USPilot: An Embodied Robotic Assistant Ultrasound System with Large Language Model Enhanced Graph Planner

In the era of Large Language Models (LLMs), embodied artificial intelligence presents transformative opportunities for robotic manipulation tasks. Ultrasound imaging, a widely used and cost-effective medical diagnostic procedure, faces challenges due to the global shortage of professional sonographers. To address this issue, we propose USPilot, an embodied robotic assistant ultrasound system powered by an LLM-based framework to enable autonomous ultrasound acquisition. USPilot is designed to function as a virtual sonographer, capable of responding to patients' ultrasound-related queries and performing ultrasound scans based on user intent. By fine-tuning the LLM, USPilot demonstrates a deep understanding of ultrasound-specific questions and tasks. Furthermore, USPilot incorporates an LLM-enhanced Graph Neural Network (GNN) to manage ultrasound robotic APIs and serve as a task planner. Experimental results show that the LLM-enhanced GNN achieves unprecedented accuracy in task planning on public datasets. Additionally, the system demonstrates significant potential in autonomously understanding and executing ultrasound procedures. These advancements bring us closer to achieving autonomous and potentially unmanned robotic ultrasound systems, addressing critical resource gaps in medical imaging.

Advancing Dense Endoscopic Reconstruction with Gaussian Splatting-driven Surface Normal-aware Tracking and Mapping

Simultaneous Localization and Mapping (SLAM) is essential for precise surgical interventions and robotic tasks in minimally invasive procedures. While recent advancements in 3D Gaussian Splatting (3DGS) have improved SLAM with high-quality novel view synthesis and fast rendering, these systems struggle with accurate depth and surface reconstruction due to multi-view inconsistencies. Simply incorporating SLAM and 3DGS leads to mismatches between the reconstructed frames. In this work, we present Endo-2DTAM, a real-time endoscopic SLAM system with 2D Gaussian Splatting (2DGS) to address these challenges. Endo-2DTAM incorporates a surface normal-aware pipeline, which consists of tracking, mapping, and bundle adjustment modules for geometrically accurate reconstruction. Our robust tracking module combines point-to-point and point-to-plane distance metrics, while the mapping module utilizes normal consistency and depth distortion to enhance surface reconstruction quality. We also introduce a pose-consistent strategy for efficient and geometrically coherent keyframe sampling. Extensive experiments on public endoscopic datasets demonstrate that Endo-2DTAM achieves an RMSE of $1.87\pm 0.63$ mm for depth reconstruction of surgical scenes while maintaining computationally efficient tracking, high-quality visual appearance, and real-time rendering. Our code will be released at github.com/lastbasket/Endo-2DTAM.

EndoChat: Grounded Multimodal Large Language Model for Endoscopic Surgery

Recently, Multimodal Large Language Models (MLLMs) have demonstrated their immense potential in computer-aided diagnosis and decision-making. In the context of robotic-assisted surgery, MLLMs can serve as effective tools for surgical training and guidance. However, there is still a lack of MLLMs specialized for surgical scene understanding in clinical applications. In this work, we introduce EndoChat to address various dialogue paradigms and subtasks in surgical scene understanding that surgeons encounter. To train our EndoChat, we construct the Surg-396K dataset through a novel pipeline that systematically extracts surgical information and generates structured annotations based on collected large-scale endoscopic surgery datasets. Furthermore, we introduce a multi-scale visual token interaction mechanism and a visual contrast-based reasoning mechanism to enhance the model's representation learning and reasoning capabilities. Our model achieves state-of-the-art performance across five dialogue paradigms and eight surgical scene understanding tasks. Additionally, we conduct evaluations with professional surgeons, most of whom provide positive feedback on collaborating with EndoChat. Overall, these results demonstrate that our EndoChat has great potential to significantly advance training and automation in robotic-assisted surgery.

Enhancing Bronchoscopy Depth Estimation through Synthetic-to-Real Domain Adaptation

Monocular depth estimation has shown promise in general imaging tasks, aiding in localization and 3D reconstruction. While effective in various domains, its application to bronchoscopic images is hindered by the lack of labeled data, challenging the use of supervised learning methods. In this work, we propose a transfer learning framework that leverages synthetic data with depth labels for training and adapts domain knowledge for accurate depth estimation in real bronchoscope data. Our network demonstrates improved depth prediction on real footage using domain adaptation compared to training solely on synthetic data, validating our approach.

Multi-Stage Airway Segmentation in Lung CT Based on Multi-scale Nested Residual UNet

Accurate and complete segmentation of airways in chest CT images is essential for the quantitative assessment of lung diseases and the facilitation of pulmonary interventional procedures. Although deep learning has led to significant advancements in medical image segmentation, maintaining airway continuity remains particularly challenging. This difficulty arises primarily from the small and dispersed nature of airway structures, as well as class imbalance in CT scans. To address these challenges, we designed a Multi-scale Nested Residual U-Net (MNR-UNet), incorporating multi-scale inputs and Residual Multi-scale Modules (RMM) into a nested residual framework to enhance information flow, effectively capturing the intricate details of small airways and mitigating gradient vanishing. Building on this, we developed a three-stage segmentation pipeline to optimize the training of the MNR-UNet. The first two stages prioritize high accuracy and sensitivity, while the third stage focuses on repairing airway breakages to balance topological completeness and correctness. To further address class imbalance, we introduced a weighted Breakage-Aware Loss (wBAL) to heighten focus on challenging samples, penalizing breakages and thereby extending the length of the airway tree. Additionally, we proposed a hierarchical evaluation framework to offer more clinically meaningful analysis. Validation on both in-house and public datasets demonstrates that our approach achieves superior performance in detecting more accurate airway voxels and identifying additional branches, significantly improving airway topological completeness. The code will be released publicly following the publication of the paper.

Making LLMs Vulnerable to Prompt Injection via Poisoning Alignment

In a prompt injection attack, an attacker injects a prompt into the original one, aiming to make the LLM follow the injected prompt and perform a task chosen by the attacker. Existing prompt injection attacks primarily focus on how to blend the injected prompt into the original prompt without altering the LLM itself. Our experiments show that these attacks achieve some success, but there is still significant room for improvement. In this work, we show that an attacker can boost the success of prompt injection attacks by poisoning the LLM's alignment process. Specifically, we propose PoisonedAlign, a method to strategically create poisoned alignment samples. When even a small fraction of the alignment data is poisoned using our method, the aligned LLM becomes more vulnerable to prompt injection while maintaining its foundational capabilities. The code is available at https://github.com/Sadcardation/PoisonedAlign

Automatically Generating Visual Hallucination Test Cases for Multimodal Large Language Models

Visual hallucination (VH) occurs when a multimodal large language model (MLLM) generates responses with incorrect visual details for prompts. Existing methods for generating VH test cases primarily rely on human annotations, typically in the form of triples: (image, question, answer). In this paper, we introduce VHExpansion, the first automated method for expanding VH test cases for MLLMs. Given an initial VH test case, VHExpansion automatically expands it by perturbing the question and answer through negation as well as modifying the image using both common and adversarial perturbations. Additionally, we propose a new evaluation metric, symmetric accuracy, which measures the proportion of correctly answered VH test-case pairs. Each pair consists of a test case and its negated counterpart. Our theoretical analysis shows that symmetric accuracy is an unbiased evaluation metric that remains unaffected by the imbalance of VH testing cases with varying answers when an MLLM is randomly guessing the answers, whereas traditional accuracy is prone to such imbalance. We apply VHExpansion to expand three VH datasets annotated manually and use these expanded datasets to benchmark seven MLLMs. Our evaluation shows that VHExpansion effectively identifies more VH test cases. Moreover, symmetric accuracy, being unbiased, leads to different conclusions about the vulnerability of MLLMs to VH compared to traditional accuracy metric. Finally, we show that fine-tuning MLLMs on the expanded VH dataset generated by VHExpansion mitigates VH more effectively than fine-tuning on the original, manually annotated dataset. Our code is available at: https://github.com/lycheeefish/VHExpansion.

Can DeepFake Speech be Reliably Detected?

Recent advances in text-to-speech (TTS) systems, particularly those with voice cloning capabilities, have made voice impersonation readily accessible, raising ethical and legal concerns due to potential misuse for malicious activities like misinformation campaigns and fraud. While synthetic speech detectors (SSDs) exist to combat this, they are vulnerable to ``test domain shift", exhibiting decreased performance when audio is altered through transcoding, playback, or background noise. This vulnerability is further exacerbated by deliberate manipulation of synthetic speech aimed at deceiving detectors. This work presents the first systematic study of such active malicious attacks against state-of-the-art open-source SSDs. White-box attacks, black-box attacks, and their transferability are studied from both attack effectiveness and stealthiness, using both hardcoded metrics and human ratings. The results highlight the urgent need for more robust detection methods in the face of evolving adversarial threats.

EndoOmni: Zero-Shot Cross-Dataset Depth Estimation in Endoscopy by Robust Self-Learning from Noisy Labels

Single-image depth estimation is essential for endoscopy tasks such as localization, reconstruction, and augmented reality. Most existing methods in surgical scenes focus on in-domain depth estimation, limiting their real-world applicability. This constraint stems from the scarcity and inferior labeling quality of medical data for training. In this work, we present EndoOmni, the first foundation model for zero-shot cross-domain depth estimation for endoscopy. To harness the potential of diverse training data, we refine the advanced self-learning paradigm that employs a teacher model to generate pseudo-labels, guiding a student model trained on large-scale labeled and unlabeled data. To address training disturbance caused by inherent noise in depth labels, we propose a robust training framework that leverages both depth labels and estimated confidence from the teacher model to jointly guide the student model training. Moreover, we propose a weighted scale-and-shift invariant loss to adaptively adjust learning weights based on label confidence, thus imposing learning bias towards cleaner label pixels while reducing the influence of highly noisy pixels. Experiments on zero-shot relative depth estimation show that our EndoOmni improves state-of-the-art methods in medical imaging for 41\% and existing foundation models for 25\% in terms of absolute relative error on specific dataset. Furthermore, our model provides strong initialization for fine-tuning to metric depth estimation, maintaining superior performance in both in-domain and out-of-domain scenarios. The source code will be publicly available.

SurgTrack: CAD-Free 3D Tracking of Real-world Surgical Instruments

Vision-based surgical navigation has received increasing attention due to its non-invasive, cost-effective, and flexible advantages. In particular, a critical element of the vision-based navigation system is tracking surgical instruments. Compared with 2D instrument tracking methods, 3D instrument tracking has broader value in clinical practice, but is also more challenging due to weak texture, occlusion, and lack of Computer-Aided Design (CAD) models for 3D registration. To solve these challenges, we propose the SurgTrack, a two-stage 3D instrument tracking method for CAD-free and robust real-world applications. In the first registration stage, we incorporate an Instrument Signed Distance Field (SDF) modeling the 3D representation of instruments, achieving CAD-freed 3D registration. Due to this, we can obtain the location and orientation of instruments in the 3D space by matching the video stream with the registered SDF model. In the second tracking stage, we devise a posture graph optimization module, leveraging the historical tracking results of the posture memory pool to optimize the tracking results and improve the occlusion robustness. Furthermore, we collect the Instrument3D dataset to comprehensively evaluate the 3D tracking of surgical instruments. The extensive experiments validate the superiority and scalability of our SurgTrack, by outperforming the state-of-the-arts with a remarkable improvement. The code and dataset are available at https://github.com/wenwucode/SurgTrack.