Daily Papers

In this paper, we study risk-sensitive Reinforcement Learning (RL), focusing on the objective of Conditional Value at Risk (CVaR) with risk tolerance tau. Starting with multi-arm bandits (MABs), we show the minimax CVaR regret rate is Omega(tau^{-1AK}), where A is the number of actions and K is the number of episodes, and that it is achieved by an Upper Confidence Bound algorithm with a novel Bernstein bonus. For online RL in tabular Markov Decision Processes (MDPs), we show a minimax regret lower bound of Omega(tau^{-1SAK}) (with normalized cumulative rewards), where S is the number of states, and we propose a novel bonus-driven Value Iteration procedure. We show that our algorithm achieves the optimal regret of widetilde O(tau^{-1SAK}) under a continuity assumption and in general attains a near-optimal regret of widetilde O(tau^{-1}SAK), which is minimax-optimal for constant tau. This improves on the best available bounds. By discretizing rewards appropriately, our algorithms are computationally efficient.

We develop a variant of the stochastic prox-linear method for minimizing the Conditional Value-at-Risk (CVaR) objective. CVaR is a risk measure focused on minimizing worst-case performance, defined as the average of the top quantile of the losses. In machine learning, such a risk measure is useful to train more robust models. Although the stochastic subgradient method (SGM) is a natural choice for minimizing the CVaR objective, we show that our stochastic prox-linear (SPL+) algorithm can better exploit the structure of the objective, while still providing a convenient closed form update. Our SPL+ method also adapts to the scaling of the loss function, which allows for easier tuning. We then specialize a general convergence theorem for SPL+ to our setting, and show that it allows for a wider selection of step sizes compared to SGM. We support this theoretical finding experimentally.

We study risk-sensitive Reinforcement Learning (RL), where we aim to maximize the Conditional Value at Risk (CVaR) with a fixed risk tolerance tau. Prior theoretical work studying risk-sensitive RL focuses on the tabular Markov Decision Processes (MDPs) setting. To extend CVaR RL to settings where state space is large, function approximation must be deployed. We study CVaR RL in low-rank MDPs with nonlinear function approximation. Low-rank MDPs assume the underlying transition kernel admits a low-rank decomposition, but unlike prior linear models, low-rank MDPs do not assume the feature or state-action representation is known. We propose a novel Upper Confidence Bound (UCB) bonus-driven algorithm to carefully balance the interplay between exploration, exploitation, and representation learning in CVaR RL. We prove that our algorithm achieves a sample complexity of Oleft(H^7 A^2 d^4{tau^2 epsilon^2}right) to yield an epsilon-optimal CVaR, where H is the length of each episode, A is the capacity of action space, and d is the dimension of representations. Computational-wise, we design a novel discretized Least-Squares Value Iteration (LSVI) algorithm for the CVaR objective as the planning oracle and show that we can find the near-optimal policy in a polynomial running time with a Maximum Likelihood Estimation oracle. To our knowledge, this is the first provably efficient CVaR RL algorithm in low-rank MDPs.

Risk-sensitive reinforcement learning (RL) aims to optimize policies that balance the expected reward and risk. In this paper, we present a novel risk-sensitive RL framework that employs an Iterated Conditional Value-at-Risk (CVaR) objective under both linear and general function approximations, enriched by human feedback. These new formulations provide a principled way to guarantee safety in each decision making step throughout the control process. Moreover, integrating human feedback into risk-sensitive RL framework bridges the gap between algorithmic decision-making and human participation, allowing us to also guarantee safety for human-in-the-loop systems. We propose provably sample-efficient algorithms for this Iterated CVaR RL and provide rigorous theoretical analysis. Furthermore, we establish a matching lower bound to corroborate the optimality of our algorithms in a linear context.

Traditional approaches to portfolio optimization, often rooted in Modern Portfolio Theory and solved via quadratic programming or evolutionary algorithms, struggle with scalability or flexibility, especially in scenarios involving complex constraints, large datasets and/or multiple conflicting objectives. To address these challenges, we introduce a benchmark framework for multi-objective portfolio optimization (MPO) using gradient descent with automatic differentiation. Our method supports any optimization objective, such as minimizing risk measures (e.g., CVaR) or maximizing Sharpe ratio, along with realistic constraints, such as tracking error limits, UCITS regulations, or asset group restrictions. We have evaluated our framework across six experimental scenarios, from single-objective setups to complex multi-objective cases, and have compared its performance against standard solvers like CVXPY and SKFOLIO. Our results show that our method achieves competitive performance while offering enhanced flexibility for modeling multiple objectives and constraints. We aim to provide a practical and extensible tool for researchers and practitioners exploring advanced portfolio optimization problems in real-world conditions.

We consider the distributionally robust optimization (DRO) problem with spectral risk-based uncertainty set and f-divergence penalty. This formulation includes common risk-sensitive learning objectives such as regularized condition value-at-risk (CVaR) and average top-k loss. We present Prospect, a stochastic gradient-based algorithm that only requires tuning a single learning rate hyperparameter, and prove that it enjoys linear convergence for smooth regularized losses. This contrasts with previous algorithms that either require tuning multiple hyperparameters or potentially fail to converge due to biased gradient estimates or inadequate regularization. Empirically, we show that Prospect can converge 2-3times faster than baselines such as stochastic gradient and stochastic saddle-point methods on distribution shift and fairness benchmarks spanning tabular, vision, and language domains.

Excellent tail performance is crucial for modern machine learning tasks, such as algorithmic fairness, class imbalance, and risk-sensitive decision making, as it ensures the effective handling of challenging samples within a dataset. Tail performance is also a vital determinant of success for personalized recommender systems to reduce the risk of losing users with low satisfaction. This study introduces a "safe" collaborative filtering method that prioritizes recommendation quality for less-satisfied users rather than focusing on the average performance. Our approach minimizes the conditional value at risk (CVaR), which represents the average risk over the tails of users' loss. To overcome computational challenges for web-scale recommender systems, we develop a robust yet practical algorithm that extends the most scalable method, implicit alternating least squares (iALS). Empirical evaluation on real-world datasets demonstrates the excellent tail performance of our approach while maintaining competitive computational efficiency.

Machine learning systems often experience a distribution shift between training and testing. In this paper, we introduce a simple variational objective whose optima are exactly the set of all representations on which risk minimizers are guaranteed to be robust to any distribution shift that preserves the Bayes predictor, e.g., covariate shifts. Our objective has two components. First, a representation must remain discriminative for the task, i.e., some predictor must be able to simultaneously minimize the source and target risk. Second, the representation's marginal support needs to be the same across source and target. We make this practical by designing self-supervised objectives that only use unlabelled data and augmentations to train robust representations. Our objectives give insights into the robustness of CLIP, and further improve CLIP's representations to achieve SOTA results on DomainBed.

The study explores the synergistic combination of Synthetic Aperture Radar (SAR) and Visible-Near Infrared-Short Wave Infrared (VNIR-SWIR) imageries for land use/land cover (LULC) classification. Image fusion, employing Bayesian fusion, merges SAR texture bands with VNIR-SWIR imageries. The research aims to investigate the impact of this fusion on LULC classification. Despite the popularity of random forests for supervised classification, their limitations, such as suboptimal performance with fewer features and accuracy stagnation, are addressed. To overcome these issues, ensembles of random forests (RFE) are created, introducing random rotations using the Forest-RC algorithm. Three rotation approaches: principal component analysis (PCA), sparse random rotation (SRP) matrix, and complete random rotation (CRP) matrix are employed. Sentinel-1 SAR data and Sentinel-2 VNIR-SWIR data from the IIT-Kanpur region constitute the training datasets, including SAR, SAR with texture, VNIR-SWIR, VNIR-SWIR with texture, and fused VNIR-SWIR with texture. The study evaluates classifier efficacy, explores the impact of SAR and VNIR-SWIR fusion on classification, and significantly enhances the execution speed of Bayesian fusion code. The SRP-based RFE outperforms other ensembles for the first two datasets, yielding average overall kappa values of 61.80% and 68.18%, while the CRP-based RFE excels for the last three datasets with average overall kappa values of 95.99%, 96.93%, and 96.30%. The fourth dataset achieves the highest overall kappa of 96.93%. Furthermore, incorporating texture with SAR bands results in a maximum overall kappa increment of 10.00%, while adding texture to VNIR-SWIR bands yields a maximum increment of approximately 3.45%.

Radiologists play a crucial role by translating medical images into medical reports. However, the field faces staffing shortages and increasing workloads. While automated approaches using vision-language models (VLMs) show promise as assistants, they require exceptionally high accuracy. Most current VLMs in radiology rely solely on supervised fine-tuning (SFT). Meanwhile, in the general domain, additional preference fine-tuning has become standard practice. The challenge in radiology lies in the prohibitive cost of obtaining radiologist feedback. We propose a scalable automated preference alignment technique for VLMs in radiology, focusing on chest X-ray (CXR) report generation. Our method leverages publicly available datasets with an LLM-as-a-Judge mechanism, eliminating the need for additional expert radiologist feedback. We evaluate and benchmark five direct alignment algorithms (DAAs). Our results show up to a 57.4% improvement in average GREEN scores, a LLM-based metric for evaluating CXR reports, and a 9.2% increase in an average across six metrics (domain specific and general), compared to the SFT baseline. We study reward overoptimization via length exploitation, with reports lengthening by up to 3.2x. To assess a potential alignment tax, we benchmark on six additional diverse tasks, finding no significant degradations. A reader study involving four board-certified radiologists indicates win rates of up to 0.62 over the SFT baseline, while significantly penalizing verbosity. Our analysis provides actionable insights for the development of VLMs in high-stakes fields like radiology.

Chest X-Ray (CXR) report generation is a promising approach to improving the efficiency of CXR interpretation. However, a significant increase in diagnostic accuracy is required before that can be realised. Motivated by this, we propose a framework that is more inline with a radiologist's workflow by considering longitudinal data. Here, the decoder is additionally conditioned on the report from the subject's previous imaging study via a prompt. We also propose a new reward for reinforcement learning based on CXR-BERT, which computes the similarity between reports. We conduct experiments on the MIMIC-CXR dataset. The results indicate that longitudinal data improves CXR report generation. CXR-BERT is also shown to be a promising alternative to the current state-of-the-art reward based on RadGraph. This investigation indicates that longitudinal CXR report generation can offer a substantial increase in diagnostic accuracy. Our Hugging Face model is available at: https://huggingface.co/aehrc/cxrmate and code is available at: https://github.com/aehrc/cxrmate.

We present VinDr-CXR-VQA, a large-scale chest X-ray dataset for explainable Medical Visual Question Answering (Med-VQA) with spatial grounding. The dataset contains 17,597 question-answer pairs across 4,394 images, each annotated with radiologist-verified bounding boxes and clinical reasoning explanations. Our question taxonomy spans six diagnostic types-Where, What, Is there, How many, Which, and Yes/No-capturing diverse clinical intents. To improve reliability, we construct a balanced distribution of 41.7% positive and 58.3% negative samples, mitigating hallucinations in normal cases. Benchmarking with MedGemma-4B-it demonstrates improved performance (F1 = 0.624, +11.8% over baseline) while enabling lesion localization. VinDr-CXR-VQA aims to advance reproducible and clinically grounded Med-VQA research. The dataset and evaluation tools are publicly available at huggingface.co/datasets/Dangindev/VinDR-CXR-VQA.

The integration of artificial intelligence in image-guided interventions holds transformative potential, promising to extract 3D geometric and quantitative information from conventional 2D imaging modalities during complex procedures. Achieving this requires the rapid and precise alignment of 2D intraoperative images (e.g., X-ray) with 3D preoperative volumes (e.g., CT, MRI). However, current 2D/3D registration methods fail across the broad spectrum of procedures dependent on X-ray guidance: traditional optimization techniques require custom parameter tuning for each subject, whereas neural networks trained on small datasets do not generalize to new patients or require labor-intensive manual annotations, increasing clinical burden and precluding application to new anatomical targets. To address these challenges, we present xvr, a fully automated framework for training patient-specific neural networks for 2D/3D registration. xvr uses physics-based simulation to generate abundant high-quality training data from a patient's own preoperative volumetric imaging, thereby overcoming the inherently limited ability of supervised models to generalize to new patients and procedures. Furthermore, xvr requires only 5 minutes of training per patient, making it suitable for emergency interventions as well as planned procedures. We perform the largest evaluation of a 2D/3D registration algorithm on real X-ray data to date and find that xvr robustly generalizes across a diverse dataset comprising multiple anatomical structures, imaging modalities, and hospitals. Across surgical tasks, xvr achieves submillimeter-accurate registration at intraoperative speeds, improving upon existing methods by an order of magnitude. xvr is released as open-source software freely available at https://github.com/eigenvivek/xvr.

A vital and rapidly growing application, remote sensing offers vast yet sparsely labeled, spatially aligned multimodal data; this makes self-supervised learning algorithms invaluable. We present CROMA: a framework that combines contrastive and reconstruction self-supervised objectives to learn rich unimodal and multimodal representations. Our method separately encodes masked-out multispectral optical and synthetic aperture radar samples -- aligned in space and time -- and performs cross-modal contrastive learning. Another encoder fuses these sensors, producing joint multimodal encodings that are used to predict the masked patches via a lightweight decoder. We show that these objectives are complementary when leveraged on spatially aligned multimodal data. We also introduce X- and 2D-ALiBi, which spatially biases our cross- and self-attention matrices. These strategies improve representations and allow our models to effectively extrapolate to images up to 17.6x larger at test-time. CROMA outperforms the current SoTA multispectral model, evaluated on: four classification benchmarks -- finetuning (avg. 1.8%), linear (avg. 2.4%) and nonlinear (avg. 1.4%) probing, kNN classification (avg. 3.5%), and K-means clustering (avg. 8.4%); and three segmentation benchmarks (avg. 6.4%). CROMA's rich, optionally multimodal representations can be widely leveraged across remote sensing applications.

Automatic Target Detection (ATD) and Recognition (ATR) from Thermal Infrared (TI) imagery in the defense and surveillance domain is a challenging computer vision (CV) task in comparison to the commercial autonomous vehicle perception domain. Limited datasets, peculiar domain-specific and TI modality-specific challenges, i.e., limited hardware, scale invariance issues due to greater distances, deliberate occlusion by tactical vehicles, lower sensor resolution and resultant lack of structural information in targets, effects of weather, temperature, and time of day variations, and varying target to clutter ratios all result in increased intra-class variability and higher inter-class similarity, making accurate real-time ATR a challenging CV task. Resultantly, contemporary state-of-the-art (SOTA) deep learning architectures underperform in the ATR domain. We propose a modified anchor-based single-stage detector, called YOLOatr, based on a modified YOLOv5s, with optimal modifications to the detection heads, feature fusion in the neck, and a custom augmentation profile. We evaluate the performance of our proposed model on a comprehensive DSIAC MWIR dataset for real-time ATR over both correlated and decorrelated testing protocols. The results demonstrate that our proposed model achieves state-of-the-art ATR performance of up to 99.6%.

Chest Xray imaging is a widely used diagnostic tool in modern medicine, and its high utilization creates substantial workloads for radiologists. To alleviate this burden, vision language models are increasingly applied to automate Chest Xray radiology report generation (CXRRRG), aiming for clinically accurate descriptions while reducing manual effort. Conventional approaches, however, typically rely on single images, failing to capture the longitudinal context necessary for producing clinically faithful comparison statements. Recently, growing attention has been directed toward incorporating longitudinal data into CXR RRG, enabling models to leverage historical studies in ways that mirror radiologists diagnostic workflows. Nevertheless, existing surveys primarily address single image CXRRRG and offer limited guidance for longitudinal settings, leaving researchers without a systematic framework for model design. To address this gap, this survey provides the first comprehensive review of longitudinal radiology report generation (LRRG). Specifically, we examine dataset construction strategies, report generation architectures alongside longitudinally tailored designs, and evaluation protocols encompassing both longitudinal specific measures and widely used benchmarks. We further summarize LRRG methods performance, alongside analyses of different ablation studies, which collectively highlight the critical role of longitudinal information and architectural design choices in improving model performance. Finally, we summarize five major limitations of current research and outline promising directions for future development, aiming to lay a foundation for advancing this emerging field.

Rationale and Objectives: To develop and validate PARROT (Polyglottal Annotated Radiology Reports for Open Testing), a large, multicentric, open-access dataset of fictional radiology reports spanning multiple languages for testing natural language processing applications in radiology. Materials and Methods: From May to September 2024, radiologists were invited to contribute fictional radiology reports following their standard reporting practices. Contributors provided at least 20 reports with associated metadata including anatomical region, imaging modality, clinical context, and for non-English reports, English translations. All reports were assigned ICD-10 codes. A human vs. AI report differentiation study was conducted with 154 participants (radiologists, healthcare professionals, and non-healthcare professionals) assessing whether reports were human-authored or AI-generated. Results: The dataset comprises 2,658 radiology reports from 76 authors across 21 countries and 13 languages. Reports cover multiple imaging modalities (CT: 36.1%, MRI: 22.8%, radiography: 19.0%, ultrasound: 16.8%) and anatomical regions, with chest (19.9%), abdomen (18.6%), head (17.3%), and pelvis (14.1%) being most prevalent. In the differentiation study, participants achieved 53.9% accuracy (95% CI: 50.7%-57.1%) in distinguishing between human and AI-generated reports, with radiologists performing significantly better (56.9%, 95% CI: 53.3%-60.6%, p<0.05) than other groups. Conclusion: PARROT represents the largest open multilingual radiology report dataset, enabling development and validation of natural language processing applications across linguistic, geographic, and clinical boundaries without privacy constraints.

Purpose: Recent advancements in large language models (LLMs) have expanded their capabilities in a multimodal fashion, potentially replicating the image interpretation of human radiologists. This study aimed to develop open-source multimodal large language model for interpreting chest X-ray images (CXR-LLaVA). We also examined the effect of prompt engineering and model parameters such as temperature and nucleus sampling. Materials and Methods: For training, we collected 659,287 publicly available CXRs: 417,336 CXRs had labels for certain radiographic abnormalities (dataset 1); 241,951 CXRs provided free-text radiology reports (dataset 2). After pre-training the Resnet50 as an image encoder, the contrastive language-image pre-training was used to align CXRs and corresponding radiographic abnormalities. Then, the Large Language Model Meta AI-2 was fine-tuned using dataset 2, which were refined using GPT-4, with generating various question answering scenarios. The code can be found at https://github.com/ECOFRI/CXR_LLaVA. Results: In the test set, we observed that the model's performance fluctuated based on its parameters. On average, it achieved F1 score of 0.34 for five pathologic findings (atelectasis, cardiomegaly, consolidation, edema, and pleural effusion), which was improved to 0.46 through prompt engineering. In the independent set, the model achieved an average F1 score of 0.30 for the same pathologic findings. Notably, for the pediatric chest radiograph dataset, which was unseen during training, the model differentiated abnormal radiographs with an F1 score ranging from 0.84 to 0.85. Conclusion: CXR-LLaVA demonstrates promising potential in CXR interpretation. Both prompt engineering and model parameter adjustments can play pivotal roles in interpreting CXRs.

Radiographs are used as the most important imaging tool for identifying spine anomalies in clinical practice. The evaluation of spinal bone lesions, however, is a challenging task for radiologists. This work aims at developing and evaluating a deep learning-based framework, named VinDr-SpineXR, for the classification and localization of abnormalities from spine X-rays. First, we build a large dataset, comprising 10,468 spine X-ray images from 5,000 studies, each of which is manually annotated by an experienced radiologist with bounding boxes around abnormal findings in 13 categories. Using this dataset, we then train a deep learning classifier to determine whether a spine scan is abnormal and a detector to localize 7 crucial findings amongst the total 13. The VinDr-SpineXR is evaluated on a test set of 2,078 images from 1,000 studies, which is kept separate from the training set. It demonstrates an area under the receiver operating characteristic curve (AUROC) of 88.61% (95% CI 87.19%, 90.02%) for the image-level classification task and a mean average precision (mAP@0.5) of 33.56% for the lesion-level localization task. These results serve as a proof of concept and set a baseline for future research in this direction. To encourage advances, the dataset, codes, and trained deep learning models are made publicly available.

While Multimodal Large Language Models (MLLMs) excel at general vision-language tasks, visuospatial cognition - reasoning about spatial layouts, relations, and dynamics - remains a significant challenge. Existing models often lack the necessary architectural components and specialized training data for fine-grained spatial understanding. We introduce ViCA2 (Visuospatial Cognitive Assistant 2), a novel MLLM designed to enhance spatial reasoning. ViCA2 features a dual vision encoder architecture integrating SigLIP for semantics and Hiera for spatial structure, coupled with a token ratio control mechanism for efficiency. We also developed ViCA-322K, a new large-scale dataset with over 322,000 spatially grounded question-answer pairs for targeted instruction tuning. On the challenging VSI-Bench benchmark, our ViCA2-7B model achieves a state-of-the-art average score of 56.8, significantly surpassing larger open-source models (e.g., LLaVA-NeXT-Video-72B, 40.9) and leading proprietary models (Gemini-1.5 Pro, 45.4). This demonstrates the effectiveness of our approach in achieving strong visuospatial intelligence with a compact model. We release ViCA2, its codebase, and the ViCA-322K dataset to facilitate further research.

Rotated object detection has made significant progress in the optical remote sensing. However, advancements in the Synthetic Aperture Radar (SAR) field are laggard behind, primarily due to the absence of a large-scale dataset. Annotating such a dataset is inefficient and costly. A promising solution is to employ a weakly supervised model (e.g., trained with available horizontal boxes only) to generate pseudo-rotated boxes for reference before manual calibration. Unfortunately, the existing weakly supervised models exhibit limited accuracy in predicting the object's angle. Previous works attempt to enhance angle prediction by using angle resolvers that decouple angles into cosine and sine encodings. In this work, we first reevaluate these resolvers from a unified perspective of dimension mapping and expose that they share the same shortcomings: these methods overlook the unit cycle constraint inherent in these encodings, easily leading to prediction biases. To address this issue, we propose the Unit Cycle Resolver, which incorporates a unit circle constraint loss to improve angle prediction accuracy. Our approach can effectively improve the performance of existing state-of-the-art weakly supervised methods and even surpasses fully supervised models on existing optical benchmarks (i.e., DOTA-v1.0 dataset). With the aid of UCR, we further annotate and introduce RSAR, the largest multi-class rotated SAR object detection dataset to date. Extensive experiments on both RSAR and optical datasets demonstrate that our UCR enhances angle prediction accuracy. Our dataset and code can be found at: https://github.com/zhasion/RSAR.

Automatic target recognition (ATR) plays a critical role in tasks such as navigation and surveillance, where safety and accuracy are paramount. In extreme use cases, such as military applications, these factors are often challenged due to the presence of unknown terrains, environmental conditions, and novel object categories. Current object detectors, including open-world detectors, lack the ability to confidently recognize novel objects or operate in unknown environments, as they have not been exposed to these new conditions. However, Large Vision-Language Models (LVLMs) exhibit emergent properties that enable them to recognize objects in varying conditions in a zero-shot manner. Despite this, LVLMs struggle to localize objects effectively within a scene. To address these limitations, we propose a novel pipeline that combines the detection capabilities of open-world detectors with the recognition confidence of LVLMs, creating a robust system for zero-shot ATR of novel classes and unknown domains. In this study, we compare the performance of various LVLMs for recognizing military vehicles, which are often underrepresented in training datasets. Additionally, we examine the impact of factors such as distance range, modality, and prompting methods on the recognition performance, providing insights into the development of more reliable ATR systems for novel conditions and classes.

The cold-start initialization stage plays a pivotal role in training Multimodal Large Reasoning Models (MLRMs), yet its mechanisms remain insufficiently understood. To analyze this stage, we introduce the Visual Attention Score (VAS), an attention-based metric that quantifies how much a model attends to visual tokens. We find that reasoning performance is strongly correlated with VAS (r=0.9616): models with higher VAS achieve substantially stronger multimodal reasoning. Surprisingly, multimodal cold-start fails to elevate VAS, resulting in attention distributions close to the base model, whereas text-only cold-start leads to a clear increase. We term this counter-intuitive phenomenon Lazy Attention Localization. To validate its causal role, we design training-free interventions that directly modulate attention allocation during inference, performance gains of 1-2% without any retraining. Building on these insights, we further propose Attention-Guided Visual Anchoring and Reflection (AVAR), a comprehensive cold-start framework that integrates visual-anchored data synthesis, attention-guided objectives, and visual-anchored reward shaping. Applied to Qwen2.5-VL-7B, AVAR achieves an average gain of 7.0% across 7 multimodal reasoning benchmarks. Ablation studies further confirm that each component of AVAR contributes step-wise to the overall gains. The code, data, and models are available at https://github.com/lrlbbzl/Qwen-AVAR.

Coronary artery disease (CAD) remains the leading cause of death globally and invasive coronary angiography (ICA) is considered the gold standard of anatomical imaging evaluation when CAD is suspected. However, risk evaluation based on ICA has several limitations, such as visual assessment of stenosis severity, which has significant interobserver variability. This motivates to development of a lesion classification system that can support specialists in their clinical procedures. Although deep learning classification methods are well-developed in other areas of medical imaging, ICA image classification is still at an early stage. One of the most important reasons is the lack of available and high-quality open-access datasets. In this paper, we reported a new annotated ICA images dataset, CADICA, to provide the research community with a comprehensive and rigorous dataset of coronary angiography consisting of a set of acquired patient videos and associated disease-related metadata. This dataset can be used by clinicians to train their skills in angiographic assessment of CAD severity and by computer scientists to create computer-aided diagnostic systems to help in such assessment. In addition, baseline classification methods are proposed and analyzed, validating the functionality of CADICA and giving the scientific community a starting point to improve CAD detection.

The rapid evolution of artificial intelligence, especially in large language models (LLMs), has significantly impacted various domains, including healthcare. In chest X-ray (CXR) analysis, previous studies have employed LLMs, but with limitations: either underutilizing the multi-tasking capabilities of LLMs or lacking clinical accuracy. This paper presents M4CXR, a multi-modal LLM designed to enhance CXR interpretation. The model is trained on a visual instruction-following dataset that integrates various task-specific datasets in a conversational format. As a result, the model supports multiple tasks such as medical report generation (MRG), visual grounding, and visual question answering (VQA). M4CXR achieves state-of-the-art clinical accuracy in MRG by employing a chain-of-thought prompting strategy, in which it identifies findings in CXR images and subsequently generates corresponding reports. The model is adaptable to various MRG scenarios depending on the available inputs, such as single-image, multi-image, and multi-study contexts. In addition to MRG, M4CXR performs visual grounding at a level comparable to specialized models and also demonstrates outstanding performance in VQA. Both quantitative and qualitative assessments reveal M4CXR's versatility in MRG, visual grounding, and VQA, while consistently maintaining clinical accuracy.

Automated radiology report generation offers an effective solution to alleviate radiologists' workload. However, most existing methods focus primarily on single or fixed-view images to model current disease conditions, which limits diagnostic accuracy and overlooks disease progression. Although some approaches utilize longitudinal data to track disease progression, they still rely on single images to analyze current visits. To address these issues, we propose enhanced contrastive learning with Multi-view Longitudinal data to facilitate chest X-ray Report Generation, named MLRG. Specifically, we introduce a multi-view longitudinal contrastive learning method that integrates spatial information from current multi-view images and temporal information from longitudinal data. This method also utilizes the inherent spatiotemporal information of radiology reports to supervise the pre-training of visual and textual representations. Subsequently, we present a tokenized absence encoding technique to flexibly handle missing patient-specific prior knowledge, allowing the model to produce more accurate radiology reports based on available prior knowledge. Extensive experiments on MIMIC-CXR, MIMIC-ABN, and Two-view CXR datasets demonstrate that our MLRG outperforms recent state-of-the-art methods, achieving a 2.3% BLEU-4 improvement on MIMIC-CXR, a 5.5% F1 score improvement on MIMIC-ABN, and a 2.7% F1 RadGraph improvement on Two-view CXR.

While highly accelerated non-Cartesian acquisition protocols significantly reduce scan time, they often entail long reconstruction delays. Deep learning based reconstruction methods can alleviate this, but often lack stability and robustness to distribution shifts. As an alternative, we train a rotation invariant weakly convex ridge regularizer (WCRR). The resulting variational reconstruction approach is benchmarked against state of the art methods on retrospectively simulated data and (out of distribution) on prospective GoLF SPARKLING and CAIPIRINHA acquisitions. Our approach consistently outperforms widely used baselines and achieves performance comparable to Plug and Play reconstruction with a state of the art 3D DRUNet denoiser, while offering substantially improved computational efficiency and robustness to acquisition changes. In summary, WCRR unifies the strengths of principled variational methods and modern deep learning based approaches.

We present a radiology-specific multimodal model for the task for generating radiological reports from chest X-rays (CXRs). Our work builds on the idea that large language model(s) can be equipped with multimodal capabilities through alignment with pre-trained vision encoders. On natural images, this has been shown to allow multimodal models to gain image understanding and description capabilities. Our proposed model (MAIRA-1) leverages a CXR-specific image encoder in conjunction with a fine-tuned large language model based on Vicuna-7B, and text-based data augmentation, to produce reports with state-of-the-art quality. In particular, MAIRA-1 significantly improves on the radiologist-aligned RadCliQ metric and across all lexical metrics considered. Manual review of model outputs demonstrates promising fluency and accuracy of generated reports while uncovering failure modes not captured by existing evaluation practices. More information and resources can be found on the project website: https://aka.ms/maira.

We consider in this paper the problem of optimal experiment design where a decision maker can choose which points to sample to obtain an estimate hatβ of the hidden parameter β^{star} of an underlying linear model. The key challenge of this work lies in the heteroscedasticity assumption that we make, meaning that each covariate has a different and unknown variance. The goal of the decision maker is then to figure out on the fly the optimal way to allocate the total budget of T samples between covariates, as sampling several times a specific one will reduce the variance of the estimated model around it (but at the cost of a possible higher variance elsewhere). By trying to minimize the ell^2-loss E [lVerthatβ-β^{star}rVert^2] the decision maker is actually minimizing the trace of the covariance matrix of the problem, which corresponds then to online A-optimal design. Combining techniques from bandit and convex optimization we propose a new active sampling algorithm and we compare it with existing ones. We provide theoretical guarantees of this algorithm in different settings, including a O(T^{-2}) regret bound in the case where the covariates form a basis of the feature space, generalizing and improving existing results. Numerical experiments validate our theoretical findings.

We revisit High-Resolution Range Profile (HRRP) classification with aspect-angle conditioning. While prior work often assumes that aspect-angle information is incomplete during training or unavailable at inference, we study a setting where angles are available for all training samples and explicitly provided to the classifier. Using three datasets and a broad range of conditioning strategies and model architectures, we show that both single-profile and sequential classifiers benefit consistently from aspect-angle awareness, with an average accuracy gain of about 7% and improvements of up to 10%, depending on the model and dataset. In practice, aspect angles are not directly measured and must be estimated. We show that a causal Kalman filter can estimate them online with a median error of 5{\textdegree}, and that training and inference with estimated angles preserves most of the gains, supporting the proposed approach in realistic conditions.

We propose a structural default model for portfolio-wide valuation adjustments (xVAs) and represent it as a system of coupled backward stochastic differential equations. The framework is divided into four layers, each capturing a key component: (i) clean values, (ii) initial margin and Collateral Valuation Adjustment (ColVA), (iii) Credit/Debit Valuation Adjustments (CVA/DVA) together with Margin Valuation Adjustment (MVA), and (iv) Funding Valuation Adjustment (FVA). Because these layers depend on one another through collateral and default effects, a naive Monte Carlo approach would require deeply nested simulations, making the problem computationally intractable. To address this challenge, we use an iterative deep BSDE approach, handling each layer sequentially so that earlier outputs serve as inputs to the subsequent layers. Initial margin is computed via deep quantile regression to reflect margin requirements over the Margin Period of Risk. We also adopt a change-of-measure method that highlights rare but significant defaults of the bank or counterparty, ensuring that these events are accurately captured in the training process. We further extend Han and Long's (2020) a posteriori error analysis to BSDEs on bounded domains. Due to the random exit from the domain, we obtain an order of convergence of O(h^{1/4-epsilon}) rather than the usual O(h^{1/2}). Numerical experiments illustrate that this method drastically reduces computational demands and successfully scales to high-dimensional, non-symmetric portfolios. The results confirm its effectiveness and accuracy, offering a practical alternative to nested Monte Carlo simulations in multi-counterparty xVA analyses.

Synthetic Aperture Radar (SAR) stands as an indispensable sensor for Earth observation, owing to its unique capability for all-day imaging. Nevertheless, in a data-driven era, the scarcity of large-scale datasets poses a significant bottleneck to advancing SAR automatic target recognition (ATR) technology. This paper introduces NUDT4MSTAR, a large-scale SAR dataset for vehicle target recognition in the wild, including 40 target types and a wide array of imaging conditions across 5 different scenes. NUDT4MSTAR represents a significant leap forward in dataset scale, containing over 190,000 images-tenfold the size of its predecessors. To enhance the utility of this dataset, we meticulously annotate each image with detailed target information and imaging conditions. We also provide data in both processed magnitude images and original complex formats. Then, we construct a comprehensive benchmark consisting of 7 experiments with 15 recognition methods focusing on the stable and effective ATR issues. Besides, we conduct transfer learning experiments utilizing various models trained on NUDT4MSTAR and applied to three other target datasets, thereby demonstrating its substantial potential to the broader field of ground objects ATR. Finally, we discuss this dataset's application value and ATR's significant challenges. To the best of our knowledge, this work marks the first-ever endeavor to create a large-scale dataset benchmark for fine-grained SAR recognition in the wild, featuring an extensive collection of exhaustively annotated vehicle images. We expect that the open source of NUDT4MSTAR will facilitate the development of SAR ATR and attract a wider community of researchers.

Vision-centric perception systems struggle with unpredictable and coupled weather degradations in the wild. Current solutions are often limited, as they either depend on specific degradation priors or suffer from significant domain gaps. To enable robust and autonomous operation in real-world conditions, we propose JarvisIR, a VLM-powered agent that leverages the VLM as a controller to manage multiple expert restoration models. To further enhance system robustness, reduce hallucinations, and improve generalizability in real-world adverse weather, JarvisIR employs a novel two-stage framework consisting of supervised fine-tuning and human feedback alignment. Specifically, to address the lack of paired data in real-world scenarios, the human feedback alignment enables the VLM to be fine-tuned effectively on large-scale real-world data in an unsupervised manner. To support the training and evaluation of JarvisIR, we introduce CleanBench, a comprehensive dataset consisting of high-quality and large-scale instruction-responses pairs, including 150K synthetic entries and 80K real entries. Extensive experiments demonstrate that JarvisIR exhibits superior decision-making and restoration capabilities. Compared with existing methods, it achieves a 50% improvement in the average of all perception metrics on CleanBench-Real. Project page: https://cvpr2025-jarvisir.github.io/.

Chest radiography is an extremely powerful imaging modality, allowing for a detailed inspection of a patient's thorax, but requiring specialized training for proper interpretation. With the advent of high performance general purpose computer vision algorithms, the accurate automated analysis of chest radiographs is becoming increasingly of interest to researchers. However, a key challenge in the development of these techniques is the lack of sufficient data. Here we describe MIMIC-CXR-JPG v2.0.0, a large dataset of 377,110 chest x-rays associated with 227,827 imaging studies sourced from the Beth Israel Deaconess Medical Center between 2011 - 2016. Images are provided with 14 labels derived from two natural language processing tools applied to the corresponding free-text radiology reports. MIMIC-CXR-JPG is derived entirely from the MIMIC-CXR database, and aims to provide a convenient processed version of MIMIC-CXR, as well as to provide a standard reference for data splits and image labels. All images have been de-identified to protect patient privacy. The dataset is made freely available to facilitate and encourage a wide range of research in medical computer vision.

Organ at risk (OAR) segmentation is a critical process in radiotherapy treatment planning such as head and neck tumors. Nevertheless, in clinical practice, radiation oncologists predominantly perform OAR segmentations manually on CT scans. This manual process is highly time-consuming and expensive, limiting the number of patients who can receive timely radiotherapy. Additionally, CT scans offer lower soft-tissue contrast compared to MRI. Despite MRI providing superior soft-tissue visualization, its time-consuming nature makes it infeasible for real-time treatment planning. To address these challenges, we propose a method called SegReg, which utilizes Elastic Symmetric Normalization for registering MRI to perform OAR segmentation. SegReg outperforms the CT-only baseline by 16.78% in mDSC and 18.77% in mIoU, showing that it effectively combines the geometric accuracy of CT with the superior soft-tissue contrast of MRI, making accurate automated OAR segmentation for clinical practice become possible. See project website https://steve-zeyu-zhang.github.io/SegReg

We introduce Contrastive Activation Addition (CAA), an innovative method for steering language models by modifying activations during their forward passes. CAA computes ``steering vectors'' by averaging the difference in residual stream activations between pairs of positive and negative examples of a particular behavior such as factual versus hallucinatory responses. During inference, these steering vectors are added at all token positions after the user's prompt with either a positive or negative coefficient, allowing precise control over the degree of the targeted behavior. We evaluate CAA's effectiveness on Llama 2 Chat using both multiple-choice behavioral question datasets and open-ended generation tasks. We demonstrate that CAA significantly alters model behavior, outperforms traditional methods like finetuning and few-shot prompting, and minimally reduces capabilities. Moreover, by employing various activation space interpretation methods, we gain deeper insights into CAA's mechanisms. CAA both accurately steers model outputs and also sheds light on how high-level concepts are represented in Large Language Models (LLMs).

Radiological imaging is central to diagnosis, treatment planning, and clinical decision-making. Vision-language foundation models have spurred interest in automated radiology report generation (RRG), but safe deployment requires reliable clinical evaluation of generated reports. Existing metrics often rely on surface-level similarity or behave as black boxes, lacking interpretability. We introduce ICARE (Interpretable and Clinically-grounded Agent-based Report Evaluation), an interpretable evaluation framework leveraging large language model agents and dynamic multiple-choice question answering (MCQA). Two agents, each with either the ground-truth or generated report, generate clinically meaningful questions and quiz each other. Agreement on answers captures preservation and consistency of findings, serving as interpretable proxies for clinical precision and recall. By linking scores to question-answer pairs, ICARE enables transparent, and interpretable assessment. Clinician studies show ICARE aligns significantly more with expert judgment than prior metrics. Perturbation analyses confirm sensitivity to clinical content and reproducibility, while model comparisons reveal interpretable error patterns.

Despite the remarkable progress in synthetic aperture radar automatic target recognition (SAR ATR), recent efforts have concentrated on detecting and classifying a specific category, e.g., vehicles, ships, airplanes, or buildings. One of the fundamental limitations of the top-performing SAR ATR methods is that the learning paradigm is supervised, task-specific, limited-category, closed-world learning, which depends on massive amounts of accurately annotated samples that are expensively labeled by expert SAR analysts and have limited generalization capability and scalability. In this work, we make the first attempt towards building a foundation model for SAR ATR, termed SARATR-X. SARATR-X learns generalizable representations via self-supervised learning (SSL) and provides a cornerstone for label-efficient model adaptation to generic SAR target detection and classification tasks. Specifically, SARATR-X is trained on 0.18 M unlabelled SAR target samples, which are curated by combining contemporary benchmarks and constitute the largest publicly available dataset till now. Considering the characteristics of SAR images, a backbone tailored for SAR ATR is carefully designed, and a two-step SSL method endowed with multi-scale gradient features was applied to ensure the feature diversity and model scalability of SARATR-X. The capabilities of SARATR-X are evaluated on classification under few-shot and robustness settings and detection across various categories and scenes, and impressive performance is achieved, often competitive with or even superior to prior fully supervised, semi-supervised, or self-supervised algorithms. Our SARATR-X and the curated dataset are released at https://github.com/waterdisappear/SARATR-X to foster research into foundation models for SAR image interpretation.

A large-scale image-text pair dataset has greatly contributed to the development of vision-language pre-training (VLP) models, which enable zero-shot or few-shot classification without costly annotation. However, in the medical domain, the scarcity of data remains a significant challenge for developing a powerful VLP model. In this paper, we tackle the lack of image-text data in chest X-ray by expanding image-label pair as image-text pair via general prompt and utilizing multiple images and multiple sections in a radiologic report. We also design two contrastive losses, named ICL and TCL, for learning study-level characteristics of medical images and reports, respectively. Our model outperforms the state-of-the-art models trained under the same conditions. Also, enlarged dataset improve the discriminative power of our pre-trained model for classification, while sacrificing marginal retrieval performance. Code is available at https://github.com/kakaobrain/cxr-clip.

Advances in artificial intelligence (AI) for surgical quality assessment promise to democratize access to expertise, with applications in training, guidance, and accreditation. This study presents the SAGES Critical View of Safety (CVS) Challenge, the first AI competition organized by a surgical society, using the CVS in laparoscopic cholecystectomy, a universally recommended yet inconsistently performed safety step, as an exemplar of surgical quality assessment. A global collaboration across 54 institutions in 24 countries engaged hundreds of clinicians and engineers to curate 1,000 videos annotated by 20 surgical experts according to a consensus-validated protocol. The challenge addressed key barriers to real-world deployment in surgery, including achieving high performance, capturing uncertainty in subjective assessment, and ensuring robustness to clinical variability. To enable this scale of effort, we developed EndoGlacier, a framework for managing large, heterogeneous surgical video and multi-annotator workflows. Thirteen international teams participated, achieving up to a 17\% relative gain in assessment performance, over 80\% reduction in calibration error, and a 17\% relative improvement in robustness over the state-of-the-art. Analysis of results highlighted methodological trends linked to model performance, providing guidance for future research toward robust, clinically deployable AI for surgical quality assessment.

Modern autonomous vehicle perception systems often struggle with occlusions and limited perception range. Previous studies have demonstrated the effectiveness of cooperative perception in extending the perception range and overcoming occlusions, thereby enhancing the safety of autonomous driving. In recent years, a series of cooperative perception datasets have emerged; however, these datasets primarily focus on cameras and LiDAR, neglecting 4D Radar, a sensor used in single-vehicle autonomous driving to provide robust perception in adverse weather conditions. In this paper, to bridge the gap created by the absence of 4D Radar datasets in cooperative perception, we present V2X-Radar, the first large-scale, real-world multi-modal dataset featuring 4D Radar. V2X-Radar dataset is collected using a connected vehicle platform and an intelligent roadside unit equipped with 4D Radar, LiDAR, and multi-view cameras. The collected data encompasses sunny and rainy weather conditions, spanning daytime, dusk, and nighttime, as well as various typical challenging scenarios. The dataset consists of 20K LiDAR frames, 40K camera images, and 20K 4D Radar data, including 350K annotated boxes across five categories. To support various research domains, we have established V2X-Radar-C for cooperative perception, V2X-Radar-I for roadside perception, and V2X-Radar-V for single-vehicle perception. Furthermore, we provide comprehensive benchmarks across these three sub-datasets. We will release all datasets and benchmark codebase at http://openmpd.com/column/V2X-Radar and https://github.com/yanglei18/V2X-Radar.

Cross-validation (CV) is one of the most popular tools for assessing and selecting predictive models. However, standard CV suffers from high computational cost when the number of folds is large. Recently, under the empirical risk minimization (ERM) framework, a line of works proposed efficient methods to approximate CV based on the solution of the ERM problem trained on the full dataset. However, in large-scale problems, it can be hard to obtain the exact solution of the ERM problem, either due to limited computational resources or due to early stopping as a way of preventing overfitting. In this paper, we propose a new paradigm to efficiently approximate CV when the ERM problem is solved via an iterative first-order algorithm, without running until convergence. Our new method extends existing guarantees for CV approximation to hold along the whole trajectory of the algorithm, including at convergence, thus generalizing existing CV approximation methods. Finally, we illustrate the accuracy and computational efficiency of our method through a range of empirical studies.

Medical vision-language models (VLMs) excel at image-text understanding but typically rely on a single-pass reasoning that neglects localized visual cues. In clinical practice, however, human experts iteratively scan, focus, and refine the regions of interest before reaching a final diagnosis. To narrow this machine-human perception gap, we introduce ViTAR, a novel VLM framework that emulates the iterative reasoning process of human experts through a cognitive chain of "think-act-rethink-answer". ViTAR treats medical images as interactive objects, enabling models to engage multi-step visual reasoning. To support this approach, we curate a high-quality instruction dataset comprising 1K interactive examples that encode expert-like diagnostic behaviors. In addition, a 16K visual question answering training data has been curated towards fine-grained visual diagnosis. We introduce a two-stage training strategy that begins with supervised fine-tuning to guide cognitive trajectories, followed by the reinforcement learning to optimize decision-making. Extensive evaluations demonstrate that ViTAR outperforms strong state-of-the-art models. Visual attention analysis reveals that from the "think" to "rethink" rounds, ViTAR increasingly anchors visual grounding to clinically critical regions and maintains high attention allocation to visual tokens during reasoning, providing mechanistic insight into its improved performance. These findings demonstrate that embedding expert-style iterative thinking chains into VLMs enhances both performance and trustworthiness of medical AI.

As autonomous vehicles and advanced driving assistance systems have entered wider deployment, there is an increased interest in building robust perception systems using radars. Radar-based systems are lower cost and more robust to adverse weather conditions than their LiDAR-based counterparts; however the point clouds produced are typically noisy and sparse by comparison. In order to combat these challenges, recent research has focused on consuming the raw radar data, instead of the final radar point cloud. We build on this line of work and demonstrate that by bringing elements of the signal processing pipeline into our network and then pre-training on the signal processing task, we are able to achieve state of the art detection performance on the RADIal dataset. Our method uses expensive offline signal processing algorithms to pseudo-label data and trains a network to distill this information into a fast convolutional backbone, which can then be finetuned for perception tasks. Extensive experiment results corroborate the effectiveness of the proposed techniques.

All vehicles must follow the rules that govern traffic behavior, regardless of whether the vehicles are human-driven or Connected Autonomous Vehicles (CAVs). Road signs indicate locally active rules, such as speed limits and requirements to yield or stop. Recent research has demonstrated attacks, such as adding stickers or projected colored patches to signs, that cause CAV misinterpretation, resulting in potential safety issues. Humans can see and potentially defend against these attacks. But humans can not detect what they can not observe. We have developed an effective physical-world attack that leverages the sensitivity of filterless image sensors and the properties of Infrared Laser Reflections (ILRs), which are invisible to humans. The attack is designed to affect CAV cameras and perception, undermining traffic sign recognition by inducing misclassification. In this work, we formulate the threat model and requirements for an ILR-based traffic sign perception attack to succeed. We evaluate the effectiveness of the ILR attack with real-world experiments against two major traffic sign recognition architectures on four IR-sensitive cameras. Our black-box optimization methodology allows the attack to achieve up to a 100% attack success rate in indoor, static scenarios and a >80.5% attack success rate in our outdoor, moving vehicle scenarios. We find the latest state-of-the-art certifiable defense is ineffective against ILR attacks as it mis-certifies >33.5% of cases. To address this, we propose a detection strategy based on the physical properties of IR laser reflections which can detect 96% of ILR attacks.

The assessment of safety performance plays a pivotal role in the development and deployment of connected and automated vehicles (CAVs). A common approach involves designing testing scenarios based on prior knowledge of CAVs (e.g., surrogate models), conducting tests in these scenarios, and subsequently evaluating CAVs' safety performances. However, substantial differences between CAVs and the prior knowledge can significantly diminish the evaluation efficiency. In response to this issue, existing studies predominantly concentrate on the adaptive design of testing scenarios during the CAV testing process. Yet, these methods have limitations in their applicability to high-dimensional scenarios. To overcome this challenge, we develop an adaptive testing environment that bolsters evaluation robustness by incorporating multiple surrogate models and optimizing the combination coefficients of these surrogate models to enhance evaluation efficiency. We formulate the optimization problem as a regression task utilizing quadratic programming. To efficiently obtain the regression target via reinforcement learning, we propose the dense reinforcement learning method and devise a new adaptive policy with high sample efficiency. Essentially, our approach centers on learning the values of critical scenes displaying substantial surrogate-to-real gaps. The effectiveness of our method is validated in high-dimensional overtaking scenarios, demonstrating that our approach achieves notable evaluation efficiency.

Knee Osteoarthritis (KOA) is a highly prevalent chronic musculoskeletal condition with no currently available treatment. The manifestation of KOA is heterogeneous and prediction of its progression is challenging. Current literature suggests that the use of multi-modal data and advanced modeling methods, such as the ones based on Deep Learning, has promise in tackling this challenge. To date, however, the evidence on the efficacy of this approach is limited. In this study, we leveraged recent advances in Deep Learning and, using a Transformer approach, developed a unified framework for the multi-modal fusion of knee imaging data. Subsequently, we analyzed its performance across a range of scenarios by investigating multiple progression horizons -- from short-term to long-term. We report our findings using a large cohort (n=2421-3967) derived from the Osteoarthritis Initiative dataset. We show that structural knee MRI allows identifying radiographic KOA progressors on par with multi-modal fusion approaches, achieving an area under the ROC curve (ROC AUC) of 0.70-0.76 and Average Precision (AP) of 0.15-0.54 in 2-8 year horizons. Progression within 1 year was better predicted with a multi-modal method using X-ray, structural, and compositional MR images -- ROC AUC of 0.76(0.04), AP of 0.13(0.04) -- or via clinical data. Our follow-up analysis generally shows that prediction from the imaging data is more accurate for post-traumatic subjects, and we further investigate which subject subgroups may benefit the most. The present study provides novel insights into multi-modal imaging of KOA and brings a unified data-driven framework for studying its progression in an end-to-end manner, providing new tools for the design of more efficient clinical trials. The source code of our framework and the pre-trained models are made publicly available.

Medical Visual Question Answering (MedVQA) is a promising field for developing clinical decision support systems, yet progress is often limited by the available datasets, which can lack clinical complexity and visual diversity. To address these gaps, we introduce Kvasir-VQA-x1, a new, large-scale dataset for gastrointestinal (GI) endoscopy. Our work significantly expands upon the original Kvasir-VQA by incorporating 159,549 new question-answer pairs that are designed to test deeper clinical reasoning. We developed a systematic method using large language models to generate these questions, which are stratified by complexity to better assess a model's inference capabilities. To ensure our dataset prepares models for real-world clinical scenarios, we have also introduced a variety of visual augmentations that mimic common imaging artifacts. The dataset is structured to support two main evaluation tracks: one for standard VQA performance and another to test model robustness against these visual perturbations. By providing a more challenging and clinically relevant benchmark, Kvasir-VQA-x1 aims to accelerate the development of more reliable and effective multimodal AI systems for use in clinical settings. The dataset is fully accessible and adheres to FAIR data principles, making it a valuable resource for the wider research community. Code and data: https://github.com/Simula/Kvasir-VQA-x1 and https://huggingface.co/datasets/SimulaMet/Kvasir-VQA-x1

We introduce MURA, a large dataset of musculoskeletal radiographs containing 40,561 images from 14,863 studies, where each study is manually labeled by radiologists as either normal or abnormal. To evaluate models robustly and to get an estimate of radiologist performance, we collect additional labels from six board-certified Stanford radiologists on the test set, consisting of 207 musculoskeletal studies. On this test set, the majority vote of a group of three radiologists serves as gold standard. We train a 169-layer DenseNet baseline model to detect and localize abnormalities. Our model achieves an AUROC of 0.929, with an operating point of 0.815 sensitivity and 0.887 specificity. We compare our model and radiologists on the Cohen's kappa statistic, which expresses the agreement of our model and of each radiologist with the gold standard. Model performance is comparable to the best radiologist performance in detecting abnormalities on finger and wrist studies. However, model performance is lower than best radiologist performance in detecting abnormalities on elbow, forearm, hand, humerus, and shoulder studies. We believe that the task is a good challenge for future research. To encourage advances, we have made our dataset freely available at https://stanfordmlgroup.github.io/competitions/mura .

Many Vision-Language-Action (VLA) models flatten image patches into a 1D token sequence, weakening the 2D spatial cues needed for precise manipulation. We introduce IVRA, a lightweight, training-free method that improves spatial understanding by exploiting affinity hints already available in the model's built-in vision encoder, without requiring any external encoder or retraining. IVRA selectively injects these affinity signals into a language-model layer in which instance-level features reside. This inference-time intervention realigns visual-token interactions and better preserves geometric structure while keeping all model parameters fixed. We demonstrate the generality of IVRA by applying it to diverse VLA architectures (LLaRA, OpenVLA, and FLOWER) across simulated benchmarks spanning both 2D and 3D manipulation (VIMA and LIBERO) and on various real-robot tasks. On 2D VIMA, IVRA improves average success by +4.2% over the baseline LLaRA in a low-data regime. On 3D LIBERO, it yields consistent gains over the OpenVLA and FLOWER baselines, including improvements when baseline accuracy is near saturation (96.3% to 97.1%). All code and models will be released publicly. Visualizations are available at: jongwoopark7978.github.io/IVRA

Multimodal Large Language Models (MLLMs) have recently achieved promising zero-shot accuracy on visual question answering (VQA) -- a fundamental task affecting various downstream applications and domains. Given the great potential for the broad use of these models, it is important to investigate their limitations in dealing with different image and question properties. In this work, we investigate whether MLLMs can perceive details as well as larger components in images. In particular, we show that their zero-shot accuracy in answering visual questions is very sensitive to the size of the visual subject related to the question, declining up to 45.91% with size. Furthermore, we show that this effect is causal by observing that human visual cropping can significantly mitigate their sensitivity to size. To scale up the usefulness of human cropping, we propose ViCrop, a general framework that utilizes automatic visual cropping to enhance zero-shot VQA of MLLMs. We construct five variants of ViCrop leveraging either external localization models or the decision process of the given MLLM itself. Our results show that ViCrop improves MLLMs' zero-shot accuracy across different VQA datasets, for example, enhances BLIP2-T5's performance by 32.23% on the TextVQA test set. To facilitate further investigation of MLLMs' behaviors, our code is publicly released.

Reinforcement learning (RL) has shown great effectiveness for fine-tuning large language models (LLMs) using tasks that are challenging yet easily verifiable, such as math reasoning or code generation. However, extending this success to visual perception in vision-language models (VLMs) has been impeded by the scarcity of vision-centric tasks that are simultaneously challenging and unambiguously verifiable. To this end, we introduce ViCrit (Visual Caption Hallucination Critic), an RL proxy task that trains VLMs to localize a subtle, synthetic visual hallucination injected into paragraphs of human-written image captions. Starting from a 200-word captions, we inject a single, subtle visual description error-altering a few words on objects, attributes, counts, or spatial relations-and task the model to pinpoint the corrupted span given the image and the modified caption. This formulation preserves the full perceptual difficulty while providing a binary, exact-match reward that is easy to compute and unambiguous. Models trained with the ViCrit Task exhibit substantial gains across a variety of VL benchmarks. Crucially, the improvements transfer beyond natural-image training data to abstract image reasoning and visual math, showing promises of learning to perceive rather than barely memorizing seen objects. To facilitate evaluation, we further introduce ViCrit-Bench, a category-balanced diagnostic benchmark that systematically probes perception errors across diverse image domains and error types. Together, our results demonstrate that fine-grained hallucination criticism is an effective and generalizable objective for enhancing visual perception in VLMs.

Vision-language models (VLMs) aligned with general human objectives, such as being harmless and hallucination-free, have become valuable assistants of humans in managing visual tasks. However, people with diversified backgrounds have different cognition even in the same situation. Consequently, they may have personalized expectations for VLM assistants. This highlights the urgent need to align VLM assistants with personalized situated cognition for real-world assistance. To study this problem, we first simplify it by characterizing individuals based on the sociological concept of Role-Set. Then, we propose to evaluate the individuals' actions to examine whether the personalized alignment is achieved. Further, we construct a benchmark named PCogAlignBench, which includes 18k instances and 20 individuals with different Role-Sets. Finally, we present a framework called PCogAlign, which constructs a cognition-aware and action-based reward model for personalized alignment. Experimental results and human evaluations demonstrate the reliability of the PCogAlignBench and the effectiveness of our proposed PCogAlign. We will open-source the constructed benchmark and code at https://github.com/NLPGM/PCogAlign.

Automated radiology report generation from 3D computed tomography (CT) volumes is challenging due to extreme sequence lengths, severe class imbalance, and the tendency of large language models (LLMs) to ignore visual tokens in favor of linguistic priors. We present Ker-VLJEPA-3B, a four-phase curriculum learning framework for free-text report generation from thoracic CT volumes. A phased training curriculum progressively adapts a Llama 3.2 3B decoder to ground its output in visual features from a frozen, self-supervised encoder. Our visual backbone (LeJEPA ViT-Large) is trained via self-supervised joint-embedding prediction on unlabeled CTs, without text supervision. Unlike contrastive models (CLIP, BiomedCLIP), this language-free backbone yields modality-pure representations. Vision-language alignment is deferred to the curriculum's bridge and generation phases. This modality-agnostic design can integrate any self-supervised encoder into an LLM without paired text during foundation training. Methodological innovations include: (1) zone-constrained cross-attention compressing slice embeddings into 32 spatially-grounded visual tokens; (2) PCA whitening of anisotropic LLM embeddings; (3) a positive-findings-only strategy eliminating posterior collapse; (4) warm bridge initialization transferring projection weights; and (5) selective cross-attention freezing with elastic weight consolidation to prevent catastrophic forgetting. Evaluated on the CT-RATE benchmark (2,984 validation volumes, 18 classes), Ker-VLJEPA-3B achieves a macro F1 of 0.429, surpassing the state-of-the-art (U-VLM, macro F1 = 0.414) by 3.6%, and reaching 0.448 (+8.2%) with threshold optimization. Ablation studies confirm 56.6% of generation quality derives from patient-specific visual content. Code and weights are available.

We introduce Kvasir-VQA, an extended dataset derived from the HyperKvasir and Kvasir-Instrument datasets, augmented with question-and-answer annotations to facilitate advanced machine learning tasks in Gastrointestinal (GI) diagnostics. This dataset comprises 6,500 annotated images spanning various GI tract conditions and surgical instruments, and it supports multiple question types including yes/no, choice, location, and numerical count. The dataset is intended for applications such as image captioning, Visual Question Answering (VQA), text-based generation of synthetic medical images, object detection, and classification. Our experiments demonstrate the dataset's effectiveness in training models for three selected tasks, showcasing significant applications in medical image analysis and diagnostics. We also present evaluation metrics for each task, highlighting the usability and versatility of our dataset. The dataset and supporting artifacts are available at https://datasets.simula.no/kvasir-vqa.

Training state-of-the-art vision models has become prohibitively expensive for researchers and practitioners. For the sake of accessibility and resource reuse, it is important to focus on adapting these models to a variety of downstream scenarios. An interesting and practical paradigm is online test-time adaptation, according to which training data is inaccessible, no labelled data from the test distribution is available, and adaptation can only happen at test time and on a handful of samples. In this paper, we investigate how test-time adaptation methods fare for a number of pre-trained models on a variety of real-world scenarios, significantly extending the way they have been originally evaluated. We show that they perform well only in narrowly-defined experimental setups and sometimes fail catastrophically when their hyperparameters are not selected for the same scenario in which they are being tested. Motivated by the inherent uncertainty around the conditions that will ultimately be encountered at test time, we propose a particularly "conservative" approach, which addresses the problem with a Laplacian Adjusted Maximum-likelihood Estimation (LAME) objective. By adapting the model's output (not its parameters), and solving our objective with an efficient concave-convex procedure, our approach exhibits a much higher average accuracy across scenarios than existing methods, while being notably faster and have a much lower memory footprint. The code is available at https://github.com/fiveai/LAME.

Current vision-language models (VLMs) in medicine are primarily designed for categorical question answering (e.g., "Is this normal or abnormal?") or qualitative descriptive tasks. However, clinical decision-making often relies on quantitative assessments, such as measuring the size of a tumor or the angle of a joint, from which physicians draw their own diagnostic conclusions. This quantitative reasoning capability remains underexplored and poorly supported in existing VLMs. In this work, we introduce MedVision, a large-scale dataset and benchmark specifically designed to evaluate and improve VLMs on quantitative medical image analysis. MedVision spans 22 public datasets covering diverse anatomies and modalities, with 30.8 million image-annotation pairs. We focus on three representative quantitative tasks: (1) detection of anatomical structures and abnormalities, (2) tumor/lesion (T/L) size estimation, and (3) angle/distance (A/D) measurement. Our benchmarks show that current off-the-shelf VLMs perform poorly on these tasks. However, with supervised fine-tuning on MedVision, we significantly enhance their performance across detection, T/L estimation, and A/D measurement, demonstrating reduced error rates and improved precision. This work provides a foundation for developing VLMs with robust quantitative reasoning capabilities in medical imaging. Code and data are available at https://medvision-vlm.github.io.

Rationale: Computer aided detection (CAD) algorithms for Pulmonary Embolism (PE) algorithms have been shown to increase radiologists' sensitivity with a small increase in specificity. However, CAD for PE has not been adopted into clinical practice, likely because of the high number of false positives current CAD software produces. Objective: To generate a database of annotated computed tomography pulmonary angiographies, use it to compare the sensitivity and false positive rate of current algorithms and to develop new methods that improve such metrics. Methods: 91 Computed tomography pulmonary angiography scans were annotated by at least one radiologist by segmenting all pulmonary emboli visible on the study. 20 annotated CTPAs were open to the public in the form of a medical image analysis challenge. 20 more were kept for evaluation purposes. 51 were made available post-challenge. 8 submissions, 6 of them novel, were evaluated on the 20 evaluation CTPAs. Performance was measured as per embolus sensitivity vs. false positives per scan curve. Results: The best algorithms achieved a per-embolus sensitivity of 75% at 2 false positives per scan (fps) or of 70% at 1 fps, outperforming the state of the art. Deep learning approaches outperformed traditional machine learning ones, and their performance improved with the number of training cases. Significance: Through this work and challenge we have improved the state-of-the art of computer aided detection algorithms for pulmonary embolism. An open database and an evaluation benchmark for such algorithms have been generated, easing the development of further improvements. Implications on clinical practice will need further research.

The Circle of Willis (CoW) is an important network of arteries connecting major circulations of the brain. Its vascular architecture is believed to affect the risk, severity, and clinical outcome of serious neurovascular diseases. However, characterizing the highly variable CoW anatomy is still a manual and time-consuming expert task. The CoW is usually imaged by two non-invasive angiographic imaging modalities, magnetic resonance angiography (MRA) and computed tomography angiography (CTA), but there exist limited datasets with annotations on CoW anatomy, especially for CTA. Therefore, we organized the TopCoW challenge with the release of an annotated CoW dataset. The TopCoW dataset is the first public dataset with voxel-level annotations for 13 CoW vessel components, enabled by virtual reality technology. It is also the first large dataset using 200 pairs of MRA and CTA from the same patients. As part of the benchmark, we invited submissions worldwide and attracted over 250 registered participants from six continents. The submissions were evaluated on both internal and external test datasets of 226 scans from over five centers. The top performing teams achieved over 90% Dice scores at segmenting the CoW components, over 80% F1 scores at detecting key CoW components, and over 70% balanced accuracy at classifying CoW variants for nearly all test sets. The best algorithms also showed clinical potential in classifying fetal-type posterior cerebral artery and locating aneurysms with CoW anatomy. TopCoW demonstrated the utility and versatility of CoW segmentation algorithms for a wide range of downstream clinical applications with explainability. The annotated datasets and best performing algorithms have been released as public Zenodo records to foster further methodological development and clinical tool building.

X-ray angiography is the gold standard imaging modality for cardiovascular diseases. However, current deep learning approaches for X-ray angiogram analysis are severely constrained by the scarcity of annotated data. While large-scale self-supervised learning (SSL) has emerged as a promising solution, its potential in this domain remains largely unexplored, primarily due to the lack of effective SSL frameworks and large-scale datasets. To bridge this gap, we introduce a vascular anatomy-aware masked image modeling (VasoMIM) framework that explicitly integrates domain-specific anatomical knowledge. Specifically, VasoMIM comprises two key designs: an anatomy-guided masking strategy and an anatomical consistency loss. The former strategically masks vessel-containing patches to compel the model to learn robust vascular semantics, while the latter preserves structural consistency of vessels between original and reconstructed images, enhancing the discriminability of the learned representations. In conjunction with VasoMIM, we curate XA-170K, the largest X-ray angiogram pre-training dataset to date. We validate VasoMIM on four downstream tasks across six datasets, where it demonstrates superior transferability and achieves state-of-the-art performance compared to existing methods. These findings highlight the significant potential of VasoMIM as a foundation model for advancing a wide range of X-ray angiogram analysis tasks. VasoMIM and XA-170K will be available at https://github.com/Dxhuang-CASIA/XA-SSL.

Most of the existing chest X-ray datasets include labels from a list of findings without specifying their locations on the radiographs. This limits the development of machine learning algorithms for the detection and localization of chest abnormalities. In this work, we describe a dataset of more than 100,000 chest X-ray scans that were retrospectively collected from two major hospitals in Vietnam. Out of this raw data, we release 18,000 images that were manually annotated by a total of 17 experienced radiologists with 22 local labels of rectangles surrounding abnormalities and 6 global labels of suspected diseases. The released dataset is divided into a training set of 15,000 and a test set of 3,000. Each scan in the training set was independently labeled by 3 radiologists, while each scan in the test set was labeled by the consensus of 5 radiologists. We designed and built a labeling platform for DICOM images to facilitate these annotation procedures. All images are made publicly available (https://www.physionet.org/content/vindr-cxr/1.0.0/) in DICOM format along with the labels of both the training set and the test set.

This paper presents a data-driven, task-specific paradigm for experimental design, to shorten acquisition time, reduce costs, and accelerate the deployment of imaging devices. Current approaches in experimental design focus on model-parameter estimation and require specification of a particular model, whereas in imaging, other tasks may drive the design. Furthermore, such approaches often lead to intractable optimization problems in real-world imaging applications. Here we present a new paradigm for experimental design that simultaneously optimizes the design (set of image channels) and trains a machine-learning model to execute a user-specified image-analysis task. The approach obtains data densely-sampled over the measurement space (many image channels) for a small number of acquisitions, then identifies a subset of channels of prespecified size that best supports the task. We propose a method: TADRED for TAsk-DRiven Experimental Design in imaging, to identify the most informative channel-subset whilst simultaneously training a network to execute the task given the subset. Experiments demonstrate the potential of TADRED in diverse imaging applications: several clinically-relevant tasks in magnetic resonance imaging; and remote sensing and physiological applications of hyperspectral imaging. Results show substantial improvement over classical experimental design, two recent application-specific methods within the new paradigm, and state-of-the-art approaches in supervised feature selection. We anticipate further applications of our approach. Code is available: https://github.com/sbb-gh/experimental-design-multichannel

Medical imaging is essential in modern radiotherapy, supporting diagnosis, treatment planning, and monitoring. Synthetic imaging, particularly synthetic computed tomography (sCT), is gaining traction in radiotherapy. The SynthRAD2025 dataset and Grand Challenge promote advancements in sCT generation by providing a benchmarking platform for algorithms using cone-beam CT (CBCT) and magnetic resonance imaging (MRI). The dataset includes 2362 cases: 890 MRI-CT and 1472 CBCT-CT pairs from head-and-neck, thoracic, and abdominal cancer patients treated at five European university medical centers (UMC Groningen, UMC Utrecht, Radboud UMC, LMU University Hospital Munich, and University Hospital of Cologne). Data were acquired with diverse scanners and protocols. Pre-processing, including rigid and deformable image registration, ensures high-quality, modality-aligned images. Extensive quality assurance validates image consistency and usability. All imaging data is provided in MetaImage (.mha) format, ensuring compatibility with medical image processing tools. Metadata, including acquisition parameters and registration details, is available in structured CSV files. To maintain dataset integrity, SynthRAD2025 is divided into training (65%), validation (10%), and test (25%) sets. The dataset is accessible at https://doi.org/10.5281/zenodo.14918089 under the SynthRAD2025 collection. This dataset supports benchmarking and the development of synthetic imaging techniques for radiotherapy applications. Use cases include sCT generation for MRI-only and MR-guided photon/proton therapy, CBCT-based dose calculations, and adaptive radiotherapy workflows. By integrating diverse acquisition settings, SynthRAD2025 fosters robust, generalizable image synthesis algorithms, advancing personalized cancer care and adaptive radiotherapy.

This paper proposes one of the first clinical applications of multimodal large language models (LLMs) as an assistant for radiologists to check errors in their reports. We created an evaluation dataset from two real-world radiology datasets (MIMIC-CXR and IU-Xray), with 1,000 subsampled reports each. A subset of original reports was modified to contain synthetic errors by introducing various type of mistakes. The evaluation contained two difficulty levels: SIMPLE for binary error-checking and COMPLEX for identifying error types. LLaVA (Large Language and Visual Assistant) variant models, including our instruction-tuned model, were used for the evaluation. Additionally, a domain expert evaluation was conducted on a small test set. At the SIMPLE level, the LLaVA v1.5 model outperformed other publicly available models. Instruction tuning significantly enhanced performance by 47.4% and 25.4% on MIMIC-CXR and IU-Xray data, respectively. The model also surpassed the domain experts accuracy in the MIMIC-CXR dataset by 1.67%. Notably, among the subsets (N=21) of the test set where a clinician did not achieve the correct conclusion, the LLaVA ensemble mode correctly identified 71.4% of these cases. This study marks a promising step toward utilizing multi-modal LLMs to enhance diagnostic accuracy in radiology. The ensemble model demonstrated comparable performance to clinicians, even capturing errors overlooked by humans. Nevertheless, future work is needed to improve the model ability to identify the types of inconsistency.