial networks (GANs) that allows us to generate visual features of perturbed scene graphs and learn from them in a joint fashion. When evaluated on the Visual Genome dataset, our approach yields marginal, but consistent improvements in zero- and few-shot metrics. We analyze the limitations of our approach indicating promising directions for future research.

Building 3D scene graphs has recently emerged as a topic in scene representation for several embodied AI applications to represent the world in a structured and rich manner. With their increased use in solving downstream tasks (eg, navigation and room rearrangement), can we leverage and recycle them for creating 3D maps of environments, a pivotal step in agent operation? We focus on the fundamental problem of aligning pairs of 3D scene graphs whose overlap can range from zero to partial and can contain arbitrary changes. We propose SGAligner, the first method for aligning pairs of 3D scene graphs that is robust to in-the-wild scenarios (ie, unknown overlap -- if any -- and changes in the environment). We get inspired by multi-modality knowledge graphs and use contrastive learning to learn a joint, multi-modal embedding space. We evaluate on the 3RScan dataset and further showcase that our method can be used for estimating the transformation between pairs of 3D scenes. Since benchmarks for these tasks are missing, we create them on this dataset. The code, benchmark, and trained models are available on the project website.

Understanding the workflow of surgical procedures in complex operating rooms requires a deep understanding of the interactions between clinicians and their environment. Surgical activity recognition (SAR) is a key computer vision task that detects activities or phases from multi-view camera recordings. Existing SAR models often fail to account for fine-grained clinician movements and multi-view knowledge, or they require calibrated multi-view camera setups and advanced point-cloud processing to obtain better results. In this work, we propose a novel calibration-free multi-view multi-modal pretraining framework called Multiview Pretraining for Video-Pose Surgical Activity Recognition PreViPS, which aligns 2D pose and vision embeddings across camera views. Our model follows CLIP-style dual-encoder architecture: one encoder processes visual features, while the other encodes human pose embeddings. To handle the continuous 2D human pose coordinates, we introduce a tokenized discrete representation to convert the continuous 2D pose coordinates into discrete pose embeddings, thereby enabling efficient integration within the dual-encoder framework. To bridge the gap between these two modalities, we propose several pretraining objectives using cross- and in-modality geometric constraints within the embedding space and incorporating masked pose token prediction strategy to enhance representation learning. Extensive experiments and ablation studies demonstrate improvements over the strong baselines, while data-efficiency experiments on two distinct operating room datasets further highlight the effectiveness of our approach. We highlight the benefits of our approach for surgical activity recognition in both multi-view and single-view settings, showcasing its practical applicability in complex surgical environments. Code will be made available at: https://github.com/CAMMA-public/PreViPS.

Continuum robots are advancing bronchoscopy procedures by accessing complex lung airways and enabling targeted interventions. However, their development is limited by the lack of realistic training and test environments: Real data is difficult to collect due to ethical constraints and patient safety concerns, and developing autonomy algorithms requires realistic imaging and physical feedback. We present ROOM (Realistic Optical Observation in Medicine), a comprehensive simulation framework designed for generating photorealistic bronchoscopy training data. By leveraging patient CT scans, our pipeline renders multi-modal sensor data including RGB images with realistic noise and light specularities, metric depth maps, surface normals, optical flow and point clouds at medically relevant scales. We validate the data generated by ROOM in two canonical tasks for medical robotics -- multi-view pose estimation and monocular depth estimation, demonstrating diverse challenges that state-of-the-art methods must overcome to transfer to these medical settings. Furthermore, we show that the data produced by ROOM can be used to fine-tune existing depth estimation models to overcome these challenges, also enabling other downstream applications such as navigation. We expect that ROOM will enable large-scale data generation across diverse patient anatomies and procedural scenarios that are challenging to capture in clinical settings. Code and data: https://github.com/iamsalvatore/room.

Generating 3D scenes from natural language holds great promise for applications in gaming, film, and design. However, existing methods struggle with automation, 3D consistency, and fine-grained control. We present DreamScene, an end-to-end framework for high-quality and editable 3D scene generation from text or dialogue. DreamScene begins with a scene planning module, where a GPT-4 agent infers object semantics and spatial constraints to construct a hybrid graph. A graph-based placement algorithm then produces a structured, collision-free layout. Based on this layout, Formation Pattern Sampling (FPS) generates object geometry using multi-timestep sampling and reconstructive optimization, enabling fast and realistic synthesis. To ensure global consistent, DreamScene employs a progressive camera sampling strategy tailored to both indoor and outdoor settings. Finally, the system supports fine-grained scene editing, including object movement, appearance changes, and 4D dynamic motion. Experiments demonstrate that DreamScene surpasses prior methods in quality, consistency, and flexibility, offering a practical solution for open-domain 3D content creation. Code and demos are available at https://jahnsonblack.github.io/DreamScene-Full/.

In recent years, the landscape of computer-assisted interventions and post-operative surgical video analysis has been dramatically reshaped by deep-learning techniques, resulting in significant advancements in surgeons' skills, operation room management, and overall surgical outcomes. However, the progression of deep-learning-powered surgical technologies is profoundly reliant on large-scale datasets and annotations. Particularly, surgical scene understanding and phase recognition stand as pivotal pillars within the realm of computer-assisted surgery and post-operative assessment of cataract surgery videos. In this context, we present the largest cataract surgery video dataset that addresses diverse requisites for constructing computerized surgical workflow analysis and detecting post-operative irregularities in cataract surgery. We validate the quality of annotations by benchmarking the performance of several state-of-the-art neural network architectures for phase recognition and surgical scene segmentation. Besides, we initiate the research on domain adaptation for instrument segmentation in cataract surgery by evaluating cross-domain instrument segmentation performance in cataract surgery videos. The dataset and annotations will be publicly available upon acceptance of the paper.

Three-dimensional scene generation is crucial in computer vision, with applications spanning autonomous driving, gaming and the metaverse. Current methods either lack user control or rely on imprecise, non-intuitive conditions. In this work, we propose a method that uses, scene graphs, an accessible, user friendly control format to generate outdoor 3D scenes. We develop an interactive system that transforms a sparse scene graph into a dense BEV (Bird's Eye View) Embedding Map, which guides a conditional diffusion model to generate 3D scenes that match the scene graph description. During inference, users can easily create or modify scene graphs to generate large-scale outdoor scenes. We create a large-scale dataset with paired scene graphs and 3D semantic scenes to train the BEV embedding and diffusion models. Experimental results show that our approach consistently produces high-quality 3D urban scenes closely aligned with the input scene graphs. To the best of our knowledge, this is the first approach to generate 3D outdoor scenes conditioned on scene graphs.

In this work, we seek new insights into the underlying challenges of the Scene Graph Generation (SGG) task. Quantitative and qualitative analysis of the Visual Genome dataset implies -- 1) Ambiguity: even if inter-object relationship contains the same object (or predicate), they may not be visually or semantically similar, 2) Asymmetry: despite the nature of the relationship that embodied the direction, it was not well addressed in previous studies, and 3) Higher-order contexts: leveraging the identities of certain graph elements can help to generate accurate scene graphs. Motivated by the analysis, we design a novel SGG framework, Local-to-Global Interaction Networks (LOGIN). Locally, interactions extract the essence between three instances of subject, object, and background, while baking direction awareness into the network by explicitly constraining the input order of subject and object. Globally, interactions encode the contexts between every graph component (i.e., nodes and edges). Finally, Attract & Repel loss is utilized to fine-tune the distribution of predicate embeddings. By design, our framework enables predicting the scene graph in a bottom-up manner, leveraging the possible complementariness. To quantify how much LOGIN is aware of relational direction, a new diagnostic task called Bidirectional Relationship Classification (BRC) is also proposed. Experimental results demonstrate that LOGIN can successfully distinguish relational direction than existing methods (in BRC task), while showing state-of-the-art results on the Visual Genome benchmark (in SGG task).

Understanding and reasoning about complex 3D environments requires structured scene representations that capture not only objects but also their semantic and spatial relationships. While recent works on 3D scene graph generation have leveraged pretrained VLMs without task-specific fine-tuning, they are largely confined to single-view settings, fail to support incremental updates as new observations arrive and lack explicit geometric grounding in 3D space, all of which are essential for embodied scenarios. In this paper, we propose, ZING-3D, a framework that leverages the vast knowledge of pretrained foundation models to enable open-vocabulary recognition and generate a rich semantic representation of the scene in a zero-shot manner while also enabling incremental updates and geometric grounding in 3D space, making it suitable for downstream robotics applications. Our approach leverages VLM reasoning to generate a rich 2D scene graph, which is grounded in 3D using depth information. Nodes represent open-vocabulary objects with features, 3D locations, and semantic context, while edges capture spatial and semantic relations with inter-object distances. Our experiments on scenes from the Replica and HM3D dataset show that ZING-3D is effective at capturing spatial and relational knowledge without the need of task-specific training.

Scene Graph Generation (SGG) aims to extract <subject, predicate, object> relationships in images for vision understanding. Although recent works have made steady progress on SGG, they still suffer long-tail distribution issues that tail-predicates are more costly to train and hard to distinguish due to a small amount of annotated data compared to frequent predicates. Existing re-balancing strategies try to handle it via prior rules but are still confined to pre-defined conditions, which are not scalable for various models and datasets. In this paper, we propose a Cross-modal prediCate boosting (CaCao) framework, where a visually-prompted language model is learned to generate diverse fine-grained predicates in a low-resource way. The proposed CaCao can be applied in a plug-and-play fashion and automatically strengthen existing SGG to tackle the long-tailed problem. Based on that, we further introduce a novel Entangled cross-modal prompt approach for open-world predicate scene graph generation (Epic), where models can generalize to unseen predicates in a zero-shot manner. Comprehensive experiments on three benchmark datasets show that CaCao consistently boosts the performance of multiple scene graph generation models in a model-agnostic way. Moreover, our Epic achieves competitive performance on open-world predicate prediction. The data and code for this paper are publicly available.

Over the past decade, computer vision applications in minimally invasive surgery have rapidly increased. Despite this growth, the impact of surgical computer vision remains limited compared to other medical fields like pathology and radiology, primarily due to the scarcity of representative annotated data. Whereas transfer learning from large annotated datasets such as ImageNet has been conventionally the norm to achieve high-performing models, recent advancements in self-supervised learning (SSL) have demonstrated superior performance. In medical image analysis, in-domain SSL pretraining has already been shown to outperform ImageNet-based initialization. Although unlabeled data in the field of surgical computer vision is abundant, the diversity within this data is limited. This study investigates the role of dataset diversity in SSL for surgical computer vision, comparing procedure-specific datasets against a more heterogeneous general surgical dataset across three different downstream surgical applications. The obtained results show that using solely procedure-specific data can lead to substantial improvements of 13.8%, 9.5%, and 36.8% compared to ImageNet pretraining. However, extending this data with more heterogeneous surgical data further increases performance by an additional 5.0%, 5.2%, and 2.5%, suggesting that increasing diversity within SSL data is beneficial for model performance. The code and pretrained model weights are made publicly available at https://github.com/TimJaspers0801/SurgeNet.

We introduce the Scene Language, a visual scene representation that concisely and precisely describes the structure, semantics, and identity of visual scenes. It represents a scene with three key components: a program that specifies the hierarchical and relational structure of entities in the scene, words in natural language that summarize the semantic class of each entity, and embeddings that capture the visual identity of each entity. This representation can be inferred from pre-trained language models via a training-free inference technique, given text or image inputs. The resulting scene can be rendered into images using traditional, neural, or hybrid graphics renderers. Together, this forms a robust, automated system for high-quality 3D and 4D scene generation. Compared with existing representations like scene graphs, our proposed Scene Language generates complex scenes with higher fidelity, while explicitly modeling the scene structures to enable precise control and editing.

As pretrained text-to-image diffusion models become increasingly powerful, recent efforts have been made to distill knowledge from these text-to-image pretrained models for optimizing a text-guided 3D model. Most of the existing methods generate a holistic 3D model from a plain text input. This can be problematic when the text describes a complex scene with multiple objects, because the vectorized text embeddings are inherently unable to capture a complex description with multiple entities and relationships. Holistic 3D modeling of the entire scene further prevents accurate grounding of text entities and concepts. To address this limitation, we propose GraphDreamer, a novel framework to generate compositional 3D scenes from scene graphs, where objects are represented as nodes and their interactions as edges. By exploiting node and edge information in scene graphs, our method makes better use of the pretrained text-to-image diffusion model and is able to fully disentangle different objects without image-level supervision. To facilitate modeling of object-wise relationships, we use signed distance fields as representation and impose a constraint to avoid inter-penetration of objects. To avoid manual scene graph creation, we design a text prompt for ChatGPT to generate scene graphs based on text inputs. We conduct both qualitative and quantitative experiments to validate the effectiveness of GraphDreamer in generating high-fidelity compositional 3D scenes with disentangled object entities.

Advancements in computer-assisted surgical procedures heavily rely on accurate visual data interpretation from camera systems used during surgeries. Traditional open-access datasets focusing on surgical procedures are often limited by their small size, typically consisting of fewer than 100 videos with less than 100K images. To address these constraints, a new dataset called Surg-3M has been compiled using a novel aggregation pipeline that collects high-resolution videos from online sources. Featuring an extensive collection of over 4K surgical videos and more than 3 million high-quality images from multiple procedure types, Surg-3M offers a comprehensive resource surpassing existing alternatives in size and scope, including two novel tasks. To demonstrate the effectiveness of this dataset, we present SurgFM, a self-supervised foundation model pretrained on Surg-3M that achieves impressive results in downstream tasks such as surgical phase recognition, action recognition, and tool presence detection. Combining key components from ConvNeXt, DINO, and an innovative augmented distillation method, SurgFM exhibits exceptional performance compared to specialist architectures across various benchmarks. Our experimental results show that SurgFM outperforms state-of-the-art models in multiple downstream tasks, including significant gains in surgical phase recognition (+8.9pp, +4.7pp, and +3.9pp of Jaccard in AutoLaparo, M2CAI16, and Cholec80), action recognition (+3.1pp of mAP in CholecT50) and tool presence detection (+4.6pp of mAP in Cholec80). Moreover, even when using only half of the data, SurgFM outperforms state-of-the-art models in AutoLaparo and achieves state-of-the-art performance in Cholec80. Both Surg-3M and SurgFM have significant potential to accelerate progress towards developing autonomous robotic surgery systems.

Segmentation of surgical instruments is crucial for enhancing surgeon performance and ensuring patient safety. Conventional techniques such as binary, semantic, and instance segmentation share a common drawback: they do not accommodate the parts of instruments obscured by tissues or other instruments. Precisely predicting the full extent of these occluded instruments can significantly improve laparoscopic surgeries by providing critical guidance during operations and assisting in the analysis of potential surgical errors, as well as serving educational purposes. In this paper, we introduce Amodal Segmentation to the realm of surgical instruments in the medical field. This technique identifies both the visible and occluded parts of an object. To achieve this, we introduce a new Amoal Instruments Segmentation (AIS) dataset, which was developed by reannotating each instrument with its complete mask, utilizing the 2017 MICCAI EndoVis Robotic Instrument Segmentation Challenge dataset. Additionally, we evaluate several leading amodal segmentation methods to establish a benchmark for this new dataset.

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

The scene graph generation (SGG) task involves detecting objects within an image and predicting predicates that represent the relationships between the objects. However, in SGG benchmark datasets, each subject-object pair is annotated with a single predicate even though a single predicate may exhibit diverse semantics (i.e., semantic diversity), existing SGG models are trained to predict the one and only predicate for each pair. This in turn results in the SGG models to overlook the semantic diversity that may exist in a predicate, thus leading to biased predictions. In this paper, we propose a novel model-agnostic Semantic Diversity-aware Prototype-based Learning (DPL) framework that enables unbiased predictions based on the understanding of the semantic diversity of predicates. Specifically, DPL learns the regions in the semantic space covered by each predicate to distinguish among the various different semantics that a single predicate can represent. Extensive experiments demonstrate that our proposed model-agnostic DPL framework brings significant performance improvement on existing SGG models, and also effectively understands the semantic diversity of predicates.

Generating artistic and coherent 3D scene layouts is crucial in digital content creation. Traditional optimization-based methods are often constrained by cumbersome manual rules, while deep generative models face challenges in producing content with richness and diversity. Furthermore, approaches that utilize large language models frequently lack robustness and fail to accurately capture complex spatial relationships. To address these challenges, this paper presents a novel vision-guided 3D layout generation system. We first construct a high-quality asset library containing 2,037 scene assets and 147 3D scene layouts. Subsequently, we employ an image generation model to expand prompt representations into images, fine-tuning it to align with our asset library. We then develop a robust image parsing module to recover the 3D layout of scenes based on visual semantics and geometric information. Finally, we optimize the scene layout using scene graphs and overall visual semantics to ensure logical coherence and alignment with the images. Extensive user testing demonstrates that our algorithm significantly outperforms existing methods in terms of layout richness and quality. The code and dataset will be available at https://github.com/HiHiAllen/Imaginarium.

A proper scene representation is central to the pursuit of spatial intelligence where agents can robustly reconstruct and efficiently understand 3D scenes. A scene representation is either metric, such as landmark maps in 3D reconstruction, 3D bounding boxes in object detection, or voxel grids in occupancy prediction, or topological, such as pose graphs with loop closures in SLAM or visibility graphs in SfM. In this work, we propose to build Multiview Scene Graphs (MSG) from unposed images, representing a scene topologically with interconnected place and object nodes. The task of building MSG is challenging for existing representation learning methods since it needs to jointly address both visual place recognition, object detection, and object association from images with limited fields of view and potentially large viewpoint changes. To evaluate any method tackling this task, we developed an MSG dataset and annotation based on a public 3D dataset. We also propose an evaluation metric based on the intersection-over-union score of MSG edges. Moreover, we develop a novel baseline method built on mainstream pretrained vision models, combining visual place recognition and object association into one Transformer decoder architecture. Experiments demonstrate our method has superior performance compared to existing relevant baselines.

In the realm of robot-assisted minimally invasive surgery, dynamic scene reconstruction can significantly enhance downstream tasks and improve surgical outcomes. Neural Radiance Fields (NeRF)-based methods have recently risen to prominence for their exceptional ability to reconstruct scenes but are hampered by slow inference speed, prolonged training, and inconsistent depth estimation. Some previous work utilizes ground truth depth for optimization but is hard to acquire in the surgical domain. To overcome these obstacles, we present Endo-4DGS, a real-time endoscopic dynamic reconstruction approach that utilizes 3D Gaussian Splatting (GS) for 3D representation. Specifically, we propose lightweight MLPs to capture temporal dynamics with Gaussian deformation fields. To obtain a satisfactory Gaussian Initialization, we exploit a powerful depth estimation foundation model, Depth-Anything, to generate pseudo-depth maps as a geometry prior. We additionally propose confidence-guided learning to tackle the ill-pose problems in monocular depth estimation and enhance the depth-guided reconstruction with surface normal constraints and depth regularization. Our approach has been validated on two surgical datasets, where it can effectively render in real-time, compute efficiently, and reconstruct with remarkable accuracy.

Surgery video segmentation is an important topic in the surgical AI field. It allows the AI model to understand the spatial information of a surgical scene. Meanwhile, due to the lack of annotated surgical data, surgery segmentation models suffer from limited performance. With the emergence of SAM2 model, a large foundation model for video segmentation trained on natural videos, zero-shot surgical video segmentation became more realistic but meanwhile remains to be explored. In this paper, we systematically evaluate the performance of SAM2 model in zero-shot surgery video segmentation task. We conducted experiments under different configurations, including different prompting strategies, robustness, etc. Moreover, we conducted an empirical evaluation over the performance, including 9 datasets with 17 different types of surgeries.

Accurately predicting the criticalness of ICU patients (such as in-ICU mortality risk) is vital for early intervention in critical care. However, conventional models often treat each patient in isolation and struggle to exploit the relational structure in Electronic Health Records (EHR). We propose a Similarity-Based Self-Construct Graph Model (SBSCGM) that dynamically builds a patient similarity graph from multi-modal EHR data, and a HybridGraphMedGNN architecture that operates on this graph to predict patient mortality and a continuous criticalness score. SBSCGM uses a hybrid similarity measure (combining feature-based and structural similarities) to connect patients with analogous clinical profiles in real-time. The HybridGraphMedGNN integrates Graph Convolutional Network (GCN), GraphSAGE, and Graph Attention Network (GAT) layers to learn robust patient representations, leveraging both local and global graph patterns. In experiments on 6,000 ICU stays from the MIMIC-III dataset, our model achieves state-of-the-art performance (AUC-ROC 0.94) outperforming baseline classifiers and single-type GNN models. We also demonstrate improved precision/recall and show that the attention mechanism provides interpretable insights into model predictions. Our framework offers a scalable and interpretable solution for critical care risk prediction, with potential to support clinicians in real-world ICU deployment.

Most benchmarks for studying surgical interventions focus on a specific challenge instead of leveraging the intrinsic complementarity among different tasks. In this work, we present a new experimental framework towards holistic surgical scene understanding. First, we introduce the Phase, Step, Instrument, and Atomic Visual Action recognition (PSI-AVA) Dataset. PSI-AVA includes annotations for both long-term (Phase and Step recognition) and short-term reasoning (Instrument detection and novel Atomic Action recognition) in robot-assisted radical prostatectomy videos. Second, we present Transformers for Action, Phase, Instrument, and steps Recognition (TAPIR) as a strong baseline for surgical scene understanding. TAPIR leverages our dataset's multi-level annotations as it benefits from the learned representation on the instrument detection task to improve its classification capacity. Our experimental results in both PSI-AVA and other publicly available databases demonstrate the adequacy of our framework to spur future research on holistic surgical scene understanding.

We introduce a novel problem, i.e., the localization of an input image within a multi-modal reference map represented by a database of 3D scene graphs. These graphs comprise multiple modalities, including object-level point clouds, images, attributes, and relationships between objects, offering a lightweight and efficient alternative to conventional methods that rely on extensive image databases. Given the available modalities, the proposed method SceneGraphLoc learns a fixed-sized embedding for each node (i.e., representing an object instance) in the scene graph, enabling effective matching with the objects visible in the input query image. This strategy significantly outperforms other cross-modal methods, even without incorporating images into the map embeddings. When images are leveraged, SceneGraphLoc achieves performance close to that of state-of-the-art techniques depending on large image databases, while requiring three orders-of-magnitude less storage and operating orders-of-magnitude faster. The code will be made public.

The ability to abstract complex 3D environments into simplified and structured representations is crucial across various domains. 3D semantic scene graphs (SSGs) achieve this by representing objects as nodes and their interrelationships as edges, facilitating high-level scene understanding. Existing methods for 3D SSG generation, however, face significant challenges, including high computational demands and non-incremental processing that hinder their suitability for real-time open-world applications. To address this issue, we propose FROSS (Faster-than-Real-Time Online 3D Semantic Scene Graph Generation), an innovative approach for online and faster-than-real-time 3D SSG generation that leverages the direct lifting of 2D scene graphs to 3D space and represents objects as 3D Gaussian distributions. This framework eliminates the dependency on precise and computationally-intensive point cloud processing. Furthermore, we extend the Replica dataset with inter-object relationship annotations, creating the ReplicaSSG dataset for comprehensive evaluation of FROSS. The experimental results from evaluations on ReplicaSSG and 3DSSG datasets show that FROSS can achieve superior performance while operating significantly faster than prior 3D SSG generation methods. Our implementation and dataset are publicly available at https://github.com/Howardkhh/FROSS.

The field of surgical computer vision has undergone considerable breakthroughs in recent years with the rising popularity of deep neural network-based methods. However, standard fully-supervised approaches for training such models require vast amounts of annotated data, imposing a prohibitively high cost; especially in the clinical domain. Self-Supervised Learning (SSL) methods, which have begun to gain traction in the general computer vision community, represent a potential solution to these annotation costs, allowing to learn useful representations from only unlabeled data. Still, the effectiveness of SSL methods in more complex and impactful domains, such as medicine and surgery, remains limited and unexplored. In this work, we address this critical need by investigating four state-of-the-art SSL methods (MoCo v2, SimCLR, DINO, SwAV) in the context of surgical computer vision. We present an extensive analysis of the performance of these methods on the Cholec80 dataset for two fundamental and popular tasks in surgical context understanding, phase recognition and tool presence detection. We examine their parameterization, then their behavior with respect to training data quantities in semi-supervised settings. Correct transfer of these methods to surgery, as described and conducted in this work, leads to substantial performance gains over generic uses of SSL - up to 7.4% on phase recognition and 20% on tool presence detection - as well as state-of-the-art semi-supervised phase recognition approaches by up to 14%. Further results obtained on a highly diverse selection of surgical datasets exhibit strong generalization properties. The code is available at https://github.com/CAMMA-public/SelfSupSurg.

In panoptic scene graph generation (PSGG), models retrieve interactions between objects in an image which are grounded by panoptic segmentation masks. Previous evaluations on panoptic scene graphs have been subject to an erroneous evaluation protocol where multiple masks for the same object can lead to multiple relation distributions per mask-mask pair. This can be exploited to increase the final score. We correct this flaw and provide a fair ranking over a wide range of existing PSGG models. The observed scores for existing methods increase by up to 7.4 mR@50 for all two-stage methods, while dropping by up to 19.3 mR@50 for all one-stage methods, highlighting the importance of a correct evaluation. Contrary to recent publications, we show that existing two-stage methods are competitive to one-stage methods. Building on this, we introduce the Decoupled SceneFormer (DSFormer), a novel two-stage model that outperforms all existing scene graph models by a large margin of +11 mR@50 and +10 mNgR@50 on the corrected evaluation, thus setting a new SOTA. As a core design principle, DSFormer encodes subject and object masks directly into feature space.

Embodied AI agents that search for objects in large environments such as households often need to make efficient decisions by predicting object locations based on partial information. We pose this as a new type of link prediction problem: link prediction on partially observable dynamic graphs. Our graph is a representation of a scene in which rooms and objects are nodes, and their relationships are encoded in the edges; only parts of the changing graph are known to the agent at each timestep. This partial observability poses a challenge to existing link prediction approaches, which we address. We propose a novel state representation -- Scene Graph Memory (SGM) -- with captures the agent's accumulated set of observations, as well as a neural net architecture called a Node Edge Predictor (NEP) that extracts information from the SGM to search efficiently. We evaluate our method in the Dynamic House Simulator, a new benchmark that creates diverse dynamic graphs following the semantic patterns typically seen at homes, and show that NEP can be trained to predict the locations of objects in a variety of environments with diverse object movement dynamics, outperforming baselines both in terms of new scene adaptability and overall accuracy. The codebase and more can be found at https://www.scenegraphmemory.com.

Blood vessel networks in the brain play a crucial role in stroke research, where understanding their topology is essential for analyzing blood flow dynamics. However, extracting detailed topological vessel network information from microscopy data remains a significant challenge, mainly due to the scarcity of labeled training data and the need for high topological accuracy. This work combines synthetic data generation with deep learning to automatically extract vessel networks as graphs from volumetric microscopy data. To combat data scarcity, we introduce a comprehensive pipeline for generating large-scale synthetic datasets that mirror the characteristics of real vessel networks. Our three-stage approach progresses from abstract graph generation through vessel mask creation to realistic medical image synthesis, incorporating biological constraints and imaging artifacts at each stage. Using this synthetic data, we develop a two-stage deep learning pipeline of 3D U-Net-based models for node detection and edge prediction. Fine-tuning on real microscopy data shows promising adaptation, improving edge prediction F1 scores from 0.496 to 0.626 by training on merely 5 manually labeled samples. These results suggest that automated vessel network extraction is becoming practically feasible, opening new possibilities for large-scale vascular analysis in stroke research.

Scene Graph Generation (SGG) offers a structured representation critical in many computer vision applications. Traditional SGG approaches, however, are limited by a closed-set assumption, restricting their ability to recognize only predefined object and relation categories. To overcome this, we categorize SGG scenarios into four distinct settings based on the node and edge: Closed-set SGG, Open Vocabulary (object) Detection-based SGG (OvD-SGG), Open Vocabulary Relation-based SGG (OvR-SGG), and Open Vocabulary Detection + Relation-based SGG (OvD+R-SGG). While object-centric open vocabulary SGG has been studied recently, the more challenging problem of relation-involved open-vocabulary SGG remains relatively unexplored. To fill this gap, we propose a unified framework named OvSGTR towards fully open vocabulary SGG from a holistic view. The proposed framework is an end-toend transformer architecture, which learns a visual-concept alignment for both nodes and edges, enabling the model to recognize unseen categories. For the more challenging settings of relation-involved open vocabulary SGG, the proposed approach integrates relation-aware pre-training utilizing image-caption data and retains visual-concept alignment through knowledge distillation. Comprehensive experimental results on the Visual Genome benchmark demonstrate the effectiveness and superiority of the proposed framework.

Vision-language pre-training (VLP) offers unique advantages for surgery by aligning language with surgical videos, enabling workflow understanding and transfer across tasks without relying on expert-labeled datasets. However, progress in surgical VLP remains constrained by the limited scale, procedural diversity, semantic quality, and hierarchical structure of existing datasets. In this work, we present SurgLaVi, the largest and most diverse surgical vision-language dataset to date, comprising nearly 240k clip-caption pairs from more than 200 procedures, and comprising hierarchical levels at phase-, step-, and task-level. At the core of SurgLaVi lies a fully automated pipeline that systematically generates fine-grained transcriptions of surgical videos and segments them into coherent procedural units. To ensure high-quality annotations, it applies dual-modality filtering to remove irrelevant and noisy samples. Within this framework, the resulting captions are enriched with contextual detail, producing annotations that are both semantically rich and easy to interpret. To ensure accessibility, we release SurgLaVi-eta, an open-source derivative of 113k clip-caption pairs constructed entirely from public data, which is over four times larger than existing surgical VLP datasets. To demonstrate the value of SurgLaVi datasets, we introduce SurgCLIP, a CLIP-style video-text contrastive framework with dual encoders, as a representative base model. SurgCLIP achieves consistent improvements across phase, step, action, and tool recognition, surpassing prior state-of-the-art methods, often by large margins. These results validate that large-scale, semantically rich, and hierarchically structured datasets directly translate into stronger and more generalizable representations, establishing SurgLaVi as a key resource for developing surgical foundation models.

Smoke generated by surgical instruments during laparoscopic surgery can obscure the visual field, impairing surgeons' ability to perform operations accurately and safely. Thus, smoke removal task for laparoscopic images is highly desirable. Despite laparoscopic image desmoking has attracted the attention of researchers in recent years and several algorithms have emerged, the lack of publicly available high-quality benchmark datasets is the main bottleneck to hamper the development progress of this task. To advance this field, we construct a new high-quality dataset for Laparoscopic Surgery image Desmoking, named LSD3K, consisting of 3,000 paired synthetic non-homogeneous smoke images. In this paper, we provide a dataset generation pipeline, which includes modeling smoke shape using Blender, collecting ground-truth images from the Cholec80 dataset, random sampling of smoke masks and etc. Based on the proposed benchmark, we further conducted a comprehensive evaluation of the existing representative desmoking algorithms. The proposed dataset is publicly available at https://drive.google.com/file/d/1v0U5_3S4nJpaUiP898Q0pc-MfEAtnbOq/view?usp=sharing

Biological neural networks define the brain function and intelligence of humans and other mammals, and form ultra-large, spatial, structured graphs. Their neuronal organization is closely interconnected with the spatial organization of the brain's microvasculature, which supplies oxygen to the neurons and builds a complementary spatial graph. This vasculature (or the vessel structure) plays an important role in neuroscience; for example, the organization of (and changes to) vessel structure can represent early signs of various pathologies, e.g. Alzheimer's disease or stroke. Recently, advances in tissue clearing have enabled whole brain imaging and segmentation of the entirety of the mouse brain's vasculature. Building on these advances in imaging, we are presenting an extendable dataset of whole-brain vessel graphs based on specific imaging protocols. Specifically, we extract vascular graphs using a refined graph extraction scheme leveraging the volume rendering engine Voreen and provide them in an accessible and adaptable form through the OGB and PyTorch Geometric dataloaders. Moreover, we benchmark numerous state-of-the-art graph learning algorithms on the biologically relevant tasks of vessel prediction and vessel classification using the introduced vessel graph dataset. Our work paves a path towards advancing graph learning research into the field of neuroscience. Complementarily, the presented dataset raises challenging graph learning research questions for the machine learning community, in terms of incorporating biological priors into learning algorithms, or in scaling these algorithms to handle sparse,spatial graphs with millions of nodes and edges. All datasets and code are available for download at https://github.com/jocpae/VesselGraph .

Foundation models have revolutionized computer vision by achieving vastly superior performance across diverse tasks through large-scale pretraining on extensive datasets. However, their application in surgical computer vision has been limited. This study addresses this gap by introducing SurgeNetXL, a novel surgical foundation model that sets a new benchmark in surgical computer vision. Trained on the largest reported surgical dataset to date, comprising over 4.7 million video frames, SurgeNetXL achieves consistent top-tier performance across six datasets spanning four surgical procedures and three tasks, including semantic segmentation, phase recognition, and critical view of safety (CVS) classification. Compared with the best-performing surgical foundation models, SurgeNetXL shows mean improvements of 2.4, 9.0, and 12.6 percent for semantic segmentation, phase recognition, and CVS classification, respectively. Additionally, SurgeNetXL outperforms the best-performing ImageNet-based variants by 14.4, 4.0, and 1.6 percent in the respective tasks. In addition to advancing model performance, this study provides key insights into scaling pretraining datasets, extending training durations, and optimizing model architectures specifically for surgical computer vision. These findings pave the way for improved generalizability and robustness in data-scarce scenarios, offering a comprehensive framework for future research in this domain. All models and a subset of the SurgeNetXL dataset, including over 2 million video frames, are publicly available at: https://github.com/TimJaspers0801/SurgeNet.

Background: We evaluate SAM 2 for surgical scene understanding by examining its semantic segmentation capabilities for organs/tissues both in zero-shot scenarios and after fine-tuning. Methods: We utilized five public datasets to evaluate and fine-tune SAM 2 for segmenting anatomical tissues in surgical videos/images. Fine-tuning was applied to the image encoder and mask decoder. We limited training subsets from 50 to 400 samples per class to better model real-world constraints with data acquisition. The impact of dataset size on fine-tuning performance was evaluated with weighted mean Dice coefficient (WMDC), and the results were also compared against previously reported state-of-the-art (SOTA) results. Results: SurgiSAM 2, a fine-tuned SAM 2 model, demonstrated significant improvements in segmentation performance, achieving a 17.9% relative WMDC gain compared to the baseline SAM 2. Increasing prompt points from 1 to 10 and training data scale from 50/class to 400/class enhanced performance; the best WMDC of 0.92 on the validation subset was achieved with 10 prompt points and 400 samples per class. On the test subset, this model outperformed prior SOTA methods in 24/30 (80%) of the classes with a WMDC of 0.91 using 10-point prompts. Notably, SurgiSAM 2 generalized effectively to unseen organ classes, achieving SOTA on 7/9 (77.8%) of them. Conclusion: SAM 2 achieves remarkable zero-shot and fine-tuned performance for surgical scene segmentation, surpassing prior SOTA models across several organ classes of diverse datasets. This suggests immense potential for enabling automated/semi-automated annotation pipelines, thereby decreasing the burden of annotations facilitating several surgical applications.

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.

This paper aims to generate materials for 3D meshes from text descriptions. Unlike existing methods that synthesize texture maps, we propose to generate segment-wise procedural material graphs as the appearance representation, which supports high-quality rendering and provides substantial flexibility in editing. Instead of relying on extensive paired data, i.e., 3D meshes with material graphs and corresponding text descriptions, to train a material graph generative model, we propose to leverage the pre-trained 2D diffusion model as a bridge to connect the text and material graphs. Specifically, our approach decomposes a shape into a set of segments and designs a segment-controlled diffusion model to synthesize 2D images that are aligned with mesh parts. Based on generated images, we initialize parameters of material graphs and fine-tune them through the differentiable rendering module to produce materials in accordance with the textual description. Extensive experiments demonstrate the superior performance of our framework in photorealism, resolution, and editability over existing methods. Project page: https://zhanghe3z.github.io/MaPa/

Purpose: Surgical workflow analysis is crucial for improving surgical efficiency and safety. However, previous studies rely heavily on large-scale annotated datasets, posing challenges in cost, scalability, and reliance on expert annotations. To address this, we propose Surg-FTDA (Few-shot Text-driven Adaptation), designed to handle various surgical workflow analysis tasks with minimal paired image-label data. Methods: Our approach has two key components. First, Few-shot selection-based modality alignment selects a small subset of images and aligns their embeddings with text embeddings from the downstream task, bridging the modality gap. Second, Text-driven adaptation leverages only text data to train a decoder, eliminating the need for paired image-text data. This decoder is then applied to aligned image embeddings, enabling image-related tasks without explicit image-text pairs. Results: We evaluate our approach to generative tasks (image captioning) and discriminative tasks (triplet recognition and phase recognition). Results show that Surg-FTDA outperforms baselines and generalizes well across downstream tasks. Conclusion: We propose a text-driven adaptation approach that mitigates the modality gap and handles multiple downstream tasks in surgical workflow analysis, with minimal reliance on large annotated datasets. The code and dataset will be released in https://github.com/CAMMA-public/Surg-FTDA

Creating high-fidelity 3D models of indoor environments is essential for applications in design, virtual reality, and robotics. However, manual 3D modeling remains time-consuming and labor-intensive. While recent advances in generative AI have enabled automated scene synthesis, existing methods often face challenges in balancing visual quality, diversity, semantic consistency, and user control. A major bottleneck is the lack of a large-scale, high-quality dataset tailored to this task. To address this gap, we introduce a comprehensive synthetic dataset, featuring 12,328 structured annotated scenes with 57,440 rooms, and 4.7M photorealistic 2D renderings. Leveraging this dataset, we present SpatialGen, a novel multi-view multi-modal diffusion model that generates realistic and semantically consistent 3D indoor scenes. Given a 3D layout and a reference image (derived from a text prompt), our model synthesizes appearance (color image), geometry (scene coordinate map), and semantic (semantic segmentation map) from arbitrary viewpoints, while preserving spatial consistency across modalities. SpatialGen consistently generates superior results to previous methods in our experiments. We are open-sourcing our data and models to empower the community and advance the field of indoor scene understanding and generation.

Surgical site infection (SSI) is one of the most common and costly healthcare-associated infections and and surgical wound care remains a significant clinical challenge in preventing SSIs and improving patient outcomes. While recent studies have explored the use of deep learning for preliminary surgical wound screening, progress has been hindered by concerns over data privacy and the high costs associated with expert annotation. Currently, no publicly available dataset or benchmark encompasses various types of surgical wounds, resulting in the absence of an open-source Surgical-Wound screening tool. To address this gap: (1) we present SurgWound, the first open-source dataset featuring a diverse array of surgical wound types. It contains 697 surgical wound images annotated by 3 professional surgeons with eight fine-grained clinical attributes. (2) Based on SurgWound, we introduce the first benchmark for surgical wound diagnosis, which includes visual question answering (VQA) and report generation tasks to comprehensively evaluate model performance. (3) Furthermore, we propose a three-stage learning framework, WoundQwen, for surgical wound diagnosis. In the first stage, we employ five independent MLLMs to accurately predict specific surgical wound characteristics. In the second stage, these predictions serve as additional knowledge inputs to two MLLMs responsible for diagnosing outcomes, which assess infection risk and guide subsequent interventions. In the third stage, we train a MLLM that integrates the diagnostic results from the previous two stages to produce a comprehensive report. This three-stage framework can analyze detailed surgical wound characteristics and provide subsequent instructions to patients based on surgical images, paving the way for personalized wound care, timely intervention, and improved patient outcomes.

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

Text-conditioned image generation has made significant progress in recent years with generative adversarial networks and more recently, diffusion models. While diffusion models conditioned on text prompts have produced impressive and high-quality images, accurately representing complex text prompts such as the number of instances of a specific object remains challenging. To address this limitation, we propose a novel guidance approach for the sampling process in the diffusion model that leverages bounding box and segmentation map information at inference time without additional training data. Through a novel loss in the sampling process, our approach guides the model with semantic features from CLIP embeddings and enforces geometric constraints, leading to high-resolution images that accurately represent the scene. To obtain bounding box and segmentation map information, we structure the text prompt as a scene graph and enrich the nodes with CLIP embeddings. Our proposed model achieves state-of-the-art performance on two public benchmarks for image generation from scene graphs, surpassing both scene graph to image and text-based diffusion models in various metrics. Our results demonstrate the effectiveness of incorporating bounding box and segmentation map guidance in the diffusion model sampling process for more accurate text-to-image generation.

While text-to-image generation has been extensively studied, generating images from scene graphs remains relatively underexplored, primarily due to challenges in accurately modeling spatial relationships and object interactions. To fill this gap, we introduce Scene-Bench, a comprehensive benchmark designed to evaluate and enhance the factual consistency in generating natural scenes. Scene-Bench comprises MegaSG, a large-scale dataset of one million images annotated with scene graphs, facilitating the training and fair comparison of models across diverse and complex scenes. Additionally, we propose SGScore, a novel evaluation metric that leverages chain-of-thought reasoning capabilities of multimodal large language models (LLMs) to assess both object presence and relationship accuracy, offering a more effective measure of factual consistency than traditional metrics like FID and CLIPScore. Building upon this evaluation framework, we develop a scene graph feedback pipeline that iteratively refines generated images by identifying and correcting discrepancies between the scene graph and the image. Extensive experiments demonstrate that Scene-Bench provides a more comprehensive and effective evaluation framework compared to existing benchmarks, particularly for complex scene generation. Furthermore, our feedback strategy significantly enhances the factual consistency of image generation models, advancing the field of controllable image generation.

The mainstream image captioning models rely on Convolutional Neural Network (CNN) image features to generate captions via recurrent models. Recently, image scene graphs have been used to augment captioning models so as to leverage their structural semantics, such as object entities, relationships and attributes. Several studies have noted that the naive use of scene graphs from a black-box scene graph generator harms image captioning performance and that scene graph-based captioning models have to incur the overhead of explicit use of image features to generate decent captions. Addressing these challenges, we propose SG2Caps, a framework that utilizes only the scene graph labels for competitive image captioning performance. The basic idea is to close the semantic gap between the two scene graphs - one derived from the input image and the other from its caption. In order to achieve this, we leverage the spatial location of objects and the Human-Object-Interaction (HOI) labels as an additional HOI graph. SG2Caps outperforms existing scene graph-only captioning models by a large margin, indicating scene graphs as a promising representation for image captioning. Direct utilization of scene graph labels avoids expensive graph convolutions over high-dimensional CNN features resulting in 49% fewer trainable parameters. Our code is available at: https://github.com/Kien085/SG2Caps

In order to provide the right type of assistance at the right time, computer-assisted surgery systems need context awareness. To achieve this, methods for surgical workflow analysis are crucial. Currently, convolutional neural networks provide the best performance for video-based workflow analysis tasks. For training such networks, large amounts of annotated data are necessary. However, collecting a sufficient amount of data is often costly, time-consuming, and not always feasible. In this paper, we address this problem by presenting and comparing different approaches for self-supervised pretraining of neural networks on unlabeled laparoscopic videos using temporal coherence. We evaluate our pretrained networks on Cholec80, a publicly available dataset for surgical phase segmentation, on which a maximum F1 score of 84.6 was reached. Furthermore, we were able to achieve an increase of the F1 score of up to 10 points when compared to a non-pretrained neural network.

State-of-the-art Video Scene Graph Generation (VSGG) systems provide structured visual understanding but operate as closed, feed-forward pipelines with no ability to incorporate human guidance. In contrast, promptable segmentation models such as SAM2 enable precise user interaction but lack semantic or relational reasoning. We introduce Click2Graph, the first interactive framework for Panoptic Video Scene Graph Generation (PVSG) that unifies visual prompting with spatial, temporal, and semantic understanding. From a single user cue, such as a click or bounding box, Click2Graph segments and tracks the subject across time, autonomously discovers interacting objects, and predicts <subject, object, predicate> triplets to form a temporally consistent scene graph. Our framework introduces two key components: a Dynamic Interaction Discovery Module that generates subject-conditioned object prompts, and a Semantic Classification Head that performs joint entity and predicate reasoning. Experiments on the OpenPVSG benchmark demonstrate that Click2Graph establishes a strong foundation for user-guided PVSG, showing how human prompting can be combined with panoptic grounding and relational inference to enable controllable and interpretable video scene understanding.

Recently, the field of text-guided 3D scene generation has garnered significant attention. High-quality generation that aligns with physical realism and high controllability is crucial for practical 3D scene applications. However, existing methods face fundamental limitations: (i) difficulty capturing complex relationships between multiple objects described in the text, (ii) inability to generate physically plausible scene layouts, and (iii) lack of controllability and extensibility in compositional scenes. In this paper, we introduce LayoutDreamer, a framework that leverages 3D Gaussian Splatting (3DGS) to facilitate high-quality, physically consistent compositional scene generation guided by text. Specifically, given a text prompt, we convert it into a directed scene graph and adaptively adjust the density and layout of the initial compositional 3D Gaussians. Subsequently, dynamic camera adjustments are made based on the training focal point to ensure entity-level generation quality. Finally, by extracting directed dependencies from the scene graph, we tailor physical and layout energy to ensure both realism and flexibility. Comprehensive experiments demonstrate that LayoutDreamer outperforms other compositional scene generation quality and semantic alignment methods. Specifically, it achieves state-of-the-art (SOTA) performance in the multiple objects generation metric of T3Bench.

Generative models hold promise for revolutionizing medical education, robot-assisted surgery, and data augmentation for medical AI development. Diffusion models can now generate realistic images from text prompts, while recent advancements have demonstrated their ability to create diverse, high-quality videos. However, these models often struggle with generating accurate representations of medical procedures and detailed anatomical structures. This paper introduces Bora, the first spatio-temporal diffusion probabilistic model designed for text-guided biomedical video generation. Bora leverages Transformer architecture and is pre-trained on general-purpose video generation tasks. It is fine-tuned through model alignment and instruction tuning using a newly established medical video corpus, which includes paired text-video data from various biomedical fields. To the best of our knowledge, this is the first attempt to establish such a comprehensive annotated biomedical video dataset. Bora is capable of generating high-quality video data across four distinct biomedical domains, adhering to medical expert standards and demonstrating consistency and diversity. This generalist video generative model holds significant potential for enhancing medical consultation and decision-making, particularly in resource-limited settings. Additionally, Bora could pave the way for immersive medical training and procedure planning. Extensive experiments on distinct medical modalities such as endoscopy, ultrasound, MRI, and cell tracking validate the effectiveness of our model in understanding biomedical instructions and its superior performance across subjects compared to state-of-the-art generation models.

Obtaining large pre-trained models that can be fine-tuned to new tasks with limited annotated samples has remained an open challenge for medical imaging data. While pre-trained deep networks on ImageNet and vision-language foundation models trained on web-scale data are prevailing approaches, their effectiveness on medical tasks is limited due to the significant domain shift between natural and medical images. To bridge this gap, we introduce LVM-Med, the first family of deep networks trained on large-scale medical datasets. We have collected approximately 1.3 million medical images from 55 publicly available datasets, covering a large number of organs and modalities such as CT, MRI, X-ray, and Ultrasound. We benchmark several state-of-the-art self-supervised algorithms on this dataset and propose a novel self-supervised contrastive learning algorithm using a graph-matching formulation. The proposed approach makes three contributions: (i) it integrates prior pair-wise image similarity metrics based on local and global information; (ii) it captures the structural constraints of feature embeddings through a loss function constructed via a combinatorial graph-matching objective; and (iii) it can be trained efficiently end-to-end using modern gradient-estimation techniques for black-box solvers. We thoroughly evaluate the proposed LVM-Med on 15 downstream medical tasks ranging from segmentation and classification to object detection, and both for the in and out-of-distribution settings. LVM-Med empirically outperforms a number of state-of-the-art supervised, self-supervised, and foundation models. For challenging tasks such as Brain Tumor Classification or Diabetic Retinopathy Grading, LVM-Med improves previous vision-language models trained on 1 billion masks by 6-7% while using only a ResNet-50.

Guided synthesis of high-quality 3D scenes is a challenging task. Diffusion models have shown promise in generating diverse data, including 3D scenes. However, current methods rely directly on text embeddings for controlling the generation, limiting the incorporation of complex spatial relationships between objects. We propose a novel approach for 3D scene diffusion guidance using scene graphs. To leverage the relative spatial information the scene graphs provide, we make use of relational graph convolutional blocks within our denoising network. We show that our approach significantly improves the alignment between scene description and generated scene.

Rapid advancements in medical image segmentation performance have been significantly driven by the development of Convolutional Neural Networks (CNNs) and Vision Transformers (ViTs). These models follow the discriminative pixel-wise classification learning paradigm and often have limited ability to generalize across diverse medical imaging datasets. In this manuscript, we introduce Generative Medical Segmentation (GMS), a novel approach leveraging a generative model to perform image segmentation. Concretely, GMS employs a robust pre-trained vision foundation model to extract latent representations for images and corresponding ground truth masks, followed by a model that learns a mapping function from the image to the mask in the latent space. Once trained, the model generates an estimated segmentation mask using the pre-trained vision foundation model to decode the predicted latent representation back into the image space. The design of GMS leads to fewer trainable parameters in the model which reduces the risk of overfitting and enhances its generalization capability. Our experimental analysis across five public datasets in different medical imaging domains demonstrates GMS outperforms existing discriminative and generative segmentation models. Furthermore, GMS is able to generalize well across datasets from different centers within the same imaging modality. Our experiments suggest GMS offers a scalable and effective solution for medical image segmentation. GMS implementation and trained model weights are available at https://github.com/King-HAW/GMS.

Large language models (LLMs) have recently demonstrated their potential in clinical applications, providing valuable medical knowledge and advice. For example, a large dialog LLM like ChatGPT has successfully passed part of the US medical licensing exam. However, LLMs currently have difficulty processing images, making it challenging to interpret information from medical images, which are rich in information that supports clinical decisions. On the other hand, computer-aided diagnosis (CAD) networks for medical images have seen significant success in the medical field by using advanced deep-learning algorithms to support clinical decision-making. This paper presents a method for integrating LLMs into medical-image CAD networks. The proposed framework uses LLMs to enhance the output of multiple CAD networks, such as diagnosis networks, lesion segmentation networks, and report generation networks, by summarizing and reorganizing the information presented in natural language text format. The goal is to merge the strengths of LLMs' medical domain knowledge and logical reasoning with the vision understanding capability of existing medical-image CAD models to create a more user-friendly and understandable system for patients compared to conventional CAD systems. In the future, LLM's medical knowledge can be also used to improve the performance of vision-based medical-image CAD models.

Existing 3D scene generation methods often struggle to model the complex logical dependencies and physical constraints between objects, limiting their ability to adapt to dynamic and realistic environments. We propose CausalStruct, a novel framework that embeds causal reasoning into 3D scene generation. Utilizing large language models (LLMs), We construct causal graphs where nodes represent objects and attributes, while edges encode causal dependencies and physical constraints. CausalStruct iteratively refines the scene layout by enforcing causal order to determine the placement order of objects and applies causal intervention to adjust the spatial configuration according to physics-driven constraints, ensuring consistency with textual descriptions and real-world dynamics. The refined scene causal graph informs subsequent optimization steps, employing a Proportional-Integral-Derivative(PID) controller to iteratively tune object scales and positions. Our method uses text or images to guide object placement and layout in 3D scenes, with 3D Gaussian Splatting and Score Distillation Sampling improving shape accuracy and rendering stability. Extensive experiments show that CausalStruct generates 3D scenes with enhanced logical coherence, realistic spatial interactions, and robust adaptability.

The scene graph generation (SGG) task is designed to identify the predicates based on the subject-object pairs.However,existing datasets generally include two imbalance cases: one is the class imbalance from the predicted predicates and another is the context imbalance from the given subject-object pairs, which presents significant challenges for SGG. Most existing methods focus on the imbalance of the predicted predicate while ignoring the imbalance of the subject-object pairs, which could not achieve satisfactory results. To address the two imbalance cases, we propose a novel Environment Invariant Curriculum Relation learning (EICR) method, which can be applied in a plug-and-play fashion to existing SGG methods. Concretely, to remove the imbalance of the subject-object pairs, we first construct different distribution environments for the subject-object pairs and learn a model invariant to the environment changes. Then, we construct a class-balanced curriculum learning strategy to balance the different environments to remove the predicate imbalance. Comprehensive experiments conducted on VG and GQA datasets demonstrate that our EICR framework can be taken as a general strategy for various SGG models, and achieve significant improvements.

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.

We present an end-to-end deep learning segmentation method by combining a 3D UNet architecture with a graph neural network (GNN) model. In this approach, the convolutional layers at the deepest level of the UNet are replaced by a GNN-based module with a series of graph convolutions. The dense feature maps at this level are transformed into a graph input to the GNN module. The incorporation of graph convolutions in the UNet provides nodes in the graph with information that is based on node connectivity, in addition to the local features learnt through the downsampled paths. This information can help improve segmentation decisions. By stacking several graph convolution layers, the nodes can access higher order neighbourhood information without substantial increase in computational expense. We propose two types of node connectivity in the graph adjacency: i) one predefined and based on a regular node neighbourhood, and ii) one dynamically computed during training and using the nearest neighbour nodes in the feature space. We have applied this method to the task of segmenting the airway tree from chest CT scans. Experiments have been performed on 32 CTs from the Danish Lung Cancer Screening Trial dataset. We evaluate the performance of the UNet-GNN models with two types of graph adjacency and compare it with the baseline UNet.