From large language models to multimodal AI: A scoping review on the potential of generative AI in medicine

Generative artificial intelligence (AI) models, such as diffusion models and OpenAI's ChatGPT, are transforming medicine by enhancing diagnostic accuracy and automating clinical workflows. The field has advanced rapidly, evolving from text-only large language models for tasks such as clinical documentation and decision support to multimodal AI systems capable of integrating diverse data modalities, including imaging, text, and structured data, within a single model. The diverse landscape of these technologies, along with rising interest, highlights the need for a comprehensive review of their applications and potential. This scoping review explores the evolution of multimodal AI, highlighting its methods, applications, datasets, and evaluation in clinical settings. Adhering to PRISMA-ScR guidelines, we systematically queried PubMed, IEEE Xplore, and Web of Science, prioritizing recent studies published up to the end of 2024. After rigorous screening, 144 papers were included, revealing key trends and challenges in this dynamic field. Our findings underscore a shift from unimodal to multimodal approaches, driving innovations in diagnostic support, medical report generation, drug discovery, and conversational AI. However, critical challenges remain, including the integration of heterogeneous data types, improving model interpretability, addressing ethical concerns, and validating AI systems in real-world clinical settings. This review summarizes the current state of the art, identifies critical gaps, and provides insights to guide the development of scalable, trustworthy, and clinically impactful multimodal AI solutions in healthcare.

Advancing Heat Demand Forecasting with Attention Mechanisms: Opportunities and Challenges

Global leaders and policymakers are unified in their unequivocal commitment to decarbonization efforts in support of Net-Zero agreements. District Heating Systems (DHS), while contributing to carbon emissions due to the continued reliance on fossil fuels for heat production, are embracing more sustainable practices albeit with some sense of vulnerability as it could constrain their ability to adapt to dynamic demand and production scenarios. As demographic demands grow and renewables become the central strategy in decarbonizing the heating sector, the need for accurate demand forecasting has intensified. Advances in digitization have paved the way for Machine Learning (ML) based solutions to become the industry standard for modeling complex time series patterns. In this paper, we focus on building a Deep Learning (DL) model that uses deconstructed components of independent and dependent variables that affect heat demand as features to perform multi-step ahead forecasting of head demand. The model represents the input features in a time-frequency space and uses an attention mechanism to generate accurate forecasts. The proposed method is evaluated on a real-world dataset and the forecasting performance is assessed against LSTM and CNN-based forecasting models. Across different supply zones, the attention-based models outperforms the baselines quantitatively and qualitatively, with an Mean Absolute Error (MAE) of 0.105 with a standard deviation of 0.06kW h and a Mean Absolute Percentage Error (MAPE) of 5.4% with a standard deviation of 2.8%, in comparison the second best model with a MAE of 0.10 with a standard deviation of 0.06kW h and a MAPE of 5.6% with a standard deviation of 3%.

A Self-supervised Multimodal Deep Learning Approach to Differentiate Post-radiotherapy Progression from Pseudoprogression in Glioblastoma

Accurate differentiation of pseudoprogression (PsP) from True Progression (TP) following radiotherapy (RT) in glioblastoma (GBM) patients is crucial for optimal treatment planning. However, this task remains challenging due to the overlapping imaging characteristics of PsP and TP. This study therefore proposes a multimodal deep-learning approach utilizing complementary information from routine anatomical MR images, clinical parameters, and RT treatment planning information for improved predictive accuracy. The approach utilizes a self-supervised Vision Transformer (ViT) to encode multi-sequence MR brain volumes to effectively capture both global and local context from the high dimensional input. The encoder is trained in a self-supervised upstream task on unlabeled glioma MRI datasets from the open BraTS2021, UPenn-GBM, and UCSF-PDGM datasets to generate compact, clinically relevant representations from FLAIR and T1 post-contrast sequences. These encoded MR inputs are then integrated with clinical data and RT treatment planning information through guided cross-modal attention, improving progression classification accuracy. This work was developed using two datasets from different centers: the Burdenko Glioblastoma Progression Dataset (n = 59) for training and validation, and the GlioCMV progression dataset from the University Hospital Erlangen (UKER) (n = 20) for testing. The proposed method achieved an AUC of 75.3%, outperforming the current state-of-the-art data-driven approaches. Importantly, the proposed approach relies on readily available anatomical MRI sequences, clinical data, and RT treatment planning information, enhancing its clinical feasibility. The proposed approach addresses the challenge of limited data availability for PsP and TP differentiation and could allow for improved clinical decision-making and optimized treatment plans for GBM patients.

Compressibility Analysis for the differentiable shift-variant Filtered Backprojection Model

The differentiable shift-variant filtered backprojection (FBP) model enables the reconstruction of cone-beam computed tomography (CBCT) data for any non-circular trajectories. This method employs deep learning technique to estimate the redundancy weights required for reconstruction, given knowledge of the specific trajectory at optimization time. However, computing the redundancy weight for each projection remains computationally intensive. This paper presents a novel approach to compress and optimize the differentiable shift-variant FBP model based on Principal Component Analysis (PCA). We apply PCA to the redundancy weights learned from sinusoidal trajectory projection data, revealing significant parameter redundancy in the original model. By integrating PCA directly into the differentiable shift-variant FBP reconstruction pipeline, we develop a method that decomposes the redundancy weight layer parameters into a trainable eigenvector matrix, compressed weights, and a mean vector. This innovative technique achieves a remarkable 97.25% reduction in trainable parameters without compromising reconstruction accuracy. As a result, our algorithm significantly decreases the complexity of the differentiable shift-variant FBP model and greatly improves training speed. These improvements make the model substantially more practical for real-world applications.

Self Pre-training with Adaptive Mask Autoencoders for Variable-Contrast 3D Medical Imaging

The Masked Autoencoder (MAE) has recently demonstrated effectiveness in pre-training Vision Transformers (ViT) for analyzing natural images. By reconstructing complete images from partially masked inputs, the ViT encoder gathers contextual information to predict the missing regions. This capability to aggregate context is especially important in medical imaging, where anatomical structures are functionally and mechanically linked to surrounding regions. However, current methods do not consider variations in the number of input images, which is typically the case in real-world Magnetic Resonance (MR) studies. To address this limitation, we propose a 3D Adaptive Masked Autoencoders (AMAE) architecture that accommodates a variable number of 3D input contrasts per subject. A magnetic resonance imaging (MRI) dataset of 45,364 subjects was used for pretraining and a subset of 1648 training, 193 validation and 215 test subjects were used for finetuning. The performance demonstrates that self pre-training of this adaptive masked autoencoders can enhance the infarct segmentation performance by 2.8%-3.7% for ViT-based segmentation models.

Refusal Behavior in Large Language Models: A Nonlinear Perspective

Refusal behavior in large language models (LLMs) enables them to decline responding to harmful, unethical, or inappropriate prompts, ensuring alignment with ethical standards. This paper investigates refusal behavior across six LLMs from three architectural families. We challenge the assumption of refusal as a linear phenomenon by employing dimensionality reduction techniques, including PCA, t-SNE, and UMAP. Our results reveal that refusal mechanisms exhibit nonlinear, multidimensional characteristics that vary by model architecture and layer. These findings highlight the need for nonlinear interpretability to improve alignment research and inform safer AI deployment strategies.

Comparison Study: Glacier Calving Front Delineation in Synthetic Aperture Radar Images With Deep Learning

Calving front position variation of marine-terminating glaciers is an indicator of ice mass loss and a crucial parameter in numerical glacier models. Deep Learning (DL) systems can automatically extract this position from Synthetic Aperture Radar (SAR) imagery, enabling continuous, weather- and illumination-independent, large-scale monitoring. This study presents the first comparison of DL systems on a common calving front benchmark dataset. A multi-annotator study with ten annotators is performed to contrast the best-performing DL system against human performance. The best DL model's outputs deviate 221 m on average, while the average deviation of the human annotators is 38 m. This significant difference shows that current DL systems do not yet match human performance and that further research is needed to enable fully automated monitoring of glacier calving fronts. The study of Vision Transformers, foundation models, and the inclusion and processing strategy of more information are identified as avenues for future research.

ProPLIKS: Probablistic 3D human body pose estimation

We present a novel approach for 3D human pose estimation by employing probabilistic modeling. This approach leverages the advantages of normalizing flows in non-Euclidean geometries to address uncertain poses. Specifically, our method employs normalizing flow tailored to the SO(3) rotational group, incorporating a coupling mechanism based on the M\"obius transformation. This enables the framework to accurately represent any distribution on SO(3), effectively addressing issues related to discontinuities. Additionally, we reinterpret the challenge of reconstructing 3D human figures from 2D pixel-aligned inputs as the task of mapping these inputs to a range of probable poses. This perspective acknowledges the intrinsic ambiguity of the task and facilitates a straightforward integration method for multi-view scenarios. The combination of these strategies showcases the effectiveness of probabilistic models in complex scenarios for human pose estimation techniques. Our approach notably surpasses existing methods in the field of pose estimation. We also validate our methodology on human pose estimation from RGB images as well as medical X-Ray datasets.

Gesture Classification in Artworks Using Contextual Image Features

Recognizing gestures in artworks can add a valuable dimension to art understanding and help to acknowledge the role of the sense of smell in cultural heritage. We propose a method to recognize smell gestures in historical artworks. We show that combining local features with global image context improves classification performance notably on different backbones.

Neural Image Unfolding: Flattening Sparse Anatomical Structures using Neural Fields

Tomographic imaging reveals internal structures of 3D objects and is crucial for medical diagnoses. Visualizing the morphology and appearance of non-planar sparse anatomical structures that extend over multiple 2D slices in tomographic volumes is inherently difficult but valuable for decision-making and reporting. Hence, various organ-specific unfolding techniques exist to map their densely sampled 3D surfaces to a distortion-minimized 2D representation. However, there is no versatile framework to flatten complex sparse structures including vascular, duct or bone systems. We deploy a neural field to fit the transformation of the anatomy of interest to a 2D overview image. We further propose distortion regularization strategies and combine geometric with intensity-based loss formulations to also display non-annotated and auxiliary targets. In addition to improved versatility, our unfolding technique outperforms mesh-based baselines for sparse structures w.r.t. peak distortion and our regularization scheme yields smoother transformations compared to Jacobian formulations from neural field-based image registration.