Mind the Tool Failures: Achieving Synergistic Tool Gains for Medical Agents

Medical AI agents increasingly use external tools for diagnosis, treatment recommendation, and evidence retrieval, yet most existing approaches assume that task-appropriate tools are reliable within their intended scope. This assumption is fragile in real clinical settings, where even relevant tools may fail on challenging instances and lead to unsafe downstream decisions. To address this issue, we study medical tool use under imperfect-tool settings to correct failure instances missed by individual tools. Instance-dependent failure patterns create a gap between the best fixed single tool and an ideal instance-wise selector, which we refer to as the Single-Oracle risk gap. The core challenge is that conventional task-level tool selection cannot realize this gap, as it is inherently bounded by the performance of the best single tool. Motivated by this observation, we therefore account for instance-level heterogeneity and formulate tool use as an instance-level selection problem. Particularly, we propose a GRPO-based reinforcement learning framework with rewards for probabilistic risk minimization and disagreement-aware synergy learning, which promotes instance-level correction of erroneous tool consensus. Furthermore, an entropy-guided sampling strategy is adopted to upweight high-disagreement instances, which provide stronger signals for learning instance-specific tool synergy. These two components complement each other in mitigating instance-level heterogeneity and improving tool synergy. Experiments on two tasks and seven medical benchmarks show that our method consistently achieves robust and stable improvements over a broad range of baselines, highlighting the importance of synergy-aware tool use for reliable medical agentic systems.

Beyond Instance-Level Self-Supervision in 3D Multi-Modal Medical Imaging

Self-supervised pre-training methods in medical imaging typically treat each individual as an isolated instance, learning representations through augmentation-based objectives or masked reconstruction. They often do not adequately capitalize on a key characteristic of physiological features: anatomical structures maintain consistent spatial relationships across individuals (instances), such as the thalamus being medial to the basal ganglia, regardless of variations in brain size, shape, or pathology. We propose leveraging this cross-instance topological consistency as a supervisory signal. The challenge arises from the inherent variability in medical imaging, which can differ significantly across instances and modalities. To tackle this, we focus on two alignment regimes. (i) Intra-instance: with pixel-level correspondences available, a cross-modal triplet objective explicitly preserves local neighborhood topology. (ii) Inter-instance: without such supervision, we derive pseudo-correspondences to control partial neighborhood alignment and prevent topology collapse across modalities. We validate our approach across 7 downstream multi-modal tasks, achieving average improvements of 1.1% and 5.94% in segmentation and classification tasks, respectively, and demonstrating significantly better robustness when modalities are missing at test time.

SemiSAM-O1: How far can we push the boundary of annotation-efficient medical image segmentation?

Semi-supervised learning (SSL) has become a promising solution to alleviate the annotation burden of deep learning-based medical image segmentation models. While recent advances in foundation model-driven SSL have pushed the boundary to extremely limited annotation scenarios, they fail to maintain robust competitive performance in complex imaging modalities. In this paper, we propose SemiSAM-O1, an annotation-efficient framework using only one annotated template image for segmentation. SemiSAM-O1 extends the specialist-generalist collaborative learning framework to the extreme one-label setting by fully exploiting the foundation model's feature representation capability beyond its prompting interface. SemiSAM-O1 operates in two stages. In the first stage, the foundation model's encoder extracts dense features from all volumes, and class prototypes derived from the single annotated template are propagated to the unlabeled pool via feature similarity to produce coarse initial pseudo-labels. In the second stage, an iterative training-and-refinement loop progressively improves both the segmentation model and the pseudo-labels over multiple rounds, where each round trains the model from scratch on current pseudo-labels and generates updated predictions with voxel-wise uncertainty estimates. An uncertainty-guided refinement step further leverages the foundation model's global feature space to correct high-uncertainty regions by aggregating labels from their most similar confident neighbors, establishing a virtuous cycle of mutual improvement. Extensive experiments on a wide range of segmentation tasks across different modalities and anatomical targets demonstrate that SemiSAM-O1 significantly narrows the performance gap between one-label semi-supervised learning and full supervision, while significantly reducing the computational overhead of online foundation model inference.

LLM-Guided Safety Agent for Edge Robotics with an ISO-Compliant Perception-Compute-Control Architecture

Ensuring functional safety in human-robot interaction is challenging because AI perception is inherently probabilistic, whereas industrial standards require deterministic behavior. We present an LLM-guided safety agent for edge robotics, built on an ISO-compliant low-latency perception-compute-control architecture. Our method translates natural-language safety regulations into executable predicates and deploys them through a redundant heterogeneous edge runtime. For fault-tolerant closed-loop execution under edge constraints, we adopt a symmetric dual-modular redundancy design with parallel independent execution for low-latency perception, computation, and control. We prototype the system on a dual-RK3588 platform and evaluate it in representative human-robot interaction scenarios. The results demonstrate a practical edge implementation path toward ISO 13849 Category 3 and PL d using cost-effective hardware, supporting practical deployment of safety-critical embodied AI.

Project Imaging-X: A Survey of 1000+ Open-Access Medical Imaging Datasets for Foundation Model Development

Foundation models have demonstrated remarkable success across diverse domains and tasks, primarily due to the thrive of large-scale, diverse, and high-quality datasets. However, in the field of medical imaging, the curation and assembling of such medical datasets are highly challenging due to the reliance on clinical expertise and strict ethical and privacy constraints, resulting in a scarcity of large-scale unified medical datasets and hindering the development of powerful medical foundation models. In this work, we present the largest survey to date of medical image datasets, covering over 1,000 open-access datasets with a systematic catalog of their modalities, tasks, anatomies, annotations, limitations, and potential for integration. Our analysis exposes a landscape that is modest in scale, fragmented across narrowly scoped tasks, and unevenly distributed across organs and modalities, which in turn limits the utility of existing medical image datasets for developing versatile and robust medical foundation models. To turn fragmentation into scale, we propose a metadata-driven fusion paradigm (MDFP) that integrates public datasets with shared modalities or tasks, thereby transforming multiple small data silos into larger, more coherent resources. Building on MDFP, we release an interactive discovery portal that enables end-to-end, automated medical image dataset integration, and compile all surveyed datasets into a unified, structured table that clearly summarizes their key characteristics and provides reference links, offering the community an accessible and comprehensive repository. By charting the current terrain and offering a principled path to dataset consolidation, our survey provides a practical roadmap for scaling medical imaging corpora, supporting faster data discovery, more principled dataset creation, and more capable medical foundation models.

Project and Generate: Divergence-Free Neural Operators for Incompressible Flows

Learning-based models for fluid dynamics often operate in unconstrained function spaces, leading to physically inadmissible, unstable simulations. While penalty-based methods offer soft regularization, they provide no structural guarantees, resulting in spurious divergence and long-term collapse. In this work, we introduce a unified framework that enforces the incompressible continuity equation as a hard, intrinsic constraint for both deterministic and generative modeling. First, to project deterministic models onto the divergence-free subspace, we integrate a differentiable spectral Leray projection grounded in the Helmholtz-Hodge decomposition, which restricts the regression hypothesis space to physically admissible velocity fields. Second, to generate physically consistent distributions, we show that simply projecting model outputs is insufficient when the prior is incompatible. To address this, we construct a divergence-free Gaussian reference measure via a curl-based pushforward, ensuring the entire probability flow remains subspace-consistent by construction. Experiments on 2D Navier-Stokes equations demonstrate exact incompressibility up to discretization error and substantially improved stability and physical consistency.

Developing Foundation Models for Universal Segmentation from 3D Whole-Body Positron Emission Tomography

Positron emission tomography (PET) is a key nuclear medicine imaging modality that visualizes radiotracer distributions to quantify in vivo physiological and metabolic processes, playing an irreplaceable role in disease management. Despite its clinical importance, the development of deep learning models for quantitative PET image analysis remains severely limited, driven by both the inherent segmentation challenge from PET's paucity of anatomical contrast and the high costs of data acquisition and annotation. To bridge this gap, we develop generalist foundational models for universal segmentation from 3D whole-body PET imaging. We first build the largest and most comprehensive PET dataset to date, comprising 11041 3D whole-body PET scans with 59831 segmentation masks for model development. Based on this dataset, we present SegAnyPET, an innovative foundational model with general-purpose applicability to diverse segmentation tasks. Built on a 3D architecture with a prompt engineering strategy for mask generation, SegAnyPET enables universal and scalable organ and lesion segmentation, supports efficient human correction with minimal effort, and enables a clinical human-in-the-loop workflow. Extensive evaluations on multi-center, multi-tracer, multi-disease datasets demonstrate that SegAnyPET achieves strong zero-shot performance across a wide range of segmentation tasks, highlighting its potential to advance the clinical applications of molecular imaging.

The Curse and Blessing of Mean Bias in FP4-Quantized LLM Training

Large language models trained on natural language exhibit pronounced anisotropy: a small number of directions concentrate disproportionate energy, while the remaining dimensions form a broad semantic tail. In low-bit training regimes, this geometry becomes numerically unstable. Because blockwise quantization scales are determined by extreme elementwise magnitudes, dominant directions stretch the dynamic range, compressing long-tail semantic variation into narrow numerical bins. We show that this instability is primarily driven by a coherent rank-one mean bias, which constitutes the dominant component of spectral anisotropy in LLM representations. This mean component emerges systematically across layers and training stages and accounts for the majority of extreme activation magnitudes, making it the principal driver of dynamic-range inflation under low precision. Crucially, because the dominant instability is rank-one, it can be eliminated through a simple source-level mean-subtraction operation. This bias-centric conditioning recovers most of the stability benefits of SVD-based spectral methods while requiring only reduction operations and standard quantization kernels. Empirical results on FP4 (W4A4G4) training show that mean removal substantially narrows the loss gap to BF16 and restores downstream performance, providing a hardware-efficient path to stable low-bit LLM training.

SD-MoE: Spectral Decomposition for Effective Expert Specialization

Mixture-of-Experts (MoE) architectures scale Large Language Models via expert specialization induced by conditional computation. In practice, however, expert specialization often fails: some experts become functionally similar, while others functioning as de facto shared experts, limiting the effective capacity and model performance. In this work, we analysis from a spectral perspective on parameter and gradient spaces, uncover that (1) experts share highly overlapping dominant spectral components in their parameters, (2) dominant gradient subspaces are strongly aligned across experts, driven by ubiquitous low-rank structure in human corpus, and (3) gating mechanisms preferentially route inputs along these dominant directions, further limiting specialization. To address this, we propose Spectral-Decoupled MoE (SD-MoE), which decomposes both parameter and gradient in the spectral space. SD-MoE improves performance across downstream tasks, enables effective expert specialization, incurring minimal additional computation, and can be seamlessly integrated into a wide range of existing MoE architectures, including Qwen and DeepSeek.

Multi-Head Attention as a Source of Catastrophic Forgetting in MoE Transformers

Mixture-of-Experts (MoE) architectures are often considered a natural fit for continual learning because sparse routing should localize updates and reduce interference, yet MoE Transformers still forget substantially even with sparse, well-balanced expert utilization. We attribute this gap to a pre-routing bottleneck: multi-head attention concatenates head-specific signals into a single post-attention router input, forcing routing to act on co-occurring feature compositions rather than separable head channels. We show that this router input simultaneously encodes multiple separately decodable semantic and structural factors with uneven head support, and that different feature compositions induce weakly aligned parameter-gradient directions; as a result, routing maps many distinct compositions to the same route. We quantify this collision effect via a route-wise effective composition number $N_{eff}$ and find that higher $N_{eff}$ is associated with larger old-task loss increases after continual training. Motivated by these findings, we propose MH-MoE, which performs head-wise routing over sub-representations to increase routing granularity and reduce composition collisions. On TRACE with Qwen3-0.6B/8B, MH-MoE effectively mitigates forgetting, reducing BWT on Qwen3-0.6B from 11.2% (LoRAMoE) to 4.5%.