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Jan 13

Multi-RADS Synthetic Radiology Report Dataset and Head-to-Head Benchmarking of 41 Open-Weight and Proprietary Language Models

Background: Reporting and Data Systems (RADS) standardize radiology risk communication but automated RADS assignment from narrative reports is challenging because of guideline complexity, output-format constraints, and limited benchmarking across RADS frameworks and model sizes. Purpose: To create RXL-RADSet, a radiologist-verified synthetic multi-RADS benchmark, and compare validity and accuracy of open-weight small language models (SLMs) with a proprietary model for RADS assignment. Materials and Methods: RXL-RADSet contains 1,600 synthetic radiology reports across 10 RADS (BI-RADS, CAD-RADS, GB-RADS, LI-RADS, Lung-RADS, NI-RADS, O-RADS, PI-RADS, TI-RADS, VI-RADS) and multiple modalities. Reports were generated by LLMs using scenario plans and simulated radiologist styles and underwent two-stage radiologist verification. We evaluated 41 quantized SLMs (12 families, 0.135-32B parameters) and GPT-5.2 under a fixed guided prompt. Primary endpoints were validity and accuracy; a secondary analysis compared guided versus zero-shot prompting. Results: Under guided prompting GPT-5.2 achieved 99.8% validity and 81.1% accuracy (1,600 predictions). Pooled SLMs (65,600 predictions) achieved 96.8% validity and 61.1% accuracy; top SLMs in the 20-32B range reached ~99% validity and mid-to-high 70% accuracy. Performance scaled with model size (inflection between <1B and >=10B) and declined with RADS complexity primarily due to classification difficulty rather than invalid outputs. Guided prompting improved validity (99.2% vs 96.7%) and accuracy (78.5% vs 69.6%) compared with zero-shot. Conclusion: RXL-RADSet provides a radiologist-verified multi-RADS benchmark; large SLMs (20-32B) can approach proprietary-model performance under guided prompting, but gaps remain for higher-complexity schemes.

  • 25 authors
·
Jan 6

SynthRAD2025 Grand Challenge dataset: generating synthetic CTs for radiotherapy

Medical imaging is essential in modern radiotherapy, supporting diagnosis, treatment planning, and monitoring. Synthetic imaging, particularly synthetic computed tomography (sCT), is gaining traction in radiotherapy. The SynthRAD2025 dataset and Grand Challenge promote advancements in sCT generation by providing a benchmarking platform for algorithms using cone-beam CT (CBCT) and magnetic resonance imaging (MRI). The dataset includes 2362 cases: 890 MRI-CT and 1472 CBCT-CT pairs from head-and-neck, thoracic, and abdominal cancer patients treated at five European university medical centers (UMC Groningen, UMC Utrecht, Radboud UMC, LMU University Hospital Munich, and University Hospital of Cologne). Data were acquired with diverse scanners and protocols. Pre-processing, including rigid and deformable image registration, ensures high-quality, modality-aligned images. Extensive quality assurance validates image consistency and usability. All imaging data is provided in MetaImage (.mha) format, ensuring compatibility with medical image processing tools. Metadata, including acquisition parameters and registration details, is available in structured CSV files. To maintain dataset integrity, SynthRAD2025 is divided into training (65%), validation (10%), and test (25%) sets. The dataset is accessible at https://doi.org/10.5281/zenodo.14918089 under the SynthRAD2025 collection. This dataset supports benchmarking and the development of synthetic imaging techniques for radiotherapy applications. Use cases include sCT generation for MRI-only and MR-guided photon/proton therapy, CBCT-based dose calculations, and adaptive radiotherapy workflows. By integrating diverse acquisition settings, SynthRAD2025 fosters robust, generalizable image synthesis algorithms, advancing personalized cancer care and adaptive radiotherapy.

  • 19 authors
·
Feb 24, 2025

Generating Synthetic Computed Tomography for Radiotherapy: SynthRAD2023 Challenge Report

Radiation therapy plays a crucial role in cancer treatment, necessitating precise delivery of radiation to tumors while sparing healthy tissues over multiple days. Computed tomography (CT) is integral for treatment planning, offering electron density data crucial for accurate dose calculations. However, accurately representing patient anatomy is challenging, especially in adaptive radiotherapy, where CT is not acquired daily. Magnetic resonance imaging (MRI) provides superior soft-tissue contrast. Still, it lacks electron density information while cone beam CT (CBCT) lacks direct electron density calibration and is mainly used for patient positioning. Adopting MRI-only or CBCT-based adaptive radiotherapy eliminates the need for CT planning but presents challenges. Synthetic CT (sCT) generation techniques aim to address these challenges by using image synthesis to bridge the gap between MRI, CBCT, and CT. The SynthRAD2023 challenge was organized to compare synthetic CT generation methods using multi-center ground truth data from 1080 patients, divided into two tasks: 1) MRI-to-CT and 2) CBCT-to-CT. The evaluation included image similarity and dose-based metrics from proton and photon plans. The challenge attracted significant participation, with 617 registrations and 22/17 valid submissions for tasks 1/2. Top-performing teams achieved high structural similarity indices (>0.87/0.90) and gamma pass rates for photon (>98.1%/99.0%) and proton (>99.0%/97.3%) plans. However, no significant correlation was found between image similarity metrics and dose accuracy, emphasizing the need for dose evaluation when assessing the clinical applicability of sCT. SynthRAD2023 facilitated the investigation and benchmarking of sCT generation techniques, providing insights for developing MRI-only and CBCT-based adaptive radiotherapy.

  • 59 authors
·
Mar 13, 2024

CheXGenBench: A Unified Benchmark For Fidelity, Privacy and Utility of Synthetic Chest Radiographs

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

  • 6 authors
·
May 15, 2025 2

Towards a clinically accessible radiology foundation model: open-access and lightweight, with automated evaluation

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

  • 27 authors
·
Mar 12, 2024

Improving Performance, Robustness, and Fairness of Radiographic AI Models with Finely-Controllable Synthetic Data

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

  • 11 authors
·
Aug 22, 2025

Dataset and Benchmark for Enhancing Critical Retained Foreign Object Detection

Critical retained foreign objects (RFOs), including surgical instruments like sponges and needles, pose serious patient safety risks and carry significant financial and legal implications for healthcare institutions. Detecting critical RFOs using artificial intelligence remains challenging due to their rarity and the limited availability of chest X-ray datasets that specifically feature critical RFOs cases. Existing datasets only contain non-critical RFOs, like necklace or zipper, further limiting their utility for developing clinically impactful detection algorithms. To address these limitations, we introduce "Hopkins RFOs Bench", the first and largest dataset of its kind, containing 144 chest X-ray images of critical RFO cases collected over 18 years from the Johns Hopkins Health System. Using this dataset, we benchmark several state-of-the-art object detection models, highlighting the need for enhanced detection methodologies for critical RFO cases. Recognizing data scarcity challenges, we further explore image synthetic methods to bridge this gap. We evaluate two advanced synthetic image methods, DeepDRR-RFO, a physics-based method, and RoentGen-RFO, a diffusion-based method, for creating realistic radiographs featuring critical RFOs. Our comprehensive analysis identifies the strengths and limitations of each synthetic method, providing insights into effectively utilizing synthetic data to enhance model training. The Hopkins RFOs Bench and our findings significantly advance the development of reliable, generalizable AI-driven solutions for detecting critical RFOs in clinical chest X-rays.

  • 16 authors
·
Jul 9, 2025

FreeTumor: Advance Tumor Segmentation via Large-Scale Tumor Synthesis

AI-driven tumor analysis has garnered increasing attention in healthcare. However, its progress is significantly hindered by the lack of annotated tumor cases, which requires radiologists to invest a lot of effort in collecting and annotation. In this paper, we introduce a highly practical solution for robust tumor synthesis and segmentation, termed FreeTumor, which refers to annotation-free synthetic tumors and our desire to free patients that suffering from tumors. Instead of pursuing sophisticated technical synthesis modules, we aim to design a simple yet effective tumor synthesis paradigm to unleash the power of large-scale data. Specifically, FreeTumor advances existing methods mainly from three aspects: (1) Existing methods only leverage small-scale labeled data for synthesis training, which limits their ability to generalize well on unseen data from different sources. To this end, we introduce the adversarial training strategy to leverage large-scale and diversified unlabeled data in synthesis training, significantly improving tumor synthesis. (2) Existing methods largely ignored the negative impact of low-quality synthetic tumors in segmentation training. Thus, we employ an adversarial-based discriminator to automatically filter out the low-quality synthetic tumors, which effectively alleviates their negative impact. (3) Existing methods only used hundreds of cases in tumor segmentation. In FreeTumor, we investigate the data scaling law in tumor segmentation by scaling up the dataset to 11k cases. Extensive experiments demonstrate the superiority of FreeTumor, e.g., on three tumor segmentation benchmarks, average +8.9% DSC over the baseline that only using real tumors and +6.6% DSC over the state-of-the-art tumor synthesis method. Code will be available.

  • 4 authors
·
Jun 3, 2024

PET2Rep: Towards Vision-Language Model-Drived Automated Radiology Report Generation for Positron Emission Tomography

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

  • 15 authors
·
Aug 5, 2025

Standardized Benchmark Dataset for Localized Exposure to a Realistic Source at 10-90 GHz

The lack of freely available standardized datasets represents an aggravating factor during the development and testing the performance of novel computational techniques in exposure assessment and dosimetry research. This hinders progress as researchers are required to generate numerical data (field, power and temperature distribution) anew using simulation software for each exposure scenario. Other than being time consuming, this approach is highly susceptible to errors that occur during the configuration of the electromagnetic model. To address this issue, in this paper, the limited available data on the incident power density and resultant maximum temperature rise on the skin surface considering various steady-state exposure scenarios at 10-90 GHz have been statistically modeled. The synthetic data have been sampled from the fitted statistical multivariate distribution with respect to predetermined dosimetric constraints. We thus present a comprehensive and open-source dataset compiled of the high-fidelity numerical data considering various exposures to a realistic source. Furthermore, different surrogate models for predicting maximum temperature rise on the skin surface were fitted based on the synthetic dataset. All surrogate models were tested on the originally available data where satisfactory predictive performance has been demonstrated. A simple technique of combining quadratic polynomial and tensor-product spline surrogates, each operating on its own cluster of data, has achieved the lowest mean absolute error of 0.058 {\deg}C. Therefore, overall experimental results indicate the validity of the proposed synthetic dataset.

  • 3 authors
·
May 3, 2023

SynthRAD2023 Grand Challenge dataset: generating synthetic CT for radiotherapy

Purpose: Medical imaging has become increasingly important in diagnosing and treating oncological patients, particularly in radiotherapy. Recent advances in synthetic computed tomography (sCT) generation have increased interest in public challenges to provide data and evaluation metrics for comparing different approaches openly. This paper describes a dataset of brain and pelvis computed tomography (CT) images with rigidly registered CBCT and MRI images to facilitate the development and evaluation of sCT generation for radiotherapy planning. Acquisition and validation methods: The dataset consists of CT, CBCT, and MRI of 540 brains and 540 pelvic radiotherapy patients from three Dutch university medical centers. Subjects' ages ranged from 3 to 93 years, with a mean age of 60. Various scanner models and acquisition settings were used across patients from the three data-providing centers. Details are available in CSV files provided with the datasets. Data format and usage notes: The data is available on Zenodo (https://doi.org/10.5281/zenodo.7260705) under the SynthRAD2023 collection. The images for each subject are available in nifti format. Potential applications: This dataset will enable the evaluation and development of image synthesis algorithms for radiotherapy purposes on a realistic multi-center dataset with varying acquisition protocols. Synthetic CT generation has numerous applications in radiation therapy, including diagnosis, treatment planning, treatment monitoring, and surgical planning.

  • 9 authors
·
Mar 28, 2023

LeFusion: Controllable Pathology Synthesis via Lesion-Focused Diffusion Models

Patient data from real-world clinical practice often suffers from data scarcity and long-tail imbalances, leading to biased outcomes or algorithmic unfairness. This study addresses these challenges by generating lesion-containing image-segmentation pairs from lesion-free images. Previous efforts in medical imaging synthesis have struggled with separating lesion information from background, resulting in low-quality backgrounds and limited control over the synthetic output. Inspired by diffusion-based image inpainting, we propose LeFusion, a lesion-focused diffusion model. By redesigning the diffusion learning objectives to focus on lesion areas, we simplify the learning process and improve control over the output while preserving high-fidelity backgrounds by integrating forward-diffused background contexts into the reverse diffusion process. Additionally, we tackle two major challenges in lesion texture synthesis: 1) multi-peak and 2) multi-class lesions. We introduce two effective strategies: histogram-based texture control and multi-channel decomposition, enabling the controlled generation of high-quality lesions in difficult scenarios. Furthermore, we incorporate lesion mask diffusion, allowing control over lesion size, location, and boundary, thus increasing lesion diversity. Validated on 3D cardiac lesion MRI and lung nodule CT datasets, LeFusion-generated data significantly improves the performance of state-of-the-art segmentation models, including nnUNet and SwinUNETR. Code and model are available at https://github.com/M3DV/LeFusion.

  • 7 authors
·
Mar 20, 2024

RTMV: A Ray-Traced Multi-View Synthetic Dataset for Novel View Synthesis

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

  • 12 authors
·
May 14, 2022

Why Registration Quality Matters: Enhancing sCT Synthesis with IMPACT-Based Registration

We participated in the SynthRAD2025 challenge (Tasks 1 and 2) with a unified pipeline for synthetic CT (sCT) generation from MRI and CBCT, implemented using the KonfAI framework. Our model is a 2.5D U-Net++ with a ResNet-34 encoder, trained jointly across anatomical regions and fine-tuned per region. The loss function combined pixel-wise L1 loss with IMPACT-Synth, a perceptual loss derived from SAM and TotalSegmentator to enhance structural fidelity. Training was performed using AdamW (initial learning rate = 0.001, halved every 25k steps) on patch-based, normalized, body-masked inputs (320x320 for MRI, 256x256 for CBCT), with random flipping as the only augmentation. No post-processing was applied. Final predictions leveraged test-time augmentation and five-fold ensembling. The best model was selected based on validation MAE. Two registration strategies were evaluated: (i) Elastix with mutual information, consistent with the challenge pipeline, and (ii) IMPACT, a feature-based similarity metric leveraging pretrained segmentation networks. On the local test sets, IMPACT-based registration achieved more accurate and anatomically consistent alignments than mutual-information-based registration, resulting in improved sCT synthesis with lower MAE and more realistic anatomical structures. On the public validation set, however, models trained with Elastix-aligned data achieved higher scores, reflecting a registration bias favoring alignment strategies consistent with the evaluation pipeline. This highlights how registration errors can propagate into supervised learning, influencing both training and evaluation, and potentially inflating performance metrics at the expense of anatomical fidelity. By promoting anatomically consistent alignment, IMPACT helps mitigate this bias and supports the development of more robust and generalizable sCT synthesis models.

  • 4 authors
·
Oct 24, 2025

Shadow and Light: Digitally Reconstructed Radiographs for Disease Classification

In this paper, we introduce DRR-RATE, a large-scale synthetic chest X-ray dataset derived from the recently released CT-RATE dataset. DRR-RATE comprises of 50,188 frontal Digitally Reconstructed Radiographs (DRRs) from 21,304 unique patients. Each image is paired with a corresponding radiology text report and binary labels for 18 pathology classes. Given the controllable nature of DRR generation, it facilitates the inclusion of lateral view images and images from any desired viewing position. This opens up avenues for research into new and novel multimodal applications involving paired CT, X-ray images from various views, text, and binary labels. We demonstrate the applicability of DRR-RATE alongside existing large-scale chest X-ray resources, notably the CheXpert dataset and CheXnet model. Experiments demonstrate that CheXnet, when trained and tested on the DRR-RATE dataset, achieves sufficient to high AUC scores for the six common pathologies cited in common literature: Atelectasis, Cardiomegaly, Consolidation, Lung Lesion, Lung Opacity, and Pleural Effusion. Additionally, CheXnet trained on the CheXpert dataset can accurately identify several pathologies, even when operating out of distribution. This confirms that the generated DRR images effectively capture the essential pathology features from CT images. The dataset and labels are publicly accessible at https://huggingface.co/datasets/farrell236/DRR-RATE.

  • 6 authors
·
Jun 5, 2024

MultiRef: Controllable Image Generation with Multiple Visual References

Visual designers naturally draw inspiration from multiple visual references, combining diverse elements and aesthetic principles to create artwork. However, current image generative frameworks predominantly rely on single-source inputs -- either text prompts or individual reference images. In this paper, we focus on the task of controllable image generation using multiple visual references. We introduce MultiRef-bench, a rigorous evaluation framework comprising 990 synthetic and 1,000 real-world samples that require incorporating visual content from multiple reference images. The synthetic samples are synthetically generated through our data engine RefBlend, with 10 reference types and 33 reference combinations. Based on RefBlend, we further construct a dataset MultiRef containing 38k high-quality images to facilitate further research. Our experiments across three interleaved image-text models (i.e., OmniGen, ACE, and Show-o) and six agentic frameworks (e.g., ChatDiT and LLM + SD) reveal that even state-of-the-art systems struggle with multi-reference conditioning, with the best model OmniGen achieving only 66.6% in synthetic samples and 79.0% in real-world cases on average compared to the golden answer. These findings provide valuable directions for developing more flexible and human-like creative tools that can effectively integrate multiple sources of visual inspiration. The dataset is publicly available at: https://multiref.github.io/.

  • 9 authors
·
Aug 9, 2025 2

Text-Driven Tumor Synthesis

Tumor synthesis can generate examples that AI often misses or over-detects, improving AI performance by training on these challenging cases. However, existing synthesis methods, which are typically unconditional -- generating images from random variables -- or conditioned only by tumor shapes, lack controllability over specific tumor characteristics such as texture, heterogeneity, boundaries, and pathology type. As a result, the generated tumors may be overly similar or duplicates of existing training data, failing to effectively address AI's weaknesses. We propose a new text-driven tumor synthesis approach, termed TextoMorph, that provides textual control over tumor characteristics. This is particularly beneficial for examples that confuse the AI the most, such as early tumor detection (increasing Sensitivity by +8.5%), tumor segmentation for precise radiotherapy (increasing DSC by +6.3%), and classification between benign and malignant tumors (improving Sensitivity by +8.2%). By incorporating text mined from radiology reports into the synthesis process, we increase the variability and controllability of the synthetic tumors to target AI's failure cases more precisely. Moreover, TextoMorph uses contrastive learning across different texts and CT scans, significantly reducing dependence on scarce image-report pairs (only 141 pairs used in this study) by leveraging a large corpus of 34,035 radiology reports. Finally, we have developed rigorous tests to evaluate synthetic tumors, including Text-Driven Visual Turing Test and Radiomics Pattern Analysis, showing that our synthetic tumors is realistic and diverse in texture, heterogeneity, boundaries, and pathology.

  • 14 authors
·
Dec 24, 2024

Vision-Language Generative Model for View-Specific Chest X-ray Generation

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.

  • 8 authors
·
Feb 23, 2023

Stable-Sim2Real: Exploring Simulation of Real-Captured 3D Data with Two-Stage Depth Diffusion

3D data simulation aims to bridge the gap between simulated and real-captured 3D data, which is a fundamental problem for real-world 3D visual tasks. Most 3D data simulation methods inject predefined physical priors but struggle to capture the full complexity of real data. An optimal approach involves learning an implicit mapping from synthetic to realistic data in a data-driven manner, but progress in this solution has met stagnation in recent studies. This work explores a new solution path of data-driven 3D simulation, called Stable-Sim2Real, based on a novel two-stage depth diffusion model. The initial stage finetunes Stable-Diffusion to generate the residual between the real and synthetic paired depth, producing a stable but coarse depth, where some local regions may deviate from realistic patterns. To enhance this, both the synthetic and initial output depth are fed into a second-stage diffusion, where diffusion loss is adjusted to prioritize these distinct areas identified by a 3D discriminator. We provide a new benchmark scheme to evaluate 3D data simulation methods. Extensive experiments show that training the network with the 3D simulated data derived from our method significantly enhances performance in real-world 3D visual tasks. Moreover, the evaluation demonstrates the high similarity between our 3D simulated data and real-captured patterns. Project page: https://mutianxu.github.io/stable-sim2real/.

  • 6 authors
·
Jul 31, 2025

Optimizing Breast Cancer Detection in Mammograms: A Comprehensive Study of Transfer Learning, Resolution Reduction, and Multi-View Classification

Mammography, an X-ray-based imaging technique, remains central to the early detection of breast cancer. Recent advances in artificial intelligence have enabled increasingly sophisticated computer-aided diagnostic methods, evolving from patch-based classifiers to whole-image approaches and then to multi-view architectures that jointly analyze complementary projections. Despite this progress, several critical questions remain unanswered. In this study, we systematically investigate these issues by addressing five key research questions: (1) the role of patch classifiers in performance, (2) the transferability of natural-image-trained backbones, (3) the advantages of learn-to-resize over conventional downscaling, (4) the contribution of multi-view integration, and (5) the robustness of findings across varying image quality. Beyond benchmarking, our experiments demonstrate clear performance gains over prior work. For the CBIS-DDSM dataset, we improved single-view AUC from 0.8153 to 0.8343, and multiple-view AUC from 0.8483 to 0.8658. Using a new comparative method, we also observed a 0.0217 AUC increase when extending from single to multiple-view analysis. On the complete VinDr-Mammo dataset, the multiple-view approach further improved results, achieving a 0.0492 AUC increase over single view and reaching 0.8511 AUC overall. These results establish new state-of-the-art benchmarks, providing clear evidence of the advantages of multi-view architectures for mammogram interpretation. Beyond performance, our analysis offers principled insights into model design and transfer learning strategies, contributing to the development of more accurate and reliable breast cancer screening tools. The inference code and trained models are publicly available at https://github.com/dpetrini/multiple-view.

  • 2 authors
·
Mar 25, 2025

A New Benchmark: On the Utility of Synthetic Data with Blender for Bare Supervised Learning and Downstream Domain Adaptation

Deep learning in computer vision has achieved great success with the price of large-scale labeled training data. However, exhaustive data annotation is impracticable for each task of all domains of interest, due to high labor costs and unguaranteed labeling accuracy. Besides, the uncontrollable data collection process produces non-IID training and test data, where undesired duplication may exist. All these nuisances may hinder the verification of typical theories and exposure to new findings. To circumvent them, an alternative is to generate synthetic data via 3D rendering with domain randomization. We in this work push forward along this line by doing profound and extensive research on bare supervised learning and downstream domain adaptation. Specifically, under the well-controlled, IID data setting enabled by 3D rendering, we systematically verify the typical, important learning insights, e.g., shortcut learning, and discover the new laws of various data regimes and network architectures in generalization. We further investigate the effect of image formation factors on generalization, e.g., object scale, material texture, illumination, camera viewpoint, and background in a 3D scene. Moreover, we use the simulation-to-reality adaptation as a downstream task for comparing the transferability between synthetic and real data when used for pre-training, which demonstrates that synthetic data pre-training is also promising to improve real test results. Lastly, to promote future research, we develop a new large-scale synthetic-to-real benchmark for image classification, termed S2RDA, which provides more significant challenges for transfer from simulation to reality. The code and datasets are available at https://github.com/huitangtang/On_the_Utility_of_Synthetic_Data.

  • 2 authors
·
Mar 16, 2023

T3: Test-Time Model Merging in VLMs for Zero-Shot Medical Imaging Analysis

In medical imaging, vision-language models face a critical duality: pretrained networks offer broad robustness but lack subtle, modality-specific characteristics, while fine-tuned expert models achieve high in-distribution accuracy yet falter under modality shift. Existing model-merging techniques, designed for natural-image benchmarks, are simple and efficient but fail to deliver consistent gains across diverse medical modalities; their static interpolation limits reliability in varied clinical tasks. To address this, we introduce Test-Time Task adaptive merging (T^3), a backpropagation-free framework that computes per-sample interpolation coefficients via the Jensen-Shannon divergence between the two models' output distributions. T^3 dynamically preserves local precision when models agree and defers to generalist robustness under drift. To overcome the inference costs of sample-wise merging, we further propose a batch-wise extension, T^3_B, that computes a merging coefficient across a batch of samples, dramatically reducing computational bottleneck. Recognizing the lack of a standardized medical-merging benchmark, we present a rigorous cross-evaluation protocol spanning in-domain, base-to-novel, and corruptions across four modalities. Empirically, T^3 sets new state-of-the-art in Top-1 accuracy and error reduction, outperforming strong baselines while maintaining efficiency, paving the way for adaptive MVLM deployment in clinical settings. Our code is available at https://github.com/Razaimam45/TCube.

  • 4 authors
·
Oct 31, 2025

ICE-Bench: A Unified and Comprehensive Benchmark for Image Creating and Editing

Image generation has witnessed significant advancements in the past few years. However, evaluating the performance of image generation models remains a formidable challenge. In this paper, we propose ICE-Bench, a unified and comprehensive benchmark designed to rigorously assess image generation models. Its comprehensiveness could be summarized in the following key features: (1) Coarse-to-Fine Tasks: We systematically deconstruct image generation into four task categories: No-ref/Ref Image Creating/Editing, based on the presence or absence of source images and reference images. And further decompose them into 31 fine-grained tasks covering a broad spectrum of image generation requirements, culminating in a comprehensive benchmark. (2) Multi-dimensional Metrics: The evaluation framework assesses image generation capabilities across 6 dimensions: aesthetic quality, imaging quality, prompt following, source consistency, reference consistency, and controllability. 11 metrics are introduced to support the multi-dimensional evaluation. Notably, we introduce VLLM-QA, an innovative metric designed to assess the success of image editing by leveraging large models. (3) Hybrid Data: The data comes from real scenes and virtual generation, which effectively improves data diversity and alleviates the bias problem in model evaluation. Through ICE-Bench, we conduct a thorough analysis of existing generation models, revealing both the challenging nature of our benchmark and the gap between current model capabilities and real-world generation requirements. To foster further advancements in the field, we will open-source ICE-Bench, including its dataset, evaluation code, and models, thereby providing a valuable resource for the research community.

  • 7 authors
·
Mar 18, 2025

AI in Lung Health: Benchmarking Detection and Diagnostic Models Across Multiple CT Scan Datasets

Lung cancer remains the leading cause of cancer-related mortality worldwide, and early detection through low-dose computed tomography (LDCT) has shown significant promise in reducing death rates. With the growing integration of artificial intelligence (AI) into medical imaging, the development and evaluation of robust AI models require access to large, well-annotated datasets. In this study, we introduce the utility of Duke Lung Cancer Screening (DLCS) Dataset, the largest open-access LDCT dataset with over 2,000 scans and 3,000 expert-verified nodules. We benchmark deep learning models for both 3D nodule detection and lung cancer classification across internal and external datasets including LUNA16, LUNA25, and NLST-3D+. For detection, we develop two MONAI-based RetinaNet models (DLCSDmD and LUNA16-mD), evaluated using the Competition Performance Metric (CPM). For classification, we compare five models, including state-of-the-art pretrained models (Models Genesis, Med3D), a selfsupervised foundation model (FMCB), a randomly initialized ResNet50, and proposed a novel Strategic Warm-Start++ (SWS++) model. SWS++ uses curated candidate patches to pretrain a classification backbone within the same detection pipeline, enabling task-relevant feature learning. Our models demonstrated strong generalizability, with SWS++ achieving comparable or superior performance to existing foundational models across multiple datasets (AUC: 0.71 to 0.90). All code, models, and data are publicly released to promote reproducibility and collaboration. This work establishes a standardized benchmarking resource for lung cancer AI research, supporting future efforts in model development, validation, and clinical translation.

  • 7 authors
·
May 7, 2024

RealPDEBench: A Benchmark for Complex Physical Systems with Real-World Data

Predicting the evolution of complex physical systems remains a central problem in science and engineering. Despite rapid progress in scientific Machine Learning (ML) models, a critical bottleneck is the lack of expensive real-world data, resulting in most current models being trained and validated on simulated data. Beyond limiting the development and evaluation of scientific ML, this gap also hinders research into essential tasks such as sim-to-real transfer. We introduce RealPDEBench, the first benchmark for scientific ML that integrates real-world measurements with paired numerical simulations. RealPDEBench consists of five datasets, three tasks, eight metrics, and ten baselines. We first present five real-world measured datasets with paired simulated datasets across different complex physical systems. We further define three tasks, which allow comparisons between real-world and simulated data, and facilitate the development of methods to bridge the two. Moreover, we design eight evaluation metrics, spanning data-oriented and physics-oriented metrics, and finally benchmark ten representative baselines, including state-of-the-art models, pretrained PDE foundation models, and a traditional method. Experiments reveal significant discrepancies between simulated and real-world data, while showing that pretraining with simulated data consistently improves both accuracy and convergence. In this work, we hope to provide insights from real-world data, advancing scientific ML toward bridging the sim-to-real gap and real-world deployment. Our benchmark, datasets, and instructions are available at https://realpdebench.github.io/.

  • 16 authors
·
Jan 5

RealGen: Photorealistic Text-to-Image Generation via Detector-Guided Rewards

With the continuous advancement of image generation technology, advanced models such as GPT-Image-1 and Qwen-Image have achieved remarkable text-to-image consistency and world knowledge However, these models still fall short in photorealistic image generation. Even on simple T2I tasks, they tend to produce " fake" images with distinct AI artifacts, often characterized by "overly smooth skin" and "oily facial sheens". To recapture the original goal of "indistinguishable-from-reality" generation, we propose RealGen, a photorealistic text-to-image framework. RealGen integrates an LLM component for prompt optimization and a diffusion model for realistic image generation. Inspired by adversarial generation, RealGen introduces a "Detector Reward" mechanism, which quantifies artifacts and assesses realism using both semantic-level and feature-level synthetic image detectors. We leverage this reward signal with the GRPO algorithm to optimize the entire generation pipeline, significantly enhancing image realism and detail. Furthermore, we propose RealBench, an automated evaluation benchmark employing Detector-Scoring and Arena-Scoring. It enables human-free photorealism assessment, yielding results that are more accurate and aligned with real user experience. Experiments demonstrate that RealGen significantly outperforms general models like GPT-Image-1 and Qwen-Image, as well as specialized photorealistic models like FLUX-Krea, in terms of realism, detail, and aesthetics. The code is available at https://github.com/yejy53/RealGen.

  • 10 authors
·
Nov 29, 2025 2

Patient-Specific Autoregressive Models for Organ Motion Prediction in Radiotherapy

Radiotherapy often involves a prolonged treatment period. During this time, patients may experience organ motion due to breathing and other physiological factors. Predicting and modeling this motion before treatment is crucial for ensuring precise radiation delivery. However, existing pre-treatment organ motion prediction methods primarily rely on deformation analysis using principal component analysis (PCA), which is highly dependent on registration quality and struggles to capture periodic temporal dynamics for motion modeling.In this paper, we observe that organ motion prediction closely resembles an autoregressive process, a technique widely used in natural language processing (NLP). Autoregressive models predict the next token based on previous inputs, naturally aligning with our objective of predicting future organ motion phases. Building on this insight, we reformulate organ motion prediction as an autoregressive process to better capture patient-specific motion patterns. Specifically, we acquire 4D CT scans for each patient before treatment, with each sequence comprising multiple 3D CT phases. These phases are fed into the autoregressive model to predict future phases based on prior phase motion patterns. We evaluate our method on a real-world test set of 4D CT scans from 50 patients who underwent radiotherapy at our institution and a public dataset containing 4D CT scans from 20 patients (some with multiple scans), totaling over 1,300 3D CT phases. The performance in predicting the motion of the lung and heart surpasses existing benchmarks, demonstrating its effectiveness in capturing motion dynamics from CT images. These results highlight the potential of our method to improve pre-treatment planning in radiotherapy, enabling more precise and adaptive radiation delivery.

  • 4 authors
·
May 17, 2025

Multi-Coil MRI Reconstruction Challenge -- Assessing Brain MRI Reconstruction Models and their Generalizability to Varying Coil Configurations

Deep-learning-based brain magnetic resonance imaging (MRI) reconstruction methods have the potential to accelerate the MRI acquisition process. Nevertheless, the scientific community lacks appropriate benchmarks to assess MRI reconstruction quality of high-resolution brain images, and evaluate how these proposed algorithms will behave in the presence of small, but expected data distribution shifts. The Multi-Coil Magnetic Resonance Image (MC-MRI) Reconstruction Challenge provides a benchmark that aims at addressing these issues, using a large dataset of high-resolution, three-dimensional, T1-weighted MRI scans. The challenge has two primary goals: 1) to compare different MRI reconstruction models on this dataset and 2) to assess the generalizability of these models to data acquired with a different number of receiver coils. In this paper, we describe the challenge experimental design, and summarize the results of a set of baseline and state of the art brain MRI reconstruction models. We provide relevant comparative information on the current MRI reconstruction state-of-the-art and highlight the challenges of obtaining generalizable models that are required prior to broader clinical adoption. The MC-MRI benchmark data, evaluation code and current challenge leaderboard are publicly available. They provide an objective performance assessment for future developments in the field of brain MRI reconstruction.

  • 23 authors
·
Nov 9, 2020

U-Bench: A Comprehensive Understanding of U-Net through 100-Variant Benchmarking

Over the past decade, U-Net has been the dominant architecture in medical image segmentation, leading to the development of thousands of U-shaped variants. Despite its widespread adoption, there is still no comprehensive benchmark to systematically evaluate their performance and utility, largely because of insufficient statistical validation and limited consideration of efficiency and generalization across diverse datasets. To bridge this gap, we present U-Bench, the first large-scale, statistically rigorous benchmark that evaluates 100 U-Net variants across 28 datasets and 10 imaging modalities. Our contributions are threefold: (1) Comprehensive Evaluation: U-Bench evaluates models along three key dimensions: statistical robustness, zero-shot generalization, and computational efficiency. We introduce a novel metric, U-Score, which jointly captures the performance-efficiency trade-off, offering a deployment-oriented perspective on model progress. (2) Systematic Analysis and Model Selection Guidance: We summarize key findings from the large-scale evaluation and systematically analyze the impact of dataset characteristics and architectural paradigms on model performance. Based on these insights, we propose a model advisor agent to guide researchers in selecting the most suitable models for specific datasets and tasks. (3) Public Availability: We provide all code, models, protocols, and weights, enabling the community to reproduce our results and extend the benchmark with future methods. In summary, U-Bench not only exposes gaps in previous evaluations but also establishes a foundation for fair, reproducible, and practically relevant benchmarking in the next decade of U-Net-based segmentation models. The project can be accessed at: https://fenghetan9.github.io/ubench. Code is available at: https://github.com/FengheTan9/U-Bench.

  • 10 authors
·
Oct 8, 2025 3

Multi-view X-ray Image Synthesis with Multiple Domain Disentanglement from CT Scans

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

  • 9 authors
·
Apr 18, 2024

RoboVerse: Towards a Unified Platform, Dataset and Benchmark for Scalable and Generalizable Robot Learning

Data scaling and standardized evaluation benchmarks have driven significant advances in natural language processing and computer vision. However, robotics faces unique challenges in scaling data and establishing evaluation protocols. Collecting real-world data is resource-intensive and inefficient, while benchmarking in real-world scenarios remains highly complex. Synthetic data and simulation offer promising alternatives, yet existing efforts often fall short in data quality, diversity, and benchmark standardization. To address these challenges, we introduce RoboVerse, a comprehensive framework comprising a simulation platform, a synthetic dataset, and unified benchmarks. Our simulation platform supports multiple simulators and robotic embodiments, enabling seamless transitions between different environments. The synthetic dataset, featuring high-fidelity physics and photorealistic rendering, is constructed through multiple approaches. Additionally, we propose unified benchmarks for imitation learning and reinforcement learning, enabling evaluation across different levels of generalization. At the core of the simulation platform is MetaSim, an infrastructure that abstracts diverse simulation environments into a universal interface. It restructures existing simulation environments into a simulator-agnostic configuration system, as well as an API aligning different simulator functionalities, such as launching simulation environments, loading assets with initial states, stepping the physics engine, etc. This abstraction ensures interoperability and extensibility. Comprehensive experiments demonstrate that RoboVerse enhances the performance of imitation learning, reinforcement learning, world model learning, and sim-to-real transfer. These results validate the reliability of our dataset and benchmarks, establishing RoboVerse as a robust solution for advancing robot learning.

  • 37 authors
·
Apr 26, 2025 2

Cross-modality (CT-MRI) prior augmented deep learning for robust lung tumor segmentation from small MR datasets

Lack of large expert annotated MR datasets makes training deep learning models difficult. Therefore, a cross-modality (MR-CT) deep learning segmentation approach that augments training data using pseudo MR images produced by transforming expert-segmented CT images was developed. Eighty-One T2-weighted MRI scans from 28 patients with non-small cell lung cancers were analyzed. Cross-modality prior encoding the transformation of CT to pseudo MR images resembling T2w MRI was learned as a generative adversarial deep learning model. This model augmented training data arising from 6 expert-segmented T2w MR patient scans with 377 pseudo MRI from non-small cell lung cancer CT patient scans with obtained from the Cancer Imaging Archive. A two-dimensional Unet implemented with batch normalization was trained to segment the tumors from T2w MRI. This method was benchmarked against (a) standard data augmentation and two state-of-the art cross-modality pseudo MR-based augmentation and (b) two segmentation networks. Segmentation accuracy was computed using Dice similarity coefficient (DSC), Hausdroff distance metrics, and volume ratio. The proposed approach produced the lowest statistical variability in the intensity distribution between pseudo and T2w MR images measured as Kullback-Leibler divergence of 0.069. This method produced the highest segmentation accuracy with a DSC of 0.75 and the lowest Hausdroff distance on the test dataset. This approach produced highly similar estimations of tumor growth as an expert (P = 0.37). A novel deep learning MR segmentation was developed that overcomes the limitation of learning robust models from small datasets by leveraging learned cross-modality priors to augment training. The results show the feasibility of the approach and the corresponding improvement over the state-of-the-art methods.

  • 7 authors
·
Jan 31, 2019

A Multimodal Knowledge-enhanced Whole-slide Pathology Foundation Model

Remarkable strides in computational pathology have been made in the task-agnostic foundation model that advances the performance of a wide array of downstream clinical tasks. Despite the promising performance, there are still several challenges. First, prior works have resorted to either vision-only or image-caption data, disregarding pathology reports with more clinically authentic information from pathologists and gene expression profiles which respectively offer distinct knowledge for versatile clinical applications. Second, the current progress in pathology FMs predominantly concentrates on the patch level, where the restricted context of patch-level pretraining fails to capture whole-slide patterns. Even recent slide-level FMs still struggle to provide whole-slide context for patch representation. In this study, for the first time, we develop a pathology foundation model incorporating three levels of modalities: pathology slides, pathology reports, and gene expression data, which resulted in 26,169 slide-level modality pairs from 10,275 patients across 32 cancer types, amounting to over 116 million pathological patch images. To leverage these data for CPath, we propose a novel whole-slide pretraining paradigm that injects the multimodal whole-slide context into the patch representation, called Multimodal Self-TAught PRetraining (mSTAR). The proposed paradigm revolutionizes the pretraining workflow for CPath, enabling the pathology FM to acquire the whole-slide context. To the best of our knowledge, this is the first attempt to incorporate three modalities at the whole-slide context for enhancing pathology FMs. To systematically evaluate the capabilities of mSTAR, we built the largest spectrum of oncological benchmark, spanning 7 categories of oncological applications in 15 types of 97 practical oncological tasks.

  • 19 authors
·
Jul 22, 2024

MedShift: Implicit Conditional Transport for X-Ray Domain Adaptation

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

  • 4 authors
·
Aug 29, 2025

Fine-tuning Segment Anything for Real-Time Tumor Tracking in Cine-MRI

In this work, we address the TrackRAD2025 challenge of real-time tumor tracking in cine-MRI sequences of the thoracic and abdominal regions under strong data scarcity constraints. Two complementary strategies were explored: (i) unsupervised registration with the IMPACT similarity metric and (ii) foundation model-based segmentation leveraging SAM 2.1 and its recent variants through prompt-based interaction. Due to the one-second runtime constraint, the SAM-based method was ultimately selected. The final configuration used SAM2.1 b+ with mask-based prompts from the first annotated slice, fine-tuned solely on the small labeled subset from TrackRAD2025. Training was configured to minimize overfitting, using 1024x1024 patches (batch size 1), standard augmentations, and a balanced Dice + IoU loss. A low uniform learning rate (0.0001) was applied to all modules (prompt encoder, decoder, Hiera backbone) to preserve generalization while adapting to annotator-specific styles. Training lasted 300 epochs (~12h on RTX A6000, 48GB). The same inference strategy was consistently applied across all anatomical sites and MRI field strengths. Test-time augmentation was considered but ultimately discarded due to negligible performance gains. The final model was selected based on the highest Dice Similarity Coefficient achieved on the validation set after fine-tuning. On the hidden test set, the model reached a Dice score of 0.8794, ranking 6th overall in the TrackRAD2025 challenge. These results highlight the strong potential of foundation models for accurate and real-time tumor tracking in MRI-guided radiotherapy.

  • 4 authors
·
Oct 29, 2025

Towards Generalist Biomedical AI

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

  • 32 authors
·
Jul 26, 2023

Preference Fine-Tuning for Factuality in Chest X-Ray Interpretation Models Without Human Feedback

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

  • 11 authors
·
Oct 9, 2024

RoentGen: Vision-Language Foundation Model for Chest X-ray Generation

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

  • 10 authors
·
Nov 23, 2022

Improving the Performance of Radiology Report De-identification with Large-Scale Training and Benchmarking Against Cloud Vendor Methods

Objective: To enhance automated de-identification of radiology reports by scaling transformer-based models through extensive training datasets and benchmarking performance against commercial cloud vendor systems for protected health information (PHI) detection. Materials and Methods: In this retrospective study, we built upon a state-of-the-art, transformer-based, PHI de-identification pipeline by fine-tuning on two large annotated radiology corpora from Stanford University, encompassing chest X-ray, chest CT, abdomen/pelvis CT, and brain MR reports and introducing an additional PHI category (AGE) into the architecture. Model performance was evaluated on test sets from Stanford and the University of Pennsylvania (Penn) for token-level PHI detection. We further assessed (1) the stability of synthetic PHI generation using a "hide-in-plain-sight" method and (2) performance against commercial systems. Precision, recall, and F1 scores were computed across all PHI categories. Results: Our model achieved overall F1 scores of 0.973 on the Penn dataset and 0.996 on the Stanford dataset, outperforming or maintaining the previous state-of-the-art model performance. Synthetic PHI evaluation showed consistent detectability (overall F1: 0.959 [0.958-0.960]) across 50 independently de-identified Penn datasets. Our model outperformed all vendor systems on synthetic Penn reports (overall F1: 0.960 vs. 0.632-0.754). Discussion: Large-scale, multimodal training improved cross-institutional generalization and robustness. Synthetic PHI generation preserved data utility while ensuring privacy. Conclusion: A transformer-based de-identification model trained on diverse radiology datasets outperforms prior academic and commercial systems in PHI detection and establishes a new benchmark for secure clinical text processing.

  • 8 authors
·
Nov 6, 2025

Complex-Edit: CoT-Like Instruction Generation for Complexity-Controllable Image Editing Benchmark

We introduce Complex-Edit, a comprehensive benchmark designed to systematically evaluate instruction-based image editing models across instructions of varying complexity. To develop this benchmark, we harness GPT-4o to automatically collect a diverse set of editing instructions at scale. Our approach follows a well-structured ``Chain-of-Edit'' pipeline: we first generate individual atomic editing tasks independently and then integrate them to form cohesive, complex instructions. Additionally, we introduce a suite of metrics to assess various aspects of editing performance, along with a VLM-based auto-evaluation pipeline that supports large-scale assessments. Our benchmark yields several notable insights: 1) Open-source models significantly underperform relative to proprietary, closed-source models, with the performance gap widening as instruction complexity increases; 2) Increased instructional complexity primarily impairs the models' ability to retain key elements from the input images and to preserve the overall aesthetic quality; 3) Decomposing a complex instruction into a sequence of atomic steps, executed in a step-by-step manner, substantially degrades performance across multiple metrics; 4) A straightforward Best-of-N selection strategy improves results for both direct editing and the step-by-step sequential approach; and 5) We observe a ``curse of synthetic data'': when synthetic data is involved in model training, the edited images from such models tend to appear increasingly synthetic as the complexity of the editing instructions rises -- a phenomenon that intriguingly also manifests in the latest GPT-4o outputs.

  • 6 authors
·
Apr 17, 2025 2

A Comprehensive Study of GPT-4V's Multimodal Capabilities in Medical Imaging

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

  • 10 authors
·
Oct 31, 2023

SridBench: Benchmark of Scientific Research Illustration Drawing of Image Generation Model

Recent years have seen rapid advances in AI-driven image generation. Early diffusion models emphasized perceptual quality, while newer multimodal models like GPT-4o-image integrate high-level reasoning, improving semantic understanding and structural composition. Scientific illustration generation exemplifies this evolution: unlike general image synthesis, it demands accurate interpretation of technical content and transformation of abstract ideas into clear, standardized visuals. This task is significantly more knowledge-intensive and laborious, often requiring hours of manual work and specialized tools. Automating it in a controllable, intelligent manner would provide substantial practical value. Yet, no benchmark currently exists to evaluate AI on this front. To fill this gap, we introduce SridBench, the first benchmark for scientific figure generation. It comprises 1,120 instances curated from leading scientific papers across 13 natural and computer science disciplines, collected via human experts and MLLMs. Each sample is evaluated along six dimensions, including semantic fidelity and structural accuracy. Experimental results reveal that even top-tier models like GPT-4o-image lag behind human performance, with common issues in text/visual clarity and scientific correctness. These findings highlight the need for more advanced reasoning-driven visual generation capabilities.

  • 7 authors
·
May 28, 2025 2

RadioDiff-3D: A 3Dtimes3D Radio Map Dataset and Generative Diffusion Based Benchmark for 6G Environment-Aware Communication

Radio maps (RMs) serve as a critical foundation for enabling environment-aware wireless communication, as they provide the spatial distribution of wireless channel characteristics. Despite recent progress in RM construction using data-driven approaches, most existing methods focus solely on pathloss prediction in a fixed 2D plane, neglecting key parameters such as direction of arrival (DoA), time of arrival (ToA), and vertical spatial variations. Such a limitation is primarily due to the reliance on static learning paradigms, which hinder generalization beyond the training data distribution. To address these challenges, we propose UrbanRadio3D, a large-scale, high-resolution 3D RM dataset constructed via ray tracing in realistic urban environments. UrbanRadio3D is over 37times3 larger than previous datasets across a 3D space with 3 metrics as pathloss, DoA, and ToA, forming a novel 3Dtimes33D dataset with 7times3 more height layers than prior state-of-the-art (SOTA) dataset. To benchmark 3D RM construction, a UNet with 3D convolutional operators is proposed. Moreover, we further introduce RadioDiff-3D, a diffusion-model-based generative framework utilizing the 3D convolutional architecture. RadioDiff-3D supports both radiation-aware scenarios with known transmitter locations and radiation-unaware settings based on sparse spatial observations. Extensive evaluations on UrbanRadio3D validate that RadioDiff-3D achieves superior performance in constructing rich, high-dimensional radio maps under diverse environmental dynamics. This work provides a foundational dataset and benchmark for future research in 3D environment-aware communication. The dataset is available at https://github.com/UNIC-Lab/UrbanRadio3D.

  • 8 authors
·
Jul 16, 2025

A Data-Efficient Pan-Tumor Foundation Model for Oncology CT Interpretation

Artificial intelligence-assisted imaging analysis has made substantial strides in tumor diagnosis and management. Here we present PASTA, a pan-tumor CT foundation model that achieves state-of-the-art performance on 45 of 46 representative oncology tasks -- including lesion segmentation, tumor detection in plain CT, tumor staging, survival prediction, structured report generation, and cross-modality transfer learning, significantly outperforming the second-best models on 35 tasks. This remarkable advancement is driven by our development of PASTA-Gen, an innovative synthetic tumor generation framework that produces a comprehensive dataset of 30,000 CT scans with pixel-level annotated lesions and paired structured reports, encompassing malignancies across ten organs and five benign lesion types. By leveraging this rich, high-quality synthetic data, we overcome a longstanding bottleneck in the development of CT foundation models -- specifically, the scarcity of publicly available, high-quality annotated datasets due to privacy constraints and the substantial labor required for scaling precise data annotation. Encouragingly, PASTA demonstrates exceptional data efficiency with promising practical value, markedly improving performance on various tasks with only a small amount of real-world data. The open release of both the synthetic dataset and PASTA foundation model effectively addresses the challenge of data scarcity, thereby advancing oncological research and clinical translation.

  • 16 authors
·
Feb 10, 2025

MedMNIST-C: Comprehensive benchmark and improved classifier robustness by simulating realistic image corruptions

The integration of neural-network-based systems into clinical practice is limited by challenges related to domain generalization and robustness. The computer vision community established benchmarks such as ImageNet-C as a fundamental prerequisite to measure progress towards those challenges. Similar datasets are largely absent in the medical imaging community which lacks a comprehensive benchmark that spans across imaging modalities and applications. To address this gap, we create and open-source MedMNIST-C, a benchmark dataset based on the MedMNIST+ collection covering 12 datasets and 9 imaging modalities. We simulate task and modality-specific image corruptions of varying severity to comprehensively evaluate the robustness of established algorithms against real-world artifacts and distribution shifts. We further provide quantitative evidence that our simple-to-use artificial corruptions allow for highly performant, lightweight data augmentation to enhance model robustness. Unlike traditional, generic augmentation strategies, our approach leverages domain knowledge, exhibiting significantly higher robustness when compared to widely adopted methods. By introducing MedMNIST-C and open-sourcing the corresponding library allowing for targeted data augmentations, we contribute to the development of increasingly robust methods tailored to the challenges of medical imaging. The code is available at https://github.com/francescodisalvo05/medmnistc-api .

  • 3 authors
·
Jun 25, 2024

Are Vision Language Models Ready for Clinical Diagnosis? A 3D Medical Benchmark for Tumor-centric Visual Question Answering

Vision-Language Models (VLMs) have shown promise in various 2D visual tasks, yet their readiness for 3D clinical diagnosis remains unclear due to stringent demands for recognition precision, reasoning ability, and domain knowledge. To systematically evaluate these dimensions, we present DeepTumorVQA, a diagnostic visual question answering (VQA) benchmark targeting abdominal tumors in CT scans. It comprises 9,262 CT volumes (3.7M slices) from 17 public datasets, with 395K expert-level questions spanning four categories: Recognition, Measurement, Visual Reasoning, and Medical Reasoning. DeepTumorVQA introduces unique challenges, including small tumor detection and clinical reasoning across 3D anatomy. Benchmarking four advanced VLMs (RadFM, M3D, Merlin, CT-CHAT), we find current models perform adequately on measurement tasks but struggle with lesion recognition and reasoning, and are still not meeting clinical needs. Two key insights emerge: (1) large-scale multimodal pretraining plays a crucial role in DeepTumorVQA testing performance, making RadFM stand out among all VLMs. (2) Our dataset exposes critical differences in VLM components, where proper image preprocessing and design of vision modules significantly affect 3D perception. To facilitate medical multimodal research, we have released DeepTumorVQA as a rigorous benchmark: https://github.com/Schuture/DeepTumorVQA.

  • 8 authors
·
May 24, 2025

A Comprehensive Library for Benchmarking Multi-class Visual Anomaly Detection

Visual anomaly detection aims to identify anomalous regions in images through unsupervised learning paradigms, with increasing application demand and value in fields such as industrial inspection and medical lesion detection. Despite significant progress in recent years, there is a lack of comprehensive benchmarks to adequately evaluate the performance of various mainstream methods across different datasets under the practical multi-class setting. The absence of standardized experimental setups can lead to potential biases in training epochs, resolution, and metric results, resulting in erroneous conclusions. This paper addresses this issue by proposing a comprehensive visual anomaly detection benchmark, ADer, which is a modular framework that is highly extensible for new methods. The benchmark includes multiple datasets from industrial and medical domains, implementing fifteen state-of-the-art methods and nine comprehensive metrics. Additionally, we have proposed the GPU-assisted ADEval package to address the slow evaluation problem of metrics like time-consuming mAU-PRO on large-scale data, significantly reducing evaluation time by more than 1000-fold. Through extensive experimental results, we objectively reveal the strengths and weaknesses of different methods and provide insights into the challenges and future directions of multi-class visual anomaly detection. We hope that ADer will become a valuable resource for researchers and practitioners in the field, promoting the development of more robust and generalizable anomaly detection systems. Full codes are open-sourced at https://github.com/zhangzjn/ader.

  • 10 authors
·
Jun 5, 2024

TrackRAD2025 challenge dataset: Real-time tumor tracking for MRI-guided radiotherapy

Purpose: Magnetic resonance imaging (MRI) to visualize anatomical motion is becoming increasingly important when treating cancer patients with radiotherapy. Hybrid MRI-linear accelerator (MRI-linac) systems allow real-time motion management during irradiation. This paper presents a multi-institutional real-time MRI time series dataset from different MRI-linac vendors. The dataset is designed to support developing and evaluating real-time tumor localization (tracking) algorithms for MRI-guided radiotherapy within the TrackRAD2025 challenge (https://trackrad2025.grand-challenge.org/). Acquisition and validation methods: The dataset consists of sagittal 2D cine MRIs in 585 patients from six centers (3 Dutch, 1 German, 1 Australian, and 1 Chinese). Tumors in the thorax, abdomen, and pelvis acquired on two commercially available MRI-linacs (0.35 T and 1.5 T) were included. For 108 cases, irradiation targets or tracking surrogates were manually segmented on each temporal frame. The dataset was randomly split into a public training set of 527 cases (477 unlabeled and 50 labeled) and a private testing set of 58 cases (all labeled). Data Format and Usage Notes: The data is publicly available under the TrackRAD2025 collection: https://doi.org/10.57967/hf/4539. Both the images and segmentations for each patient are available in metadata format. Potential Applications: This novel clinical dataset will enable the development and evaluation of real-time tumor localization algorithms for MRI-guided radiotherapy. By enabling more accurate motion management and adaptive treatment strategies, this dataset has the potential to advance the field of radiotherapy significantly.

  • 28 authors
·
Mar 24, 2025

BARS-CTR: Open Benchmarking for Click-Through Rate Prediction

Click-through rate (CTR) prediction is a critical task for many applications, as its accuracy has a direct impact on user experience and platform revenue. In recent years, CTR prediction has been widely studied in both academia and industry, resulting in a wide variety of CTR prediction models. Unfortunately, there is still a lack of standardized benchmarks and uniform evaluation protocols for CTR prediction research. This leads to non-reproducible or even inconsistent experimental results among existing studies, which largely limits the practical value and potential impact of their research. In this work, we aim to perform open benchmarking for CTR prediction and present a rigorous comparison of different models in a reproducible manner. To this end, we ran over 7,000 experiments for more than 12,000 GPU hours in total to re-evaluate 24 existing models on multiple datasets and settings. Surprisingly, our experiments show that with sufficient hyper-parameter search and model tuning, many deep models have smaller differences than expected. The results also reveal that making real progress on the modeling of CTR prediction is indeed a very challenging research task. We believe that our benchmarking work could not only allow researchers to gauge the effectiveness of new models conveniently but also make them fairly compare with the state of the arts. We have publicly released the benchmarking code, evaluation protocols, and hyper-parameter settings of our work to promote reproducible research in this field.

  • 5 authors
·
Sep 12, 2020

Towards a Single Unified Model for Effective Detection, Segmentation, and Diagnosis of Eight Major Cancers Using a Large Collection of CT Scans

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

  • 25 authors
·
Jan 28, 2023

MedQ-Bench: Evaluating and Exploring Medical Image Quality Assessment Abilities in MLLMs

Medical Image Quality Assessment (IQA) serves as the first-mile safety gate for clinical AI, yet existing approaches remain constrained by scalar, score-based metrics and fail to reflect the descriptive, human-like reasoning process central to expert evaluation. To address this gap, we introduce MedQ-Bench, a comprehensive benchmark that establishes a perception-reasoning paradigm for language-based evaluation of medical image quality with Multi-modal Large Language Models (MLLMs). MedQ-Bench defines two complementary tasks: (1) MedQ-Perception, which probes low-level perceptual capability via human-curated questions on fundamental visual attributes; and (2) MedQ-Reasoning, encompassing both no-reference and comparison reasoning tasks, aligning model evaluation with human-like reasoning on image quality. The benchmark spans five imaging modalities and over forty quality attributes, totaling 2,600 perceptual queries and 708 reasoning assessments, covering diverse image sources including authentic clinical acquisitions, images with simulated degradations via physics-based reconstructions, and AI-generated images. To evaluate reasoning ability, we propose a multi-dimensional judging protocol that assesses model outputs along four complementary axes. We further conduct rigorous human-AI alignment validation by comparing LLM-based judgement with radiologists. Our evaluation of 14 state-of-the-art MLLMs demonstrates that models exhibit preliminary but unstable perceptual and reasoning skills, with insufficient accuracy for reliable clinical use. These findings highlight the need for targeted optimization of MLLMs in medical IQA. We hope that MedQ-Bench will catalyze further exploration and unlock the untapped potential of MLLMs for medical image quality evaluation.

  • 20 authors
·
Oct 2, 2025 2

Enhanced Contrastive Learning with Multi-view Longitudinal Data for Chest X-ray Report Generation

Automated radiology report generation offers an effective solution to alleviate radiologists' workload. However, most existing methods focus primarily on single or fixed-view images to model current disease conditions, which limits diagnostic accuracy and overlooks disease progression. Although some approaches utilize longitudinal data to track disease progression, they still rely on single images to analyze current visits. To address these issues, we propose enhanced contrastive learning with Multi-view Longitudinal data to facilitate chest X-ray Report Generation, named MLRG. Specifically, we introduce a multi-view longitudinal contrastive learning method that integrates spatial information from current multi-view images and temporal information from longitudinal data. This method also utilizes the inherent spatiotemporal information of radiology reports to supervise the pre-training of visual and textual representations. Subsequently, we present a tokenized absence encoding technique to flexibly handle missing patient-specific prior knowledge, allowing the model to produce more accurate radiology reports based on available prior knowledge. Extensive experiments on MIMIC-CXR, MIMIC-ABN, and Two-view CXR datasets demonstrate that our MLRG outperforms recent state-of-the-art methods, achieving a 2.3% BLEU-4 improvement on MIMIC-CXR, a 5.5% F1 score improvement on MIMIC-ABN, and a 2.7% F1 RadGraph improvement on Two-view CXR.

  • 7 authors
·
Feb 27, 2025

ICON: Improving Inter-Report Consistency of Radiology Report Generation via Lesion-aware Mix-up Augmentation

Previous research on radiology report generation has made significant progress in terms of increasing the clinical accuracy of generated reports. In this paper, we emphasize another crucial quality that it should possess, i.e., inter-report consistency, which refers to the capability of generating consistent reports for semantically equivalent radiographs. This quality is even of greater significance than the overall report accuracy in terms of ensuring the system's credibility, as a system prone to providing conflicting results would severely erode users' trust. Regrettably, existing approaches struggle to maintain inter-report consistency, exhibiting biases towards common patterns and susceptibility to lesion variants. To address this issue, we propose ICON, which improves the inter-report consistency of radiology report generation. Aiming at enhancing the system's ability to capture the similarities in semantically equivalent lesions, our approach involves first extracting lesions from input images and examining their characteristics. Then, we introduce a lesion-aware mix-up augmentation technique to ensure that the representations of the semantically equivalent lesions align with the same attributes, by linearly interpolating them during the training phase. Extensive experiments on three publicly available chest X-ray datasets verify the effectiveness of our approach, both in terms of improving the consistency and accuracy of the generated reports.

  • 6 authors
·
Feb 20, 2024

Calibration and Uncertainty for multiRater Volume Assessment in multiorgan Segmentation (CURVAS) challenge results

Deep learning (DL) has become the dominant approach for medical image segmentation, yet ensuring the reliability and clinical applicability of these models requires addressing key challenges such as annotation variability, calibration, and uncertainty estimation. This is why we created the Calibration and Uncertainty for multiRater Volume Assessment in multiorgan Segmentation (CURVAS), which highlights the critical role of multiple annotators in establishing a more comprehensive ground truth, emphasizing that segmentation is inherently subjective and that leveraging inter-annotator variability is essential for robust model evaluation. Seven teams participated in the challenge, submitting a variety of DL models evaluated using metrics such as Dice Similarity Coefficient (DSC), Expected Calibration Error (ECE), and Continuous Ranked Probability Score (CRPS). By incorporating consensus and dissensus ground truth, we assess how DL models handle uncertainty and whether their confidence estimates align with true segmentation performance. Our findings reinforce the importance of well-calibrated models, as better calibration is strongly correlated with the quality of the results. Furthermore, we demonstrate that segmentation models trained on diverse datasets and enriched with pre-trained knowledge exhibit greater robustness, particularly in cases deviating from standard anatomical structures. Notably, the best-performing models achieved high DSC and well-calibrated uncertainty estimates. This work underscores the need for multi-annotator ground truth, thorough calibration assessments, and uncertainty-aware evaluations to develop trustworthy and clinically reliable DL-based medical image segmentation models.

  • 32 authors
·
May 13, 2025

MoSt-DSA: Modeling Motion and Structural Interactions for Direct Multi-Frame Interpolation in DSA Images

Artificial intelligence has become a crucial tool for medical image analysis. As an advanced cerebral angiography technique, Digital Subtraction Angiography (DSA) poses a challenge where the radiation dose to humans is proportional to the image count. By reducing images and using AI interpolation instead, the radiation can be cut significantly. However, DSA images present more complex motion and structural features than natural scenes, making interpolation more challenging. We propose MoSt-DSA, the first work that uses deep learning for DSA frame interpolation. Unlike natural scene Video Frame Interpolation (VFI) methods that extract unclear or coarse-grained features, we devise a general module that models motion and structural context interactions between frames in an efficient full convolution manner by adjusting optimal context range and transforming contexts into linear functions. Benefiting from this, MoSt-DSA is also the first method that directly achieves any number of interpolations at any time steps with just one forward pass during both training and testing. We conduct extensive comparisons with 7 representative VFI models for interpolating 1 to 3 frames, MoSt-DSA demonstrates robust results across 470 DSA image sequences (each typically 152 images), with average SSIM over 0.93, average PSNR over 38 (standard deviations of less than 0.030 and 3.6, respectively), comprehensively achieving state-of-the-art performance in accuracy, speed, visual effect, and memory usage. Our code is available at https://github.com/ZyoungXu/MoSt-DSA.

  • 6 authors
·
Jul 9, 2024

A Review of Longitudinal Radiology Report Generation: Dataset Composition, Methods, and Performance Evaluation

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

  • 6 authors
·
Oct 14, 2025

Exploring Multimodal Large Language Models for Radiology Report Error-checking

This paper proposes one of the first clinical applications of multimodal large language models (LLMs) as an assistant for radiologists to check errors in their reports. We created an evaluation dataset from two real-world radiology datasets (MIMIC-CXR and IU-Xray), with 1,000 subsampled reports each. A subset of original reports was modified to contain synthetic errors by introducing various type of mistakes. The evaluation contained two difficulty levels: SIMPLE for binary error-checking and COMPLEX for identifying error types. LLaVA (Large Language and Visual Assistant) variant models, including our instruction-tuned model, were used for the evaluation. Additionally, a domain expert evaluation was conducted on a small test set. At the SIMPLE level, the LLaVA v1.5 model outperformed other publicly available models. Instruction tuning significantly enhanced performance by 47.4% and 25.4% on MIMIC-CXR and IU-Xray data, respectively. The model also surpassed the domain experts accuracy in the MIMIC-CXR dataset by 1.67%. Notably, among the subsets (N=21) of the test set where a clinician did not achieve the correct conclusion, the LLaVA ensemble mode correctly identified 71.4% of these cases. This study marks a promising step toward utilizing multi-modal LLMs to enhance diagnostic accuracy in radiology. The ensemble model demonstrated comparable performance to clinicians, even capturing errors overlooked by humans. Nevertheless, future work is needed to improve the model ability to identify the types of inconsistency.

  • 10 authors
·
Dec 20, 2023

MOSAIC: A Multilingual, Taxonomy-Agnostic, and Computationally Efficient Approach for Radiological Report Classification

Radiology reports contain rich clinical information that can be used to train imaging models without relying on costly manual annotation. However, existing approaches face critical limitations: rule-based methods struggle with linguistic variability, supervised models require large annotated datasets, and recent LLM-based systems depend on closed-source or resource-intensive models that are unsuitable for clinical use. Moreover, current solutions are largely restricted to English and single-modality, single-taxonomy datasets. We introduce MOSAIC, a multilingual, taxonomy-agnostic, and computationally efficient approach for radiological report classification. Built on a compact open-access language model (MedGemma-4B), MOSAIC supports both zero-/few-shot prompting and lightweight fine-tuning, enabling deployment on consumer-grade GPUs. We evaluate MOSAIC across seven datasets in English, Spanish, French, and Danish, spanning multiple imaging modalities and label taxonomies. The model achieves a mean macro F1 score of 88 across five chest X-ray datasets, approaching or exceeding expert-level performance, while requiring only 24 GB of GPU memory. With data augmentation, as few as 80 annotated samples are sufficient to reach a weighted F1 score of 82 on Danish reports, compared to 86 with the full 1600-sample training set. MOSAIC offers a practical alternative to large or proprietary LLMs in clinical settings. Code and models are open-source. We invite the community to evaluate and extend MOSAIC on new languages, taxonomies, and modalities.

  • 9 authors
·
Aug 29, 2025

MInDI-3D: Iterative Deep Learning in 3D for Sparse-view Cone Beam Computed Tomography

We present MInDI-3D (Medical Inversion by Direct Iteration in 3D), the first 3D conditional diffusion-based model for real-world sparse-view Cone Beam Computed Tomography (CBCT) artefact removal, aiming to reduce imaging radiation exposure. A key contribution is extending the "InDI" concept from 2D to a full 3D volumetric approach for medical images, implementing an iterative denoising process that refines the CBCT volume directly from sparse-view input. A further contribution is the generation of a large pseudo-CBCT dataset (16,182) from chest CT volumes of the CT-RATE public dataset to robustly train MInDI-3D. We performed a comprehensive evaluation, including quantitative metrics, scalability analysis, generalisation tests, and a clinical assessment by 11 clinicians. Our results show MInDI-3D's effectiveness, achieving a 12.96 (6.10) dB PSNR gain over uncorrected scans with only 50 projections on the CT-RATE pseudo-CBCT (independent real-world) test set and enabling an 8x reduction in imaging radiation exposure. We demonstrate its scalability by showing that performance improves with more training data. Importantly, MInDI-3D matches the performance of a 3D U-Net on real-world scans from 16 cancer patients across distortion and task-based metrics. It also generalises to new CBCT scanner geometries. Clinicians rated our model as sufficient for patient positioning across all anatomical sites and found it preserved lung tumour boundaries well.

  • 10 authors
·
Aug 13, 2025

MultiBanana: A Challenging Benchmark for Multi-Reference Text-to-Image Generation

Recent text-to-image generation models have acquired the ability of multi-reference generation and editing; the ability to inherit the appearance of subjects from multiple reference images and re-render them under new contexts. However, the existing benchmark datasets often focus on the generation with single or a few reference images, which prevents us from measuring the progress on how model performance advances or pointing out their weaknesses, under different multi-reference conditions. In addition, their task definitions are still vague, typically limited to axes such as "what to edit" or "how many references are given", and therefore fail to capture the intrinsic difficulty of multi-reference settings. To address this gap, we introduce MultiBanana, which is carefully designed to assesses the edge of model capabilities by widely covering multi-reference-specific problems at scale: (1) varying the number of references, (2) domain mismatch among references (e.g., photo vs. anime), (3) scale mismatch between reference and target scenes, (4) references containing rare concepts (e.g., a red banana), and (5) multilingual textual references for rendering. Our analysis among a variety of text-to-image models reveals their superior performances, typical failure modes, and areas for improvement. MultiBanana will be released as an open benchmark to push the boundaries and establish a standardized basis for fair comparison in multi-reference image generation. Our data and code are available at https://github.com/matsuolab/multibanana .

  • 7 authors
·
Nov 28, 2025 2

A for-loop is all you need. For solving the inverse problem in the case of personalized tumor growth modeling

Solving the inverse problem is the key step in evaluating the capacity of a physical model to describe real phenomena. In medical image computing, it aligns with the classical theme of image-based model personalization. Traditionally, a solution to the problem is obtained by performing either sampling or variational inference based methods. Both approaches aim to identify a set of free physical model parameters that results in a simulation best matching an empirical observation. When applied to brain tumor modeling, one of the instances of image-based model personalization in medical image computing, the overarching drawback of the methods is the time complexity for finding such a set. In a clinical setting with limited time between imaging and diagnosis or even intervention, this time complexity may prove critical. As the history of quantitative science is the history of compression, we align in this paper with the historical tendency and propose a method compressing complex traditional strategies for solving an inverse problem into a simple database query task. We evaluated different ways of performing the database query task assessing the trade-off between accuracy and execution time. On the exemplary task of brain tumor growth modeling, we prove that the proposed method achieves one order speed-up compared to existing approaches for solving the inverse problem. The resulting compute time offers critical means for relying on more complex and, hence, realistic models, for integrating image preprocessing and inverse modeling even deeper, or for implementing the current model into a clinical workflow.

  • 15 authors
·
May 9, 2022

CHIPS: Efficient CLIP Adaptation via Curvature-aware Hybrid Influence-based Data Selection

Adapting CLIP to vertical domains is typically approached by novel fine-tuning strategies or by continual pre-training (CPT) on large domain-specific datasets. Yet, data itself remains an underexplored factor in this process. We revisit this task from a data-centric perspective: Can effective data selection substitute for large-scale datasets in CPT? We introduce CHIPS (Curvature-aware Hybrid Influence in Projection Subspace), which assigns each image-text pair a utility score that integrates three complementary factors aligned with three goals: faithfulness via a curvature-aware, Newton-style alignment computed in CLIP's end-point subspace; scalability via an InfoNCE-aware curvature estimator with Johnson-Lindenstrauss (JL) sketching; and retention via a selection-aware relevance weight combined with learnability to balance target adaptation against general-domain preservation. We justify this design theoretically by proving a lower-bound guarantee on the proxy's correlation with full-parameter alignment and by characterizing the bias-variance trade-offs introduced by curvature mixing and JL sketching. We evaluate CHIPS empirically across various settings: 1) CHIPS attains state-of-the-art performance among selection baselines on 17 medical benchmarks, matches full-dataset CPT with 30% of the data, and outperforms half-dataset CPT using only 10%; 2) on 31 general-domain benchmarks, CHIPS yields the smallest performance drop under 10-30% data-retention budgets. Code, data, and checkpoints will be released.

  • 14 authors
·
Nov 23, 2025

SEAL: A Framework for Systematic Evaluation of Real-World Super-Resolution

Real-world Super-Resolution (Real-SR) methods focus on dealing with diverse real-world images and have attracted increasing attention in recent years. The key idea is to use a complex and high-order degradation model to mimic real-world degradations. Although they have achieved impressive results in various scenarios, they are faced with the obstacle of evaluation. Currently, these methods are only assessed by their average performance on a small set of degradation cases randomly selected from a large space, which fails to provide a comprehensive understanding of their overall performance and often yields inconsistent and potentially misleading results. To overcome the limitation in evaluation, we propose SEAL, a framework for systematic evaluation of real-SR. In particular, we cluster the extensive degradation space to create a set of representative degradation cases, which serves as a comprehensive test set. Next, we propose a coarse-to-fine evaluation protocol to measure the distributed and relative performance of real-SR methods on the test set. The protocol incorporates two new metrics: acceptance rate (AR) and relative performance ratio (RPR), derived from acceptance and excellence lines. Under SEAL, we benchmark existing real-SR methods, obtain new observations and insights into their performance, and develop a new strong baseline. We consider SEAL as the first step towards creating a comprehensive real-SR evaluation platform, which can promote the development of real-SR. The source code is available at https://github.com/XPixelGroup/SEAL

  • 6 authors
·
Sep 6, 2023

NeFII: Inverse Rendering for Reflectance Decomposition with Near-Field Indirect Illumination

Inverse rendering methods aim to estimate geometry, materials and illumination from multi-view RGB images. In order to achieve better decomposition, recent approaches attempt to model indirect illuminations reflected from different materials via Spherical Gaussians (SG), which, however, tends to blur the high-frequency reflection details. In this paper, we propose an end-to-end inverse rendering pipeline that decomposes materials and illumination from multi-view images, while considering near-field indirect illumination. In a nutshell, we introduce the Monte Carlo sampling based path tracing and cache the indirect illumination as neural radiance, enabling a physics-faithful and easy-to-optimize inverse rendering method. To enhance efficiency and practicality, we leverage SG to represent the smooth environment illuminations and apply importance sampling techniques. To supervise indirect illuminations from unobserved directions, we develop a novel radiance consistency constraint between implicit neural radiance and path tracing results of unobserved rays along with the joint optimization of materials and illuminations, thus significantly improving the decomposition performance. Extensive experiments demonstrate that our method outperforms the state-of-the-art on multiple synthetic and real datasets, especially in terms of inter-reflection decomposition.Our code and data are available at https://woolseyyy.github.io/nefii/.

  • 6 authors
·
Mar 29, 2023

M4-SAR: A Multi-Resolution, Multi-Polarization, Multi-Scene, Multi-Source Dataset and Benchmark for Optical-SAR Fusion Object Detection

Single-source remote sensing object detection using optical or SAR images struggles in complex environments. Optical images offer rich textural details but are often affected by low-light, cloud-obscured, or low-resolution conditions, reducing the detection performance. SAR images are robust to weather, but suffer from speckle noise and limited semantic expressiveness. Optical and SAR images provide complementary advantages, and fusing them can significantly improve the detection accuracy. However, progress in this field is hindered by the lack of large-scale, standardized datasets. To address these challenges, we propose the first comprehensive dataset for optical-SAR fusion object detection, named Multi-resolution, Multi-polarization, Multi-scene, Multi-source SAR dataset (M4-SAR). It contains 112,184 precisely aligned image pairs and nearly one million labeled instances with arbitrary orientations, spanning six key categories. To enable standardized evaluation, we develop a unified benchmarking toolkit that integrates six state-of-the-art multi-source fusion methods. Furthermore, we propose E2E-OSDet, a novel end-to-end multi-source fusion detection framework that mitigates cross-domain discrepancies and establishes a robust baseline for future studies. Extensive experiments on M4-SAR demonstrate that fusing optical and SAR data can improve mAP by 5.7\% over single-source inputs, with particularly significant gains in complex environments. The dataset and code are publicly available at https://github.com/wchao0601/M4-SAR.

  • 5 authors
·
May 16, 2025