MedVista3D: Vision-Language Modeling for Reducing Diagnostic Errors in 3D CT Disease Detection, Understanding and Reporting

Radiologic diagnostic errors-under-reading errors, inattentional blindness, and communication failures-remain prevalent in clinical practice. These issues often stem from missed localized abnormalities, limited global context, and variability in report language. These challenges are amplified in 3D imaging, where clinicians must examine hundreds of slices per scan. Addressing them requires systems with precise localized detection, global volume-level reasoning, and semantically consistent natural language reporting. However, existing 3D vision-language models are unable to meet all three needs jointly, lacking local-global understanding for spatial reasoning and struggling with the variability and noise of uncurated radiology reports. We present MedVista3D, a multi-scale semantic-enriched vision-language pretraining framework for 3D CT analysis. To enable joint disease detection and holistic interpretation, MedVista3D performs local and global image-text alignment for fine-grained representation learning within full-volume context. To address report variability, we apply language model rewrites and introduce a Radiology Semantic Matching Bank for semantics-aware alignment. MedVista3D achieves state-of-the-art performance on zero-shot disease classification, report retrieval, and medical visual question answering, while transferring well to organ segmentation and prognosis prediction. Code and datasets will be released.

Enhancing Large Multimodal Models with Adaptive Sparsity and KV Cache Compression

Large multimodal models (LMMs) have advanced significantly by integrating visual encoders with extensive language models, enabling robust reasoning capabilities. However, compressing LMMs for deployment on edge devices remains a critical challenge. In this work, we propose an adaptive search algorithm that optimizes sparsity and KV cache compression to enhance LMM efficiency. Utilizing the Tree-structured Parzen Estimator, our method dynamically adjusts pruning ratios and KV cache quantization bandwidth across different LMM layers, using model performance as the optimization objective. This approach uniquely combines pruning with key-value cache quantization and incorporates a fast pruning technique that eliminates the need for additional fine-tuning or weight adjustments, achieving efficient compression without compromising accuracy. Comprehensive evaluations on benchmark datasets, including LLaVA-1.5 7B and 13B, demonstrate our method superiority over state-of-the-art techniques such as SparseGPT and Wanda across various compression levels. Notably, our framework automatic allocation of KV cache compression resources sets a new standard in LMM optimization, delivering memory efficiency without sacrificing much performance.

X-Fusion: Introducing New Modality to Frozen Large Language Models

We propose X-Fusion, a framework that extends pretrained Large Language Models (LLMs) for multimodal tasks while preserving their language capabilities. X-Fusion employs a dual-tower design with modality-specific weights, keeping the LLM's parameters frozen while integrating vision-specific information for both understanding and generation. Our experiments demonstrate that X-Fusion consistently outperforms alternative architectures on both image-to-text and text-to-image tasks. We find that incorporating understanding-focused data improves generation quality, reducing image data noise enhances overall performance, and feature alignment accelerates convergence for smaller models but has minimal impact on larger ones. Our findings provide valuable insights into building efficient unified multimodal models.

YoChameleon: Personalized Vision and Language Generation

Large Multimodal Models (e.g., GPT-4, Gemini, Chameleon) have evolved into powerful tools with millions of users. However, they remain generic models and lack personalized knowledge of specific user concepts. Previous work has explored personalization for text generation, yet it remains unclear how these methods can be adapted to new modalities, such as image generation. In this paper, we introduce Yo'Chameleon, the first attempt to study personalization for large multimodal models. Given 3-5 images of a particular concept, Yo'Chameleon leverages soft-prompt tuning to embed subject-specific information to (i) answer questions about the subject and (ii) recreate pixel-level details to produce images of the subject in new contexts. Yo'Chameleon is trained with (i) a self-prompting optimization mechanism to balance performance across multiple modalities, and (ii) a ``soft-positive" image generation approach to enhance image quality in a few-shot setting.

RoMedFormer: A Rotary-Embedding Transformer Foundation Model for 3D Genito-Pelvic Structure Segmentation in MRI and CT

Deep learning-based segmentation of genito-pelvic structures in MRI and CT is crucial for applications such as radiation therapy, surgical planning, and disease diagnosis. However, existing segmentation models often struggle with generalizability across imaging modalities, and anatomical variations. In this work, we propose RoMedFormer, a rotary-embedding transformer-based foundation model designed for 3D female genito-pelvic structure segmentation in both MRI and CT. RoMedFormer leverages self-supervised learning and rotary positional embeddings to enhance spatial feature representation and capture long-range dependencies in 3D medical data. We pre-train our model using a diverse dataset of 3D MRI and CT scans and fine-tune it for downstream segmentation tasks. Experimental results demonstrate that RoMedFormer achieves superior performance segmenting genito-pelvic organs. Our findings highlight the potential of transformer-based architectures in medical image segmentation and pave the way for more transferable segmentation frameworks.

Towards Universal Text-driven CT Image Segmentation

Computed tomography (CT) is extensively used for accurate visualization and segmentation of organs and lesions. While deep learning models such as convolutional neural networks (CNNs) and vision transformers (ViTs) have significantly improved CT image analysis, their performance often declines when applied to diverse, real-world clinical data. Although foundation models offer a broader and more adaptable solution, their potential is limited due to the challenge of obtaining large-scale, voxel-level annotations for medical images. In response to these challenges, prompting-based models using visual or text prompts have emerged. Visual-prompting methods, such as the Segment Anything Model (SAM), still require significant manual input and can introduce ambiguity when applied to clinical scenarios. Instead, foundation models that use text prompts offer a more versatile and clinically relevant approach. Notably, current text-prompt models, such as the CLIP-Driven Universal Model, are limited to text prompts already encountered during training and struggle to process the complex and diverse scenarios of real-world clinical applications. Instead of fine-tuning models trained from natural imaging, we propose OpenVocabCT, a vision-language model pretrained on large-scale 3D CT images for universal text-driven segmentation. Using the large-scale CT-RATE dataset, we decompose the diagnostic reports into fine-grained, organ-level descriptions using large language models for multi-granular contrastive learning. We evaluate our OpenVocabCT on downstream segmentation tasks across nine public datasets for organ and tumor segmentation, demonstrating the superior performance of our model compared to existing methods. All code, datasets, and models will be publicly released at https://github.com/ricklisz/OpenVocabCT.

Removing Distributional Discrepancies in Captions Improves Image-Text Alignment

In this paper, we introduce a model designed to improve the prediction of image-text alignment, targeting the challenge of compositional understanding in current visual-language models. Our approach focuses on generating high-quality training datasets for the alignment task by producing mixed-type negative captions derived from positive ones. Critically, we address the distribution imbalance between positive and negative captions to ensure that the alignment model does not depend solely on textual information but also considers the associated images for predicting alignment accurately. By creating this enhanced training data, we fine-tune an existing leading visual-language model to boost its capability in understanding alignment. Our model significantly outperforms current top-performing methods across various datasets. We also demonstrate the applicability of our model by ranking the images generated by text-to-image models based on text alignment. Project page: \url{https://yuheng-li.github.io/LLaVA-score/}

AnatoMask: Enhancing Medical Image Segmentation with Reconstruction-guided Self-masking

Due to the scarcity of labeled data, self-supervised learning (SSL) has gained much attention in 3D medical image segmentation, by extracting semantic representations from unlabeled data. Among SSL strategies, Masked image modeling (MIM) has shown effectiveness by reconstructing randomly masked images to learn detailed representations. However, conventional MIM methods require extensive training data to achieve good performance, which still poses a challenge for medical imaging. Since random masking uniformly samples all regions within medical images, it may overlook crucial anatomical regions and thus degrade the pretraining efficiency. We propose AnatoMask, a novel MIM method that leverages reconstruction loss to dynamically identify and mask out anatomically significant regions to improve pretraining efficacy. AnatoMask takes a self-distillation approach, where the model learns both how to find more significant regions to mask and how to reconstruct these masked regions. To avoid suboptimal learning, Anatomask adjusts the pretraining difficulty progressively using a masking dynamics function. We have evaluated our method on 4 public datasets with multiple imaging modalities (CT, MRI, and PET). AnatoMask demonstrates superior performance and scalability compared to existing SSL methods. The code is available at https://github.com/ricklisz/AnatoMask.

Yo'LLaVA: Your Personalized Language and Vision Assistant

Large Multimodal Models (LMMs) have shown remarkable capabilities across a variety of tasks (e.g., image captioning, visual question answering). While broad, their knowledge remains generic (e.g., recognizing a dog), and they are unable to handle personalized subjects (e.g., recognizing a user's pet dog). Human reasoning, in contrast, typically operates within the context of specific subjects in our surroundings. For example, one might ask, "What should I buy for my dog's birthday?"; as opposed to a generic inquiry about "What should I buy for a dog's birthday?". Similarly, when looking at a friend's image, the interest lies in seeing their activities (e.g., "my friend is holding a cat"), rather than merely observing generic human actions (e.g., "a man is holding a cat"). In this paper, we introduce the novel task of personalizing LMMs, so that they can have conversations about a specific subject. We propose Yo'LLaVA, which learns to embed a personalized subject into a set of latent tokens given a handful of example images of the subject. Our qualitative and quantitative analyses reveal that Yo'LLaVA can learn the concept more efficiently using fewer tokens and more effectively encode the visual attributes compared to strong prompting baselines (e.g., LLaVA).

Mammo-CLIP: Leveraging Contrastive Language-Image Pre-training (CLIP) for Enhanced Breast Cancer Diagnosis with Multi-view Mammography

Although fusion of information from multiple views of mammograms plays an important role to increase accuracy of breast cancer detection, developing multi-view mammograms-based computer-aided diagnosis (CAD) schemes still faces challenges and no such CAD schemes have been used in clinical practice. To overcome the challenges, we investigate a new approach based on Contrastive Language-Image Pre-training (CLIP), which has sparked interest across various medical imaging tasks. By solving the challenges in (1) effectively adapting the single-view CLIP for multi-view feature fusion and (2) efficiently fine-tuning this parameter-dense model with limited samples and computational resources, we introduce Mammo-CLIP, the first multi-modal framework to process multi-view mammograms and corresponding simple texts. Mammo-CLIP uses an early feature fusion strategy to learn multi-view relationships in four mammograms acquired from the CC and MLO views of the left and right breasts. To enhance learning efficiency, plug-and-play adapters are added into CLIP image and text encoders for fine-tuning parameters and limiting updates to about 1% of the parameters. For framework evaluation, we assembled two datasets retrospectively. The first dataset, comprising 470 malignant and 479 benign cases, was used for few-shot fine-tuning and internal evaluation of the proposed Mammo-CLIP via 5-fold cross-validation. The second dataset, including 60 malignant and 294 benign cases, was used to test generalizability of Mammo-CLIP. Study results show that Mammo-CLIP outperforms the state-of-art cross-view transformer in AUC (0.841 vs. 0.817, 0.837 vs. 0.807) on both datasets. It also surpasses previous two CLIP-based methods by 20.3% and 14.3%. This study highlights the potential of applying the finetuned vision-language models for developing next-generation, image-text-based CAD schemes of breast cancer.