Neural Finite-State Machines for Surgical Phase Recognition

Surgical phase recognition is essential for analyzing procedure-specific surgical videos. While recent transformer-based architectures have advanced sequence processing capabilities, they struggle with maintaining consistency across lengthy surgical procedures. Drawing inspiration from classical hidden Markov models' finite-state interpretations, we introduce the neural finite-state machine (NFSM) module, which bridges procedural understanding with deep learning approaches. NFSM combines procedure-level understanding with neural networks through global state embeddings, attention-based dynamic transition tables, and transition-aware training and inference mechanisms for offline and online applications. When integrated into our future-aware architecture, NFSM improves video-level accuracy, phase-level precision, recall, and Jaccard indices on Cholec80 datasets by 2.3, 3.2, 3.0, and 4.8 percentage points respectively. As an add-on module to existing state-of-the-art models like Surgformer, NFSM further enhances performance, demonstrating its complementary value. Extended experiments on non-surgical datasets validate NFSM's generalizability beyond surgical domains. Comprehensive experiments demonstrate that incorporating NSFM into deep learning frameworks enables more robust and consistent phase recognition across long procedural videos.

Seq2Time: Sequential Knowledge Transfer for Video LLM Temporal Grounding

Temporal awareness is essential for video large language models (LLMs) to understand and reason about events within long videos, enabling applications like dense video captioning and temporal video grounding in a unified system. However, the scarcity of long videos with detailed captions and precise temporal annotations limits their temporal awareness. In this paper, we propose Seq2Time, a data-oriented training paradigm that leverages sequences of images and short video clips to enhance temporal awareness in long videos. By converting sequence positions into temporal annotations, we transform large-scale image and clip captioning datasets into sequences that mimic the temporal structure of long videos, enabling self-supervised training with abundant time-sensitive data. To enable sequence-to-time knowledge transfer, we introduce a novel time representation that unifies positional information across image sequences, clip sequences, and long videos. Experiments demonstrate the effectiveness of our method, achieving a 27.6% improvement in F1 score and 44.8% in CIDEr on the YouCook2 benchmark and a 14.7% increase in recall on the Charades-STA benchmark compared to the baseline.

LEAF: Learning and Evaluation Augmented by Fact-Checking to Improve Factualness in Large Language Models

Large language models (LLMs) have shown remarkable capabilities in various natural language processing tasks, yet they often struggle with maintaining factual accuracy, particularly in knowledge-intensive domains like healthcare. This study introduces LEAF: Learning and Evaluation Augmented by Fact-Checking, a novel approach designed to enhance the factual reliability of LLMs, with a focus on medical question answering (QA). LEAF utilizes a dual strategy to enhance the factual accuracy of responses from models such as Llama 3 70B Instruct and Llama 3 8B Instruct. The first strategy, Fact-Check-Then-RAG, improves Retrieval-Augmented Generation (RAG) by incorporating fact-checking results to guide the retrieval process without updating model parameters. The second strategy, Learning from Fact-Checks via Self-Training, involves supervised fine-tuning (SFT) on fact-checked responses or applying Simple Preference Optimization (SimPO) with fact-checking as a ranking mechanism, both updating LLM parameters from supervision. These findings suggest that integrating fact-checked responses whether through RAG enhancement or self-training enhances the reliability and factual correctness of LLM outputs, offering a promising solution for applications where information accuracy is crucial.

SemiHVision: Enhancing Medical Multimodal Models with a Semi-Human Annotated Dataset and Fine-Tuned Instruction Generation

Multimodal large language models (MLLMs) have made significant strides, yet they face challenges in the medical domain due to limited specialized knowledge. While recent medical MLLMs demonstrate strong performance in lab settings, they often struggle in real-world applications, highlighting a substantial gap between research and practice. In this paper, we seek to address this gap at various stages of the end-to-end learning pipeline, including data collection, model fine-tuning, and evaluation. At the data collection stage, we introduce SemiHVision, a dataset that combines human annotations with automated augmentation techniques to improve both medical knowledge representation and diagnostic reasoning. For model fine-tuning, we trained PMC-Cambrian-8B-AN over 2400 H100 GPU hours, resulting in performance that surpasses public medical models like HuatuoGPT-Vision-34B (79.0% vs. 66.7%) and private general models like Claude3-Opus (55.7%) on traditional benchmarks such as SLAKE and VQA-RAD. In the evaluation phase, we observed that traditional benchmarks cannot accurately reflect realistic clinical task capabilities. To overcome this limitation and provide more targeted guidance for model evaluation, we introduce the JAMA Clinical Challenge, a novel benchmark specifically designed to evaluate diagnostic reasoning. On this benchmark, PMC-Cambrian-AN achieves state-of-the-art performance with a GPT-4 score of 1.29, significantly outperforming HuatuoGPT-Vision-34B (1.13) and Claude3-Opus (1.17), demonstrating its superior diagnostic reasoning abilities.

DaRePlane: Direction-aware Representations for Dynamic Scene Reconstruction

Numerous recent approaches to modeling and re-rendering dynamic scenes leverage plane-based explicit representations, addressing slow training times associated with models like neural radiance fields (NeRF) and Gaussian splatting (GS). However, merely decomposing 4D dynamic scenes into multiple 2D plane-based representations is insufficient for high-fidelity re-rendering of scenes with complex motions. In response, we present DaRePlane, a novel direction-aware representation approach that captures scene dynamics from six different directions. This learned representation undergoes an inverse dual-tree complex wavelet transformation (DTCWT) to recover plane-based information. Within NeRF pipelines, DaRePlane computes features for each space-time point by fusing vectors from these recovered planes, then passed to a tiny MLP for color regression. When applied to Gaussian splatting, DaRePlane computes the features of Gaussian points, followed by a tiny multi-head MLP for spatial-time deformation prediction. Notably, to address redundancy introduced by the six real and six imaginary direction-aware wavelet coefficients, we introduce a trainable masking approach, mitigating storage issues without significant performance decline. To demonstrate the generality and efficiency of DaRePlane, we test it on both regular and surgical dynamic scenes, for both NeRF and GS systems. Extensive experiments show that DaRePlane yields state-of-the-art performance in novel view synthesis for various complex dynamic scenes.

Order-aware Interactive Segmentation

Interactive segmentation aims to accurately segment target objects with minimal user interactions. However, current methods often fail to accurately separate target objects from the background, due to a limited understanding of order, the relative depth between objects in a scene. To address this issue, we propose OIS: order-aware interactive segmentation, where we explicitly encode the relative depth between objects into order maps. We introduce a novel order-aware attention, where the order maps seamlessly guide the user interactions (in the form of clicks) to attend to the image features. We further present an object-aware attention module to incorporate a strong object-level understanding to better differentiate objects with similar order. Our approach allows both dense and sparse integration of user clicks, enhancing both accuracy and efficiency as compared to prior works. Experimental results demonstrate that OIS achieves state-of-the-art performance, improving mIoU after one click by 7.61 on the HQSeg44K dataset and 1.32 on the DAVIS dataset as compared to the previous state-of-the-art SegNext, while also doubling inference speed compared to current leading methods. The project page is https://ukaukaaaa.github.io/projects/OIS/index.html

3D Vision-Language Gaussian Splatting

Recent advancements in 3D reconstruction methods and vision-language models have propelled the development of multi-modal 3D scene understanding, which has vital applications in robotics, autonomous driving, and virtual/augmented reality. However, current multi-modal scene understanding approaches have naively embedded semantic representations into 3D reconstruction methods without striking a balance between visual and language modalities, which leads to unsatisfying semantic rasterization of translucent or reflective objects, as well as over-fitting on color modality. To alleviate these limitations, we propose a solution that adequately handles the distinct visual and semantic modalities, i.e., a 3D vision-language Gaussian splatting model for scene understanding, to put emphasis on the representation learning of language modality. We propose a novel cross-modal rasterizer, using modality fusion along with a smoothed semantic indicator for enhancing semantic rasterization. We also employ a camera-view blending technique to improve semantic consistency between existing and synthesized views, thereby effectively mitigating over-fitting. Extensive experiments demonstrate that our method achieves state-of-the-art performance in open-vocabulary semantic segmentation, surpassing existing methods by a significant margin.

6DGS: Enhanced Direction-Aware Gaussian Splatting for Volumetric Rendering

Novel view synthesis has advanced significantly with the development of neural radiance fields (NeRF) and 3D Gaussian splatting (3DGS). However, achieving high quality without compromising real-time rendering remains challenging, particularly for physically-based ray tracing with view-dependent effects. Recently, N-dimensional Gaussians (N-DG) introduced a 6D spatial-angular representation to better incorporate view-dependent effects, but the Gaussian representation and control scheme are sub-optimal. In this paper, we revisit 6D Gaussians and introduce 6D Gaussian Splatting (6DGS), which enhances color and opacity representations and leverages the additional directional information in the 6D space for optimized Gaussian control. Our approach is fully compatible with the 3DGS framework and significantly improves real-time radiance field rendering by better modeling view-dependent effects and fine details. Experiments demonstrate that 6DGS significantly outperforms 3DGS and N-DG, achieving up to a 15.73 dB improvement in PSNR with a reduction of 66.5% Gaussian points compared to 3DGS.

Auxiliary Input in Training: Incorporating Catheter Features into Deep Learning Models for ECG-Free Dynamic Coronary Roadmapping

Dynamic coronary roadmapping is a technology that overlays the vessel maps (the "roadmap") extracted from an offline image sequence of X-ray angiography onto a live stream of X-ray fluoroscopy in real-time. It aims to offer navigational guidance for interventional surgeries without the need for repeated contrast agent injections, thereby reducing the risks associated with radiation exposure and kidney failure. The precision of the roadmaps is contingent upon the accurate alignment of angiographic and fluoroscopic images based on their cardiac phases, as well as precise catheter tip tracking. The former ensures the selection of a roadmap that closely matches the vessel shape in the current frame, while the latter uses catheter tips as reference points to adjust for translational motion between the roadmap and the present vessel tree. Training deep learning models for both tasks is challenging and underexplored. However, incorporating catheter features into the models could offer substantial benefits, given humans heavily rely on catheters to complete the tasks. To this end, we introduce a simple but effective method, auxiliary input in training (AIT), and demonstrate that it enhances model performance across both tasks, outperforming baseline methods in knowledge incorporation and transfer learning.

Few-Shot 3D Volumetric Segmentation with Multi-Surrogate Fusion

Conventional 3D medical image segmentation methods typically require learning heavy 3D networks (e.g., 3D-UNet), as well as large amounts of in-domain data with accurate pixel/voxel-level labels to avoid overfitting. These solutions are thus extremely time- and labor-expensive, but also may easily fail to generalize to unseen objects during training. To alleviate this issue, we present MSFSeg, a novel few-shot 3D segmentation framework with a lightweight multi-surrogate fusion (MSF). MSFSeg is able to automatically segment unseen 3D objects/organs (during training) provided with one or a few annotated 2D slices or 3D sequence segments, via learning dense query-support organ/lesion anatomy correlations across patient populations. Our proposed MSF module mines comprehensive and diversified morphology correlations between unlabeled and the few labeled slices/sequences through multiple designated surrogates, making it able to generate accurate cross-domain 3D segmentation masks given annotated slices or sequences. We demonstrate the effectiveness of our proposed framework by showing superior performance on conventional few-shot segmentation benchmarks compared to prior art, and remarkable cross-domain cross-volume segmentation performance on proprietary 3D segmentation datasets for challenging entities, i.e., tubular structures, with only limited 2D or 3D labels.