Medical Multimodal Foundation Models in Clinical Diagnosis and Treatment: Applications, Challenges, and Future Directions

Recent advancements in deep learning have significantly revolutionized the field of clinical diagnosis and treatment, offering novel approaches to improve diagnostic precision and treatment efficacy across diverse clinical domains, thus driving the pursuit of precision medicine. The growing availability of multi-organ and multimodal datasets has accelerated the development of large-scale Medical Multimodal Foundation Models (MMFMs). These models, known for their strong generalization capabilities and rich representational power, are increasingly being adapted to address a wide range of clinical tasks, from early diagnosis to personalized treatment strategies. This review offers a comprehensive analysis of recent developments in MMFMs, focusing on three key aspects: datasets, model architectures, and clinical applications. We also explore the challenges and opportunities in optimizing multimodal representations and discuss how these advancements are shaping the future of healthcare by enabling improved patient outcomes and more efficient clinical workflows.

Bidirectional-Reachable Hierarchical Reinforcement Learning with Mutually Responsive Policies

Hierarchical reinforcement learning (HRL) addresses complex long-horizon tasks by skillfully decomposing them into subgoals. Therefore, the effectiveness of HRL is greatly influenced by subgoal reachability. Typical HRL methods only consider subgoal reachability from the unilateral level, where a dominant level enforces compliance to the subordinate level. However, we observe that when the dominant level becomes trapped in local exploration or generates unattainable subgoals, the subordinate level is negatively affected and cannot follow the dominant level's actions. This can potentially make both levels stuck in local optima, ultimately hindering subsequent subgoal reachability. Allowing real-time bilateral information sharing and error correction would be a natural cure for this issue, which motivates us to propose a mutual response mechanism. Based on this, we propose the Bidirectional-reachable Hierarchical Policy Optimization (BrHPO)--a simple yet effective algorithm that also enjoys computation efficiency. Experiment results on a variety of long-horizon tasks showcase that BrHPO outperforms other state-of-the-art HRL baselines, coupled with a significantly higher exploration efficiency and robustness.

SAM-VMNet: Deep Neural Networks For Coronary Angiography Vessel Segmentation

Coronary artery disease (CAD) is one of the most prevalent diseases in the cardiovascular field and one of the major contributors to death worldwide. Computed Tomography Angiography (CTA) images are regarded as the authoritative standard for the diagnosis of coronary artery disease, and by performing vessel segmentation and stenosis detection on CTA images, physicians are able to diagnose coronary artery disease more accurately. In order to combine the advantages of both the base model and the domain-specific model, and to achieve high-precision and fully-automatic segmentation and detection with a limited number of training samples, we propose a novel architecture, SAM-VMNet, which combines the powerful feature extraction capability of MedSAM with the advantage of the linear complexity of the visual state-space model of VM-UNet, giving it faster inferences than Vision Transformer with faster inference speed and stronger data processing capability, achieving higher segmentation accuracy and stability for CTA images. Experimental results show that the SAM-VMNet architecture performs excellently in the CTA image segmentation task, with a segmentation accuracy of up to 98.32% and a sensitivity of up to 99.33%, which is significantly better than other existing models and has stronger domain adaptability. Comprehensive evaluation of the CTA image segmentation task shows that SAM-VMNet accurately extracts the vascular trunks and capillaries, demonstrating its great potential and wide range of application scenarios for the vascular segmentation task, and also laying a solid foundation for further stenosis detection.

OMPO: A Unified Framework for RL under Policy and Dynamics Shifts

Training reinforcement learning policies using environment interaction data collected from varying policies or dynamics presents a fundamental challenge. Existing works often overlook the distribution discrepancies induced by policy or dynamics shifts, or rely on specialized algorithms with task priors, thus often resulting in suboptimal policy performances and high learning variances. In this paper, we identify a unified strategy for online RL policy learning under diverse settings of policy and dynamics shifts: transition occupancy matching. In light of this, we introduce a surrogate policy learning objective by considering the transition occupancy discrepancies and then cast it into a tractable min-max optimization problem through dual reformulation. Our method, dubbed Occupancy-Matching Policy Optimization (OMPO), features a specialized actor-critic structure equipped with a distribution discriminator and a small-size local buffer. We conduct extensive experiments based on the OpenAI Gym, Meta-World, and Panda Robots environments, encompassing policy shifts under stationary and nonstationary dynamics, as well as domain adaption. The results demonstrate that OMPO outperforms the specialized baselines from different categories in all settings. We also find that OMPO exhibits particularly strong performance when combined with domain randomization, highlighting its potential in RL-based robotics applications

Offline-Boosted Actor-Critic: Adaptively Blending Optimal Historical Behaviors in Deep Off-Policy RL

Off-policy reinforcement learning (RL) has achieved notable success in tackling many complex real-world tasks, by leveraging previously collected data for policy learning. However, most existing off-policy RL algorithms fail to maximally exploit the information in the replay buffer, limiting sample efficiency and policy performance. In this work, we discover that concurrently training an offline RL policy based on the shared online replay buffer can sometimes outperform the original online learning policy, though the occurrence of such performance gains remains uncertain. This motivates a new possibility of harnessing the emergent outperforming offline optimal policy to improve online policy learning. Based on this insight, we present Offline-Boosted Actor-Critic (OBAC), a model-free online RL framework that elegantly identifies the outperforming offline policy through value comparison, and uses it as an adaptive constraint to guarantee stronger policy learning performance. Our experiments demonstrate that OBAC outperforms other popular model-free RL baselines and rivals advanced model-based RL methods in terms of sample efficiency and asymptotic performance across 53 tasks spanning 6 task suites.

Joint Edge Optimization Deep Unfolding Network for Accelerated MRI Reconstruction

Magnetic Resonance Imaging (MRI) is a widely used imaging technique, however it has the limitation of long scanning time. Though previous model-based and learning-based MRI reconstruction methods have shown promising performance, most of them have not fully utilized the edge prior of MR images, and there is still much room for improvement. In this paper, we build a joint edge optimization model that not only incorporates individual regularizers specific to both the MR image and the edges, but also enforces a co-regularizer to effectively establish a stronger correlation between them. Specifically, the edge information is defined through a non-edge probability map to guide the image reconstruction during the optimization process. Meanwhile, the regularizers pertaining to images and edges are incorporated into a deep unfolding network to automatically learn their respective inherent a-priori information.Numerical experiments, consisting of multi-coil and single-coil MRI data with different sampling schemes at a variety of sampling factors, demonstrate that the proposed method outperforms other compared methods.

Adaptive Mixed-Scale Feature Fusion Network for Blind AI-Generated Image Quality Assessment

With the increasing maturity of the text-to-image and image-to-image generative models, AI-generated images (AGIs) have shown great application potential in advertisement, entertainment, education, social media, etc. Although remarkable advancements have been achieved in generative models, very few efforts have been paid to design relevant quality assessment models. In this paper, we propose a novel blind image quality assessment (IQA) network, named AMFF-Net, for AGIs. AMFF-Net evaluates AGI quality from three dimensions, i.e., "visual quality", "authenticity", and "consistency". Specifically, inspired by the characteristics of the human visual system and motivated by the observation that "visual quality" and "authenticity" are characterized by both local and global aspects, AMFF-Net scales the image up and down and takes the scaled images and original-sized image as the inputs to obtain multi-scale features. After that, an Adaptive Feature Fusion (AFF) block is used to adaptively fuse the multi-scale features with learnable weights. In addition, considering the correlation between the image and prompt, AMFF-Net compares the semantic features from text encoder and image encoder to evaluate the text-to-image alignment. We carry out extensive experiments on three AGI quality assessment databases, and the experimental results show that our AMFF-Net obtains better performance than nine state-of-the-art blind IQA methods. The results of ablation experiments further demonstrate the effectiveness of the proposed multi-scale input strategy and AFF block.

CSST Strong Lensing Preparation: a Framework for Detecting Strong Lenses in the Multi-color Imaging Survey by the China Survey Space Telescope (CSST)

Strong gravitational lensing is a powerful tool for investigating dark matter and dark energy properties. With the advent of large-scale sky surveys, we can discover strong lensing systems on an unprecedented scale, which requires efficient tools to extract them from billions of astronomical objects. The existing mainstream lens-finding tools are based on machine learning algorithms and applied to cut-out-centered galaxies. However, according to the design and survey strategy of optical surveys by CSST, preparing cutouts with multiple bands requires considerable efforts. To overcome these challenges, we have developed a framework based on a hierarchical visual Transformer with a sliding window technique to search for strong lensing systems within entire images. Moreover, given that multi-color images of strong lensing systems can provide insights into their physical characteristics, our framework is specifically crafted to identify strong lensing systems in images with any number of channels. As evaluated using CSST mock data based on an Semi-Analytic Model named CosmoDC2, our framework achieves precision and recall rates of 0.98 and 0.90, respectively. To evaluate the effectiveness of our method in real observations, we have applied it to a subset of images from the DESI Legacy Imaging Surveys and media images from Euclid Early Release Observations. 61 new strong lensing system candidates are discovered by our method. However, we also identified false positives arising primarily from the simplified galaxy morphology assumptions within the simulation. This underscores the practical limitations of our approach while simultaneously highlighting potential avenues for future improvements.

Smooth Computation without Input Delay: Robust Tube-Based Model Predictive Control for Robot Manipulator Planning

Model Predictive Control (MPC) has exhibited remarkable capabilities in optimizing objectives and meeting constraints. However, the substantial computational burden associated with solving the Optimal Control Problem (OCP) at each triggering instant introduces significant delays between state sampling and control application. These delays limit the practicality of MPC in resource-constrained systems when engaging in complex tasks. The intuition to address this issue in this paper is that by predicting the successor state, the controller can solve the OCP one time step ahead of time thus avoiding the delay of the next action. To this end, we compute deviations between real and nominal system states, predicting forthcoming real states as initial conditions for the imminent OCP solution. Anticipatory computation stores optimal control based on current nominal states, thus mitigating the delay effects. Additionally, we establish an upper bound for linearization error, effectively linearizing the nonlinear system, reducing OCP complexity, and enhancing response speed. We provide empirical validation through two numerical simulations and corresponding real-world robot tasks, demonstrating significant performance improvements and augmented response speed (up to $90\%$) resulting from the seamless integration of our proposed approach compared to conventional time-triggered MPC strategies.

ACE : Off-Policy Actor-Critic with Causality-Aware Entropy Regularization

The varying significance of distinct primitive behaviors during the policy learning process has been overlooked by prior model-free RL algorithms. Leveraging this insight, we explore the causal relationship between different action dimensions and rewards to evaluate the significance of various primitive behaviors during training. We introduce a causality-aware entropy term that effectively identifies and prioritizes actions with high potential impacts for efficient exploration. Furthermore, to prevent excessive focus on specific primitive behaviors, we analyze the gradient dormancy phenomenon and introduce a dormancy-guided reset mechanism to further enhance the efficacy of our method. Our proposed algorithm, ACE: Off-policy Actor-critic with Causality-aware Entropy regularization, demonstrates a substantial performance advantage across 29 diverse continuous control tasks spanning 7 domains compared to model-free RL baselines, which underscores the effectiveness, versatility, and efficient sample efficiency of our approach. Benchmark results and videos are available at https://ace-rl.github.io/.