A Knowledge-enhanced Pathology Vision-language Foundation Model for Cancer Diagnosis

Deep learning has enabled the development of highly robust foundation models for various pathological tasks across diverse diseases and patient cohorts. Among these models, vision-language pre-training, which leverages large-scale paired data to align pathology image and text embedding spaces, and provides a novel zero-shot paradigm for downstream tasks. However, existing models have been primarily data-driven and lack the incorporation of domain-specific knowledge, which limits their performance in cancer diagnosis, especially for rare tumor subtypes. To address this limitation, we establish a Knowledge-enhanced Pathology (KEEP) foundation model that harnesses disease knowledge to facilitate vision-language pre-training. Specifically, we first construct a disease knowledge graph (KG) that covers 11,454 human diseases with 139,143 disease attributes, including synonyms, definitions, and hypernym relations. We then systematically reorganize the millions of publicly available noisy pathology image-text pairs, into 143K well-structured semantic groups linked through the hierarchical relations of the disease KG. To derive more nuanced image and text representations, we propose a novel knowledge-enhanced vision-language pre-training approach that integrates disease knowledge into the alignment within hierarchical semantic groups instead of unstructured image-text pairs. Validated on 18 diverse benchmarks with more than 14,000 whole slide images (WSIs), KEEP achieves state-of-the-art performance in zero-shot cancer diagnostic tasks. Notably, for cancer detection, KEEP demonstrates an average sensitivity of 89.8% at a specificity of 95.0% across 7 cancer types. For cancer subtyping, KEEP achieves a median balanced accuracy of 0.456 in subtyping 30 rare brain cancers, indicating strong generalizability for diagnosing rare tumors.

Can Modern LLMs Act as Agent Cores in Radiology~Environments?

Advancements in large language models (LLMs) have paved the way for LLM-based agent systems that offer enhanced accuracy and interpretability across various domains. Radiology, with its complex analytical requirements, is an ideal field for the application of these agents. This paper aims to investigate the pre-requisite question for building concrete radiology agents which is, `Can modern LLMs act as agent cores in radiology environments?' To investigate it, we introduce RadABench with three-fold contributions: First, we present RadABench-Data, a comprehensive synthetic evaluation dataset for LLM-based agents, generated from an extensive taxonomy encompassing 6 anatomies, 5 imaging modalities, 10 tool categories, and 11 radiology tasks. Second, we propose RadABench-EvalPlat, a novel evaluation platform for agents featuring a prompt-driven workflow and the capability to simulate a wide range of radiology toolsets. Third, we assess the performance of 7 leading LLMs on our benchmark from 5 perspectives with multiple metrics. Our findings indicate that while current LLMs demonstrate strong capabilities in many areas, they are still not sufficiently advanced to serve as the central agent core in a fully operational radiology agent system. Additionally, we identify key factors influencing the performance of LLM-based agent cores, offering insights for clinicians on how to apply agent systems in real-world radiology practices effectively. All of our code and data are open-sourced in https://github.com/MAGIC-AI4Med/RadABench.

MRGen: Diffusion-based Controllable Data Engine for MRI Segmentation towards Unannotated Modalities

Medical image segmentation has recently demonstrated impressive progress with deep neural networks, yet the heterogeneous modalities and scarcity of mask annotations limit the development of segmentation models on unannotated modalities. This paper investigates a new paradigm for leveraging generative models in medical applications: controllably synthesizing data for unannotated modalities, without requiring registered data pairs. Specifically, we make the following contributions in this paper: (i) we collect and curate a large-scale radiology image-text dataset, MedGen-1M, comprising modality labels, attributes, region, and organ information, along with a subset of organ mask annotations, to support research in controllable medical image generation; (ii) we propose a diffusion-based data engine, termed MRGen, which enables generation conditioned on text prompts and masks, synthesizing MR images for diverse modalities lacking mask annotations, to train segmentation models on unannotated modalities; (iii) we conduct extensive experiments across various modalities, illustrating that our data engine can effectively synthesize training samples and extend MRI segmentation towards unannotated modalities.

Unlocking Video-LLM via Agent-of-Thoughts Distillation

This paper tackles the problem of video question answering (VideoQA), a task that often requires multi-step reasoning and a profound understanding of spatial-temporal dynamics. While large video-language models perform well on benchmarks, they often lack explainability and spatial-temporal grounding. In this paper, we propose Agent-of-Thoughts Distillation (AoTD), a method that enhances models by incorporating automatically generated Chain-of-Thoughts (CoTs) into the instruction-tuning process. Specifically, we leverage an agent-based system to decompose complex questions into sub-tasks, and address them with specialized vision models, the intermediate results are then treated as reasoning chains. We also introduce a verification mechanism using a large language model (LLM) to ensure the reliability of generated CoTs. Extensive experiments demonstrate that AoTD improves the performance on multiple-choice and open-ended benchmarks.

LamRA: Large Multimodal Model as Your Advanced Retrieval Assistant

With the rapid advancement of multimodal information retrieval, increasingly complex retrieval tasks have emerged. Existing methods predominately rely on task-specific fine-tuning of vision-language models, often those trained with image-text contrastive learning. In this paper, we explore the possibility of re-purposing generative Large Multimodal Models (LMMs) for retrieval. This approach enables unifying all retrieval tasks under the same formulation and, more importantly, allows for extrapolation towards unseen retrieval tasks without additional training. Our contributions can be summarised in the following aspects: (i) We introduce LamRA, a versatile framework designed to empower LMMs with sophisticated retrieval and reranking capabilities. (ii) For retrieval, we adopt a two-stage training strategy comprising language-only pre-training and multimodal instruction tuning to progressively enhance LMM's retrieval performance. (iii) For reranking, we employ joint training for both pointwise and listwise reranking, offering two distinct ways to further boost the retrieval performance. (iv) Extensive experimental results underscore the efficacy of our method in handling more than ten retrieval tasks, demonstrating robust performance in both supervised and zero-shot settings, including scenarios involving previously unseen retrieval tasks.

LoRKD: Low-Rank Knowledge Decomposition for Medical Foundation Models

The widespread adoption of large-scale pre-training techniques has significantly advanced the development of medical foundation models, enabling them to serve as versatile tools across a broad range of medical tasks. However, despite their strong generalization capabilities, medical foundation models pre-trained on large-scale datasets tend to suffer from domain gaps between heterogeneous data, leading to suboptimal performance on specific tasks compared to specialist models, as evidenced by previous studies. In this paper, we explore a new perspective called "Knowledge Decomposition" to improve the performance on specific medical tasks, which deconstructs the foundation model into multiple lightweight expert models, each dedicated to a particular anatomical region, with the aim of enhancing specialization and simultaneously reducing resource consumption. To accomplish the above objective, we propose a novel framework named Low-Rank Knowledge Decomposition (LoRKD), which explicitly separates gradients from different tasks by incorporating low-rank expert modules and efficient knowledge separation convolution. The low-rank expert modules resolve gradient conflicts between heterogeneous data from different anatomical regions, providing strong specialization at lower costs. The efficient knowledge separation convolution significantly improves algorithm efficiency by achieving knowledge separation within a single forward propagation. Extensive experimental results on segmentation and classification tasks demonstrate that our decomposed models not only achieve state-of-the-art performance but also exhibit superior transferability on downstream tasks, even surpassing the original foundation models in task-specific evaluations. The code is available at here.

Grounded Multi-Hop VideoQA in Long-Form Egocentric Videos

This paper considers the problem of Multi-Hop Video Question Answering (MH-VidQA) in long-form egocentric videos. This task not only requires to answer visual questions, but also to localize multiple relevant time intervals within the video as visual evidences. We develop an automated pipeline to create multi-hop question-answering pairs with associated temporal evidence, enabling to construct a large-scale dataset for instruction-tuning. To monitor the progress of this new task, we further curate a high-quality benchmark, MultiHop-EgoQA, with careful manual verification and refinement. Experimental results reveal that existing multi-modal systems exhibit inadequate multi-hop grounding and reasoning abilities, resulting in unsatisfactory performance. We then propose a novel architecture, termed as Grounding Scattered Evidence with Large Language Model (GeLM), that enhances multi-modal large language models (MLLMs) by incorporating a grounding module to retrieve temporal evidence from videos using flexible grounding tokens. Trained on our visual instruction data, GeLM demonstrates improved multi-hop grounding and reasoning capabilities, setting a new baseline for this challenging task. Furthermore, when trained on third-person view videos, the same architecture also achieves state-of-the-art performance on the single-hop VidQA benchmark, ActivityNet-RTL, demonstrating its effectiveness.

Can Visual Foundation Models Achieve Long-term Point Tracking?

Large-scale vision foundation models have demonstrated remarkable success across various tasks, underscoring their robust generalization capabilities. While their proficiency in two-view correspondence has been explored, their effectiveness in long-term correspondence within complex environments remains unexplored. To address this, we evaluate the geometric awareness of visual foundation models in the context of point tracking: (i) in zero-shot settings, without any training; (ii) by probing with low-capacity layers; (iii) by fine-tuning with Low Rank Adaptation (LoRA). Our findings indicate that features from Stable Diffusion and DINOv2 exhibit superior geometric correspondence abilities in zero-shot settings. Furthermore, DINOv2 achieves performance comparable to supervised models in adaptation settings, demonstrating its potential as a strong initialization for correspondence learning.

Towards Evaluating and Building Versatile Large Language Models for Medicine

In this study, we present MedS-Bench, a comprehensive benchmark designed to evaluate the performance of large language models (LLMs) in clinical contexts. Unlike existing benchmarks that focus on multiple-choice question answering, MedS-Bench spans 11 high-level clinical tasks, including clinical report summarization, treatment recommendations, diagnosis, named entity recognition, and medical concept explanation, among others. We evaluated six leading LLMs, e.g., MEDITRON, Mistral, InternLM 2, Llama 3, GPT-4, and Claude-3.5 using few-shot prompting, and found that even the most sophisticated models struggle with these complex tasks. To address these limitations, we developed MedS-Ins, a large-scale instruction tuning dataset for medicine. MedS-Ins comprises 58 medically oriented language corpora, totaling 13.5 million samples across 122 tasks. To demonstrate the dataset's utility, we conducted a proof-of-concept experiment by performing instruction tuning on a lightweight, open-source medical language model. The resulting model, MMedIns-Llama 3, significantly outperformed existing models across nearly all clinical tasks. To promote further advancements in the application of LLMs to clinical challenges, we have made the MedS-Ins dataset fully accessible and invite the research community to contribute to its expansion.Additionally, we have launched a dynamic leaderboard for MedS-Bench, which we plan to regularly update the test set to track progress and enhance the adaptation of general LLMs to the medical domain. Leaderboard: https://henrychur.github.io/MedS-Bench/. Github: https://github.com/MAGIC-AI4Med/MedS-Ins.

AutoRG-Brain: Grounded Report Generation for Brain MRI

Radiologists are tasked with interpreting a large number of images in a daily base, with the responsibility of generating corresponding reports. This demanding workload elevates the risk of human error, potentially leading to treatment delays, increased healthcare costs, revenue loss, and operational inefficiencies. To address these challenges, we initiate a series of work on grounded Automatic Report Generation (AutoRG), starting from the brain MRI interpretation system, which supports the delineation of brain structures, the localization of anomalies, and the generation of well-organized findings. We make contributions from the following aspects, first, on dataset construction, we release a comprehensive dataset encompassing segmentation masks of anomaly regions and manually authored reports, termed as RadGenome-Brain MRI. This data resource is intended to catalyze ongoing research and development in the field of AI-assisted report generation systems. Second, on system design, we propose AutoRG-Brain, the first brain MRI report generation system with pixel-level grounded visual clues. Third, for evaluation, we conduct quantitative assessments and human evaluations of brain structure segmentation, anomaly localization, and report generation tasks to provide evidence of its reliability and accuracy. This system has been integrated into real clinical scenarios, where radiologists were instructed to write reports based on our generated findings and anomaly segmentation masks. The results demonstrate that our system enhances the report-writing skills of junior doctors, aligning their performance more closely with senior doctors, thereby boosting overall productivity.