Can DeepSeek Reason Like a Surgeon? An Empirical Evaluation for Vision-Language Understanding in Robotic-Assisted Surgery

DeepSeek series have demonstrated outstanding performance in general scene understanding, question-answering (QA), and text generation tasks, owing to its efficient training paradigm and strong reasoning capabilities. In this study, we investigate the dialogue capabilities of the DeepSeek model in robotic surgery scenarios, focusing on tasks such as Single Phrase QA, Visual QA, and Detailed Description. The Single Phrase QA tasks further include sub-tasks such as surgical instrument recognition, action understanding, and spatial position analysis. We conduct extensive evaluations using publicly available datasets, including EndoVis18 and CholecT50, along with their corresponding dialogue data. Our comprehensive evaluation results indicate that, when provided with specific prompts, DeepSeek-V3 performs well in surgical instrument and tissue recognition tasks However, DeepSeek-V3 exhibits significant limitations in spatial position analysis and struggles to understand surgical actions accurately. Additionally, our findings reveal that, under general prompts, DeepSeek-V3 lacks the ability to effectively analyze global surgical concepts and fails to provide detailed insights into surgical scenarios. Based on our observations, we argue that the DeepSeek-V3 is not ready for vision-language tasks in surgical contexts without fine-tuning on surgery-specific datasets.

Optimal Complexity in Byzantine-Robust Distributed Stochastic Optimization with Data Heterogeneity

In this paper, we establish tight lower bounds for Byzantine-robust distributed first-order stochastic optimization methods in both strongly convex and non-convex stochastic optimization. We reveal that when the distributed nodes have heterogeneous data, the convergence error comprises two components: a non-vanishing Byzantine error and a vanishing optimization error. We establish the lower bounds on the Byzantine error and on the minimum number of queries to a stochastic gradient oracle required to achieve an arbitrarily small optimization error. Nevertheless, we identify significant discrepancies between our established lower bounds and the existing upper bounds. To fill this gap, we leverage the techniques of Nesterov's acceleration and variance reduction to develop novel Byzantine-robust distributed stochastic optimization methods that provably match these lower bounds, up to logarithmic factors, implying that our established lower bounds are tight.

KVQ: Boosting Video Quality Assessment via Saliency-guided Local Perception

Video Quality Assessment (VQA), which intends to predict the perceptual quality of videos, has attracted increasing attention. Due to factors like motion blur or specific distortions, the quality of different regions in a video varies. Recognizing the region-wise local quality within a video is beneficial for assessing global quality and can guide us in adopting fine-grained enhancement or transcoding strategies. Due to the heavy cost of annotating region-wise quality, the lack of ground truth constraints from relevant datasets further complicates the utilization of local perception. Inspired by the Human Visual System (HVS) that links global quality to the local texture of different regions and their visual saliency, we propose a Kaleidoscope Video Quality Assessment (KVQ) framework, which aims to effectively assess both saliency and local texture, thereby facilitating the assessment of global quality. Our framework extracts visual saliency and allocates attention using Fusion-Window Attention (FWA) while incorporating a Local Perception Constraint (LPC) to mitigate the reliance of regional texture perception on neighboring areas. KVQ obtains significant improvements across multiple scenarios on five VQA benchmarks compared to SOTA methods. Furthermore, to assess local perception, we establish a new Local Perception Visual Quality (LPVQ) dataset with region-wise annotations. Experimental results demonstrate the capability of KVQ in perceiving local distortions. KVQ models and the LPVQ dataset will be available at https://github.com/qyp2000/KVQ.

MM-OR: A Large Multimodal Operating Room Dataset for Semantic Understanding of High-Intensity Surgical Environments

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

A Memory Efficient Randomized Subspace Optimization Method for Training Large Language Models

The memory challenges associated with training Large Language Models (LLMs) have become a critical concern, particularly when using the Adam optimizer. To address this issue, numerous memory-efficient techniques have been proposed, with GaLore standing out as a notable example designed to reduce the memory footprint of optimizer states. However, these approaches do not alleviate the memory burden imposed by activations, rendering them unsuitable for scenarios involving long context sequences or large mini-batches. Moreover, their convergence properties are still not well-understood in the literature. In this work, we introduce a Randomized Subspace Optimization framework for pre-training and fine-tuning LLMs. Our approach decomposes the high-dimensional training problem into a series of lower-dimensional subproblems. At each iteration, a random subspace is selected, and the parameters within that subspace are optimized. This structured reduction in dimensionality allows our method to simultaneously reduce memory usage for both activations and optimizer states. We establish comprehensive convergence guarantees and derive rates for various scenarios, accommodating different optimization strategies to solve the subproblems. Extensive experiments validate the superior memory and communication efficiency of our method, achieving performance comparable to GaLore and Adam.

Medical Multimodal Model Stealing Attacks via Adversarial Domain Alignment

Medical multimodal large language models (MLLMs) are becoming an instrumental part of healthcare systems, assisting medical personnel with decision making and results analysis. Models for radiology report generation are able to interpret medical imagery, thus reducing the workload of radiologists. As medical data is scarce and protected by privacy regulations, medical MLLMs represent valuable intellectual property. However, these assets are potentially vulnerable to model stealing, where attackers aim to replicate their functionality via black-box access. So far, model stealing for the medical domain has focused on classification; however, existing attacks are not effective against MLLMs. In this paper, we introduce Adversarial Domain Alignment (ADA-STEAL), the first stealing attack against medical MLLMs. ADA-STEAL relies on natural images, which are public and widely available, as opposed to their medical counterparts. We show that data augmentation with adversarial noise is sufficient to overcome the data distribution gap between natural images and the domain-specific distribution of the victim MLLM. Experiments on the IU X-RAY and MIMIC-CXR radiology datasets demonstrate that Adversarial Domain Alignment enables attackers to steal the medical MLLM without any access to medical data.

CE-LoRA: Computation-Efficient LoRA Fine-Tuning for Language Models

Large Language Models (LLMs) demonstrate exceptional performance across various tasks but demand substantial computational resources even for fine-tuning computation. Although Low-Rank Adaptation (LoRA) significantly alleviates memory consumption during fine-tuning, its impact on computational cost reduction is limited. This paper identifies the computation of activation gradients as the primary bottleneck in LoRA's backward propagation and introduces the Computation-Efficient LoRA (CE-LoRA) algorithm, which enhances computational efficiency while preserving memory efficiency. CE-LoRA leverages two key techniques: Approximated Matrix Multiplication, which replaces dense multiplications of large and complete matrices with sparse multiplications involving only critical rows and columns, and the Double-LoRA technique, which reduces error propagation in activation gradients. Theoretically, CE-LoRA converges at the same rate as LoRA, $ \mathcal{O}(1/\sqrt{T}) $, where $T$ is the number of iteartions. Empirical evaluations confirm that CE-LoRA significantly reduces computational costs compared to LoRA without notable performance degradation.

Visual Autoregressive Modeling for Image Super-Resolution

Image Super-Resolution (ISR) has seen significant progress with the introduction of remarkable generative models. However, challenges such as the trade-off issues between fidelity and realism, as well as computational complexity, have also posed limitations on their application. Building upon the tremendous success of autoregressive models in the language domain, we propose \textbf{VARSR}, a novel visual autoregressive modeling for ISR framework with the form of next-scale prediction. To effectively integrate and preserve semantic information in low-resolution images, we propose using prefix tokens to incorporate the condition. Scale-aligned Rotary Positional Encodings are introduced to capture spatial structures and the diffusion refiner is utilized for modeling quantization residual loss to achieve pixel-level fidelity. Image-based Classifier-free Guidance is proposed to guide the generation of more realistic images. Furthermore, we collect large-scale data and design a training process to obtain robust generative priors. Quantitative and qualitative results show that VARSR is capable of generating high-fidelity and high-realism images with more efficiency than diffusion-based methods. Our codes will be released at https://github.com/qyp2000/VARSR.

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.

Text-driven Adaptation of Foundation Models for Few-shot Surgical Workflow Analysis

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