Daily Papers

Radiology reports are one of the main forms of communication between radiologists and other clinicians and contain important information for patient care. In order to use this information for research and automated patient care programs, it is necessary to convert the raw text into structured data suitable for analysis. State-of-the-art natural language processing (NLP) domain-specific contextual word embeddings have been shown to achieve impressive accuracy for these tasks in medicine, but have yet to be utilized for section structure segmentation. In this work, we pre-trained a contextual embedding BERT model using breast radiology reports and developed a classifier that incorporated the embedding with auxiliary global textual features in order to perform section segmentation. This model achieved a 98% accuracy at segregating free text reports sentence by sentence into sections of information outlined in the Breast Imaging Reporting and Data System (BI-RADS) lexicon, a significant improvement over the Classic BERT model without auxiliary information. We then evaluated whether using section segmentation improved the downstream extraction of clinically relevant information such as modality/procedure, previous cancer, menopausal status, the purpose of the exam, breast density, and breast MRI background parenchymal enhancement. Using the BERT model pre-trained on breast radiology reports combined with section segmentation resulted in an overall accuracy of 95.9% in the field extraction tasks. This is a 17% improvement compared to an overall accuracy of 78.9% for field extraction with models using Classic BERT embeddings and not using section segmentation. Our work shows the strength of using BERT in radiology report analysis and the advantages of section segmentation in identifying key features of patient factors recorded in breast radiology reports.

Multi-modal models have shown a promising capability to effectively integrate information from various sources, yet meanwhile, they are found vulnerable to pervasive perturbations, such as uni-modal attacks and missing conditions. To counter these perturbations, robust multi-modal representations are highly expected, which are positioned well away from the discriminative multi-modal decision boundary. In this paper, different from conventional empirical studies, we focus on a commonly used joint multi-modal framework and theoretically discover that larger uni-modal representation margins and more reliable integration for modalities are essential components for achieving higher robustness. This discovery can further explain the limitation of multi-modal robustness and the phenomenon that multi-modal models are often vulnerable to attacks on the specific modality. Moreover, our analysis reveals how the widespread issue, that the model has different preferences for modalities, limits the multi-modal robustness by influencing the essential components and could lead to attacks on the specific modality highly effective. Inspired by our theoretical finding, we introduce a training procedure called Certifiable Robust Multi-modal Training (CRMT), which can alleviate this influence from modality preference and explicitly regulate essential components to significantly improve robustness in a certifiable manner. Our method demonstrates substantial improvements in performance and robustness compared with existing methods. Furthermore, our training procedure can be easily extended to enhance other robust training strategies, highlighting its credibility and flexibility.

Weakly-supervised audio-visual violence detection aims to distinguish snippets containing multimodal violence events with video-level labels. Many prior works perform audio-visual integration and interaction in an early or intermediate manner, yet overlooking the modality heterogeneousness over the weakly-supervised setting. In this paper, we analyze the modality asynchrony and undifferentiated instances phenomena of the multiple instance learning (MIL) procedure, and further investigate its negative impact on weakly-supervised audio-visual learning. To address these issues, we propose a modality-aware contrastive instance learning with self-distillation (MACIL-SD) strategy. Specifically, we leverage a lightweight two-stream network to generate audio and visual bags, in which unimodal background, violent, and normal instances are clustered into semi-bags in an unsupervised way. Then audio and visual violent semi-bag representations are assembled as positive pairs, and violent semi-bags are combined with background and normal instances in the opposite modality as contrastive negative pairs. Furthermore, a self-distillation module is applied to transfer unimodal visual knowledge to the audio-visual model, which alleviates noises and closes the semantic gap between unimodal and multimodal features. Experiments show that our framework outperforms previous methods with lower complexity on the large-scale XD-Violence dataset. Results also demonstrate that our proposed approach can be used as plug-in modules to enhance other networks. Codes are available at https://github.com/JustinYuu/MACIL_SD.

In the diverse field of medical imaging, automatic segmentation has numerous applications and must handle a wide variety of input domains, such as different types of Computed Tomography (CT) scans and Magnetic Resonance (MR) images. This heterogeneity challenges automatic segmentation algorithms to maintain consistent performance across different modalities due to the requirement for spatially aligned and paired images. Typically, segmentation models are trained using a single modality, which limits their ability to generalize to other types of input data without employing transfer learning techniques. Additionally, leveraging complementary information from different modalities to enhance segmentation precision often necessitates substantial modifications to popular encoder-decoder designs, such as introducing multiple branched encoding or decoding paths for each modality. In this work, we propose a simple Multi-Modal Segmentation (MulModSeg) strategy to enhance medical image segmentation across multiple modalities, specifically CT and MR. It incorporates two key designs: a modality-conditioned text embedding framework via a frozen text encoder that adds modality awareness to existing segmentation frameworks without significant structural modifications or computational overhead, and an alternating training procedure that facilitates the integration of essential features from unpaired CT and MR inputs. Through extensive experiments with both Fully Convolutional Network and Transformer-based backbones, MulModSeg consistently outperforms previous methods in segmenting abdominal multi-organ and cardiac substructures for both CT and MR modalities. The code is available in this {https://github.com/ChengyinLee/MulModSeg_2024{link}}.

Extracting key information from scientific papers has the potential to help researchers work more efficiently and accelerate the pace of scientific progress. Over the last few years, research on Scientific Information Extraction (SciIE) witnessed the release of several new systems and benchmarks. However, existing paper-focused datasets mostly focus only on specific parts of a manuscript (e.g., abstracts) and are single-modality (i.e., text- or table-only), due to complex processing and expensive annotations. Moreover, core information can be present in either text or tables or across both. To close this gap in data availability and enable cross-modality IE, while alleviating labeling costs, we propose a semi-supervised pipeline for annotating entities in text, as well as entities and relations in tables, in an iterative procedure. Based on this pipeline, we release novel resources for the scientific community, including a high-quality benchmark, a large-scale corpus, and a semi-supervised annotation pipeline. We further report the performance of state-of-the-art IE models on the proposed benchmark dataset, as a baseline. Lastly, we explore the potential capability of large language models such as ChatGPT for the current task. Our new dataset, results, and analysis validate the effectiveness and efficiency of our semi-supervised pipeline, and we discuss its remaining limitations.

Multimodal models are becoming increasingly effective, in part due to unified components, such as the Transformer architecture. However, multimodal models still often consist of many task- and modality-specific pieces and training procedures. For example, CLIP (Radford et al., 2021) trains independent text and image towers via a contrastive loss. We explore an additional unification: the use of a pure pixel-based model to perform image, text, and multimodal tasks. Our model is trained with contrastive loss alone, so we call it CLIP-Pixels Only (CLIPPO). CLIPPO uses a single encoder that processes both regular images and text rendered as images. CLIPPO performs image-based tasks such as retrieval and zero-shot image classification almost as well as CLIP, with half the number of parameters and no text-specific tower or embedding. When trained jointly via image-text contrastive learning and next-sentence contrastive learning, CLIPPO can perform well on natural language understanding tasks, without any word-level loss (language modelling or masked language modelling), outperforming pixel-based prior work. Surprisingly, CLIPPO can obtain good accuracy in visual question answering, simply by rendering the question and image together. Finally, we exploit the fact that CLIPPO does not require a tokenizer to show that it can achieve strong performance on multilingual multimodal retrieval without

The accelerating development of general medical artificial intelligence (GMAI), powered by multimodal large language models (MLLMs), offers transformative potential for addressing persistent healthcare challenges, including workforce deficits and escalating costs. The parallel development of systematic evaluation benchmarks emerges as a critical imperative to enable performance assessment and provide technological guidance. Meanwhile, as an invaluable knowledge source, the potential of medical textbooks for benchmark development remains underexploited. Here, we present MedBookVQA, a systematic and comprehensive multimodal benchmark derived from open-access medical textbooks. To curate this benchmark, we propose a standardized pipeline for automated extraction of medical figures while contextually aligning them with corresponding medical narratives. Based on this curated data, we generate 5,000 clinically relevant questions spanning modality recognition, disease classification, anatomical identification, symptom diagnosis, and surgical procedures. A multi-tier annotation system categorizes queries through hierarchical taxonomies encompassing medical imaging modalities (42 categories), body anatomies (125 structures), and clinical specialties (31 departments), enabling nuanced analysis across medical subdomains. We evaluate a wide array of MLLMs, including proprietary, open-sourced, medical, and reasoning models, revealing significant performance disparities across task types and model categories. Our findings highlight critical capability gaps in current GMAI systems while establishing textbook-derived multimodal benchmarks as essential evaluation tools. MedBookVQA establishes textbook-derived benchmarking as a critical paradigm for advancing clinical AI, exposing limitations in GMAI systems while providing anatomically structured performance metrics across specialties.

Our experience of the world is multimodal - we see objects, hear sounds, feel texture, smell odors, and taste flavors. Modality refers to the way in which something happens or is experienced and a research problem is characterized as multimodal when it includes multiple such modalities. In order for Artificial Intelligence to make progress in understanding the world around us, it needs to be able to interpret such multimodal signals together. Multimodal machine learning aims to build models that can process and relate information from multiple modalities. It is a vibrant multi-disciplinary field of increasing importance and with extraordinary potential. Instead of focusing on specific multimodal applications, this paper surveys the recent advances in multimodal machine learning itself and presents them in a common taxonomy. We go beyond the typical early and late fusion categorization and identify broader challenges that are faced by multimodal machine learning, namely: representation, translation, alignment, fusion, and co-learning. This new taxonomy will enable researchers to better understand the state of the field and identify directions for future research.

Modality is the linguistic ability to describe events with added information such as how desirable, plausible, or feasible they are. Modality is important for many NLP downstream tasks such as the detection of hedging, uncertainty, speculation, and more. Previous studies that address modality detection in NLP often restrict modal expressions to a closed syntactic class, and the modal sense labels are vastly different across different studies, lacking an accepted standard. Furthermore, these senses are often analyzed independently of the events that they modify. This work builds on the theoretical foundations of the Georgetown Gradable Modal Expressions (GME) work by Rubinstein et al. (2013) to propose an event-based modality detection task where modal expressions can be words of any syntactic class and sense labels are drawn from a comprehensive taxonomy which harmonizes the modal concepts contributed by the different studies. We present experiments on the GME corpus aiming to detect and classify fine-grained modal concepts and associate them with their modified events. We show that detecting and classifying modal expressions is not only feasible, but also improves the detection of modal events in their own right.

Quantification of real-time informal feedback delivered by an experienced surgeon to a trainee during surgery is important for skill improvements in surgical training. Such feedback in the live operating room is inherently multimodal, consisting of verbal conversations (e.g., questions and answers) as well as non-verbal elements (e.g., through visual cues like pointing to anatomic elements). In this work, we leverage a clinically-validated five-category classification of surgical feedback: "Anatomic", "Technical", "Procedural", "Praise" and "Visual Aid". We then develop a multi-label machine learning model to classify these five categories of surgical feedback from inputs of text, audio, and video modalities. The ultimate goal of our work is to help automate the annotation of real-time contextual surgical feedback at scale. Our automated classification of surgical feedback achieves AUCs ranging from 71.5 to 77.6 with the fusion improving performance by 3.1%. We also show that high-quality manual transcriptions of feedback audio from experts improve AUCs to between 76.5 and 96.2, which demonstrates a clear path toward future improvements. Empirically, we find that the Staged training strategy, with first pre-training each modality separately and then training them jointly, is more effective than training different modalities altogether. We also present intuitive findings on the importance of modalities for different feedback categories. This work offers an important first look at the feasibility of automated classification of real-world live surgical feedback based on text, audio, and video modalities.

Procedures are inherently hierarchical. To "make videos", one may need to "purchase a camera", which in turn may require one to "set a budget". While such hierarchical knowledge is critical for reasoning about complex procedures, most existing work has treated procedures as shallow structures without modeling the parent-child relation. In this work, we attempt to construct an open-domain hierarchical knowledge-base (KB) of procedures based on wikiHow, a website containing more than 110k instructional articles, each documenting the steps to carry out a complex procedure. To this end, we develop a simple and efficient method that links steps (e.g., "purchase a camera") in an article to other articles with similar goals (e.g., "how to choose a camera"), recursively constructing the KB. Our method significantly outperforms several strong baselines according to automatic evaluation, human judgment, and application to downstream tasks such as instructional video retrieval. A demo with partial data can be found at https://wikihow-hierarchy.github.io. The code and the data are at https://github.com/shuyanzhou/wikihow_hierarchy.

Recent advances in learning multi-modal representation have witnessed the success in biomedical domains. While established techniques enable handling multi-modal information, the challenges are posed when extended to various clinical modalities and practical modalitymissing setting due to the inherent modality gaps. To tackle these, we propose an innovative Modality-prompted Heterogeneous Graph for Omnimodal Learning (GTP-4o), which embeds the numerous disparate clinical modalities into a unified representation, completes the deficient embedding of missing modality and reformulates the cross-modal learning with a graph-based aggregation. Specially, we establish a heterogeneous graph embedding to explicitly capture the diverse semantic properties on both the modality-specific features (nodes) and the cross-modal relations (edges). Then, we design a modality-prompted completion that enables completing the inadequate graph representation of missing modality through a graph prompting mechanism, which generates hallucination graphic topologies to steer the missing embedding towards the intact representation. Through the completed graph, we meticulously develop a knowledge-guided hierarchical cross-modal aggregation consisting of a global meta-path neighbouring to uncover the potential heterogeneous neighbors along the pathways driven by domain knowledge, and a local multi-relation aggregation module for the comprehensive cross-modal interaction across various heterogeneous relations. We assess the efficacy of our methodology on rigorous benchmarking experiments against prior state-of-the-arts. In a nutshell, GTP-4o presents an initial foray into the intriguing realm of embedding, relating and perceiving the heterogeneous patterns from various clinical modalities holistically via a graph theory. Project page: https://gtp-4-o.github.io/.

Different medical imaging modalities capture diagnostic information at varying spatial resolutions, from coarse global patterns to fine-grained localized structures. However, most existing vision-language frameworks in the medical domain apply a uniform strategy for local feature extraction, overlooking the modality-specific demands. In this work, we present MedMoE, a modular and extensible vision-language processing framework that dynamically adapts visual representation based on the diagnostic context. MedMoE incorporates a Mixture-of-Experts (MoE) module conditioned on the report type, which routes multi-scale image features through specialized expert branches trained to capture modality-specific visual semantics. These experts operate over feature pyramids derived from a Swin Transformer backbone, enabling spatially adaptive attention to clinically relevant regions. This framework produces localized visual representations aligned with textual descriptions, without requiring modality-specific supervision at inference. Empirical results on diverse medical benchmarks demonstrate that MedMoE improves alignment and retrieval performance across imaging modalities, underscoring the value of modality-specialized visual representations in clinical vision-language systems.

Contrastive learning methods, such as CLIP, leverage naturally paired data-for example, images and their corresponding text captions-to learn general representations that transfer efficiently to downstream tasks. While such approaches are generally applied to two modalities, domains such as robotics, healthcare, and video need to support many types of data at once. We show that the pairwise application of CLIP fails to capture joint information between modalities, thereby limiting the quality of the learned representations. To address this issue, we present Symile, a simple contrastive learning approach that captures higher-order information between any number of modalities. Symile provides a flexible, architecture-agnostic objective for learning modality-specific representations. To develop Symile's objective, we derive a lower bound on total correlation, and show that Symile representations for any set of modalities form a sufficient statistic for predicting the remaining modalities. Symile outperforms pairwise CLIP, even with modalities missing in the data, on cross-modal classification and retrieval across several experiments including on an original multilingual dataset of 33M image, text and audio samples and a clinical dataset of chest X-rays, electrocardiograms, and laboratory measurements. All datasets and code used in this work are publicly available at https://github.com/rajesh-lab/symile.

Medical decision-making requires integrating diverse medical information, from imaging to clinical narratives. These medical modalities are often acquired in a many-to-many manner. However, current medical vision-language pretraining models (Med-VLPMs) fail to directly account for this many-to-many mapping in their model training and embeddings. To address this, we present Probabilistic Modality-Enhanced Diagnosis (ProbMED), a multimodal Med-VLPM that employs probabilistic contrastive learning to model distributions over embeddings rather than deterministic estimates. ProbMED aligns four distinct modalities -- chest X-rays, electrocardiograms, echocardiograms, and clinical text -- into a unified probabilistic embedding space. We use InfoNCE loss with Hellinger distance to integrate inter-modality distributions. We introduce a probabilistic synthetic sampling loss that captures modality-specific mean and variance to improve intra-modality binding. Extensive experiments across 13 medical datasets demonstrate that our model outperforms current Med-VLPMs in cross-modality retrieval, zero-shot, and few-shot classification. We also demonstrate the robust integration of multiple modalities for prognostication, showing improved intra- and inter-medical modality binding.

Purpose: Surgical workflow analysis is crucial for improving surgical efficiency and safety. However, previous studies rely heavily on large-scale annotated datasets, posing challenges in cost, scalability, and reliance on expert annotations. To address this, we propose Surg-FTDA (Few-shot Text-driven Adaptation), designed to handle various surgical workflow analysis tasks with minimal paired image-label data. Methods: Our approach has two key components. First, Few-shot selection-based modality alignment selects a small subset of images and aligns their embeddings with text embeddings from the downstream task, bridging the modality gap. Second, Text-driven adaptation leverages only text data to train a decoder, eliminating the need for paired image-text data. This decoder is then applied to aligned image embeddings, enabling image-related tasks without explicit image-text pairs. Results: We evaluate our approach to generative tasks (image captioning) and discriminative tasks (triplet recognition and phase recognition). Results show that Surg-FTDA outperforms baselines and generalizes well across downstream tasks. Conclusion: We propose a text-driven adaptation approach that mitigates the modality gap and handles multiple downstream tasks in surgical workflow analysis, with minimal reliance on large annotated datasets. The code and dataset will be released in https://github.com/CAMMA-public/Surg-FTDA

Multimodal large language models (MLLMs) have achieved significant success in the general field of image processing. Their emerging task generalization and freeform conversational capabilities can greatly facilitate medical diagnostic assistance, helping patients better understand their conditions and enhancing doctor-patient trust. Computed Tomography (CT) is a non-invasive imaging technique used to capture the internal mechanisms of a patient's condition and is widely utilized. However, in past research, the complex textural features of this imaging data have made accurate interpretation by algorithms challenging, impeding the performance of general LLMs in diagnostic assistance. To address this, we developed OrthoDoc, a MLLM designed for CT diagnostics. OrthoDoc is trained on 120,000 CT images and diagnostic reports and includes a Retrieval-Augmented Generation (RAG) module capable of effectively mitigating model hallucinations. This module is informed by extensive medical literature, textbooks, and explanatory data. Thus, OrthoDoc not only processes complex CT images but also stores, understands, and reasons over medical knowledge and language. In extensive experiments, OrthoDoc outperforms commercial models led by GPT-4, demonstrating superior diagnostic capabilities and accuracy. Specifically, OrthoDoc significantly surpasses existing models in the diagnosis of common orthopedic conditions such as fractures, arthritis, and tumors. Additionally, OrthoDoc exhibits robust generalization and stability when handling rare and complex cases.

Medical image retrieval is essential for clinical decision-making and translational research, relying on discriminative visual representations. Yet, current methods remain fragmented, relying on separate architectures and training strategies for 2D, 3D, and video-based medical data. This modality-specific design hampers scalability and inhibits the development of unified representations. To enable unified learning, we curate a large-scale hybrid-modality dataset comprising 867,653 medical imaging samples, including 2D X-rays and ultrasounds, RGB endoscopy videos, and 3D CT scans. Leveraging this dataset, we train M3Ret, a unified visual encoder without any modality-specific customization. It successfully learns transferable representations using both generative (MAE) and contrastive (SimDINO) self-supervised learning (SSL) paradigms. Our approach sets a new state-of-the-art in zero-shot image-to-image retrieval across all individual modalities, surpassing strong baselines such as DINOv3 and the text-supervised BMC-CLIP. More remarkably, strong cross-modal alignment emerges without paired data, and the model generalizes to unseen MRI tasks, despite never observing MRI during pretraining, demonstrating the generalizability of purely visual self-supervision to unseen modalities. Comprehensive analyses further validate the scalability of our framework across model and data sizes. These findings deliver a promising signal to the medical imaging community, positioning M3Ret as a step toward foundation models for visual SSL in multimodal medical image understanding.

This book is the result of a seminar in which we reviewed multimodal approaches and attempted to create a solid overview of the field, starting with the current state-of-the-art approaches in the two subfields of Deep Learning individually. Further, modeling frameworks are discussed where one modality is transformed into the other, as well as models in which one modality is utilized to enhance representation learning for the other. To conclude the second part, architectures with a focus on handling both modalities simultaneously are introduced. Finally, we also cover other modalities as well as general-purpose multi-modal models, which are able to handle different tasks on different modalities within one unified architecture. One interesting application (Generative Art) eventually caps off this booklet.

Recently, the newly emerged multimodal models, which leverage both visual and linguistic modalities to train powerful encoders, have gained increasing attention. However, learning from a large-scale unlabeled dataset also exposes the model to the risk of potential poisoning attacks, whereby the adversary aims to perturb the model's training data to trigger malicious behaviors in it. In contrast to previous work, only poisoning visual modality, in this work, we take the first step to studying poisoning attacks against multimodal models in both visual and linguistic modalities. Specially, we focus on answering two questions: (1) Is the linguistic modality also vulnerable to poisoning attacks? and (2) Which modality is most vulnerable? To answer the two questions, we propose three types of poisoning attacks against multimodal models. Extensive evaluations on different datasets and model architectures show that all three attacks can achieve significant attack performance while maintaining model utility in both visual and linguistic modalities. Furthermore, we observe that the poisoning effect differs between different modalities. To mitigate the attacks, we propose both pre-training and post-training defenses. We empirically show that both defenses can significantly reduce the attack performance while preserving the model's utility.

Multimodal MRI provides critical complementary information for accurate brain tumor segmentation. However, conventional methods struggle when certain modalities are missing due to issues such as image quality, protocol inconsistencies, patient allergies, or financial constraints. To address this, we propose a robust single-modality parallel processing framework that achieves high segmentation accuracy even with incomplete modalities. Leveraging Holder divergence and mutual information, our model maintains modality-specific features while dynamically adjusting network parameters based on the available inputs. By using these divergence- and information-based loss functions, the framework effectively quantifies discrepancies between predictions and ground-truth labels, resulting in consistently accurate segmentation. Extensive evaluations on the BraTS 2018 and BraTS 2020 datasets demonstrate superior performance over existing methods in handling missing modalities.

Retrieval-Augmented Generation (RAG) has shown substantial promise in improving factual accuracy by grounding model responses with external knowledge relevant to queries. However, most existing RAG approaches are limited to a text-only corpus, and while recent efforts have extended RAG to other modalities such as images and videos, they typically operate over a single modality-specific corpus. In contrast, real-world queries vary widely in the type of knowledge they require, which a single type of knowledge source cannot address. To address this, we introduce UniversalRAG, a novel RAG framework designed to retrieve and integrate knowledge from heterogeneous sources with diverse modalities and granularities. Specifically, motivated by the observation that forcing all modalities into a unified representation space derived from a single combined corpus causes a modality gap, where the retrieval tends to favor items from the same modality as the query, we propose a modality-aware routing mechanism that dynamically identifies the most appropriate modality-specific corpus and performs targeted retrieval within it. Also, beyond modality, we organize each modality into multiple granularity levels, enabling fine-tuned retrieval tailored to the complexity and scope of the query. We validate UniversalRAG on 8 benchmarks spanning multiple modalities, showing its superiority over modality-specific and unified baselines.

Medical vision-and-language pre-training (Med-VLP) has shown promising improvements on many downstream medical tasks owing to its applicability to extracting generic representations from medical images and texts. Practically, there exist two typical types, i.e., the fusion-encoder type and the dual-encoder type, depending on whether a heavy fusion module is used. The former is superior at multi-modal tasks owing to the sufficient interaction between modalities; the latter is good at uni-modal and cross-modal tasks due to the single-modality encoding ability. To take advantage of these two types, we propose an effective yet straightforward scheme named PTUnifier to unify the two types. We first unify the input format by introducing visual and textual prompts, which serve as a feature bank that stores the most representative images/texts. By doing so, a single model could serve as a foundation model that processes various tasks adopting different input formats (i.e., image-only, text-only, and image-text-pair). Furthermore, we construct a prompt pool (instead of static ones) to improve diversity and scalability. Experimental results show that our approach achieves state-of-the-art results on a broad range of tasks, spanning uni-modal tasks (i.e., image/text classification and text summarization), cross-modal tasks (i.e., image-to-text generation and image-text/text-image retrieval), and multi-modal tasks (i.e., visual question answering), demonstrating the effectiveness of our approach. Note that the adoption of prompts is orthogonal to most existing Med-VLP approaches and could be a beneficial and complementary extension to these approaches.

Recent advancements in surgical computer vision have been driven by vision-only models, which lack language semantics, relying on manually annotated videos to predict fixed object categories. This limits their generalizability to unseen surgical procedures and tasks. We propose leveraging surgical video lectures from e-learning platforms to provide effective vision and language supervisory signals for multi-modal representation learning, bypassing manual annotations. We address surgery-specific linguistic challenges using multiple automatic speech recognition systems for text transcriptions. We introduce SurgVLP - Surgical Vision Language Pre-training - a novel method for multi-modal representation learning. SurgVLP employs a new contrastive learning objective, aligning video clip embeddings with corresponding multiple text embeddings in a joint latent space. We demonstrate the representational capability of this space through several vision-and-language surgical tasks and vision-only tasks specific to surgery. Unlike current fully supervised approaches, SurgVLP adapts to different surgical procedures and tasks without specific fine-tuning, achieving zero-shot adaptation to tasks such as surgical tool, phase, and triplet recognition without manual annotation. These results highlight the transferability and versatility of the learned multi-modal representations in surgical video analysis. The code is available at https://github.com/CAMMA-public/SurgVLP

Large Multimodal Models (LMMs) have shown remarkable progress in the field of medical Visual Question Answering (Med-VQA), achieving high accuracy on existing benchmarks. However, their reliability under robust evaluation is questionable. This study reveals that state-of-the-art models, when subjected to simple probing evaluation, perform worse than random guessing on medical diagnosis questions. To address this critical evaluation problem, we introduce the Probing Evaluation for Medical Diagnosis (ProbMed) dataset to rigorously assess LMM performance in medical imaging through probing evaluation and procedural diagnosis. Particularly, probing evaluation features pairing original questions with negation questions with hallucinated attributes, while procedural diagnosis requires reasoning across various diagnostic dimensions for each image, including modality recognition, organ identification, clinical findings, abnormalities, and positional grounding. Our evaluation reveals that top-performing models like GPT-4V and Gemini Pro perform worse than random guessing on specialized diagnostic questions, indicating significant limitations in handling fine-grained medical inquiries. Besides, models like LLaVA-Med struggle even with more general questions, and results from CheXagent demonstrate the transferability of expertise across different modalities of the same organ, showing that specialized domain knowledge is still crucial for improving performance. This study underscores the urgent need for more robust evaluation to ensure the reliability of LMMs in critical fields like medical diagnosis, and current LMMs are still far from applicable to those fields.

Medical image segmentation involves partitioning medical images into meaningful regions, with a focus on identifying anatomical structures and lesions. It has broad applications in healthcare, and deep learning methods have enabled significant advancements in automating this process. Recently, the introduction of the Segmentation Anything Model (SAM), the first foundation model for segmentation task, has prompted researchers to adapt it for the medical domain to improve performance across various tasks. However, SAM's large model size and high GPU requirements hinder its scalability and development in the medical domain. In this work, we propose MCP-MedSAM, a powerful and lightweight medical SAM model designed to be trainable on a single A100 GPU with 40GB of memory within one day while delivering superior segmentation performance. Recognizing the significant internal differences between modalities and the need for direct segmentation target information within bounding boxes, we introduce two kinds of prompts: the modality prompt and the content prompt. After passing through the prompt encoder, their embedding representations can further improve the segmentation performance by incorporating more relevant information without adding significant training overhead. Additionally, we adopt an effective modality-based data sampling strategy to address data imbalance between modalities, ensuring more balanced performance across all modalities. Our method was trained and evaluated using a large-scale challenge dataset, compared to top-ranking methods on the challenge leaderboard, MCP-MedSAM achieved superior performance while requiring only one day of training on a single GPU. The code is publicly available at blue{https://github.com/dong845/MCP-MedSAM}.}

The integration of multimodal data including pathology images and gene profiles is widely applied in precise survival prediction. Despite recent advances in multimodal survival models, collecting complete modalities for multimodal fusion still poses a significant challenge, hindering their application in clinical settings. Current approaches tackling incomplete modalities often fall short, as they typically compensate for only a limited part of the knowledge of missing modalities. To address this issue, we propose a Distilled Prompt Learning framework (DisPro) to utilize the strong robustness of Large Language Models (LLMs) to missing modalities, which employs two-stage prompting for compensation of comprehensive information for missing modalities. In the first stage, Unimodal Prompting (UniPro) distills the knowledge distribution of each modality, preparing for supplementing modality-specific knowledge of the missing modality in the subsequent stage. In the second stage, Multimodal Prompting (MultiPro) leverages available modalities as prompts for LLMs to infer the missing modality, which provides modality-common information. Simultaneously, the unimodal knowledge acquired in the first stage is injected into multimodal inference to compensate for the modality-specific knowledge of the missing modality. Extensive experiments covering various missing scenarios demonstrated the superiority of the proposed method. The code is available at https://github.com/Innse/DisPro.

Brain MRI scans are often found in four modalities, consisting of T1-weighted with and without contrast enhancement (T1ce and T1w), T2-weighted imaging (T2w), and Flair. Leveraging complementary information from these different modalities enables models to learn richer, more discriminative features for understanding brain anatomy, which could be used in downstream tasks such as anomaly detection. However, in clinical practice, not all MRI modalities are always available due to various reasons. This makes missing modality generation a critical challenge in medical image analysis. In this paper, we propose SLaM-DiMM, a novel missing modality generation framework that harnesses the power of diffusion models to synthesize any of the four target MRI modalities from other available modalities. Our approach not only generates high-fidelity images but also ensures structural coherence across the depth of the volume through a dedicated coherence enhancement mechanism. Qualitative and quantitative evaluations on the BraTS-Lighthouse-2025 Challenge dataset demonstrate the effectiveness of the proposed approach in synthesizing anatomically plausible and structurally consistent results. Code is available at https://github.com/BheeshmSharma/SLaM-DiMM-MICCAI-BraTS-Challenge-2025.

Embodied agents have achieved prominent performance in following human instructions to complete tasks. However, the potential of providing instructions informed by texts and images to assist humans in completing tasks remains underexplored. To uncover this capability, we present the multimodal procedural planning (MPP) task, in which models are given a high-level goal and generate plans of paired text-image steps, providing more complementary and informative guidance than unimodal plans. The key challenges of MPP are to ensure the informativeness, temporal coherence,and accuracy of plans across modalities. To tackle this, we propose Text-Image Prompting (TIP), a dual-modality prompting method that jointly leverages zero-shot reasoning ability in large language models (LLMs) and compelling text-to-image generation ability from diffusion-based models. TIP improves the interaction in the dual modalities using Text-to-Image Bridge and Image-to-Text Bridge, allowing LLMs to guide the textual-grounded image plan generation and leveraging the descriptions of image plans to ground the textual plan reversely. To address the lack of relevant datasets, we collect WIKIPLAN and RECIPEPLAN as a testbed for MPP. Our results show compelling human preferences and automatic scores against unimodal and multimodal baselines on WIKIPLAN and RECIPEPLAN in terms of informativeness, temporal coherence, and plan accuracy. Our code and data: https://github.com/YujieLu10/MPP.

Multimodal large language models (MLLMs) have achieved remarkable performance on complex tasks with multimodal context. However, it is still understudied whether they exhibit modality preference when processing multimodal contexts. To study this question, we first build a MC\textsuperscript{2} benchmark under controlled evidence conflict scenarios to systematically evaluate modality preference, which is the tendency to favor one modality over another when making decisions based on multimodal conflicting evidence. Our extensive evaluation reveals that all 18 tested MLLMs generally demonstrate clear modality bias, and modality preference can be influenced by external interventions. An in-depth analysis reveals that the preference direction can be captured within the latent representations of MLLMs. Built on this, we propose a probing and steering method based on representation engineering to explicitly control modality preference without additional fine-tuning or carefully crafted prompts. Our method effectively amplifies modality preference toward a desired direction and applies to downstream tasks such as hallucination mitigation and multimodal machine translation, yielding promising improvements.

Problem: Effective patient-centered communication is a core competency for physicians. However, both seasoned providers and medical trainees report decreased confidence in leading conversations on sensitive topics such as goals of care or end-of-life discussions. The significant administrative burden and the resources required to provide dedicated training in leading difficult conversations has been a long-standing problem in medical education. Approach: In this work, we present a novel educational tool designed to facilitate interactive, real-time simulations of difficult conversations in a video-based format through the use of multimodal generative artificial intelligence (AI). Leveraging recent advances in language modeling, computer vision, and generative audio, this tool creates realistic, interactive scenarios with avatars, or "synthetic patients." These synthetic patients interact with users throughout various stages of medical care using a custom-built video chat application, offering learners the chance to practice conversations with patients from diverse belief systems, personalities, and ethnic backgrounds. Outcomes: While the development of this platform demanded substantial upfront investment in labor, it offers a highly-realistic simulation experience with minimal financial investment. For medical trainees, this educational tool can be implemented within programs to simulate patient-provider conversations and can be incorporated into existing palliative care curriculum to provide a scalable, high-fidelity simulation environment for mastering difficult conversations. Next Steps: Future developments will explore enhancing the authenticity of these encounters by working with patients to incorporate their histories and personalities, as well as employing the use of AI-generated evaluations to offer immediate, constructive feedback to learners post-simulation.

With the rapid development of artificial intelligence, large language models (LLMs) have shown promising capabilities in mimicking human-level language comprehension and reasoning. This has sparked significant interest in applying LLMs to enhance various aspects of healthcare, ranging from medical education to clinical decision support. However, medicine involves multifaceted data modalities and nuanced reasoning skills, presenting challenges for integrating LLMs. This paper provides a comprehensive review on the applications and implications of LLMs in medicine. It begins by examining the fundamental applications of general-purpose and specialized LLMs, demonstrating their utilities in knowledge retrieval, research support, clinical workflow automation, and diagnostic assistance. Recognizing the inherent multimodality of medicine, the review then focuses on multimodal LLMs, investigating their ability to process diverse data types like medical imaging and EHRs to augment diagnostic accuracy. To address LLMs' limitations regarding personalization and complex clinical reasoning, the paper explores the emerging development of LLM-powered autonomous agents for healthcare. Furthermore, it summarizes the evaluation methodologies for assessing LLMs' reliability and safety in medical contexts. Overall, this review offers an extensive analysis on the transformative potential of LLMs in modern medicine. It also highlights the pivotal need for continuous optimizations and ethical oversight before these models can be effectively integrated into clinical practice. Visit https://github.com/mingze-yuan/Awesome-LLM-Healthcare for an accompanying GitHub repository containing latest papers.

Clinical diagnosis is a highly specialized discipline requiring both domain expertise and strict adherence to rigorous guidelines. While current AI-driven medical research predominantly focuses on knowledge graphs or natural text pretraining paradigms to incorporate medical knowledge, these approaches primarily rely on implicitly encoded knowledge within model parameters, neglecting task-specific knowledge required by diverse downstream tasks. To address this limitation, we propose Retrieval-Augmented Diagnosis (RAD), a novel framework that explicitly injects external knowledge into multimodal models directly on downstream tasks. Specifically, RAD operates through three key mechanisms: retrieval and refinement of disease-centered knowledge from multiple medical sources, a guideline-enhanced contrastive loss that constrains the latent distance between multi-modal features and guideline knowledge, and the dual transformer decoder that employs guidelines as queries to steer cross-modal fusion, aligning the models with clinical diagnostic workflows from guideline acquisition to feature extraction and decision-making. Moreover, recognizing the lack of quantitative evaluation of interpretability for multimodal diagnostic models, we introduce a set of criteria to assess the interpretability from both image and text perspectives. Extensive evaluations across four datasets with different anatomies demonstrate RAD's generalizability, achieving state-of-the-art performance. Furthermore, RAD enables the model to concentrate more precisely on abnormal regions and critical indicators, ensuring evidence-based, trustworthy diagnosis. Our code is available at https://github.com/tdlhl/RAD.

Colonoscopy is currently one of the most sensitive screening methods for colorectal cancer. This study investigates the frontiers of intelligent colonoscopy techniques and their prospective implications for multimodal medical applications. With this goal, we begin by assessing the current data-centric and model-centric landscapes through four tasks for colonoscopic scene perception, including classification, detection, segmentation, and vision-language understanding. This assessment enables us to identify domain-specific challenges and reveals that multimodal research in colonoscopy remains open for further exploration. To embrace the coming multimodal era, we establish three foundational initiatives: a large-scale multimodal instruction tuning dataset ColonINST, a colonoscopy-designed multimodal language model ColonGPT, and a multimodal benchmark. To facilitate ongoing monitoring of this rapidly evolving field, we provide a public website for the latest updates: https://github.com/ai4colonoscopy/IntelliScope.

Multimodal foundation models can process several modalities. However, since the space of possible modalities is large and evolving over time, training a model from scratch to encompass all modalities is unfeasible. Moreover, integrating a modality into a pre-existing foundation model currently requires a significant amount of paired data, which is often not available for low-resource modalities. In this paper, we introduce a method for sample-efficient modality integration (SEMI) into Large Language Models (LLMs). To this end, we devise a hypernetwork that can adapt a shared projector -- placed between modality-specific encoders and an LLM -- to any modality. The hypernetwork, trained on high-resource modalities (i.e., text, speech, audio, video), is conditioned on a few samples from any arbitrary modality at inference time to generate a suitable adapter. To increase the diversity of training modalities, we artificially multiply the number of encoders through isometric transformations. We find that SEMI achieves a significant boost in sample efficiency during few-shot integration of new modalities (i.e., satellite images, astronomical images, inertial measurements, and molecules) with encoders of arbitrary embedding dimensionality. For instance, to reach the same accuracy as 32-shot SEMI, training the projector from scratch needs 64times more data. As a result, SEMI holds promise to extend the modality coverage of foundation models.

The rapid progress of Multimodal Large Language Models(MLLMs) has transformed the AI landscape. These models combine pre-trained LLMs with various modality encoders. This integration requires a systematic understanding of how different modalities connect to the language backbone. Our survey presents an LLM-centric analysis of current approaches. We examine methods for transforming and aligning diverse modal inputs into the language embedding space. This addresses a significant gap in existing literature. We propose a classification framework for MLLMs based on three key dimensions. First, we examine architectural strategies for modality integration. This includes both the specific integration mechanisms and the fusion level. Second, we categorize representation learning techniques as either joint or coordinate representations. Third, we analyze training paradigms, including training strategies and objective functions. By examining 125 MLLMs developed between 2021 and 2025, we identify emerging patterns in the field. Our taxonomy provides researchers with a structured overview of current integration techniques. These insights aim to guide the development of more robust multimodal integration strategies for future models built on pre-trained foundations.

Online video web content is richly multimodal: a single video blends vision, speech, ambient audio, and on-screen text. Retrieval systems typically treat these modalities as independent retrieval sources, which can lead to noisy and subpar retrieval. We explore multimodal video content retrieval, where relevance can be scored from one particular modality or jointly across multiple modalities simultaneously. Consequently, an effective retriever must dynamically choose which modality (or set of modalities) best addresses the query. We introduce CLaMR, a multimodal, late-interaction retriever that jointly indexes 4 modalities: video frames, transcribed speech, on-screen text, and metadata. CLaMR jointly encodes all modalities with a unified multimodal backbone for improved contextualization and is trained to enhance dynamic modality selection via two key innovations. First, given the lack of training data for multimodal retrieval, we introduce MultiVENT 2.0++, a large-scale synthetic training dataset built on MultiVENT 2.0 (event-centric videos in various languages paired with queries) with modality-targeted queries. Next, we propose a modality-aware loss that jointly trains according to a standard contrastive objective alongside an objective for learning correct modality usage. On the test sets of MultiVENT 2.0++ and MSRVTT, conventional aggregation strategies, such as averaging similarities for baseline retrievers, degrade performance by introducing noise from irrelevant modalities. In contrast, CLaMR consistently outperforms existing retrievers: on MultiVENT 2.0++, CLaMR improves nDCG@10 by 25.6 over the best single-modality retriever and by 35.4 over the best multi-modality retriever. We illustrate CLaMR's downstream utility on long-video QA, retrieving relevant frames and obtaining a 3.50% boost over LanguageBind on Video-MME and 1.42% over dense sampling on LongVideoBench.

Omni-modal language models (OLMs) aim to integrate and reason over diverse input modalities--such as text, images, video, and audio--while maintaining strong language capabilities. Despite recent advancements, existing models, especially open-source ones, remain far from true omni-modality, struggling to generalize beyond the specific modality pairs they are trained on or to achieve strong performance when processing multi-modal inputs. We study the effect of extending modality, the dominant technique for training multimodal models, where an off-the-shelf language model is fine-tuned on target-domain and language data. Specifically, we investigate three key questions: (1) Does modality extension compromise core language abilities? (2) Can model merging effectively integrate independently fine-tuned modality-specific models to achieve omni-modality? (3) Does omni-modality extension lead to better knowledge sharing and generalization compared to sequential extension? Through extensive experiments, we analyze these trade-offs and provide insights into the feasibility of achieving true omni-modality using current approaches.

Vision-language pre-training (VLP) offers unique advantages for surgery by aligning language with surgical videos, enabling workflow understanding and transfer across tasks without relying on expert-labeled datasets. However, progress in surgical VLP remains constrained by the limited scale, procedural diversity, semantic quality, and hierarchical structure of existing datasets. In this work, we present SurgLaVi, the largest and most diverse surgical vision-language dataset to date, comprising nearly 240k clip-caption pairs from more than 200 procedures, and comprising hierarchical levels at phase-, step-, and task-level. At the core of SurgLaVi lies a fully automated pipeline that systematically generates fine-grained transcriptions of surgical videos and segments them into coherent procedural units. To ensure high-quality annotations, it applies dual-modality filtering to remove irrelevant and noisy samples. Within this framework, the resulting captions are enriched with contextual detail, producing annotations that are both semantically rich and easy to interpret. To ensure accessibility, we release SurgLaVi-eta, an open-source derivative of 113k clip-caption pairs constructed entirely from public data, which is over four times larger than existing surgical VLP datasets. To demonstrate the value of SurgLaVi datasets, we introduce SurgCLIP, a CLIP-style video-text contrastive framework with dual encoders, as a representative base model. SurgCLIP achieves consistent improvements across phase, step, action, and tool recognition, surpassing prior state-of-the-art methods, often by large margins. These results validate that large-scale, semantically rich, and hierarchically structured datasets directly translate into stronger and more generalizable representations, establishing SurgLaVi as a key resource for developing surgical foundation models.

We propose to improve transformers of a specific modality with irrelevant data from other modalities, e.g., improve an ImageNet model with audio or point cloud datasets. We would like to highlight that the data samples of the target modality are irrelevant to the other modalities, which distinguishes our method from other works utilizing paired (e.g., CLIP) or interleaved data of different modalities. We propose a methodology named Multimodal Pathway - given a target modality and a transformer designed for it, we use an auxiliary transformer trained with data of another modality and construct pathways to connect components of the two models so that data of the target modality can be processed by both models. In this way, we utilize the universal sequence-to-sequence modeling abilities of transformers obtained from two modalities. As a concrete implementation, we use a modality-specific tokenizer and task-specific head as usual but utilize the transformer blocks of the auxiliary model via a proposed method named Cross-Modal Re-parameterization, which exploits the auxiliary weights without any inference costs. On the image, point cloud, video, and audio recognition tasks, we observe significant and consistent performance improvements with irrelevant data from other modalities. The code and models are available at https://github.com/AILab-CVC/M2PT.

Multimodal foundation models that can holistically process text alongside images, video, audio, and other sensory modalities are increasingly used in a variety of real-world applications. However, it is challenging to characterize and study progress in multimodal foundation models, given the range of possible modeling decisions, tasks, and domains. In this paper, we introduce Holistic Evaluation of Multimodal Models (HEMM) to systematically evaluate the capabilities of multimodal foundation models across a set of 3 dimensions: basic skills, information flow, and real-world use cases. Basic multimodal skills are internal abilities required to solve problems, such as learning interactions across modalities, fine-grained alignment, multi-step reasoning, and the ability to handle external knowledge. Information flow studies how multimodal content changes during a task through querying, translation, editing, and fusion. Use cases span domain-specific challenges introduced in real-world multimedia, affective computing, natural sciences, healthcare, and human-computer interaction applications. Through comprehensive experiments across the 30 tasks in HEMM, we (1) identify key dataset dimensions (e.g., basic skills, information flows, and use cases) that pose challenges to today's models, and (2) distill performance trends regarding how different modeling dimensions (e.g., scale, pre-training data, multimodal alignment, pre-training, and instruction tuning objectives) influence performance. Our conclusions regarding challenging multimodal interactions, use cases, and tasks requiring reasoning and external knowledge, the benefits of data and model scale, and the impacts of instruction tuning yield actionable insights for future work in multimodal foundation models.

Alzheimer's disease (AD) is a common neurodegenerative disease among the elderly. Early prediction and timely intervention of its prodromal stage, mild cognitive impairment (MCI), can decrease the risk of advancing to AD. Combining information from various modalities can significantly improve predictive accuracy. However, challenges such as missing data and heterogeneity across modalities complicate multimodal learning methods as adding more modalities can worsen these issues. Current multimodal fusion techniques often fail to adapt to the complexity of medical data, hindering the ability to identify relationships between modalities. To address these challenges, we propose an innovative multimodal approach for predicting MCI conversion, focusing specifically on the issues of missing positron emission tomography (PET) data and integrating diverse medical information. The proposed incomplete triple-modal MCI conversion prediction network is tailored for this purpose. Through the missing modal generation module, we synthesize the missing PET data from the magnetic resonance imaging and extract features using specifically designed encoders. We also develop a channel aggregation module and a triple-modal co-attention fusion module to reduce feature redundancy and achieve effective multimodal data fusion. Furthermore, we design a loss function to handle missing modality issues and align cross-modal features. These components collectively harness multimodal data to boost network performance. Experimental results on the ADNI1 and ADNI2 datasets show that our method significantly surpasses existing unimodal and other multimodal models. Our code is available at https://github.com/justinhxy/ITFC.

The advancement of Large Vision-Language Models (LVLMs) has propelled their application in the medical field. However, Medical LVLMs (Med-LVLMs) encounter factuality challenges due to modality misalignment, where the models prioritize textual knowledge over visual input, leading to hallucinations that contradict information in medical images. Previous attempts to enhance modality alignment in Med-LVLMs through preference optimization have inadequately mitigated clinical relevance in preference data, making these samples easily distinguishable and reducing alignment effectiveness. To address this challenge, we propose MMedPO, a novel multimodal medical preference optimization approach that considers the clinical relevance of preference samples to enhance Med-LVLM alignment. MMedPO curates multimodal preference data by introducing two types of dispreference: (1) plausible hallucinations injected through target Med-LVLMs or GPT-4o to produce medically inaccurate responses, and (2) lesion region neglect achieved through local lesion-noising, disrupting visual understanding of critical areas. We then calculate clinical relevance for each sample based on scores from multiple Med-LLMs and visual tools, and integrate these scores into the preference optimization process as weights, enabling effective alignment. Our experiments demonstrate that MMedPO significantly enhances factual accuracy in Med-LVLMs, achieving substantial improvements over existing preference optimization methods by averaging 14.2% and 51.7% across the Med-VQA and report generation tasks. Our code are available in https://github.com/aiming-lab/MMedPO.

Multimodal models have gained significant success in recent years. Standard multimodal approaches often assume unchanged modalities from training stage to inference stage. In practice, however, many scenarios fail to satisfy such assumptions with missing modalities during inference, leading to limitations on where multimodal models can be applied. While existing methods mitigate the problem through reconstructing the missing modalities, it increases unnecessary computational cost, which could be just as critical, especially for large, deployed systems. To solve the problem from both sides, we propose a novel guidance network that promotes knowledge sharing during training, taking advantage of the multimodal representations to train better single-modality models for inference. Real-life experiment in violence detection shows that our proposed framework trains single-modality models that significantly outperform its traditionally trained counterparts while maintaining the same inference cost.

Multimodal large language models (MLLMs) can simultaneously process visual, textual, and auditory data, capturing insights that complement human analysis. However, existing video question-answering (VidQA) benchmarks and datasets often exhibit a bias toward a single modality, despite the goal of requiring advanced reasoning skills that integrate diverse modalities to answer the queries. In this work, we introduce the modality importance score (MIS) to identify such bias. It is designed to assess which modality embeds the necessary information to answer the question. Additionally, we propose an innovative method using state-of-the-art MLLMs to estimate the modality importance, which can serve as a proxy for human judgments of modality perception. With this MIS, we demonstrate the presence of unimodal bias and the scarcity of genuinely multimodal questions in existing datasets. We further validate the modality importance score with multiple ablation studies to evaluate the performance of MLLMs on permuted feature sets. Our results indicate that current models do not effectively integrate information due to modality imbalance in existing datasets. Our proposed MLLM-derived MIS can guide the curation of modality-balanced datasets that advance multimodal learning and enhance MLLMs' capabilities to understand and utilize synergistic relations across modalities.

The field of computer vision applied to videos of minimally invasive surgery is ever-growing. Workflow recognition pertains to the automated recognition of various aspects of a surgery: including which surgical steps are performed; and which surgical instruments are used. This information can later be used to assist clinicians when learning the surgery; during live surgery; and when writing operation notes. The Pituitary Vision (PitVis) 2023 Challenge tasks the community to step and instrument recognition in videos of endoscopic pituitary surgery. This is a unique task when compared to other minimally invasive surgeries due to the smaller working space, which limits and distorts vision; and higher frequency of instrument and step switching, which requires more precise model predictions. Participants were provided with 25-videos, with results presented at the MICCAI-2023 conference as part of the Endoscopic Vision 2023 Challenge in Vancouver, Canada, on 08-Oct-2023. There were 18-submissions from 9-teams across 6-countries, using a variety of deep learning models. A commonality between the top performing models was incorporating spatio-temporal and multi-task methods, with greater than 50% and 10% macro-F1-score improvement over purely spacial single-task models in step and instrument recognition respectively. The PitVis-2023 Challenge therefore demonstrates state-of-the-art computer vision models in minimally invasive surgery are transferable to a new dataset, with surgery specific techniques used to enhance performance, progressing the field further. Benchmark results are provided in the paper, and the dataset is publicly available at: https://doi.org/10.5522/04/26531686.

Medicine is inherently multimodal, with rich data modalities spanning text, imaging, genomics, and more. Generalist biomedical artificial intelligence (AI) systems that flexibly encode, integrate, and interpret this data at scale can potentially enable impactful applications ranging from scientific discovery to care delivery. To enable the development of these models, we first curate MultiMedBench, a new multimodal biomedical benchmark. MultiMedBench encompasses 14 diverse tasks such as medical question answering, mammography and dermatology image interpretation, radiology report generation and summarization, and genomic variant calling. We then introduce Med-PaLM Multimodal (Med-PaLM M), our proof of concept for a generalist biomedical AI system. Med-PaLM M is a large multimodal generative model that flexibly encodes and interprets biomedical data including clinical language, imaging, and genomics with the same set of model weights. Med-PaLM M reaches performance competitive with or exceeding the state of the art on all MultiMedBench tasks, often surpassing specialist models by a wide margin. We also report examples of zero-shot generalization to novel medical concepts and tasks, positive transfer learning across tasks, and emergent zero-shot medical reasoning. To further probe the capabilities and limitations of Med-PaLM M, we conduct a radiologist evaluation of model-generated (and human) chest X-ray reports and observe encouraging performance across model scales. In a side-by-side ranking on 246 retrospective chest X-rays, clinicians express a pairwise preference for Med-PaLM M reports over those produced by radiologists in up to 40.50% of cases, suggesting potential clinical utility. While considerable work is needed to validate these models in real-world use cases, our results represent a milestone towards the development of generalist biomedical AI systems.

Machine learning systems are often deployed in domains that entail data from multiple modalities, for example, phenotypic and genotypic characteristics describe patients in healthcare. Previous works have developed multimodal variational autoencoders (VAEs) that generate several modalities. We consider subjective data, where single datapoints from one modality (such as class labels) describe multiple datapoints from another modality (such as images). We theoretically and empirically demonstrate that multimodal VAEs with a mixture of experts posterior can struggle to capture variability in such surjective data.

Cerebrovascular disease often requires multiple imaging modalities for accurate diagnosis, treatment, and monitoring. Computed Tomography Angiography (CTA) and Time-of-Flight Magnetic Resonance Angiography (TOF-MRA) are two common non-invasive angiography techniques, each with distinct strengths in accessibility, safety, and diagnostic accuracy. While CTA is more widely used in acute stroke due to its faster acquisition times and higher diagnostic accuracy, TOF-MRA is preferred for its safety, as it avoids radiation exposure and contrast agent-related health risks. Despite the predominant role of CTA in clinical workflows, there is a scarcity of open-source CTA data, limiting the research and development of AI models for tasks such as large vessel occlusion detection and aneurysm segmentation. This study explores diffusion-based image-to-image translation models to generate synthetic CTA images from TOF-MRA input. We demonstrate the modality conversion from TOF-MRA to CTA and show that diffusion models outperform a traditional U-Net-based approach. Our work compares different state-of-the-art diffusion architectures and samplers, offering recommendations for optimal model performance in this cross-modality translation task.

Due to the remarkable capabilities of powerful Large Language Models (LLMs) in effectively following instructions, there has been a growing number of assistants in the community to assist humans. Recently, significant progress has been made in the development of Vision Language Models (VLMs), expanding the capabilities of LLMs and enabling them to execute more diverse instructions. However, it is foreseeable that models will likely need to handle tasks involving additional modalities such as speech, video, and others. This poses a particularly prominent challenge of dealing with the complexity of mixed modalities. To address this, we introduce a novel architecture called PILL: Plug Into LLM with adapter expert and attention gate to better decouple these complex modalities and leverage efficient fine-tuning. We introduce two modules: Firstly, utilizing Mixture-of-Modality-Adapter-Expert to independently handle different modalities, enabling better adaptation to downstream tasks while preserving the expressive capability of the original model. Secondly, by introducing Modality-Attention-Gating, which enables adaptive control of the contribution of modality tokens to the overall representation. In addition, we have made improvements to the Adapter to enhance its learning and expressive capabilities. Experimental results demonstrate that our approach exhibits competitive performance compared to other mainstream methods for modality fusion. For researchers interested in our work, we provide free access to the code and models at https://github.com/DsaltYfish/PILL.

Color fundus photography and Optical Coherence Tomography (OCT) are the two most cost-effective tools for glaucoma screening. Both two modalities of images have prominent biomarkers to indicate glaucoma suspected. Clinically, it is often recommended to take both of the screenings for a more accurate and reliable diagnosis. However, although numerous algorithms are proposed based on fundus images or OCT volumes in computer-aided diagnosis, there are still few methods leveraging both of the modalities for the glaucoma assessment. Inspired by the success of Retinal Fundus Glaucoma Challenge (REFUGE) we held previously, we set up the Glaucoma grAding from Multi-Modality imAges (GAMMA) Challenge to encourage the development of fundus \& OCT-based glaucoma grading. The primary task of the challenge is to grade glaucoma from both the 2D fundus images and 3D OCT scanning volumes. As part of GAMMA, we have publicly released a glaucoma annotated dataset with both 2D fundus color photography and 3D OCT volumes, which is the first multi-modality dataset for glaucoma grading. In addition, an evaluation framework is also established to evaluate the performance of the submitted methods. During the challenge, 1272 results were submitted, and finally, top-10 teams were selected to the final stage. We analysis their results and summarize their methods in the paper. Since all these teams submitted their source code in the challenge, a detailed ablation study is also conducted to verify the effectiveness of the particular modules proposed. We find many of the proposed techniques are practical for the clinical diagnosis of glaucoma. As the first in-depth study of fundus \& OCT multi-modality glaucoma grading, we believe the GAMMA Challenge will be an essential starting point for future research.

Vision foundation models like DINOv2 demonstrate remarkable potential in medical imaging despite their origin in natural image domains. However, their design inherently works best for uni-modal image analysis, limiting their effectiveness for multi-modal imaging tasks that are common in many medical fields, such as neurology and oncology. While supervised models perform well in this setting, they fail to leverage unlabeled datasets and struggle with missing modalities, a frequent challenge in clinical settings. To bridge these gaps, we introduce MM-DINOv2, a novel and efficient framework that adapts the pre-trained vision foundation model DINOv2 for multi-modal medical imaging. Our approach incorporates multi-modal patch embeddings, enabling vision foundation models to effectively process multi-modal imaging data. To address missing modalities, we employ full-modality masking, which encourages the model to learn robust cross-modality relationships. Furthermore, we leverage semi-supervised learning to harness large unlabeled datasets, enhancing both the accuracy and reliability of medical predictions. Applied to glioma subtype classification from multi-sequence brain MRI, our method achieves a Matthews Correlation Coefficient (MCC) of 0.6 on an external test set, surpassing state-of-the-art supervised approaches by +11.1%. Our work establishes a scalable and robust solution for multi-modal medical imaging tasks, leveraging powerful vision foundation models pre-trained on natural images while addressing real-world clinical challenges such as missing data and limited annotations.

Multimodal learning is a rapidly growing research field that has revolutionized multitasking and generative modeling in AI. While much of the research has focused on dealing with unstructured data (e.g., language, images, audio, or video), structured data (e.g., tabular data, time series, or signals) has received less attention. However, many industry-relevant use cases involve or can be benefited from both types of data. In this work, we propose a modular, end-to-end multimodal learning method called MAGNUM, which can natively handle both structured and unstructured data. MAGNUM is flexible enough to employ any specialized unimodal module to extract, compress, and fuse information from all available modalities.

Computed Tomography (CT) is one of the most popular modalities for medical imaging. By far, CT images have contributed to the largest publicly available datasets for volumetric medical segmentation tasks, covering full-body anatomical structures. Large amounts of full-body CT images provide the opportunity to pre-train powerful models, e.g., STU-Net pre-trained in a supervised fashion, to segment numerous anatomical structures. However, it remains unclear in which conditions these pre-trained models can be transferred to various downstream medical segmentation tasks, particularly segmenting the other modalities and diverse targets. To address this problem, a large-scale benchmark for comprehensive evaluation is crucial for finding these conditions. Thus, we collected 87 public datasets varying in modality, target, and sample size to evaluate the transfer ability of full-body CT pre-trained models. We then employed a representative model, STU-Net with multiple model scales, to conduct transfer learning across modalities and targets. Our experimental results show that (1) there may be a bottleneck effect concerning the dataset size in fine-tuning, with more improvement on both small- and large-scale datasets than medium-size ones. (2) Models pre-trained on full-body CT demonstrate effective modality transfer, adapting well to other modalities such as MRI. (3) Pre-training on the full-body CT not only supports strong performance in structure detection but also shows efficacy in lesion detection, showcasing adaptability across target tasks. We hope that this large-scale open evaluation of transfer learning can direct future research in volumetric medical image segmentation.

Skin carcinoma is the most prevalent form of cancer globally, accounting for over $8 billion in annual healthcare expenditures. In clinical settings, physicians document patient visits using detailed SOAP (Subjective, Objective, Assessment, and Plan) notes. However, manually generating these notes is labor-intensive and contributes to clinician burnout. In this work, we propose a weakly supervised multimodal framework to generate clinically structured SOAP notes from limited inputs, including lesion images and sparse clinical text. Our approach reduces reliance on manual annotations, enabling scalable, clinically grounded documentation while alleviating clinician burden and reducing the need for large annotated data. Our method achieves performance comparable to GPT-4o, Claude, and DeepSeek Janus Pro across key clinical relevance metrics. To evaluate clinical quality, we introduce two novel metrics MedConceptEval and Clinical Coherence Score (CCS) which assess semantic alignment with expert medical concepts and input features, respectively.

In real-world scenarios, using multiple modalities like visible (RGB) and infrared (IR) can greatly improve the performance of a predictive task such as object detection (OD). Multimodal learning is a common way to leverage these modalities, where multiple modality-specific encoders and a fusion module are used to improve performance. In this paper, we tackle a different way to employ RGB and IR modalities, where only one modality or the other is observed by a single shared vision encoder. This realistic setting requires a lower memory footprint and is more suitable for applications such as autonomous driving and surveillance, which commonly rely on RGB and IR data. However, when learning a single encoder on multiple modalities, one modality can dominate the other, producing uneven recognition results. This work investigates how to efficiently leverage RGB and IR modalities to train a common transformer-based OD vision encoder, while countering the effects of modality imbalance. For this, we introduce a novel training technique to Mix Patches (MiPa) from the two modalities, in conjunction with a patch-wise modality agnostic module, for learning a common representation of both modalities. Our experiments show that MiPa can learn a representation to reach competitive results on traditional RGB/IR benchmarks while only requiring a single modality during inference. Our code is available at: https://github.com/heitorrapela/MiPa.

Histopathology and transcriptomics are fundamental modalities in oncology, encapsulating the morphological and molecular aspects of the disease. Multi-modal self-supervised learning has demonstrated remarkable potential in learning pathological representations by integrating diverse data sources. Conventional multi-modal integration methods primarily emphasize modality alignment, while paying insufficient attention to retaining the modality-specific structures. However, unlike conventional scenarios where multi-modal inputs share highly overlapping features, histopathology and transcriptomics exhibit pronounced heterogeneity, offering orthogonal yet complementary insights. Histopathology provides morphological and spatial context, elucidating tissue architecture and cellular topology, whereas transcriptomics delineates molecular signatures through gene expression patterns. This inherent disparity introduces a major challenge in aligning them while maintaining modality-specific fidelity. To address these challenges, we present MIRROR, a novel multi-modal representation learning method designed to foster both modality alignment and retention. MIRROR employs dedicated encoders to extract comprehensive features for each modality, which is further complemented by a modality alignment module to achieve seamless integration between phenotype patterns and molecular profiles. Furthermore, a modality retention module safeguards unique attributes from each modality, while a style clustering module mitigates redundancy and enhances disease-relevant information by modeling and aligning consistent pathological signatures within a clustering space. Extensive evaluations on TCGA cohorts for cancer subtyping and survival analysis highlight MIRROR's superior performance, demonstrating its effectiveness in constructing comprehensive oncological feature representations and benefiting the cancer diagnosis.

This study investigates self-supervised learning techniques to obtain representations of Event Sequences. It is a key modality in various applications, including but not limited to banking, e-commerce, and healthcare. We perform a comprehensive study of generative and contrastive approaches in self-supervised learning, applying them both independently. We find that there is no single supreme method. Consequently, we explore the potential benefits of combining these approaches. To achieve this goal, we introduce a novel method that aligns generative and contrastive embeddings as distinct modalities, drawing inspiration from contemporary multimodal research. Generative and contrastive approaches are often treated as mutually exclusive, leaving a gap for their combined exploration. Our results demonstrate that this aligned model performs at least on par with, and mostly surpasses, existing methods and is more universal across a variety of tasks. Furthermore, we demonstrate that self-supervised methods consistently outperform the supervised approach on our datasets.

We introduce OmnixR, an evaluation suite designed to benchmark SoTA Omni-modality Language Models, such as GPT-4o and Gemini. Evaluating OLMs, which integrate multiple modalities such as text, vision, and audio, presents unique challenges. Particularly, the user message might often consist of multiple modalities, such that OLMs have to establish holistic understanding and reasoning across modalities to accomplish the task. Existing benchmarks are limited to single modality or dual-modality tasks, overlooking comprehensive multi-modal assessments of model reasoning. To address this, OmnixR offers two evaluation variants: (1)synthetic subset: a synthetic dataset generated automatically by translating text into multiple modalities--audio, images, video, and hybrids (Omnify). (2)realistic subset: a real-world dataset, manually curated and annotated by experts, for evaluating cross-modal reasoning in natural settings. OmnixR presents a unique evaluation towards assessing OLMs over a diverse mix of modalities, such as a question that involves video, audio, and text, providing a rigorous cross-modal reasoning testbed unlike any existing benchmarks. Our experiments find that all state-of-the-art OLMs struggle with OmnixR questions that require integrating information from multiple modalities to answer. Further analysis highlights differences in reasoning behavior, underscoring the challenges of omni-modal AI alignment.

GRAFT is a structured multimodal benchmark for evaluating models on instruction-following, visual reasoning, and visual-textual alignment tasks. It features programmatically generated charts and synthetically rendered tables, created with Python visualization libraries to ensure control over data semantics, structure, and clarity. Each GRAFT instance pairs a chart or table image with a systematically generated, multi-step analytical question based solely on visual content. Answers are provided in structured formats such as JSON or YAML, supporting consistent evaluation of both reasoning and output format. The benchmark introduces a taxonomy of reasoning types including comparison, trend identification, ranking, aggregation, proportion estimation, and anomaly detection to enable comprehensive assessment. Reference answers follow strict factual and formatting guidelines for precise, aspect-based evaluation. GRAFT offers a unified, scalable framework for fine-grained benchmarking of multimodal models on visually grounded, structured reasoning tasks, setting a new evaluation standard in this field.

Multimodal Large Language Models have demonstrated impressive capabilities across tasks, yet they often exhibit difficulty in distinguishing task-relevant from irrelevant signals -- particularly in tasks like Visual Question Answering -- which can lead to susceptibility to misleading or spurious inputs. We refer to this broader limitation as the Cross-Modality Competency Problem -- the model's inability to fairly evaluate all modalities. This vulnerability becomes more evident in modality-specific tasks -- such as image classification or pure text question answering -- where models are expected to rely solely on one modality. In such tasks, spurious information from irrelevant modalities often leads to significant performance degradation. We refer to this failure as Modality Interference, which serves as a concrete and measurable instance of the cross-modality competency problem, and we further design a perturbation-based causal diagnostic experiment to verify and quantify this problem. To mitigate modality interference, we propose a novel framework to finetune MLLMs, including perturbation-based data augmentations with both heuristic perturbations and adversarial perturbations, and a consistency regularization strategy applying on model outputs with original and perturbed inputs. Experiments on multiple benchmark datasets (image-heavy, text-heavy and multimodal tasks) and multiple model families with different scales demonstrate significant improvements in robustness and cross-modality competency, indicating our method's effectiveness in boosting unimodal reasoning ability while enhancing performance on multimodal tasks.

Accessibility remains a critical concern in today's society, as many technologies are not developed to support the full range of user needs. Existing multi-agent systems (MAS) often cannot provide comprehensive assistance for users in need due to the lack of customization stemming from closed-source designs. Consequently, individuals with disabilities frequently encounter significant barriers when attempting to interact with digital environments. We introduce MATE, a multimodal accessibility MAS, which performs the modality conversions based on the user's needs. The system is useful for assisting people with disabilities by ensuring that data will be converted to an understandable format. For instance, if the user cannot see well and receives an image, the system converts this image to its audio description. MATE can be applied to a wide range of domains, industries, and areas, such as healthcare, and can become a useful assistant for various groups of users. The system supports multiple types of models, ranging from LLM API calling to using custom machine learning (ML) classifiers. This flexibility ensures that the system can be adapted to various needs and is compatible with a wide variety of hardware. Since the system is expected to run locally, it ensures the privacy and security of sensitive information. In addition, the framework can be effectively integrated with institutional technologies (e.g., digital healthcare service) for real-time user assistance. Furthermore, we introduce ModCon-Task-Identifier, a model that is capable of extracting the precise modality conversion task from the user input. Numerous experiments show that ModCon-Task-Identifier consistently outperforms other LLMs and statistical models on our custom data. Our code and data are publicly available at https://github.com/AlgazinovAleksandr/Multi-Agent-MATE.

Drug discovery typically consists of multiple steps, including identifying a target protein key to a disease's etiology, validating that interacting with this target could prevent symptoms or cure the disease, discovering a small molecule or biologic therapeutic to interact with it, and optimizing the candidate molecule through a complex landscape of required properties. Drug discovery related tasks often involve prediction and generation while considering multiple entities that potentially interact, which poses a challenge for typical AI models. For this purpose we present MAMMAL - Molecular Aligned Multi-Modal Architecture and Language - a method that we applied to create a versatile multi-task foundation model ibm/biomed.omics.bl.sm.ma-ted-458m that learns from large-scale biological datasets (2 billion samples) across diverse modalities, including proteins, small molecules, and genes. We introduce a prompt syntax that supports a wide range of classification, regression, and generation tasks. It allows combining different modalities and entity types as inputs and/or outputs. Our model handles combinations of tokens and scalars and enables the generation of small molecules and proteins, property prediction, and transcriptomic lab test predictions. We evaluated the model on 11 diverse downstream tasks spanning different steps within a typical drug discovery pipeline, where it reaches new SOTA in 9 tasks and is comparable to SOTA in 2 tasks. This performance is achieved while using a unified architecture serving all tasks, in contrast to the original SOTA performance achieved using tailored architectures. The model code and pretrained weights are publicly available at https://github.com/BiomedSciAI/biomed-multi-alignment and https://huggingface.co/ibm/biomed.omics.bl.sm.ma-ted-458m.

Artificial Intelligence (AI) has demonstrated significant potential in healthcare, particularly in disease diagnosis and treatment planning. Recent progress in Medical Large Vision-Language Models (Med-LVLMs) has opened up new possibilities for interactive diagnostic tools. However, these models often suffer from factual hallucination, which can lead to incorrect diagnoses. Fine-tuning and retrieval-augmented generation (RAG) have emerged as methods to address these issues. However, the amount of high-quality data and distribution shifts between training data and deployment data limit the application of fine-tuning methods. Although RAG is lightweight and effective, existing RAG-based approaches are not sufficiently general to different medical domains and can potentially cause misalignment issues, both between modalities and between the model and the ground truth. In this paper, we propose a versatile multimodal RAG system, MMed-RAG, designed to enhance the factuality of Med-LVLMs. Our approach introduces a domain-aware retrieval mechanism, an adaptive retrieved contexts selection method, and a provable RAG-based preference fine-tuning strategy. These innovations make the RAG process sufficiently general and reliable, significantly improving alignment when introducing retrieved contexts. Experimental results across five medical datasets (involving radiology, ophthalmology, pathology) on medical VQA and report generation demonstrate that MMed-RAG can achieve an average improvement of 43.8% in the factual accuracy of Med-LVLMs. Our data and code are available in https://github.com/richard-peng-xia/MMed-RAG.

Medical diagnostic applications require models that can process multimodal medical inputs (images, patient histories, lab results) and generate diverse outputs including both textual reports and visual content (annotations, segmentation masks, and images). Despite this need, existing medical AI systems disrupt this unified process: medical image understanding models interpret images but cannot generate visual outputs, while medical image generation models synthesize images but cannot provide textual explanations. This leads to gaps in data representation, feature integration, and task-level multimodal capabilities. To this end, we propose a multi-level framework that draws inspiration from diagnostic workflows through the Observation-Knowledge-Analysis (OKA) paradigm. Specifically, at the observation level, we construct UniMed-5M, a dataset comprising over 5.6M samples that reformat diverse unimodal data into multimodal pairs for foundational observation. At the knowledge level, we propose Progressive Curriculum Learning that systematically introduces medical multimodal knowledge. At the analysis level, we introduce UniMedVL, the first medical unified multimodal model for the simultaneous analysis of image understanding and generation tasks within a single architecture. UniMedVL achieves superior performance on five medical image understanding benchmarks, while matching specialized models in generation quality across eight medical imaging modalities. Crucially, our unified architecture enables bidirectional knowledge sharing: generation tasks enhance visual understanding features, demonstrating that integrating traditionally separate capabilities within a single medical framework unlocks improvements across diverse medical vision-language tasks. Code is available at https://github.com/uni-medical/UniMedVL.

In this work, we introduce Multiple Embedding Model for EHR (MEME), an approach that views Electronic Health Records (EHR) as multimodal data. This approach incorporates "pseudo-notes", textual representations of tabular EHR concepts such as diagnoses and medications, and allows us to effectively employ Large Language Models (LLMs) for EHR representation. This framework also adopts a multimodal approach, embedding each EHR modality separately. We demonstrate the effectiveness of MEME by applying it to several tasks within the Emergency Department across multiple hospital systems. Our findings show that MEME surpasses the performance of both single modality embedding methods and traditional machine learning approaches. However, we also observe notable limitations in generalizability across hospital institutions for all tested models.

Clinical diagnosis of the eye is performed over multifarious data modalities including scalar clinical labels, vectorized biomarkers, two-dimensional fundus images, and three-dimensional Optical Coherence Tomography (OCT) scans. Clinical practitioners use all available data modalities for diagnosing and treating eye diseases like Diabetic Retinopathy (DR) or Diabetic Macular Edema (DME). Enabling usage of machine learning algorithms within the ophthalmic medical domain requires research into the relationships and interactions between all relevant data over a treatment period. Existing datasets are limited in that they neither provide data nor consider the explicit relationship modeling between the data modalities. In this paper, we introduce the Ophthalmic Labels for Investigating Visual Eye Semantics (OLIVES) dataset that addresses the above limitation. This is the first OCT and near-IR fundus dataset that includes clinical labels, biomarker labels, disease labels, and time-series patient treatment information from associated clinical trials. The dataset consists of 1268 near-IR fundus images each with at least 49 OCT scans, and 16 biomarkers, along with 4 clinical labels and a disease diagnosis of DR or DME. In total, there are 96 eyes' data averaged over a period of at least two years with each eye treated for an average of 66 weeks and 7 injections. We benchmark the utility of OLIVES dataset for ophthalmic data as well as provide benchmarks and concrete research directions for core and emerging machine learning paradigms within medical image analysis.

Surgical practice involves complex visual interpretation, procedural skills, and advanced medical knowledge, making surgical vision-language pretraining (VLP) particularly challenging due to this complexity and the limited availability of annotated data. To address the gap, we propose OphCLIP, a hierarchical retrieval-augmented vision-language pretraining framework specifically designed for ophthalmic surgical workflow understanding. OphCLIP leverages the OphVL dataset we constructed, a large-scale and comprehensive collection of over 375K hierarchically structured video-text pairs with tens of thousands of different combinations of attributes (surgeries, phases/operations/actions, instruments, medications, as well as more advanced aspects like the causes of eye diseases, surgical objectives, and postoperative recovery recommendations, etc). These hierarchical video-text correspondences enable OphCLIP to learn both fine-grained and long-term visual representations by aligning short video clips with detailed narrative descriptions and full videos with structured titles, capturing intricate surgical details and high-level procedural insights, respectively. Our OphCLIP also designs a retrieval-augmented pretraining framework to leverage the underexplored large-scale silent surgical procedure videos, automatically retrieving semantically relevant content to enhance the representation learning of narrative videos. Evaluation across 11 datasets for phase recognition and multi-instrument identification shows OphCLIP's robust generalization and superior performance.

In medical vision, different imaging modalities provide complementary information. However, in practice, not all modalities may be available during inference or even training. Previous approaches, e.g., knowledge distillation or image synthesis, often assume the availability of full modalities for all patients during training; this is unrealistic and impractical due to the variability in data collection across sites. We propose a novel approach to learn enhanced modality-agnostic representations by employing a meta-learning strategy in training, even when only limited full modality samples are available. Meta-learning enhances partial modality representations to full modality representations by meta-training on partial modality data and meta-testing on limited full modality samples. Additionally, we co-supervise this feature enrichment by introducing an auxiliary adversarial learning branch. More specifically, a missing modality detector is used as a discriminator to mimic the full modality setting. Our segmentation framework significantly outperforms state-of-the-art brain tumor segmentation techniques in missing modality scenarios.

In this paper, we propose a multi-modal search engine for interior design that combines visual and textual queries. The goal of our engine is to retrieve interior objects, e.g. furniture or wall clocks, that share visual and aesthetic similarities with the query. Our search engine allows the user to take a photo of a room and retrieve with a high recall a list of items identical or visually similar to those present in the photo. Additionally, it allows to return other items that aesthetically and stylistically fit well together. To achieve this goal, our system blends the results obtained using textual and visual modalities. Thanks to this blending strategy, we increase the average style similarity score of the retrieved items by 11%. Our work is implemented as a Web-based application and it is planned to be opened to the public.

One important challenge of applying deep learning to electronic health records (EHR) is the complexity of their multimodal structure. EHR usually contains a mixture of structured (codes) and unstructured (free-text) data with sparse and irregular longitudinal features -- all of which doctors utilize when making decisions. In the deep learning regime, determining how different modality representations should be fused together is a difficult problem, which is often addressed by handcrafted modeling and intuition. In this work, we extend state-of-the-art neural architecture search (NAS) methods and propose MUltimodal Fusion Architecture SeArch (MUFASA) to simultaneously search across multimodal fusion strategies and modality-specific architectures for the first time. We demonstrate empirically that our MUFASA method outperforms established unimodal NAS on public EHR data with comparable computation costs. In addition, MUFASA produces architectures that outperform Transformer and Evolved Transformer. Compared with these baselines on CCS diagnosis code prediction, our discovered models improve top-5 recall from 0.88 to 0.91 and demonstrate the ability to generalize to other EHR tasks. Studying our top architecture in depth, we provide empirical evidence that MUFASA's improvements are derived from its ability to both customize modeling for each data modality and find effective fusion strategies.

Large Language Models (LLMs), primarily trained on text-based datasets, exhibit exceptional proficiencies in understanding and executing complex linguistic instructions via text outputs. However, they falter when requests to generate non-text ones. Concurrently, modality conversion models, such as text-to-image, despite generating high-quality images, suffer from a lack of extensive textual pretraining. As a result, these models are only capable of accommodating specific image descriptions rather than comprehending more complex instructions. To bridge this gap, we propose a novel approach, \methodname, from a modality conversion perspective that evolves a text-based LLM into a multi-modal one. We specifically employ a minimal dataset to instruct LLMs to recognize the intended output modality as directed by the instructions. Consequently, the adapted LLM can effectively summon various off-the-shelf modality conversion models from the model zoos to generate non-text responses. This circumvents the necessity for complicated pretraining that typically requires immense quantities of paired multi-modal data, while simultaneously inheriting the extensive knowledge of LLMs and the ability of high-quality generative models. To evaluate and compare the adapted multi-modal LLM with its traditional counterparts, we have constructed a multi-modal instruction benchmark that solicits diverse modality outputs. The experiment results reveal that, with minimal training, LLMs can be conveniently adapted to comprehend requests for non-text responses, thus achieving higher flexibility in multi-modal scenarios. Code and data will be made available at https://github.com/xinke-wang/SwitchGPT.

Endoscopic procedures are essential for diagnosing and treating internal diseases, and multi-modal large language models (MLLMs) are increasingly applied to assist in endoscopy analysis. However, current benchmarks are limited, as they typically cover specific endoscopic scenarios and a small set of clinical tasks, failing to capture the real-world diversity of endoscopic scenarios and the full range of skills needed in clinical workflows. To address these issues, we introduce EndoBench, the first comprehensive benchmark specifically designed to assess MLLMs across the full spectrum of endoscopic practice with multi-dimensional capacities. EndoBench encompasses 4 distinct endoscopic scenarios, 12 specialized clinical tasks with 12 secondary subtasks, and 5 levels of visual prompting granularities, resulting in 6,832 rigorously validated VQA pairs from 21 diverse datasets. Our multi-dimensional evaluation framework mirrors the clinical workflow--spanning anatomical recognition, lesion analysis, spatial localization, and surgical operations--to holistically gauge the perceptual and diagnostic abilities of MLLMs in realistic scenarios. We benchmark 23 state-of-the-art models, including general-purpose, medical-specialized, and proprietary MLLMs, and establish human clinician performance as a reference standard. Our extensive experiments reveal: (1) proprietary MLLMs outperform open-source and medical-specialized models overall, but still trail human experts; (2) medical-domain supervised fine-tuning substantially boosts task-specific accuracy; and (3) model performance remains sensitive to prompt format and clinical task complexity. EndoBench establishes a new standard for evaluating and advancing MLLMs in endoscopy, highlighting both progress and persistent gaps between current models and expert clinical reasoning. We publicly release our benchmark and code.

Accurate and interpretable multi-disease diagnosis remains a critical challenge in medical research, particularly when leveraging heterogeneous multimodal medical data. Current approaches often rely on single-modal data, limiting their ability to comprehensively understand complex diseases. To address this, we propose MedTVT-R1, a novel Multimodal Large Language Model (MLLM) framework designed to integrate clinical multimodal data for reasoning and diagnosing multiple diseases. We construct MedTVT-QA, a curated instruction dataset that provides question-answer pairs for physiological-level interpretations and disease-level diagnoses with a Chain of Evidence approach. MedTVT-R1 incorporates a modality perception layer to capture inter-modal dependencies and adaptively weight modality contributions. Additionally, we employ Group Relative Policy Optimization (GRPO)-based Reinforcement Fine-Tuning with a Jaccard Reward function to enhance diagnostic reasoning. Experimental results demonstrate MedTVT-R1's superiority in multimodal feature utilization and multi-disease diagnosis, offering significant potential for clinical applications such as diagnostic report generation and comorbidity reasoning. The dataset and code are available at https://github.com/keke-nice/MedTVT-R1.

Reinforcement learning from human feedback (RLHF) has proven effective in enhancing the instruction-following capabilities of large language models; however, it remains underexplored in the cross-modality domain. As the number of modalities increases, aligning all-modality models with human intentions -- such as instruction following -- becomes a pressing challenge. In this work, we make the first attempt to fine-tune all-modality models (i.e. input and output with any modality, also named any-to-any models) using human preference data across all modalities (including text, image, audio, and video), ensuring its behavior aligns with human intentions. This endeavor presents several challenges. First, there is no large-scale all-modality human preference data in existing open-source resources, as most datasets are limited to specific modalities, predominantly text and image. Secondly, the effectiveness of binary preferences in RLHF for post-training alignment in complex all-modality scenarios remains an unexplored area. Finally, there is a lack of a systematic framework to evaluate the capabilities of all-modality models, particularly regarding modality selection and synergy. To address these challenges, we propose the align-anything framework, which includes meticulously annotated 200k all-modality human preference data. Then, we introduce an alignment method that learns from unified language feedback, effectively capturing complex modality-specific human preferences and enhancing the model's instruction-following capabilities. Furthermore, to assess performance improvements in all-modality models after post-training alignment, we construct a challenging all-modality capability evaluation framework -- eval-anything. All data, models, and code frameworks have been open-sourced for the community. For more details, please refer to https://github.com/PKU-Alignment/align-anything.

Multimodal magnetic resonance imaging (MRI) constitutes the first line of investigation for clinicians in the care of brain tumors, providing crucial insights for surgery planning, treatment monitoring, and biomarker identification. Pre-training on large datasets have been shown to help models learn transferable representations and adapt with minimal labeled data. This behavior is especially valuable in medical imaging, where annotations are often scarce. However, applying this paradigm to multimodal medical data introduces a challenge: most existing approaches assume that all imaging modalities are available during both pre-training and fine-tuning. In practice, missing modalities often occur due to acquisition issues, specialist unavailability, or specific experimental designs on small in-house datasets. Consequently, a common approach involves training a separate model for each desired modality combination, making the process both resource-intensive and impractical for clinical use. Therefore, we introduce BM-MAE, a masked image modeling pre-training strategy tailored for multimodal MRI data. The same pre-trained model seamlessly adapts to any combination of available modalities, extracting rich representations that capture both intra- and inter-modal information. This allows fine-tuning on any subset of modalities without requiring architectural changes, while still benefiting from a model pre-trained on the full set of modalities. Extensive experiments show that the proposed pre-training strategy outperforms or remains competitive with baselines that require separate pre-training for each modality subset, while substantially surpassing training from scratch on several downstream tasks. Additionally, it can quickly and efficiently reconstruct missing modalities, highlighting its practical value. Code and trained models are available at: https://github.com/Lucas-rbnt/BM-MAE

Information retrieval is an ever-evolving and crucial research domain. The substantial demand for high-quality human motion data especially in online acquirement has led to a surge in human motion research works. Prior works have mainly concentrated on dual-modality learning, such as text and motion tasks, but three-modality learning has been rarely explored. Intuitively, an extra introduced modality can enrich a model's application scenario, and more importantly, an adequate choice of the extra modality can also act as an intermediary and enhance the alignment between the other two disparate modalities. In this work, we introduce LAVIMO (LAnguage-VIdeo-MOtion alignment), a novel framework for three-modality learning integrating human-centric videos as an additional modality, thereby effectively bridging the gap between text and motion. Moreover, our approach leverages a specially designed attention mechanism to foster enhanced alignment and synergistic effects among text, video, and motion modalities. Empirically, our results on the HumanML3D and KIT-ML datasets show that LAVIMO achieves state-of-the-art performance in various motion-related cross-modal retrieval tasks, including text-to-motion, motion-to-text, video-to-motion and motion-to-video.

We introduce X-VILA, an omni-modality model designed to extend the capabilities of large language models (LLMs) by incorporating image, video, and audio modalities. By aligning modality-specific encoders with LLM inputs and diffusion decoders with LLM outputs, X-VILA achieves cross-modality understanding, reasoning, and generation. To facilitate this cross-modality alignment, we curate an effective interleaved any-to-any modality instruction-following dataset. Furthermore, we identify a significant problem with the current cross-modality alignment method, which results in visual information loss. To address the issue, we propose a visual alignment mechanism with a visual embedding highway module. We then introduce a resource-efficient recipe for training X-VILA, that exhibits proficiency in any-to-any modality conversation, surpassing previous approaches by large margins. X-VILA also showcases emergent properties across modalities even in the absence of similar training data. The project will be made open-source.

Medicine, by its nature, is a multifaceted domain that requires the synthesis of information across various modalities. Medical generative vision-language models (VLMs) make a first step in this direction and promise many exciting clinical applications. However, existing models typically have to be fine-tuned on sizeable down-stream datasets, which poses a significant limitation as in many medical applications data is scarce, necessitating models that are capable of learning from few examples in real-time. Here we propose Med-Flamingo, a multimodal few-shot learner adapted to the medical domain. Based on OpenFlamingo-9B, we continue pre-training on paired and interleaved medical image-text data from publications and textbooks. Med-Flamingo unlocks few-shot generative medical visual question answering (VQA) abilities, which we evaluate on several datasets including a novel challenging open-ended VQA dataset of visual USMLE-style problems. Furthermore, we conduct the first human evaluation for generative medical VQA where physicians review the problems and blinded generations in an interactive app. Med-Flamingo improves performance in generative medical VQA by up to 20\% in clinician's rating and firstly enables multimodal medical few-shot adaptations, such as rationale generation. We release our model, code, and evaluation app under https://github.com/snap-stanford/med-flamingo.

Several medical Multimodal Large Languange Models (MLLMs) have been developed to address tasks involving visual images with textual instructions across various medical modalities, achieving impressive results. Most current medical generalist models are region-agnostic, treating the entire image as a holistic representation. However, they struggle to identify which specific regions they are focusing on when generating a sentence. To mimic the behavior of doctors, who typically begin by reviewing the entire image before concentrating on specific regions for a thorough evaluation, we aim to enhance the capability of medical MLLMs in understanding anatomical regions within entire medical scans. To achieve it, we first formulate Region-Centric tasks and construct a large-scale dataset, MedRegInstruct, to incorporate regional information into training. Combining our collected dataset with other medical multimodal corpora for training, we propose a Region-Aware medical MLLM, MedRegA, which is the first bilingual generalist medical AI system to simultaneously handle image-level and region-level medical vision-language tasks across a broad range of modalities. Our MedRegA not only enables three region-centric tasks, but also achieves the best performance for visual question answering, report generation and medical image classification over 8 modalities, showcasing significant versatility. Experiments demonstrate that our model can not only accomplish powerful performance across various medical vision-language tasks in bilingual settings, but also recognize and detect structures in multimodal medical scans, boosting the interpretability and user interactivity of medical MLLMs. Our project page is https://medrega.github.io.

The automated generation of imaging reports proves invaluable in alleviating the workload of radiologists. A clinically applicable reports generation algorithm should demonstrate its effectiveness in producing reports that accurately describe radiology findings and attend to patient-specific indications. In this paper, we introduce a novel method, Structural Entities extraction and patient indications Incorporation (SEI) for chest X-ray report generation. Specifically, we employ a structural entities extraction (SEE) approach to eliminate presentation-style vocabulary in reports and improve the quality of factual entity sequences. This reduces the noise in the following cross-modal alignment module by aligning X-ray images with factual entity sequences in reports, thereby enhancing the precision of cross-modal alignment and further aiding the model in gradient-free retrieval of similar historical cases. Subsequently, we propose a cross-modal fusion network to integrate information from X-ray images, similar historical cases, and patient-specific indications. This process allows the text decoder to attend to discriminative features of X-ray images, assimilate historical diagnostic information from similar cases, and understand the examination intention of patients. This, in turn, assists in triggering the text decoder to produce high-quality reports. Experiments conducted on MIMIC-CXR validate the superiority of SEI over state-of-the-art approaches on both natural language generation and clinical efficacy metrics.

Learning from multiple modalities, such as audio and video, offers opportunities for leveraging complementary information, enhancing robustness, and improving contextual understanding and performance. However, combining such modalities presents challenges, especially when modalities differ in data structure, predictive contribution, and the complexity of their learning processes. It has been observed that one modality can potentially dominate the learning process, hindering the effective utilization of information from other modalities and leading to sub-optimal model performance. To address this issue the vast majority of previous works suggest to assess the unimodal contributions and dynamically adjust the training to equalize them. We improve upon previous work by introducing a multi-loss objective and further refining the balancing process, allowing it to dynamically adjust the learning pace of each modality in both directions, acceleration and deceleration, with the ability to phase out balancing effects upon convergence. We achieve superior results across three audio-video datasets: on CREMA-D, models with ResNet backbone encoders surpass the previous best by 1.9% to 12.4%, and Conformer backbone models deliver improvements ranging from 2.8% to 14.1% across different fusion methods. On AVE, improvements range from 2.7% to 7.7%, while on UCF101, gains reach up to 6.1%.

Multimodal large language models (MLLMs) recently showed strong capacity in integrating data among multiple modalities, empowered by a generalizable attention architecture. Advanced methods predominantly focus on language-centric tuning while less exploring multimodal tokens mixed through attention, posing challenges in high-level tasks that require fine-grained cognition and emotion understanding. In this work, we identify the attention deficit disorder problem in multimodal learning, caused by inconsistent cross-modal attention and layer-by-layer decayed attention activation. To address this, we propose a novel attention mechanism, termed MOdular Duplex Attention (MODA), simultaneously conducting the inner-modal refinement and inter-modal interaction. MODA employs a correct-after-align strategy to effectively decouple modality alignment from cross-layer token mixing. In the alignment phase, tokens are mapped to duplex modality spaces based on the basis vectors, enabling the interaction between visual and language modality. Further, the correctness of attention scores is ensured through adaptive masked attention, which enhances the model's flexibility by allowing customizable masking patterns for different modalities. Extensive experiments on 21 benchmark datasets verify the effectiveness of MODA in perception, cognition, and emotion tasks. Source code and demo are available in https://zzcheng.top/MODA.

Pain is a complex and pervasive condition that affects a significant portion of the population. Accurate and consistent assessment is essential for individuals suffering from pain, as well as for developing effective management strategies in a healthcare system. Automatic pain assessment systems enable continuous monitoring, support clinical decision-making, and help minimize patient distress while mitigating the risk of functional deterioration. Leveraging physiological signals offers objective and precise insights into a person's state, and their integration in a multimodal framework can further enhance system performance. This study has been submitted to the Second Multimodal Sensing Grand Challenge for Next-Gen Pain Assessment (AI4PAIN). The proposed approach introduces Tiny-BioMoE, a lightweight pretrained embedding model for biosignal analysis. Trained on 4.4 million biosignal image representations and consisting of only 7.3 million parameters, it serves as an effective tool for extracting high-quality embeddings for downstream tasks. Extensive experiments involving electrodermal activity, blood volume pulse, respiratory signals, peripheral oxygen saturation, and their combinations highlight the model's effectiveness across diverse modalities in automatic pain recognition tasks. The model's architecture (code) and weights are available at https://github.com/GkikasStefanos/Tiny-BioMoE.

Medical image grounding aims to align natural language phrases with specific regions in medical images, serving as a foundational task for intelligent diagnosis, visual question answering (VQA), and automated report generation (MRG). However, existing research is constrained by limited modality coverage, coarse-grained annotations, and the absence of a unified, generalizable grounding framework. To address these challenges, we construct a large-scale medical grounding dataset Med-GLIP-5M comprising over 5.3 million region-level annotations across seven imaging modalities, covering diverse anatomical structures and pathological findings. The dataset supports both segmentation and grounding tasks with hierarchical region labels, ranging from organ-level boundaries to fine-grained lesions. Based on this foundation, we propose Med-GLIP, a modality-aware grounding framework trained on Med-GLIP-5M. Rather than relying on explicitly designed expert modules, Med-GLIP implicitly acquires hierarchical semantic understanding from diverse training data -- enabling it to recognize multi-granularity structures, such as distinguishing lungs from pneumonia lesions. Extensive experiments demonstrate that Med-GLIP consistently outperforms state-of-the-art baselines across multiple grounding benchmarks. Furthermore, integrating its spatial outputs into downstream tasks, including medical VQA and report generation, leads to substantial performance gains. Our dataset will be released soon.

In this paper, we introduce a novel Multi-Modal Contrastive Pre-training Framework that synergistically combines X-rays, electrocardiograms (ECGs), and radiology/cardiology reports. Our approach leverages transformers to encode these diverse modalities into a unified representation space, aiming to enhance diagnostic accuracy and facilitate comprehensive patient assessments. We utilize LoRA-Peft to significantly reduce trainable parameters in the LLM and incorporate recent linear attention dropping strategy in the Vision Transformer(ViT) for smoother attention. Furthermore, we provide novel multimodal attention explanations and retrieval for our model. To the best of our knowledge, we are the first to propose an integrated model that combines X-ray, ECG, and Radiology/Cardiology Report with this approach. By utilizing contrastive loss, MoRE effectively aligns modality-specific features into a coherent embedding, which supports various downstream tasks such as zero-shot classification and multimodal retrieval. Employing our proposed methodology, we achieve state-of-the-art (SOTA) on the Mimic-IV, CheXpert, Edema Severity, and PtbXl downstream datasets, surpassing existing multimodal approaches. Our proposed framework shows significant improvements in capturing intricate inter-modal relationships and its robustness in medical diagnosis that establishes a framework for future research in multimodal learning in the healthcare sector.

Computed tomography and magnetic resonance imaging are two widely used clinical imaging modalities for non-invasive diagnosis. However, both of these modalities come with certain problems. CT uses harmful ionising radiation, and MRI suffers from slow acquisition speed. Both problems can be tackled by undersampling, such as sparse sampling. However, such undersampled data leads to lower resolution and introduces artefacts. Several techniques, including deep learning based methods, have been proposed to reconstruct such data. However, the undersampled reconstruction problem for these two modalities was always considered as two different problems and tackled separately by different research works. This paper proposes a unified solution for both sparse CT and undersampled radial MRI reconstruction, achieved by applying Fourier transform-based pre-processing on the radial MRI and then finally reconstructing both modalities using sinogram upsampling combined with filtered back-projection. The Primal-Dual network is a deep learning based method for reconstructing sparsely-sampled CT data. This paper introduces Primal-Dual UNet, which improves the Primal-Dual network in terms of accuracy and reconstruction speed. The proposed method resulted in an average SSIM of 0.932\textpm0.021 while performing sparse CT reconstruction for fan-beam geometry with a sparsity level of 16, achieving a statistically significant improvement over the previous model, which resulted in 0.919\textpm0.016. Furthermore, the proposed model resulted in 0.903\textpm0.019 and 0.957\textpm0.023 average SSIM while reconstructing undersampled brain and abdominal MRI data with an acceleration factor of 16, respectively - statistically significant improvements over the original model, which resulted in 0.867\textpm0.025 and 0.949\textpm0.025.

Multimodal large language models (MLLMs) promise enhanced reasoning by integrating diverse inputs such as text, vision, and audio. Yet cross-modal reasoning remains underexplored, with conflicting reports on whether added modalities help or harm performance. These inconsistencies stem from a lack of controlled evaluation frameworks and analysis of models' internals to isolate when and why modality interactions support or undermine reasoning. We address this gap through a logic-grounded evaluation framework that categorizes multimodal reasoning into six interaction patterns, varying how facts are distributed across modalities and logically combined. Empirically, additional modalities enhance reasoning only when they provide independent and sufficient reasoning paths, while redundant or chained entailment support often hurts performance. Moreover, reasoning degrades in three systematic ways: weaker modalities drag down overall performance, conflicts bias preference toward certain modalities, and joint signals from different modalities fail to be integrated effectively. Therefore, we identify two core failures: task-composition bottleneck, where recognition and reasoning cannot be jointly executed in one pass, and fusion bottleneck, where early integration introduces bias. For further investigation, we find that attention patterns fail to encode fact usefulness, but a simple two-step prompting (recognize then reason) restores performance, confirming the task-composition bottleneck. Moreover, modality identity remains recoverable in early layers, and softening attention in early fusion improves reasoning, highlighting biased fusion as another failure mode. Overall, our findings show that integration, not perception, is the main barrier to multimodal reasoning, suggesting composition-aware training and early fusion control as promising directions.

The multifaceted nature of human perception and comprehension indicates that, when we think, our body can naturally take any combination of senses, a.k.a., modalities and form a beautiful picture in our brain. For example, when we see a cattery and simultaneously perceive the cat's purring sound, our brain can construct a picture of a cat in the cattery. Intuitively, generative AI models should hold the versatility of humans and be capable of generating images from any combination of modalities efficiently and collaboratively. This paper presents ImgAny, a novel end-to-end multi-modal generative model that can mimic human reasoning and generate high-quality images. Our method serves as the first attempt in its capacity of efficiently and flexibly taking any combination of seven modalities, ranging from language, audio to vision modalities, including image, point cloud, thermal, depth, and event data. Our key idea is inspired by human-level cognitive processes and involves the integration and harmonization of multiple input modalities at both the entity and attribute levels without specific tuning across modalities. Accordingly, our method brings two novel training-free technical branches: 1) Entity Fusion Branch ensures the coherence between inputs and outputs. It extracts entity features from the multi-modal representations powered by our specially constructed entity knowledge graph; 2) Attribute Fusion Branch adeptly preserves and processes the attributes. It efficiently amalgamates distinct attributes from diverse input modalities via our proposed attribute knowledge graph. Lastly, the entity and attribute features are adaptively fused as the conditional inputs to the pre-trained Stable Diffusion model for image generation. Extensive experiments under diverse modality combinations demonstrate its exceptional capability for visual content creation.

Multimodal large language models (MLLMs) have demonstrated promising prospects in healthcare, particularly for addressing complex medical tasks, supporting multidisciplinary treatment (MDT), and enabling personalized precision medicine. However, their practical deployment faces critical challenges in resource efficiency, diagnostic accuracy, clinical considerations, and ethical privacy. To address these limitations, we propose Infi-Med, a comprehensive framework for medical MLLMs that introduces three key innovations: (1) a resource-efficient approach through curating and constructing high-quality supervised fine-tuning (SFT) datasets with minimal sample requirements, with a forward-looking design that extends to both pretraining and posttraining phases; (2) enhanced multimodal reasoning capabilities for cross-modal integration and clinical task understanding; and (3) a systematic evaluation system that assesses model performance across medical modalities and task types. Our experiments demonstrate that Infi-Med achieves state-of-the-art (SOTA) performance in general medical reasoning while maintaining rapid adaptability to clinical scenarios. The framework establishes a solid foundation for deploying MLLMs in real-world healthcare settings by balancing model effectiveness with operational constraints.

Medical Visual Language Models have shown great potential in various healthcare applications, including medical image captioning and diagnostic assistance. However, most existing models rely on text-based instructions, limiting their usability in real-world clinical environments especially in scenarios such as surgery, text-based interaction is often impractical for physicians. In addition, current medical image analysis models typically lack comprehensive reasoning behind their predictions, which reduces their reliability for clinical decision-making. Given that medical diagnosis errors can have life-changing consequences, there is a critical need for interpretable and rational medical assistance. To address these challenges, we introduce an end-to-end speech-driven medical VLM, SilVar-Med, a multimodal medical image assistant that integrates speech interaction with VLMs, pioneering the task of voice-based communication for medical image analysis. In addition, we focus on the interpretation of the reasoning behind each prediction of medical abnormalities with a proposed reasoning dataset. Through extensive experiments, we demonstrate a proof-of-concept study for reasoning-driven medical image interpretation with end-to-end speech interaction. We believe this work will advance the field of medical AI by fostering more transparent, interactive, and clinically viable diagnostic support systems. Our code and dataset are publicly available at SiVar-Med.

Conditional inference on joint textual and visual clues is a multi-modal reasoning task that textual clues provide prior permutation or external knowledge, which are complementary with visual content and pivotal to deducing the correct option. Previous methods utilizing pretrained vision-language models (VLMs) have achieved impressive performances, yet they show a lack of multimodal context reasoning capability, especially for text-modal information. To address this issue, we propose a Multi-modal Context Reasoning approach, named ModCR. Compared to VLMs performing reasoning via cross modal semantic alignment, it regards the given textual abstract semantic and objective image information as the pre-context information and embeds them into the language model to perform context reasoning. Different from recent vision-aided language models used in natural language processing, ModCR incorporates the multi-view semantic alignment information between language and vision by introducing the learnable alignment prefix between image and text in the pretrained language model. This makes the language model well-suitable for such multi-modal reasoning scenario on joint textual and visual clues. We conduct extensive experiments on two corresponding data sets and experimental results show significantly improved performance (exact gain by 4.8% on PMR test set) compared to previous strong baselines. Code Link: https://github.com/YunxinLi/Multimodal-Context-Reasoning.

How do we most effectively treat a disease or condition? Ideally, we could consult a database of evidence gleaned from clinical trials to answer such questions. Unfortunately, no such database exists; clinical trial results are instead disseminated primarily via lengthy natural language articles. Perusing all such articles would be prohibitively time-consuming for healthcare practitioners; they instead tend to depend on manually compiled systematic reviews of medical literature to inform care. NLP may speed this process up, and eventually facilitate immediate consult of published evidence. The Evidence Inference dataset was recently released to facilitate research toward this end. This task entails inferring the comparative performance of two treatments, with respect to a given outcome, from a particular article (describing a clinical trial) and identifying supporting evidence. For instance: Does this article report that chemotherapy performed better than surgery for five-year survival rates of operable cancers? In this paper, we collect additional annotations to expand the Evidence Inference dataset by 25\%, provide stronger baseline models, systematically inspect the errors that these make, and probe dataset quality. We also release an abstract only (as opposed to full-texts) version of the task for rapid model prototyping. The updated corpus, documentation, and code for new baselines and evaluations are available at http://evidence-inference.ebm-nlp.com/.

We present Composable Diffusion (CoDi), a novel generative model capable of generating any combination of output modalities, such as language, image, video, or audio, from any combination of input modalities. Unlike existing generative AI systems, CoDi can generate multiple modalities in parallel and its input is not limited to a subset of modalities like text or image. Despite the absence of training datasets for many combinations of modalities, we propose to align modalities in both the input and output space. This allows CoDi to freely condition on any input combination and generate any group of modalities, even if they are not present in the training data. CoDi employs a novel composable generation strategy which involves building a shared multimodal space by bridging alignment in the diffusion process, enabling the synchronized generation of intertwined modalities, such as temporally aligned video and audio. Highly customizable and flexible, CoDi achieves strong joint-modality generation quality, and outperforms or is on par with the unimodal state-of-the-art for single-modality synthesis. The project page with demonstrations and code is at https://codi-gen.github.io

The proliferation of Large Language Models (LLMs) in medicine has enabled impressive capabilities, yet a critical gap remains in their ability to perform systematic, transparent, and verifiable reasoning, a cornerstone of clinical practice. This has catalyzed a shift from single-step answer generation to the development of LLMs explicitly designed for medical reasoning. This paper provides the first systematic review of this emerging field. We propose a taxonomy of reasoning enhancement techniques, categorized into training-time strategies (e.g., supervised fine-tuning, reinforcement learning) and test-time mechanisms (e.g., prompt engineering, multi-agent systems). We analyze how these techniques are applied across different data modalities (text, image, code) and in key clinical applications such as diagnosis, education, and treatment planning. Furthermore, we survey the evolution of evaluation benchmarks from simple accuracy metrics to sophisticated assessments of reasoning quality and visual interpretability. Based on an analysis of 60 seminal studies from 2022-2025, we conclude by identifying critical challenges, including the faithfulness-plausibility gap and the need for native multimodal reasoning, and outlining future directions toward building efficient, robust, and sociotechnically responsible medical AI.

Multimodal large language models (MLLMs) hold significant potential in the medical field, but their capabilities are often limited by insufficient data in certain medical domains, highlighting the need for understanding what kinds of images can be used by MLLMs for generalization. Current research suggests that multi-task training outperforms single-task as different tasks can benefit each other, but they often overlook the internal relationships within these tasks, providing limited guidance on selecting datasets to enhance specific tasks. To analyze this phenomenon, we attempted to employ compositional generalization (CG)-the ability of models to understand novel combinations by recombining learned elements-as a guiding framework. Since medical images can be precisely defined by Modality, Anatomical area, and Task, naturally providing an environment for exploring CG. Therefore, we assembled 106 medical datasets to create Med-MAT for comprehensive experiments. The experiments confirmed that MLLMs can use CG to understand unseen medical images and identified CG as one of the main drivers of the generalization observed in multi-task training. Additionally, further studies demonstrated that CG effectively supports datasets with limited data and delivers consistent performance across different backbones, highlighting its versatility and broad applicability. Med-MAT is publicly available at https://github.com/FreedomIntelligence/Med-MAT.

In the era of modern healthcare, swiftly generating medical question summaries is crucial for informed and timely patient care. Despite the increasing complexity and volume of medical data, existing studies have focused solely on text-based summarization, neglecting the integration of visual information. Recognizing the untapped potential of combining textual queries with visual representations of medical conditions, we introduce the Multimodal Medical Question Summarization (MMQS) Dataset. This dataset, a major contribution to our work, pairs medical queries with visual aids, facilitating a richer and more nuanced understanding of patient needs. We also propose a framework, utilizing the power of Contrastive Language Image Pretraining(CLIP) and Large Language Models(LLMs), consisting of four modules that identify medical disorders, generate relevant context, filter medical concepts, and craft visually aware summaries. Our comprehensive framework harnesses the power of CLIP, a multimodal foundation model, and various general-purpose LLMs, comprising four main modules: the medical disorder identification module, the relevant context generation module, the context filtration module for distilling relevant medical concepts and knowledge, and finally, a general-purpose LLM to generate visually aware medical question summaries. Leveraging our MMQS dataset, we showcase how visual cues from images enhance the generation of medically nuanced summaries. This multimodal approach not only enhances the decision-making process in healthcare but also fosters a more nuanced understanding of patient queries, laying the groundwork for future research in personalized and responsive medical care

Multimodal learning seeks to combine data from multiple input sources to enhance the performance of different downstream tasks. In real-world scenarios, performance can degrade substantially if some input modalities are missing. Existing methods that can handle missing modalities involve custom training or adaptation steps for each input modality combination. These approaches are either tied to specific modalities or become computationally expensive as the number of input modalities increases. In this paper, we propose Masked Modality Projection (MMP), a method designed to train a single model that is robust to any missing modality scenario. We achieve this by randomly masking a subset of modalities during training and learning to project available input modalities to estimate the tokens for the masked modalities. This approach enables the model to effectively learn to leverage the information from the available modalities to compensate for the missing ones, enhancing missing modality robustness. We conduct a series of experiments with various baseline models and datasets to assess the effectiveness of this strategy. Experiments demonstrate that our approach improves robustness to different missing modality scenarios, outperforming existing methods designed for missing modalities or specific modality combinations.

Motivated by in-context learning (ICL) capabilities of Large Language models (LLMs), multimodal LLMs with additional visual modality are also exhibited with similar ICL abilities when multiple image-text pairs are provided as demonstrations. However, relatively less work has been done to investigate the principles behind how and why multimodal ICL works. We conduct a systematic and principled evaluation of multimodal ICL for models of different scales on a broad spectrum of new yet critical tasks. Through perturbations over different modality information, we show that modalities matter differently across tasks in multimodal ICL. Considering such modality impact, we further utilize modality-driven demonstration strategies to boost ICL performance. We also identify that demonstration selection is closely related to the models' ability to capture task inductive biases from multimodal ICL. Our principled analysis provides a comprehensive way of understanding the role of demonstrations in multimodal in-context learning, and sheds light on effectively improving multimodal ICL on a wide range of tasks even if those tasks are not seen in or even contradict pretraining data.

Retrieval augmented generation (RAG) has shown great power in improving Large Language Models (LLMs). However, most existing RAG-based LLMs are dedicated to retrieving single modality information, mainly text; while for many real-world problems, such as healthcare, information relevant to queries can manifest in various modalities such as knowledge graph, text (clinical notes), and complex molecular structure. Thus, being able to retrieve relevant multi-modality domain-specific information, and reason and synthesize diverse knowledge to generate an accurate response is important. To address the gap, we present BioMol-MQA, a new question-answering (QA) dataset on polypharmacy, which is composed of two parts (i) a multimodal knowledge graph (KG) with text and molecular structure for information retrieval; and (ii) challenging questions that designed to test LLM capabilities in retrieving and reasoning over multimodal KG to answer questions. Our benchmarks indicate that existing LLMs struggle to answer these questions and do well only when given the necessary background data, signaling the necessity for strong RAG frameworks.

Standard multi-modal models assume the use of the same modalities in training and inference stages. However, in practice, the environment in which multi-modal models operate may not satisfy such assumption. As such, their performances degrade drastically if any modality is missing in the inference stage. We ask: how can we train a model that is robust to missing modalities? This paper seeks a set of good practices for multi-modal action recognition, with a particular interest in circumstances where some modalities are not available at an inference time. First, we study how to effectively regularize the model during training (e.g., data augmentation). Second, we investigate on fusion methods for robustness to missing modalities: we find that transformer-based fusion shows better robustness for missing modality than summation or concatenation. Third, we propose a simple modular network, ActionMAE, which learns missing modality predictive coding by randomly dropping modality features and tries to reconstruct them with the remaining modality features. Coupling these good practices, we build a model that is not only effective in multi-modal action recognition but also robust to modality missing. Our model achieves the state-of-the-arts on multiple benchmarks and maintains competitive performances even in missing modality scenarios. Codes are available at https://github.com/sangminwoo/ActionMAE.

Human perception integrates multiple modalities, such as vision, hearing, and language, into a unified understanding of the surrounding reality. While recent multimodal models have achieved significant progress by aligning pairs of modalities via contrastive learning, their solutions are unsuitable when scaling to multiple modalities. These models typically align each modality to a designated anchor without ensuring the alignment of all modalities with each other, leading to suboptimal performance in tasks requiring a joint understanding of multiple modalities. In this paper, we structurally rethink the pairwise conventional approach to multimodal learning and we present the novel Gramian Representation Alignment Measure (GRAM), which overcomes the above-mentioned limitations. GRAM learns and then aligns n modalities directly in the higher-dimensional space in which modality embeddings lie by minimizing the Gramian volume of the k-dimensional parallelotope spanned by the modality vectors, ensuring the geometric alignment of all modalities simultaneously. GRAM can replace cosine similarity in any downstream method, holding for 2 to n modalities and providing more meaningful alignment with respect to previous similarity measures. The novel GRAM-based contrastive loss function enhances the alignment of multimodal models in the higher-dimensional embedding space, leading to new state-of-the-art performance in downstream tasks such as video-audio-text retrieval and audio-video classification. The project page, the code, and the pretrained models are available at https://ispamm.github.io/GRAM/.

Recent advancements in multimodal large language models (MLLMs) have aimed to integrate and interpret data across diverse modalities. However, the capacity of these models to concurrently process and reason about multiple modalities remains inadequately explored, partly due to the lack of comprehensive modality-wise benchmarks. We introduce OmniBench, a novel benchmark designed to rigorously evaluate models' ability to recognize, interpret, and reason across visual, acoustic, and textual inputs simultaneously. We define models capable of such tri-modal processing as omni-language models (OLMs). OmniBench is distinguished by high-quality human annotations, ensuring that accurate responses require integrated understanding and reasoning across all three modalities. Our main findings reveal that: i) open-source OLMs exhibit critical limitations in instruction-following and reasoning capabilities within tri-modal contexts; and ii) the baseline models perform poorly (below 50% accuracy) even when provided with alternative textual representations of images and audio. These results suggest that the ability to construct a consistent context from text, image, and audio is often overlooked in existing MLLM training paradigms. We advocate for future research to focus on developing more robust tri-modal integration techniques and training strategies to enhance OLM performance across diverse modalities. The codes and live leaderboard could be found at https://m-a-p.ai/OmniBench.

Vanilla image completion approaches exhibit sensitivity to large missing regions, attributed to the limited availability of reference information for plausible generation. To mitigate this, existing methods incorporate the extra cue as a guidance for image completion. Despite improvements, these approaches are often restricted to employing a single modality (e.g., segmentation or sketch maps), which lacks scalability in leveraging multi-modality for more plausible completion. In this paper, we propose a novel, simple yet effective method for Multi-modal Guided Image Completion, dubbed MaGIC, which not only supports a wide range of single modality as the guidance (e.g., text, canny edge, sketch, segmentation, depth, and pose), but also adapts to arbitrarily customized combination of these modalities (i.e., arbitrary multi-modality) for image completion. For building MaGIC, we first introduce a modality-specific conditional U-Net (MCU-Net) that injects single-modal signal into a U-Net denoiser for single-modal guided image completion. Then, we devise a consistent modality blending (CMB) method to leverage modality signals encoded in multiple learned MCU-Nets through gradient guidance in latent space. Our CMB is training-free, thereby avoids the cumbersome joint re-training of different modalities, which is the secret of MaGIC to achieve exceptional flexibility in accommodating new modalities for completion. Experiments show the superiority of MaGIC over state-of-the-art methods and its generalization to various completion tasks. Our project with code and models is available at yeates.github.io/MaGIC-Page/.

The ability to provide fine-grained control for generating and editing visual imagery has profound implications for computer vision and its applications. Previous works have explored extending controllability in two directions: instruction tuning with text-based prompts and multi-modal conditioning. However, these works make one or more unnatural assumptions on the number and/or type of modality inputs used to express controllability. We propose InstructAny2Pix, a flexible multi-modal instruction-following system that enables users to edit an input image using instructions involving audio, images, and text. InstructAny2Pix consists of three building blocks that facilitate this capability: a multi-modal encoder that encodes different modalities such as images and audio into a unified latent space, a diffusion model that learns to decode representations in this latent space into images, and a multi-modal LLM that can understand instructions involving multiple images and audio pieces and generate a conditional embedding of the desired output, which can be used by the diffusion decoder. Additionally, to facilitate training efficiency and improve generation quality, we include an additional refinement prior module that enhances the visual quality of LLM outputs. These designs are critical to the performance of our system. We demonstrate that our system can perform a series of novel instruction-guided editing tasks. The code is available at https://github.com/jacklishufan/InstructAny2Pix.git

Extracting causal relationships from observed correlations is a growing area in probabilistic reasoning, originating with the seminal work of Pearl and others from the early 1990s. This paper develops a new, categorically oriented view based on a clear distinction between syntax (string diagrams) and semantics (stochastic matrices), connected via interpretations as structure-preserving functors. A key notion in the identification of causal effects is that of an intervention, whereby a variable is forcefully set to a particular value independent of any prior propensities. We represent the effect of such an intervention as an endofunctor which performs `string diagram surgery' within the syntactic category of string diagrams. This diagram surgery in turn yields a new, interventional distribution via the interpretation functor. While in general there is no way to compute interventional distributions purely from observed data, we show that this is possible in certain special cases using a calculational tool called comb disintegration. We demonstrate the use of this technique on a well-known toy example, where we predict the causal effect of smoking on cancer in the presence of a confounding common cause. After developing this specific example, we show this technique provides simple sufficient conditions for computing interventions which apply to a wide variety of situations considered in the causal inference literature.

Operating rooms (ORs) are complex, high-stakes environments requiring precise understanding of interactions among medical staff, tools, and equipment for enhancing surgical assistance, situational awareness, and patient safety. Current datasets fall short in scale, realism and do not capture the multimodal nature of OR scenes, limiting progress in OR modeling. To this end, we introduce MM-OR, a realistic and large-scale multimodal spatiotemporal OR dataset, and the first dataset to enable multimodal scene graph generation. MM-OR captures comprehensive OR scenes containing RGB-D data, detail views, audio, speech transcripts, robotic logs, and tracking data and is annotated with panoptic segmentations, semantic scene graphs, and downstream task labels. Further, we propose MM2SG, the first multimodal large vision-language model for scene graph generation, and through extensive experiments, demonstrate its ability to effectively leverage multimodal inputs. Together, MM-OR and MM2SG establish a new benchmark for holistic OR understanding, and open the path towards multimodal scene analysis in complex, high-stakes environments. Our code, and data is available at https://github.com/egeozsoy/MM-OR.

We address a challenging and practical task of labeling questions in speech in real time during telephone calls to emergency medical services in English, which embeds within a broader decision support system for emergency call-takers. We propose a novel multimodal approach to real-time sequence labeling in speech. Our model treats speech and its own textual representation as two separate modalities or views, as it jointly learns from streamed audio and its noisy transcription into text via automatic speech recognition. Our results show significant gains of jointly learning from the two modalities when compared to text or audio only, under adverse noise and limited volume of training data. The results generalize to medical symptoms detection where we observe a similar pattern of improvements with multimodal learning.

Multimodal reasoning is a challenging task that requires models to reason across multiple modalities to answer questions. Existing approaches have made progress by incorporating language and visual modalities into a two-stage reasoning framework, separating rationale generation from answer inference. However, these approaches often fall short due to the inadequate quality of the generated rationales. In this work, we delve into the importance of rationales in model reasoning. We observe that when rationales are completely accurate, the model's accuracy significantly improves, highlighting the need for high-quality rationale generation. Motivated by this, we propose MC-CoT, a self-consistency training strategy that generates multiple rationales and answers, subsequently selecting the most accurate through a voting process. This approach not only enhances the quality of generated rationales but also leads to more accurate and robust answers. Through extensive experiments, we demonstrate that our approach significantly improves model performance across various benchmarks. Remarkably, we show that even smaller base models, when equipped with our proposed approach, can achieve results comparable to those of larger models, illustrating the potential of our approach in harnessing the power of rationales for improved multimodal reasoning. The code is available at https://github.com/chengtan9907/mc-cot.

Building an intelligent and efficient medical assistant is still a challenging AI problem. The major limitation comes from the data modality scarceness, which reduces comprehensive patient perception. This demo paper presents the GigaPevt, the first multimodal medical assistant that combines the dialog capabilities of large language models with specialized medical models. Such an approach shows immediate advantages in dialog quality and metric performance, with a 1.18% accuracy improvement in the question-answering task.

Leveraging information across diverse modalities is known to enhance performance on multimodal segmentation tasks. However, effectively fusing information from different modalities remains challenging due to the unique characteristics of each modality. In this paper, we propose a novel fusion strategy that can effectively fuse information from different modality combinations. We also propose a new model named Multi-Modal Segmentation TransFormer (MMSFormer) that incorporates the proposed fusion strategy to perform multimodal material and semantic segmentation tasks. MMSFormer outperforms current state-of-the-art models on three different datasets. As we begin with only one input modality, performance improves progressively as additional modalities are incorporated, showcasing the effectiveness of the fusion block in combining useful information from diverse input modalities. Ablation studies show that different modules in the fusion block are crucial for overall model performance. Furthermore, our ablation studies also highlight the capacity of different input modalities to improve performance in the identification of different types of materials. The code and pretrained models will be made available at https://github.com/csiplab/MMSFormer.

Developing reliable AI systems to assist human clinicians in multi-modal medical diagnosis has long been a key objective for researchers. Recently, Multi-modal Large Language Models (MLLMs) have gained significant attention and achieved success across various domains. With strong reasoning capabilities and the ability to perform diverse tasks based on user instructions, they hold great potential for enhancing medical diagnosis. However, directly applying MLLMs to the medical domain still presents challenges. They lack detailed perception of visual inputs, limiting their ability to perform quantitative image analysis, which is crucial for medical diagnostics. Additionally, MLLMs often exhibit hallucinations and inconsistencies in reasoning, whereas clinical diagnoses must adhere strictly to established criteria. To address these challenges, we propose MedAgent-Pro, an evidence-based reasoning agentic system designed to achieve reliable, explainable, and precise medical diagnoses. This is accomplished through a hierarchical workflow: at the task level, knowledge-based reasoning generate reliable diagnostic plans for specific diseases following retrieved clinical criteria. While at the case level, multiple tool agents process multi-modal inputs, analyze different indicators according to the plan, and provide a final diagnosis based on both quantitative and qualitative evidence. Comprehensive experiments on both 2D and 3D medical diagnosis tasks demonstrate the superiority and effectiveness of MedAgent-Pro, while case studies further highlight its reliability and interpretability. The code is available at https://github.com/jinlab-imvr/MedAgent-Pro.

Online medical consultation (OMC) restricts doctors to gathering patient information solely through inquiries, making the already complex sequential decision-making process of diagnosis even more challenging. Recently, the rapid advancement of large language models has demonstrated a significant potential to transform OMC. However, most studies have primarily focused on improving diagnostic accuracy under conditions of relatively sufficient information, while paying limited attention to the "inquiry" phase of the consultation process. This lack of focus has left the relationship between "inquiry" and "diagnosis" insufficiently explored. In this paper, we first extract real patient interaction strategies from authentic doctor-patient conversations and use these strategies to guide the training of a patient simulator that closely mirrors real-world behavior. By inputting medical records into our patient simulator to simulate patient responses, we conduct extensive experiments to explore the relationship between "inquiry" and "diagnosis" in the consultation process. Experimental results demonstrate that inquiry and diagnosis adhere to the Liebig's law: poor inquiry quality limits the effectiveness of diagnosis, regardless of diagnostic capability, and vice versa. Furthermore, the experiments reveal significant differences in the inquiry performance of various models. To investigate this phenomenon, we categorize the inquiry process into four types: (1) chief complaint inquiry; (2) specification of known symptoms; (3) inquiry about accompanying symptoms; and (4) gathering family or medical history. We analyze the distribution of inquiries across the four types for different models to explore the reasons behind their significant performance differences. We plan to open-source the weights and related code of our patient simulator at https://github.com/LIO-H-ZEN/PatientSimulator.

Textual health records of cancer patients are usually protracted and highly unstructured, making it very time-consuming for health professionals to get a complete overview of the patient's therapeutic course. As such limitations can lead to suboptimal and/or inefficient treatment procedures, healthcare providers would greatly benefit from a system that effectively summarizes the information of those records. With the advent of deep neural models, this objective has been partially attained for English clinical texts, however, the research community still lacks an effective solution for languages with limited resources. In this paper, we present the approach we developed to extract procedures, drugs, and diseases from oncology health records written in European Portuguese. This project was conducted in collaboration with the Portuguese Institute for Oncology which, besides holding over 10 years of duly protected medical records, also provided oncologist expertise throughout the development of the project. Since there is no annotated corpus for biomedical entity extraction in Portuguese, we also present the strategy we followed in annotating the corpus for the development of the models. The final models, which combined a neural architecture with entity linking, achieved F_1 scores of 88.6, 95.0, and 55.8 per cent in the mention extraction of procedures, drugs, and diseases, respectively.

Evaluating the truthfulness of online content is critical for combating misinformation. This study examines the efficiency and effectiveness of crowdsourced truthfulness assessments through a comparative analysis of two approaches: one involving full-length webpages as evidence for each claim, and another using summaries for each evidence document generated with a large language model. Using an A/B testing setting, we engage a diverse pool of participants tasked with evaluating the truthfulness of statements under these conditions. Our analysis explores both the quality of assessments and the behavioral patterns of participants. The results reveal that relying on summarized evidence offers comparable accuracy and error metrics to the Standard modality while significantly improving efficiency. Workers in the Summary setting complete a significantly higher number of assessments, reducing task duration and costs. Additionally, the Summary modality maximizes internal agreement and maintains consistent reliance on and perceived usefulness of evidence, demonstrating its potential to streamline large-scale truthfulness evaluations.

Recent advances in generative medical models are constrained by modality-specific scenarios that hinder the integration of complementary evidence from imaging, pathology, and clinical notes. This fragmentation limits their evolution into foundation models that can learn and reason across the full spectrum of biomedical data. We propose MeDiM, the first medical discrete diffusion model that learns shared distributions across modalities without modality-specific components. MeDiM unifies multiple generative tasks: translating between images and text, and jointly producing image-report pairs across domains in response to prompts. Built on a discrete diffusion framework, MeDiM bridges vision and language representations through a shared probabilistic space. To enable unified and flexible medical generation, we employ a multimodal large language model (MLLM) as the diffusion backbone, leveraging its prior knowledge and cross-modal reasoning. Two key designs are introduced: (1) removing the causal attention mask for bidirectional context, and (2) injecting continuous timestep embeddings for diffusion awareness. Experiments demonstrate high-fidelity medical generation (FID 16.60 on MIMIC-CXR and FID 24.19 on PathGen) and accurate report generation (METEOR 0.2650 and 0.2580). Jointly generated image-report pairs further enhance downstream performance (plus6.43 percent BLEU-1, plus18.57 percent BLEU-2, plus31.58 percent BLEU-3, plus4.80 percent METEOR), showing that MeDiM supports coherent and clinically grounded multimodal outputs.

In an effort to create a more efficient AI system, we introduce a new multi-modality learning framework that leverages a modality-agnostic concept space possessing abstract knowledge and a set of modality-specific projection models tailored to process distinct modality inputs and map them onto the concept space. Decoupled from specific modalities and their associated projection models, the concept space focuses on learning abstract knowledge that is universally applicable across modalities. Subsequently, the knowledge embedded into the concept space streamlines the learning processes of modality-specific projection models. We evaluate our framework on two popular tasks: Image-Text Matching and Visual Question Answering. Our framework achieves performance on par with benchmark models while demonstrating more efficient learning curves.

Remarkable strides in computational pathology have been made in the task-agnostic foundation model that advances the performance of a wide array of downstream clinical tasks. Despite the promising performance, there are still several challenges. First, prior works have resorted to either vision-only or image-caption data, disregarding pathology reports with more clinically authentic information from pathologists and gene expression profiles which respectively offer distinct knowledge for versatile clinical applications. Second, the current progress in pathology FMs predominantly concentrates on the patch level, where the restricted context of patch-level pretraining fails to capture whole-slide patterns. Even recent slide-level FMs still struggle to provide whole-slide context for patch representation. In this study, for the first time, we develop a pathology foundation model incorporating three levels of modalities: pathology slides, pathology reports, and gene expression data, which resulted in 26,169 slide-level modality pairs from 10,275 patients across 32 cancer types, amounting to over 116 million pathological patch images. To leverage these data for CPath, we propose a novel whole-slide pretraining paradigm that injects the multimodal whole-slide context into the patch representation, called Multimodal Self-TAught PRetraining (mSTAR). The proposed paradigm revolutionizes the pretraining workflow for CPath, enabling the pathology FM to acquire the whole-slide context. To the best of our knowledge, this is the first attempt to incorporate three modalities at the whole-slide context for enhancing pathology FMs. To systematically evaluate the capabilities of mSTAR, we built the largest spectrum of oncological benchmark, spanning 7 categories of oncological applications in 15 types of 97 practical oncological tasks.

Clinical diagnosis is critical in medical practice, typically requiring a continuous and evolving process that includes primary diagnosis, differential diagnosis, and final diagnosis. However, most existing clinical diagnostic tasks are single-step processes, which does not align with the complex multi-step diagnostic procedures found in real-world clinical settings. In this paper, we propose a multi-step diagnostic task and annotate a clinical diagnostic dataset (MSDiagnosis). This dataset includes primary diagnosis, differential diagnosis, and final diagnosis questions. Additionally, we propose a novel and effective framework. This framework combines forward inference, backward inference, reflection, and refinement, enabling the LLM to self-evaluate and adjust its diagnostic results. To assess the effectiveness of our proposed method, we design and conduct extensive experiments. The experimental results demonstrate the effectiveness of the proposed method. We also provide a comprehensive experimental analysis and suggest future research directions for this task.

We investigate how both the adaptation of a generic foundation model via transfer learning and the integration of complementary modalities from the operating room (OR) can support surgical data science. To this end, we use V-JEPA as the single-modality foundation of a multimodal model for minimally invasive surgery support. We analyze how the model's downstream performance can benefit (a) from finetuning on unlabeled surgical video data and (b) from providing additional time-resolved data streams from the OR in a multimodal setup. In an in-house dataset of liver surgery videos, we analyze the tasks of predicting hospital length of stay and postoperative complications. In videos of the public HeiCo dataset, we analyze the task of surgical phase recognition. As a baseline, we apply pretrained V-JEPA to all tasks. We then finetune it on unlabeled, held-out videos to investigate its change in performance after domain adaptation. Following the idea of modular decision support networks, we integrate additional data streams from the OR by training a separate encoder to form a shared representation space with V-JEPA's embeddings. Our experiments show that finetuning on domain-specific data increases model performance. On the in-house data, integrating additional time-resolved data likewise benefits the model. On the HeiCo data, accuracy of the pretrained video-only, single-modality baseline setup is on par with the top-performing submissions of the EndoVis2017 challenge, while finetuning on domain-specific data increases accuracy further. Our results thus demonstrate how surgical data science can leverage public, generic foundation models. Likewise, they indicate the potential of domain adaptation and of integrating suitable complementary data streams from the OR. To support further research, we release our code and model weights at https://github.com/DigitalSurgeryLab-Basel/ML-CDS-2025.

Recent advances in Multimodal Large Language Models (MLLMs) have shown promising results in integrating diverse modalities such as texts and images. MLLMs are heavily influenced by modality bias, often relying on language while under-utilizing other modalities like visual inputs. This position paper argues that MLLMs are deeply affected by modality bias. Firstly, we diagnose the current state of modality bias, highlighting its manifestations across various tasks. Secondly, we propose a systematic research road-map related to modality bias in MLLMs. Thirdly, we identify key factors of modality bias in MLLMs and offer actionable suggestions for future research to mitigate it. To substantiate these findings, we conduct experiments that demonstrate the influence of each factor: 1. Data Characteristics: Language data is compact and abstract, while visual data is redundant and complex, creating an inherent imbalance in learning dynamics. 2. Imbalanced Backbone Capabilities: The dominance of pretrained language models in MLLMs leads to overreliance on language and neglect of visual information. 3. Training Objectives: Current objectives often fail to promote balanced cross-modal alignment, resulting in shortcut learning biased toward language. These findings highlight the need for balanced training strategies and model architectures to better integrate multiple modalities in MLLMs. We call for interdisciplinary efforts to tackle these challenges and drive innovation in MLLM research. Our work provides a fresh perspective on modality bias in MLLMs and offers insights for developing more robust and generalizable multimodal systems-advancing progress toward Artificial General Intelligence.

Videos serve as a powerful medium to convey ideas, tell stories, and provide detailed instructions, especially through long-format tutorials. Such tutorials are valuable for learning new skills at one's own pace, yet they can be overwhelming due to their length and dense content. Viewers often seek specific information, like precise measurements or step-by-step execution details, making it essential to extract and summarize key segments efficiently. An intelligent, time-sensitive video assistant capable of summarizing and detecting highlights in long videos is highly sought after. Recent advancements in Multimodal Large Language Models offer promising solutions to develop such an assistant. Our research explores the use of multimodal models to enhance video summarization and step-by-step instruction generation within specific domains. These models need to understand temporal events and relationships among actions across video frames. Our approach focuses on fine-tuning TimeChat to improve its performance in specific domains: cooking and medical procedures. By training the model on domain-specific datasets like Tasty for cooking and MedVidQA for medical procedures, we aim to enhance its ability to generate concise, accurate summaries of instructional videos. We curate and restructure these datasets to create high-quality video-centric instruction data. Our findings indicate that when finetuned on domain-specific procedural data, TimeChat can significantly improve the extraction and summarization of key instructional steps in long-format videos. This research demonstrates the potential of specialized multimodal models to assist with practical tasks by providing personalized, step-by-step guidance tailored to the unique aspects of each domain.

Recent advancements in large multimodal models (LMMs) have significantly enhanced performance across diverse tasks, with ongoing efforts to further integrate additional modalities such as video and audio. However, most existing LMMs remain vulnerable to hallucinations, the discrepancy between the factual multimodal input and the generated textual output, which has limited their applicability in various real-world scenarios. This paper presents the first systematic investigation of hallucinations in LMMs involving the three most common modalities: language, visual, and audio. Our study reveals two key contributors to hallucinations: overreliance on unimodal priors and spurious inter-modality correlations. To address these challenges, we introduce the benchmark The Curse of Multi-Modalities (CMM), which comprehensively evaluates hallucinations in LMMs, providing a detailed analysis of their underlying issues. Our findings highlight key vulnerabilities, including imbalances in modality integration and biases from training data, underscoring the need for balanced cross-modal learning and enhanced hallucination mitigation strategies. Based on our observations and findings, we suggest potential research directions that could enhance the reliability of LMMs.

We introduce Radiology-GPT, a large language model for radiology. Using an instruction tuning approach on an extensive dataset of radiology domain knowledge, Radiology-GPT demonstrates superior performance compared to general language models such as StableLM, Dolly and LLaMA. It exhibits significant versatility in radiological diagnosis, research, and communication. This work serves as a catalyst for future developments in clinical NLP. The successful implementation of Radiology-GPT is indicative of the potential of localizing generative large language models, specifically tailored for distinctive medical specialties, while ensuring adherence to privacy standards such as HIPAA. The prospect of developing individualized, large-scale language models that cater to specific needs of various hospitals presents a promising direction. The fusion of conversational competence and domain-specific knowledge in these models is set to foster future development in healthcare AI. A demo of Radiology-GPT is available at https://huggingface.co/spaces/allen-eric/radiology-gpt.

Medical vision-and-language pre-training (Med-VLP) has received considerable attention owing to its applicability to extracting generic vision-and-language representations from medical images and texts. Most existing methods mainly contain three elements: uni-modal encoders (i.e., a vision encoder and a language encoder), a multi-modal fusion module, and pretext tasks, with few studies considering the importance of medical domain expert knowledge and explicitly exploiting such knowledge to facilitate Med-VLP. Although there exist knowledge-enhanced vision-and-language pre-training (VLP) methods in the general domain, most require off-the-shelf toolkits (e.g., object detectors and scene graph parsers), which are unavailable in the medical domain. In this paper, we propose a systematic and effective approach to enhance Med-VLP by structured medical knowledge from three perspectives. First, considering knowledge can be regarded as the intermediate medium between vision and language, we align the representations of the vision encoder and the language encoder through knowledge. Second, we inject knowledge into the multi-modal fusion model to enable the model to perform reasoning using knowledge as the supplementation of the input image and text. Third, we guide the model to put emphasis on the most critical information in images and texts by designing knowledge-induced pretext tasks. To perform a comprehensive evaluation and facilitate further research, we construct a medical vision-and-language benchmark including three tasks. Experimental results illustrate the effectiveness of our approach, where state-of-the-art performance is achieved on all downstream tasks. Further analyses explore the effects of different components of our approach and various settings of pre-training.

Recent advances such as LLaVA and Mini-GPT4 have successfully integrated visual information into LLMs, yielding inspiring outcomes and giving rise to a new generation of multi-modal LLMs, or MLLMs. Nevertheless, these methods struggle with hallucinations and the mutual interference between tasks. To tackle these problems, we propose an efficient and accurate approach to adapt to downstream tasks by utilizing LLM as a bridge to connect multiple expert models, namely u-LLaVA. Firstly, we incorporate the modality alignment module and multi-task modules into LLM. Then, we reorganize or rebuild multi-type public datasets to enable efficient modality alignment and instruction following. Finally, task-specific information is extracted from the trained LLM and provided to different modules for solving downstream tasks. The overall framework is simple, effective, and achieves state-of-the-art performance across multiple benchmarks. We also release our model, the generated data, and the code base publicly available.

State-of-the-art vision and vision-and-language models rely on large-scale visio-linguistic pretraining for obtaining good performance on a variety of downstream tasks. Generally, such models are often either cross-modal (contrastive) or multi-modal (with earlier fusion) but not both; and they often only target specific modalities or tasks. A promising direction would be to use a single holistic universal model, as a "foundation", that targets all modalities at once -- a true vision and language foundation model should be good at vision tasks, language tasks, and cross- and multi-modal vision and language tasks. We introduce FLAVA as such a model and demonstrate impressive performance on a wide range of 35 tasks spanning these target modalities.

Different modalities hold considerable gaps in optimization trajectories, including speeds and paths, which lead to modality laziness and modality clash when jointly training multimodal models, resulting in insufficient and imbalanced multimodal learning. Existing methods focus on enforcing the weak modality by adding modality-specific optimization objectives, aligning their optimization speeds, or decomposing multimodal learning to enhance unimodal learning. These methods fail to achieve both unimodal sufficiency and multimodal balance. In this paper, we, for the first time, address both concerns by proposing multimodal Data Remixing, including decoupling multimodal data and filtering hard samples for each modality to mitigate modality imbalance; and then batch-level reassembling to align the gradient directions and avoid cross-modal interference, thus enhancing unimodal learning sufficiency. Experimental results demonstrate that our method can be seamlessly integrated with existing approaches, improving accuracy by approximately 6.50%uparrow on CREMAD and 3.41%uparrow on Kinetic-Sounds, without training set expansion or additional computational overhead during inference. The source code is available at https://github.com/MatthewMaxy/Remix_ICML2025.

Multimodal sentiment analysis (MSA) and emotion recognition in conversation (ERC) are key research topics for computers to understand human behaviors. From a psychological perspective, emotions are the expression of affect or feelings during a short period, while sentiments are formed and held for a longer period. However, most existing works study sentiment and emotion separately and do not fully exploit the complementary knowledge behind the two. In this paper, we propose a multimodal sentiment knowledge-sharing framework (UniMSE) that unifies MSA and ERC tasks from features, labels, and models. We perform modality fusion at the syntactic and semantic levels and introduce contrastive learning between modalities and samples to better capture the difference and consistency between sentiments and emotions. Experiments on four public benchmark datasets, MOSI, MOSEI, MELD, and IEMOCAP, demonstrate the effectiveness of the proposed method and achieve consistent improvements compared with state-of-the-art methods.

Omni-modal large language models (OLLMs) aim to unify audio, vision, and text understanding within a single framework. While existing benchmarks primarily evaluate general cross-modal question-answering ability, it remains unclear whether OLLMs achieve modality-invariant reasoning or exhibit modality-specific biases. We introduce XModBench, a large-scale tri-modal benchmark explicitly designed to measure cross-modal consistency. XModBench comprises 60,828 multiple-choice questions spanning five task families and systematically covers all six modality compositions in question-answer pairs, enabling fine-grained diagnosis of an OLLM's modality-invariant reasoning, modality disparity, and directional imbalance. Experiments show that even the strongest model, Gemini 2.5 Pro, (i) struggles with spatial and temporal reasoning, achieving less than 60% accuracy, (ii) reveals persistent modality disparities, with performance dropping substantially when the same semantic content is conveyed through audio rather than text, and (iii) shows systematic directional imbalance, exhibiting lower consistency when vision serves as context compared to text. These findings indicate that current OLLMs remain far from truly modality-invariant reasoning and position XModBench as a fundamental diagnostic tool for evaluating and improving cross-modal competence. All data and evaluation tools will be available at https://xingruiwang.github.io/projects/XModBench/.

While the field of multi-modal learning keeps growing fast, the deficiency of the standard joint training paradigm has become clear through recent studies. They attribute the sub-optimal performance of the jointly trained model to the modality competition phenomenon. Existing works attempt to improve the jointly trained model by modulating the training process. Despite their effectiveness, those methods can only apply to late fusion models. More importantly, the mechanism of the modality competition remains unexplored. In this paper, we first propose an adaptive gradient modulation method that can boost the performance of multi-modal models with various fusion strategies. Extensive experiments show that our method surpasses all existing modulation methods. Furthermore, to have a quantitative understanding of the modality competition and the mechanism behind the effectiveness of our modulation method, we introduce a novel metric to measure the competition strength. This metric is built on the mono-modal concept, a function that is designed to represent the competition-less state of a modality. Through systematic investigation, our results confirm the intuition that the modulation encourages the model to rely on the more informative modality. In addition, we find that the jointly trained model typically has a preferred modality on which the competition is weaker than other modalities. However, this preferred modality need not dominate others. Our code will be available at https://github.com/lihong2303/AGM_ICCV2023.

Recent advancements in mixed-modal generative models have enabled flexible integration of information across image-text content. These models have opened new avenues for developing unified biomedical assistants capable of analyzing biomedical images, answering complex questions about them, and predicting the impact of medical procedures on a patient's health. However, existing resources face challenges such as limited data availability, narrow domain coverage, and restricted sources (e.g., medical papers). To address these gaps, we present MedMax, the first large-scale multimodal biomedical instruction-tuning dataset for mixed-modal foundation models. With 1.47 million instances, MedMax encompasses a diverse range of tasks, including multimodal content generation (interleaved image-text data), biomedical image captioning and generation, visual chatting, and report understanding. These tasks span diverse medical domains such as radiology and histopathology. Subsequently, we fine-tune a mixed-modal foundation model on the MedMax dataset, achieving significant performance improvements: a 26% gain over the Chameleon model and an 18.3% improvement over GPT-4o across 12 downstream biomedical visual question-answering tasks. Additionally, we introduce a unified evaluation suite for biomedical tasks, providing a robust framework to guide the development of next-generation mixed-modal biomedical AI assistants.

Multi-modal semantic segmentation (MMSS) addresses the limitations of single-modality data by integrating complementary information across modalities. Despite notable progress, a significant gap persists between research and real-world deployment due to variability and uncertainty in multi-modal data quality. Robustness has thus become essential for practical MMSS applications. However, the absence of standardized benchmarks for evaluating robustness hinders further advancement. To address this, we first survey existing MMSS literature and categorize representative methods to provide a structured overview. We then introduce a robustness benchmark that evaluates MMSS models under three scenarios: Entire-Missing Modality (EMM), Random-Missing Modality (RMM), and Noisy Modality (NM). From a probabilistic standpoint, we model modality failure under two conditions: (1) all damaged combinations are equally probable; (2) each modality fails independently following a Bernoulli distribution. Based on these, we propose four metrics-mIoU^{Avg}_{EMM}, mIoU^{E}_{EMM}, mIoU^{Avg}_{RMM}, and mIoU^{E}_{RMM}-to assess model robustness under EMM and RMM. This work provides the first dedicated benchmark for MMSS robustness, offering new insights and tools to advance the field. Source code is available at https://github.com/Chenfei-Liao/Multi-Modal-Semantic-Segmentation-Robustness-Benchmark.

Multimodal information retrieval (MIR) faces inherent challenges due to the heterogeneity of data sources and the complexity of cross-modal alignment. While previous studies have identified modal gaps in feature spaces, a systematic approach to address these challenges remains unexplored. In this work, we introduce UNITE, a universal framework that tackles these challenges through two critical yet underexplored aspects: data curation and modality-aware training configurations. Our work provides the first comprehensive analysis of how modality-specific data properties influence downstream task performance across diverse scenarios. Moreover, we propose Modal-Aware Masked Contrastive Learning (MAMCL) to mitigate the competitive relationships among the instances of different modalities. Our framework achieves state-of-the-art results on multiple multimodal retrieval benchmarks, outperforming existing methods by notable margins. Through extensive experiments, we demonstrate that strategic modality curation and tailored training protocols are pivotal for robust cross-modal representation learning. This work not only advances MIR performance but also provides a foundational blueprint for future research in multimodal systems. Our project is available at https://friedrichor.github.io/projects/UNITE.

Multi-modality image fusion is a technique that combines information from different sensors or modalities, enabling the fused image to retain complementary features from each modality, such as functional highlights and texture details. However, effective training of such fusion models is challenging due to the scarcity of ground truth fusion data. To tackle this issue, we propose the Equivariant Multi-Modality imAge fusion (EMMA) paradigm for end-to-end self-supervised learning. Our approach is rooted in the prior knowledge that natural imaging responses are equivariant to certain transformations. Consequently, we introduce a novel training paradigm that encompasses a fusion module, a pseudo-sensing module, and an equivariant fusion module. These components enable the net training to follow the principles of the natural sensing-imaging process while satisfying the equivariant imaging prior. Extensive experiments confirm that EMMA yields high-quality fusion results for infrared-visible and medical images, concurrently facilitating downstream multi-modal segmentation and detection tasks. The code is available at https://github.com/Zhaozixiang1228/MMIF-EMMA.

Recent text and image foundation models are incredibly impressive, and these models are attracting an ever-increasing portion of research resources. In this position piece we aim to shift the ML research community's priorities ever so slightly to a different modality: tabular data. Tabular data is the dominant modality in many fields, yet it is given hardly any research attention and significantly lags behind in terms of scale and power. We believe the time is now to start developing tabular foundation models, or what we coin a Large Tabular Model (LTM). LTMs could revolutionise the way science and ML use tabular data: not as single datasets that are analyzed in a vacuum, but contextualized with respect to related datasets. The potential impact is far-reaching: from few-shot tabular models to automating data science; from out-of-distribution synthetic data to empowering multidisciplinary scientific discovery. We intend to excite reflections on the modalities we study, and convince some researchers to study large tabular models.

The potential for agents, whether embodied or software, to learn by observing other agents performing procedures involving objects and actions is rich. Current research on automatic procedure learning heavily relies on action labels or video subtitles, even during the evaluation phase, which makes them infeasible in real-world scenarios. This leads to our question: can the human-consensus structure of a procedure be learned from a large set of long, unconstrained videos (e.g., instructional videos from YouTube) with only visual evidence? To answer this question, we introduce the problem of procedure segmentation--to segment a video procedure into category-independent procedure segments. Given that no large-scale dataset is available for this problem, we collect a large-scale procedure segmentation dataset with procedure segments temporally localized and described; we use cooking videos and name the dataset YouCook2. We propose a segment-level recurrent network for generating procedure segments by modeling the dependencies across segments. The generated segments can be used as pre-processing for other tasks, such as dense video captioning and event parsing. We show in our experiments that the proposed model outperforms competitive baselines in procedure segmentation.

Foley is a key element in video production, refers to the process of adding an audio signal to a silent video while ensuring semantic and temporal alignment. In recent years, the rise of personalized content creation and advancements in automatic video-to-audio models have increased the demand for greater user control in the process. One possible approach is to incorporate text to guide audio generation. While supported by existing methods, challenges remain in ensuring compatibility between modalities, particularly when the text introduces additional information or contradicts the sounds naturally inferred from the visuals. In this work, we introduce CAFA (Controllable Automatic Foley Artist) a video-and-text-to-audio model that generates semantically and temporally aligned audio for a given video, guided by text input. CAFA is built upon a text-to-audio model and integrates video information through a modality adapter mechanism. By incorporating text, users can refine semantic details and introduce creative variations, guiding the audio synthesis beyond the expected video contextual cues. Experiments show that besides its superior quality in terms of semantic alignment and audio-visual synchronization the proposed method enable high textual controllability as demonstrated in subjective and objective evaluations.

Magnetic resonance imaging (MRI) is a central modality for stroke imaging. It is used upon patient admission to make treatment decisions such as selecting patients for intravenous thrombolysis or endovascular therapy. MRI is later used in the duration of hospital stay to predict outcome by visualizing infarct core size and location. Furthermore, it may be used to characterize stroke etiology, e.g. differentiation between (cardio)-embolic and non-embolic stroke. Computer based automated medical image processing is increasingly finding its way into clinical routine. Previous iterations of the Ischemic Stroke Lesion Segmentation (ISLES) challenge have aided in the generation of identifying benchmark methods for acute and sub-acute ischemic stroke lesion segmentation. Here we introduce an expert-annotated, multicenter MRI dataset for segmentation of acute to subacute stroke lesions. This dataset comprises 400 multi-vendor MRI cases with high variability in stroke lesion size, quantity and location. It is split into a training dataset of n=250 and a test dataset of n=150. All training data will be made publicly available. The test dataset will be used for model validation only and will not be released to the public. This dataset serves as the foundation of the ISLES 2022 challenge with the goal of finding algorithmic methods to enable the development and benchmarking of robust and accurate segmentation algorithms for ischemic stroke.

Humans use different modalities, such as speech, text, images, videos, etc., to communicate their intent and goals with teammates. For robots to become better assistants, we aim to endow them with the ability to follow instructions and understand tasks specified by their human partners. Most robotic policy learning methods have focused on one single modality of task specification while ignoring the rich cross-modal information. We present MUTEX, a unified approach to policy learning from multimodal task specifications. It trains a transformer-based architecture to facilitate cross-modal reasoning, combining masked modeling and cross-modal matching objectives in a two-stage training procedure. After training, MUTEX can follow a task specification in any of the six learned modalities (video demonstrations, goal images, text goal descriptions, text instructions, speech goal descriptions, and speech instructions) or a combination of them. We systematically evaluate the benefits of MUTEX in a newly designed dataset with 100 tasks in simulation and 50 tasks in the real world, annotated with multiple instances of task specifications in different modalities, and observe improved performance over methods trained specifically for any single modality. More information at https://ut-austin-rpl.github.io/MUTEX/

This article presents the Cogni-CISMeF project, which aims at improving medical information search in the CISMeF system (Catalog and Index of French-language health resources) by including a conversational agent to interact with the user in natural language. To study the cognitive processes involved during the information search, a bottom-up methodology was adopted. Experimentation has been set up to obtain human dialogs between a user (playing the role of patient) dealing with medical information search and a CISMeF expert refining the request. The analysis of these dialogs underlined the use of discursive evidence: vocabulary, reformulation, implicit or explicit expression of user intentions, conversational sequences, etc. A model of artificial agent is proposed. It leads the user in its information search by proposing to him examples, assistance and choices. This model was implemented and integrated in the CISMeF system. ---- Cet article d\'ecrit le projet Cogni-CISMeF qui propose un module de dialogue Homme-Machine \`a int\'egrer dans le syst\`eme d'indexation de connaissances m\'edicales CISMeF (Catalogue et Index des Sites M\'edicaux Francophones). Nous avons adopt\'e une d\'emarche de mod\'elisation cognitive en proc\'edant \`a un recueil de corpus de dialogues entre un utilisateur (jouant le r\^ole d'un patient) d\'esirant une information m\'edicale et un expert CISMeF af inant cette demande pour construire la requ\^ete. Nous avons analys\'e la structure des dialogues ainsi obtenus et avons \'etudi\'e un certain nombre d'indices discursifs : vocabulaire employ\'e, marques de reformulation, commentaires m\'eta et \'epilinguistiques, expression implicite ou explicite des intentions de l'utilisateur, encha\^inement conversationnel, etc. De cette analyse, nous avons construit un mod\`ele d'agent artificiel dot\'e de capacit\'es cognitives capables d'aider l'utilisateur dans sa t\^ache de recherche d'information. Ce mod\`ele a \'et\'e impl\'ement\'e et int\'egr\'e dans le syst\`eme CISMeF.

Generalist vision language models (VLMs) have made significant strides in computer vision, but they fall short in specialized fields like healthcare, where expert knowledge is essential. In traditional computer vision tasks, creative or approximate answers may be acceptable, but in healthcare, precision is paramount.Current large multimodal models like Gemini and GPT-4o are insufficient for medical tasks due to their reliance on memorized internet knowledge rather than the nuanced expertise required in healthcare. VLMs are usually trained in three stages: vision pre-training, vision-language pre-training, and instruction fine-tuning (IFT). IFT has been typically applied using a mixture of generic and healthcare data. In contrast, we propose that for medical VLMs, a fourth stage of specialized IFT is necessary, which focuses on medical data and includes information from domain expert models. Domain expert models developed for medical use are crucial because they are specifically trained for certain clinical tasks, e.g. to detect tumors and classify abnormalities through segmentation and classification, which learn fine-grained features of medical data-features that are often too intricate for a VLM to capture effectively especially in radiology. This paper introduces a new framework, VILA-M3, for medical VLMs that utilizes domain knowledge via expert models. Through our experiments, we show an improved state-of-the-art (SOTA) performance with an average improvement of ~9% over the prior SOTA model Med-Gemini and ~6% over models trained on the specific tasks. Our approach emphasizes the importance of domain expertise in creating precise, reliable VLMs for medical applications.

We discuss an algorithm which produces the meaning of a sentence given meanings of its words, and its resemblance to quantum teleportation. In fact, this protocol was the main source of inspiration for this algorithm which has many applications in the area of Natural Language Processing.

This paper introduces MedTrinity-25M, a comprehensive, large-scale multimodal dataset for medicine, covering over 25 million images across 10 modalities, with multigranular annotations for more than 65 diseases. These enriched annotations encompass both global textual information, such as disease/lesion type, modality, region-specific descriptions, and inter-regional relationships, as well as detailed local annotations for regions of interest (ROIs), including bounding boxes, segmentation masks. Unlike existing approach which is limited by the availability of image-text pairs, we have developed the first automated pipeline that scales up multimodal data by generating multigranular visual and texual annotations (in the form of image-ROI-description triplets) without the need for any paired text descriptions. Specifically, data from over 90 different sources have been collected, preprocessed, and grounded using domain-specific expert models to identify ROIs related to abnormal regions. We then build a comprehensive knowledge base and prompt multimodal large language models to perform retrieval-augmented generation with the identified ROIs as guidance, resulting in multigranular texual descriptions. Compared to existing datasets, MedTrinity-25M provides the most enriched annotations, supporting a comprehensive range of multimodal tasks such as captioning and report generation, as well as vision-centric tasks like classification and segmentation. Pretraining on MedTrinity-25M, our model achieves state-of-the-art performance on VQA-RAD and PathVQA, surpassing both multimodal large language models and other representative SoTA approaches. This dataset can also be utilized to support large-scale pre-training of multimodal medical AI models, contributing to the development of future foundation models in the medical domain.

Multimodal question answering (QA) often requires identifying which video, audio, or sensor tokens are relevant to the question. Yet modality disagreements are common: off-camera speech, background noise, or motion outside the field of view often mislead fusion models that weight all streams equally. We present RAVEN, a unified QA architecture whose core is QuART, a query-conditioned cross-modal gating module that assigns scalar relevance scores to each token across modalities, enabling the model to amplify informative signals and suppress distractors before fusion. RAVEN is trained through a three-stage pipeline comprising unimodal pretraining, query-aligned fusion, and disagreement-oriented fine-tuning -- each stage targeting a distinct challenge in multi-modal reasoning: representation quality, cross-modal relevance, and robustness to modality mismatch. To support training and evaluation, we release AVS-QA, a dataset of 300K synchronized Audio--Video-Sensor streams paired with automatically generated question-answer pairs. Experimental results on seven multi-modal QA benchmarks -- including egocentric and exocentric tasks -- show that RAVEN achieves up to 14.5\% and 8.0\% gains in accuracy compared to state-of-the-art multi-modal large language models, respectively. Incorporating sensor data provides an additional 16.4\% boost, and the model remains robust under modality corruption, outperforming SOTA baselines by 50.23\%. Our code and dataset are available at https://github.com/BASHLab/RAVEN.

As information exists in various modalities in real world, effective interaction and fusion among multimodal information plays a key role for the creation and perception of multimodal data in computer vision and deep learning research. With superb power in modeling the interaction among multimodal information, multimodal image synthesis and editing has become a hot research topic in recent years. Instead of providing explicit guidance for network training, multimodal guidance offers intuitive and flexible means for image synthesis and editing. On the other hand, this field is also facing several challenges in alignment of multimodal features, synthesis of high-resolution images, faithful evaluation metrics, etc. In this survey, we comprehensively contextualize the advance of the recent multimodal image synthesis and editing and formulate taxonomies according to data modalities and model types. We start with an introduction to different guidance modalities in image synthesis and editing, and then describe multimodal image synthesis and editing approaches extensively according to their model types. After that, we describe benchmark datasets and evaluation metrics as well as corresponding experimental results. Finally, we provide insights about the current research challenges and possible directions for future research. A project associated with this survey is available at https://github.com/fnzhan/Generative-AI.

Multi-Modal Large Language Models (MLLMs), despite being successful, exhibit limited generality and often fall short when compared to specialized models. Recently, LLM-based agents have been developed to address these challenges by selecting appropriate specialized models as tools based on user inputs. However, such advancements have not been extensively explored within the medical domain. To bridge this gap, this paper introduces the first agent explicitly designed for the medical field, named Multi-modal Medical Agent (MMedAgent). We curate an instruction-tuning dataset comprising six medical tools solving seven tasks across five modalities, enabling the agent to choose the most suitable tools for a given task. Comprehensive experiments demonstrate that MMedAgent achieves superior performance across a variety of medical tasks compared to state-of-the-art open-source methods and even the closed-source model, GPT-4o. Furthermore, MMedAgent exhibits efficiency in updating and integrating new medical tools. Codes and models are all available.

We present Any-Modality Augmented Language Model (AnyMAL), a unified model that reasons over diverse input modality signals (i.e. text, image, video, audio, IMU motion sensor), and generates textual responses. AnyMAL inherits the powerful text-based reasoning abilities of the state-of-the-art LLMs including LLaMA-2 (70B), and converts modality-specific signals to the joint textual space through a pre-trained aligner module. To further strengthen the multimodal LLM's capabilities, we fine-tune the model with a multimodal instruction set manually collected to cover diverse topics and tasks beyond simple QAs. We conduct comprehensive empirical analysis comprising both human and automatic evaluations, and demonstrate state-of-the-art performance on various multimodal tasks.

Multimodal recommendation systems have attracted increasing attention for their improved performance by leveraging items' multimodal information. Prior methods often build modality-specific item-item semantic graphs from raw modality features and use them as supplementary structures alongside the user-item interaction graph to enhance user preference learning. However, these semantic graphs suffer from semantic deficiencies, including (1) insufficient modeling of collaborative signals among items and (2) structural distortions introduced by noise in raw modality features, ultimately compromising performance. To address these issues, we first extract collaborative signals from the interaction graph and infuse them into each modality-specific item semantic graph to enhance semantic modeling. Then, we design a modulus-based personalized embedding perturbation mechanism that injects perturbations with modulus-guided personalized intensity into embeddings to generate contrastive views. This enables the model to learn noise-robust representations through contrastive learning, thereby reducing the effect of structural noise in semantic graphs. Besides, we propose a dual representation alignment mechanism that first aligns multiple semantic representations via a designed Anchor-based InfoNCE loss using behavior representations as anchors, and then aligns behavior representations with the fused semantics by standard InfoNCE, to ensure representation consistency. Extensive experiments on four benchmark datasets validate the effectiveness of our framework.

Multimodal language models (MLMs) show promise for clinical decision support and diagnostic reasoning, raising the prospect of end-to-end automated medical image interpretation. However, clinicians are highly selective in adopting AI tools; a model that makes errors on seemingly simple perception tasks such as determining image orientation or identifying whether a CT scan is contrast-enhance are unlikely to be adopted for clinical tasks. We introduce Medblink, a benchmark designed to probe these models for such perceptual abilities. Medblink spans eight clinically meaningful tasks across multiple imaging modalities and anatomical regions, totaling 1,429 multiple-choice questions over 1,605 images. We evaluate 19 state-of-the-art MLMs, including general purpose (GPT4o, Claude 3.5 Sonnet) and domain specific (Med Flamingo, LLaVA Med, RadFM) models. While human annotators achieve 96.4% accuracy, the best-performing model reaches only 65%. These results show that current MLMs frequently fail at routine perceptual checks, suggesting the need to strengthen their visual grounding to support clinical adoption. Data is available on our project page.

Biomedical data is inherently multimodal, consisting of electronic health records, medical imaging, digital pathology, genome sequencing, wearable sensors, and more. The application of artificial intelligence tools to these multifaceted sensing technologies has the potential to revolutionize the prognosis, diagnosis, and management of human health and disease. However, current approaches to biomedical AI typically only train and evaluate with one or a small set of medical modalities and tasks. This limitation hampers the development of comprehensive tools that can leverage the rich interconnected information across many heterogeneous biomedical sensors. To address this challenge, we present MultiMed, a benchmark designed to evaluate and enable large-scale learning across a wide spectrum of medical modalities and tasks. MultiMed consists of 2.56 million samples across ten medical modalities such as medical reports, pathology, genomics, and protein data, and is structured into eleven challenging tasks, including disease prognosis, protein structure prediction, and medical question answering. Using MultiMed, we conduct comprehensive experiments benchmarking state-of-the-art unimodal, multimodal, and multitask models. Our analysis highlights the advantages of training large-scale medical models across many related modalities and tasks. Moreover, MultiMed enables studies of generalization across related medical concepts, robustness to real-world noisy data and distribution shifts, and novel modality combinations to improve prediction performance. MultiMed will be publicly available and regularly updated and welcomes inputs from the community.

Multimodal learning is defined as learning over multiple heterogeneous input modalities such as video, audio, and text. In this work, we are concerned with understanding how models behave as the type of modalities differ between training and deployment, a situation that naturally arises in many applications of multimodal learning to hardware platforms. We present a multimodal robustness framework to provide a systematic analysis of common multimodal representation learning methods. Further, we identify robustness short-comings of these approaches and propose two intervention techniques leading to 1.5times-4times robustness improvements on three datasets, AudioSet, Kinetics-400 and ImageNet-Captions. Finally, we demonstrate that these interventions better utilize additional modalities, if present, to achieve competitive results of 44.2 mAP on AudioSet 20K.

Large language models (LLMs) have shown remarkable progress in encoding clinical knowledge and responding to complex medical queries with appropriate clinical reasoning. However, their applicability in subspecialist or complex medical settings remains underexplored. In this work, we probe the performance of AMIE, a research conversational diagnostic AI system, in the subspecialist domain of breast oncology care without specific fine-tuning to this challenging domain. To perform this evaluation, we curated a set of 50 synthetic breast cancer vignettes representing a range of treatment-naive and treatment-refractory cases and mirroring the key information available to a multidisciplinary tumor board for decision-making (openly released with this work). We developed a detailed clinical rubric for evaluating management plans, including axes such as the quality of case summarization, safety of the proposed care plan, and recommendations for chemotherapy, radiotherapy, surgery and hormonal therapy. To improve performance, we enhanced AMIE with the inference-time ability to perform web search retrieval to gather relevant and up-to-date clinical knowledge and refine its responses with a multi-stage self-critique pipeline. We compare response quality of AMIE with internal medicine trainees, oncology fellows, and general oncology attendings under both automated and specialist clinician evaluations. In our evaluations, AMIE outperformed trainees and fellows demonstrating the potential of the system in this challenging and important domain. We further demonstrate through qualitative examples, how systems such as AMIE might facilitate conversational interactions to assist clinicians in their decision making. However, AMIE's performance was overall inferior to attending oncologists suggesting that further research is needed prior to consideration of prospective uses.

Vision-and-language models (VLMs) have been increasingly explored in the medical domain, particularly following the success of CLIP in general domain. However, unlike the relatively straightforward pairing of 2D images and text, curating large-scale paired data in the medical field for volumetric modalities such as CT scans remains a challenging and time-intensive process. This difficulty often limits the performance on downstream tasks. To address these challenges, we propose a novel vision-language pre-training (VLP) framework, termed as VELVET-Med, specifically designed for limited volumetric data such as 3D CT and associated radiology reports. Instead of relying on large-scale data collection, our method focuses on the development of effective pre-training objectives and model architectures. The key contributions are: 1) We incorporate uni-modal self-supervised learning into VLP framework, which are often underexplored in the existing literature. 2) We propose a novel language encoder, termed as TriBERT, for learning multi-level textual semantics. 3) We devise the hierarchical contrastive learning to capture multi-level vision-language correspondence. Using only 38,875 scan-report pairs, our approach seeks to uncover rich spatial and semantic relationships embedded in volumetric medical images and corresponding clinical narratives, thereby enhancing the generalization ability of the learned encoders. The resulting encoders exhibit strong transferability, achieving state-of-the-art performance across a wide range of downstream tasks, including 3D segmentation, cross-modal retrieval, visual question answering, and report generation.

Multimodal pathology-genomic analysis is critical for cancer survival prediction. However, existing approaches predominantly integrate formalin-fixed paraffin-embedded (FFPE) slides with genomic data, while neglecting the availability of other preservation slides, such as Fresh Froze (FF) slides. Moreover, as the high-resolution spatial nature of pathology data tends to dominate the cross-modality fusion process, it hinders effective multimodal fusion and leads to modality imbalance challenges between pathology and genomics. These methods also typically require complete data modalities, limiting their clinical applicability with incomplete modalities, such as missing either pathology or genomic data. In this paper, we propose a multimodal survival prediction framework that leverages hypergraph learning to effectively integrate multi-WSI information and cross-modality interactions between pathology slides and genomics data while addressing modality imbalance. In addition, we introduce a memory mechanism that stores previously learned paired pathology-genomic features and dynamically compensates for incomplete modalities. Experiments on five TCGA datasets demonstrate that our model outperforms advanced methods by over 2.3% in C-Index. Under incomplete modality scenarios, our approach surpasses pathology-only (3.3%) and gene-only models (7.9%). Code: https://github.com/MCPathology/M2Surv

While Large Language Models (LLMs) can generate fluent and convincing responses, they are not necessarily correct. This is especially apparent in the popular decompose-then-verify factuality evaluation pipeline, where LLMs evaluate generations by decomposing the generations into individual, valid claims. Factuality evaluation is especially important for medical answers, since incorrect medical information could seriously harm the patient. However, existing factuality systems are a poor match for the medical domain, as they are typically only evaluated on objective, entity-centric, formulaic texts such as biographies and historical topics. This differs from condition-dependent, conversational, hypothetical, sentence-structure diverse, and subjective medical answers, which makes decomposition into valid facts challenging. We propose MedScore, a new pipeline to decompose medical answers into condition-aware valid facts and verify against in-domain corpora. Our method extracts up to three times more valid facts than existing methods, reducing hallucination and vague references, and retaining condition-dependency in facts. The resulting factuality score substantially varies by decomposition method, verification corpus, and used backbone LLM, highlighting the importance of customizing each step for reliable factuality evaluation by using our generalizable and modularized pipeline for domain adaptation.

The emergence of GPT-4o-like large multimodal models (LMMs) has raised the exploration of integrating text, vision, and speech modalities to support more flexible multimodal interaction. Existing LMMs typically concatenate representation of modalities along the sequence dimension and feed them into a large language model (LLM) backbone. While sequence-dimension concatenation is straightforward for modality integration, it often relies heavily on large-scale data to learn modality alignments. In this paper, we aim to model the relationships between modalities more purposefully, thereby achieving more efficient and flexible modality alignments. To this end, we propose Stream-Omni, a large language-vision-speech model with efficient modality alignments, which can simultaneously support interactions under various modality combinations. Stream-Omni employs LLM as the backbone and aligns the vision and speech to the text based on their relationships. For vision that is semantically complementary to text, Stream-Omni uses sequence-dimension concatenation to achieve vision-text alignment. For speech that is semantically consistent with text, Stream-Omni introduces a CTC-based layer-dimension mapping to achieve speech-text alignment. In this way, Stream-Omni can achieve modality alignments with less data (especially speech), enabling the transfer of text capabilities to other modalities. Experiments on various benchmarks demonstrate that Stream-Omni achieves strong performance on visual understanding, speech interaction, and vision-grounded speech interaction tasks. Owing to the layer-dimensional mapping, Stream-Omni can simultaneously provide intermediate text outputs (such as ASR transcriptions and model responses) during speech interaction, offering users a comprehensive multimodal experience.

Multimodal Large Language Models excel in various tasks, yet often struggle with modality bias, where the model tends to rely heavily on a single modality and overlook critical information in other modalities, which leads to incorrect focus and generating irrelevant responses. In this paper, we propose using the paradigm of preference optimization to solve the modality bias problem, including RLAIFVBias, a debiased preference optimization dataset, and a Noise Aware Preference Optimization algorithm. Specifically, we first construct the dataset by introducing perturbations to reduce the informational content of certain modalities, compelling the model to rely on a specific modality when generating negative responses. To address the inevitable noise in automatically constructed data, we combine the noise robust Mean Absolute Error with the Binary Cross Entropy in Direct Preference Optimization by a negative Box Cox transformation, and dynamically adjust the algorithm noise robustness based on the evaluated noise levels in the data. Extensive experiments validate our approach, demonstrating not only its effectiveness in mitigating modality bias but also its significant role in minimizing hallucinations.

Vision-Language Models (VLMs) trained via contrastive learning have achieved notable success in natural image tasks. However, their application in the medical domain remains limited due to the scarcity of openly accessible, large-scale medical image-text datasets. Existing medical VLMs either train on closed-source proprietary or relatively small open-source datasets that do not generalize well. Similarly, most models remain specific to a single or limited number of medical imaging domains, again restricting their applicability to other modalities. To address this gap, we introduce UniMed, a large-scale, open-source multi-modal medical dataset comprising over 5.3 million image-text pairs across six diverse imaging modalities: X-ray, CT, MRI, Ultrasound, Pathology, and Fundus. UniMed is developed using a data-collection framework that leverages Large Language Models (LLMs) to transform modality-specific classification datasets into image-text formats while incorporating existing image-text data from the medical domain, facilitating scalable VLM pretraining. Using UniMed, we trained UniMed-CLIP, a unified VLM for six modalities that significantly outperforms existing generalist VLMs and matches modality-specific medical VLMs, achieving notable gains in zero-shot evaluations. For instance, UniMed-CLIP improves over BiomedCLIP (trained on proprietary data) by an absolute gain of +12.61, averaged over 21 datasets, while using 3x less training data. To facilitate future research, we release UniMed dataset, training codes, and models at https://github.com/mbzuai-oryx/UniMed-CLIP.

Recent advances in AI foundation models have significant potential for lightening the clinical workload by mimicking the comprehensive and multi-faceted approaches used by medical professionals. In the field of radiation oncology, the integration of multiple modalities holds great importance, so the opportunity of foundational model is abundant. Inspired by this, here we present RO-LMM, a multi-purpose, comprehensive large multimodal model (LMM) tailored for the field of radiation oncology. This model effectively manages a series of tasks within the clinical workflow, including clinical context summarization, radiation treatment plan suggestion, and plan-guided target volume segmentation by leveraging the capabilities of LMM. In particular, to perform consecutive clinical tasks without error accumulation, we present a novel Consistency Embedding Fine-Tuning (CEFTune) technique, which boosts LMM's robustness to noisy inputs while preserving the consistency of handling clean inputs. We further extend this concept to LMM-driven segmentation framework, leading to a novel Consistency Embedding Segmentation~(CESEG) techniques. Experimental results including multi-centre validation confirm that our RO-LMM with CEFTune and CESEG results in promising performance for multiple clinical tasks with generalization capabilities.

Clinical decision-making relies heavily on understanding relative positions of anatomical structures and anomalies. Therefore, for Vision-Language Models (VLMs) to be applicable in clinical practice, the ability to accurately determine relative positions on medical images is a fundamental prerequisite. Despite its importance, this capability remains highly underexplored. To address this gap, we evaluate the ability of state-of-the-art VLMs, GPT-4o, Llama3.2, Pixtral, and JanusPro, and find that all models fail at this fundamental task. Inspired by successful approaches in computer vision, we investigate whether visual prompts, such as alphanumeric or colored markers placed on anatomical structures, can enhance performance. While these markers provide moderate improvements, results remain significantly lower on medical images compared to observations made on natural images. Our evaluations suggest that, in medical imaging, VLMs rely more on prior anatomical knowledge than on actual image content for answering relative position questions, often leading to incorrect conclusions. To facilitate further research in this area, we introduce the MIRP , Medical Imaging Relative Positioning, benchmark dataset, designed to systematically evaluate the capability to identify relative positions in medical images.

Segmentation of surgical instruments is crucial for enhancing surgeon performance and ensuring patient safety. Conventional techniques such as binary, semantic, and instance segmentation share a common drawback: they do not accommodate the parts of instruments obscured by tissues or other instruments. Precisely predicting the full extent of these occluded instruments can significantly improve laparoscopic surgeries by providing critical guidance during operations and assisting in the analysis of potential surgical errors, as well as serving educational purposes. In this paper, we introduce Amodal Segmentation to the realm of surgical instruments in the medical field. This technique identifies both the visible and occluded parts of an object. To achieve this, we introduce a new Amoal Instruments Segmentation (AIS) dataset, which was developed by reannotating each instrument with its complete mask, utilizing the 2017 MICCAI EndoVis Robotic Instrument Segmentation Challenge dataset. Additionally, we evaluate several leading amodal segmentation methods to establish a benchmark for this new dataset.

Predicting multiple real-world tasks in a single model often requires a particularly diverse feature space. Multimodal (MM) models aim to extract the synergistic predictive potential of multiple data types to create a shared feature space with aligned semantic meaning across inputs of drastically varying sizes (i.e. images, text, sound). Most current MM architectures fuse these representations in parallel, which not only limits their interpretability but also creates a dependency on modality availability. We present MultiModN, a multimodal, modular network that fuses latent representations in a sequence of any number, combination, or type of modality while providing granular real-time predictive feedback on any number or combination of predictive tasks. MultiModN's composable pipeline is interpretable-by-design, as well as innately multi-task and robust to the fundamental issue of biased missingness. We perform four experiments on several benchmark MM datasets across 10 real-world tasks (predicting medical diagnoses, academic performance, and weather), and show that MultiModN's sequential MM fusion does not compromise performance compared with a baseline of parallel fusion. By simulating the challenging bias of missing not-at-random (MNAR), this work shows that, contrary to MultiModN, parallel fusion baselines erroneously learn MNAR and suffer catastrophic failure when faced with different patterns of MNAR at inference. To the best of our knowledge, this is the first inherently MNAR-resistant approach to MM modeling. In conclusion, MultiModN provides granular insights, robustness, and flexibility without compromising performance.

Effective root cause analysis (RCA) is vital for swiftly restoring services, minimizing losses, and ensuring the smooth operation and management of complex systems. Previous data-driven RCA methods, particularly those employing causal discovery techniques, have primarily focused on constructing dependency or causal graphs for backtracking the root causes. However, these methods often fall short as they rely solely on data from a single modality, thereby resulting in suboptimal solutions. In this work, we propose Mulan, a unified multi-modal causal structure learning method for root cause localization. We leverage a log-tailored language model to facilitate log representation learning, converting log sequences into time-series data. To explore intricate relationships across different modalities, we propose a contrastive learning-based approach to extract modality-invariant and modality-specific representations within a shared latent space. Additionally, we introduce a novel key performance indicator-aware attention mechanism for assessing modality reliability and co-learning a final causal graph. Finally, we employ random walk with restart to simulate system fault propagation and identify potential root causes. Extensive experiments on three real-world datasets validate the effectiveness of our proposed framework.

LLMs have demonstrated remarkable abilities at interacting with humans through language, especially with the usage of instruction-following data. Recent advancements in LLMs, such as MiniGPT-4, LLaVA, and X-LLM, further enlarge their abilities by incorporating multi-modal inputs, including image, video, and speech. Despite their effectiveness at generating precise and detailed language understanding of the given modality signal, these LLMs give up the ability to ground specific parts of inputs, thus only constructing a coarse-grained mapping. However, explicit and informative correspondence between text and other modalities will not only improve the user experience but also help to expand the application scenario of multi-modal LLMs. Therefore, we propose BuboGPT, a multi-modal LLM with visual grounding that can perform cross-modal interaction between vision, audio and language, providing fine-grained understanding of visual objects and other given modalities. As a result, BuboGPT is able to point out the specific location of an object in the image, when it is generating response or description for that object. Our contributions are two-fold: 1) An off-the-shelf visual grounding module based on SAM that extracts entities in a sentence and find corresponding masks in the image. 2) A two-stage training scheme and instruction dataset to endow joint text-image-audio understanding. Our experiments show that BuboGPT achieves impressive multi-modality understanding and visual grounding abilities during the interaction with human. It performs consistently well when provided by arbitrary modality combinations (either aligned or unaligned). Our code, model and dataset are available at https://bubo-gpt.github.io .

This paper presents OmniDataComposer, an innovative approach for multimodal data fusion and unlimited data generation with an intent to refine and uncomplicate interplay among diverse data modalities. Coming to the core breakthrough, it introduces a cohesive data structure proficient in processing and merging multimodal data inputs, which include video, audio, and text. Our crafted algorithm leverages advancements across multiple operations such as video/image caption extraction, dense caption extraction, Automatic Speech Recognition (ASR), Optical Character Recognition (OCR), Recognize Anything Model(RAM), and object tracking. OmniDataComposer is capable of identifying over 6400 categories of objects, substantially broadening the spectrum of visual information. It amalgamates these diverse modalities, promoting reciprocal enhancement among modalities and facilitating cross-modal data correction. The final output metamorphoses each video input into an elaborate sequential document, virtually transmuting videos into thorough narratives, making them easier to be processed by large language models. Future prospects include optimizing datasets for each modality to encourage unlimited data generation. This robust base will offer priceless insights to models like ChatGPT, enabling them to create higher quality datasets for video captioning and easing question-answering tasks based on video content. OmniDataComposer inaugurates a new stage in multimodal learning, imparting enormous potential for augmenting AI's understanding and generation of complex, real-world data.

The ability to automatically detect and track surgical instruments in endoscopic videos can enable transformational interventions. Assessing surgical performance and efficiency, identifying skilled tool use and choreography, and planning operational and logistical aspects of OR resources are just a few of the applications that could benefit. Unfortunately, obtaining the annotations needed to train machine learning models to identify and localize surgical tools is a difficult task. Annotating bounding boxes frame-by-frame is tedious and time-consuming, yet large amounts of data with a wide variety of surgical tools and surgeries must be captured for robust training. Moreover, ongoing annotator training is needed to stay up to date with surgical instrument innovation. In robotic-assisted surgery, however, potentially informative data like timestamps of instrument installation and removal can be programmatically harvested. The ability to rely on tool installation data alone would significantly reduce the workload to train robust tool-tracking models. With this motivation in mind we invited the surgical data science community to participate in the challenge, SurgToolLoc 2022. The goal was to leverage tool presence data as weak labels for machine learning models trained to detect tools and localize them in video frames with bounding boxes. We present the results of this challenge along with many of the team's efforts. We conclude by discussing these results in the broader context of machine learning and surgical data science. The training data used for this challenge consisting of 24,695 video clips with tool presence labels is also being released publicly and can be accessed at https://console.cloud.google.com/storage/browser/isi-surgtoolloc-2022.

Ultrasound (US) is a widely used medical imaging modality due to its real-time capabilities, non-invasive nature, and cost-effectiveness. Robotic ultrasound can further enhance its utility by reducing operator dependence and improving access to complex anatomical regions. For this, while deep reinforcement learning (DRL) and imitation learning (IL) have shown potential for autonomous navigation, their use in complex surgical tasks such as anatomy reconstruction and surgical guidance remains limited -- largely due to the lack of realistic and efficient simulation environments tailored to these tasks. We introduce SonoGym, a scalable simulation platform for complex robotic ultrasound tasks that enables parallel simulation across tens to hundreds of environments. Our framework supports realistic and real-time simulation of US data from CT-derived 3D models of the anatomy through both a physics-based and a generative modeling approach. Sonogym enables the training of DRL and recent IL agents (vision transformers and diffusion policies) for relevant tasks in robotic orthopedic surgery by integrating common robotic platforms and orthopedic end effectors. We further incorporate submodular DRL -- a recent method that handles history-dependent rewards -- for anatomy reconstruction and safe reinforcement learning for surgery. Our results demonstrate successful policy learning across a range of scenarios, while also highlighting the limitations of current methods in clinically relevant environments. We believe our simulation can facilitate research in robot learning approaches for such challenging robotic surgery applications. Dataset, codes, and videos are publicly available at https://sonogym.github.io/.

Large-language models have recently demonstrated impressive zero-shot capabilities in a variety of natural language tasks such as summarization, dialogue generation, and question-answering. Despite many promising applications in clinical medicine, adoption of these models in real-world settings has been largely limited by their tendency to generate incorrect and sometimes even toxic statements. In this study, we develop Almanac, a large language model framework augmented with retrieval capabilities for medical guideline and treatment recommendations. Performance on a novel dataset of clinical scenarios (n = 130) evaluated by a panel of 5 board-certified and resident physicians demonstrates significant increases in factuality (mean of 18% at p-value < 0.05) across all specialties, with improvements in completeness and safety. Our results demonstrate the potential for large language models to be effective tools in the clinical decision-making process, while also emphasizing the importance of careful testing and deployment to mitigate their shortcomings.

Despite the impressive capabilities of multimodal large language models (MLLMs) in vision-language tasks, they are prone to hallucinations in real-world scenarios. This paper investigates the hallucination phenomenon in MLLMs from the perspective of modality conflict. Unlike existing works focusing on the conflicts between model responses and inputs, we study the inherent conflicts in inputs from different modalities that place MLLMs in a dilemma and directly lead to hallucinations. We formally define the modality conflict and construct a dataset named Multimodal Modality Conflict (MMMC) to simulate this phenomenon in vision-language tasks. Three methods based on prompt engineering, supervised fine-tuning, and reinforcement learning are proposed to alleviate the hallucination caused by modality conflict. Extensive experiments are conducted on the MMMC dataset to analyze the merits and demerits of these methods. Our results show that the reinforcement learning method achieves the best performance in mitigating the hallucination under modality conflict, while the supervised fine-tuning method shows promising and stable performance. Our work sheds light on the unnoticed modality conflict that leads to hallucinations and provides more insights into the robustness of MLLMs.

Natural language could play an important role in developing generalist surgical models by providing a broad source of supervision from raw texts. This flexible form of supervision can enable the model's transferability across datasets and tasks as natural language can be used to reference learned visual concepts or describe new ones. In this work, we present HecVL, a novel hierarchical video-language pretraining approach for building a generalist surgical model. Specifically, we construct a hierarchical video-text paired dataset by pairing the surgical lecture video with three hierarchical levels of texts: at clip-level, atomic actions using transcribed audio texts; at phase-level, conceptual text summaries; and at video-level, overall abstract text of the surgical procedure. Then, we propose a novel fine-to-coarse contrastive learning framework that learns separate embedding spaces for the three video-text hierarchies using a single model. By disentangling embedding spaces of different hierarchical levels, the learned multi-modal representations encode short-term and long-term surgical concepts in the same model. Thanks to the injected textual semantics, we demonstrate that the HecVL approach can enable zero-shot surgical phase recognition without any human annotation. Furthermore, we show that the same HecVL model for surgical phase recognition can be transferred across different surgical procedures and medical centers. The code is available at https://github.com/CAMMA-public/SurgVLP

Electronic Health Records (EHRs), which contain patients' medical histories in various multi-modal formats, often overlook the potential for joint reasoning across imaging and table modalities underexplored in current EHR Question Answering (QA) systems. In this paper, we introduce EHRXQA, a novel multi-modal question answering dataset combining structured EHRs and chest X-ray images. To develop our dataset, we first construct two uni-modal resources: 1) The MIMIC- CXR-VQA dataset, our newly created medical visual question answering (VQA) benchmark, specifically designed to augment the imaging modality in EHR QA, and 2) EHRSQL (MIMIC-IV), a refashioned version of a previously established table-based EHR QA dataset. By integrating these two uni-modal resources, we successfully construct a multi-modal EHR QA dataset that necessitates both uni-modal and cross-modal reasoning. To address the unique challenges of multi-modal questions within EHRs, we propose a NeuralSQL-based strategy equipped with an external VQA API. This pioneering endeavor enhances engagement with multi-modal EHR sources and we believe that our dataset can catalyze advances in real-world medical scenarios such as clinical decision-making and research. EHRXQA is available at https://github.com/baeseongsu/ehrxqa.

The Segment Anything Model (SAM) has demonstrated outstanding adaptation to medical image segmentation but still faces three major challenges. Firstly, the huge computational costs of SAM limit its real-world applicability. Secondly, SAM depends on manual annotations (e.g., points, boxes) as prompts, which are laborious and impractical in clinical scenarios. Thirdly, SAM handles all segmentation targets equally, which is suboptimal for diverse medical modalities with inherent heterogeneity. To address these issues, we propose an Efficient Self-Prompting SAM for universal medical image segmentation, named ESP-MedSAM. We devise a Multi-Modal Decoupled Knowledge Distillation (MMDKD) strategy to distil common image knowledge and domain-specific medical knowledge from the foundation model to train a lightweight image encoder and a modality controller. Further, they combine with the additionally introduced Self-Patch Prompt Generator (SPPG) and Query-Decoupled Modality Decoder (QDMD) to construct ESP-MedSAM. Specifically, SPPG aims to generate a set of patch prompts automatically and QDMD leverages a one-to-one strategy to provide an independent decoding channel for every modality. Extensive experiments indicate that ESP-MedSAM outperforms state-of-the-arts in diverse medical imaging segmentation takes, displaying superior zero-shot learning and modality transfer ability. Especially, our framework uses only 31.4% parameters compared to SAM-Base.

Accurate segmentation of tumors in PET/CT images is important in computer-aided diagnosis and treatment of cancer. The key issue of such a segmentation problem lies in the effective integration of complementary information from PET and CT images. However, the quality of PET and CT images varies widely in clinical settings, which leads to uncertainty in the modality information extracted by networks. To take the uncertainty into account in multi-modal information fusion, this paper proposes a novel Multi-modal Evidential Fusion Network (MEFN) comprising a Cross-Modal Feature Learning (CFL) module and a Multi-modal Trusted Fusion (MTF) module. The CFL module reduces the domain gap upon modality conversion and highlights common tumor features, thereby alleviating the needs of the segmentation module to handle modality specificity. The MTF module utilizes mutual attention mechanisms and an uncertainty calibrator to fuse modality features based on modality uncertainty and then fuse the segmentation results under the guidance of Dempster-Shafer Theory. Besides, a new uncertainty perceptual loss is introduced to force the model focusing on uncertain features and hence improve its ability to extract trusted modality information. Extensive comparative experiments are conducted on two publicly available PET/CT datasets to evaluate the performance of our proposed method whose results demonstrate that our MEFN significantly outperforms state-of-the-art methods with improvements of 2.15% and 3.23% in DSC scores on the AutoPET dataset and the Hecktor dataset, respectively. More importantly, our model can provide radiologists with credible uncertainty of the segmentation results for their decision in accepting or rejecting the automatic segmentation results, which is particularly important for clinical applications. Our code will be available at https://github.com/QPaws/MEFN.

This paper presents Audio-Visual LLM, a Multimodal Large Language Model that takes both visual and auditory inputs for holistic video understanding. A key design is the modality-augmented training, which involves the integration of modality-specific tokens engineered to activate the appropriate visual and/or auditory encoder selectively. This mechanism is pivotal in enabling end-to-end joint training with video data at different modalities, including visual-only, audio-only, and audio-visual formats. Moreover, we introduce a high-quality video instruction dataset, derived from GPT-4. This dataset allows Audio-Visual LLM to adeptly process a variety of task-oriented video instructions, ranging from multi-turn conversations and audio-visual narratives to complex reasoning tasks. Extensive experiments demonstrate that Audio-Visual LLM impressively achieves strong zero-shot results across a range of video understanding tasks. For example, Audio-Visual LLM achieves an accuracy of 53.7% on MSRVTT-QA, outperforming non-LLM-based InterVideo by 6.6% and LLM-based Valley by 4.4%, respectively. Additionally, our Audio-Visual LLM also achieves competitive performance on audio tasks (e.g., AudioCaps).

Dermatological diagnosis represents a complex multimodal challenge that requires integrating visual features with specialized clinical knowledge. While vision-language pretraining (VLP) has advanced medical AI, its effectiveness in dermatology is limited by text length constraints and the lack of structured texts. In this paper, we introduce MAKE, a Multi-Aspect Knowledge-Enhanced vision-language pretraining framework for zero-shot dermatological tasks. Recognizing that comprehensive dermatological descriptions require multiple knowledge aspects that exceed standard text constraints, our framework introduces: (1) a multi-aspect contrastive learning strategy that decomposes clinical narratives into knowledge-enhanced sub-texts through large language models, (2) a fine-grained alignment mechanism that connects subcaptions with diagnostically relevant image features, and (3) a diagnosis-guided weighting scheme that adaptively prioritizes different sub-captions based on clinical significance prior. Through pretraining on 403,563 dermatological image-text pairs collected from education resources, MAKE significantly outperforms state-of-the-art VLP models on eight datasets across zero-shot skin disease classification, concept annotation, and cross-modal retrieval tasks. Our code will be made publicly available at https: //github.com/SiyuanYan1/MAKE.

Connecting text and visual modalities plays an essential role in generative intelligence. For this reason, inspired by the success of large language models, significant research efforts are being devoted to the development of Multimodal Large Language Models (MLLMs). These models can seamlessly integrate visual and textual modalities, both as input and output, while providing a dialogue-based interface and instruction-following capabilities. In this paper, we provide a comprehensive review of recent visual-based MLLMs, analyzing their architectural choices, multimodal alignment strategies, and training techniques. We also conduct a detailed analysis of these models across a wide range of tasks, including visual grounding, image generation and editing, visual understanding, and domain-specific applications. Additionally, we compile and describe training datasets and evaluation benchmarks, conducting comparisons among existing models in terms of performance and computational requirements. Overall, this survey offers a comprehensive overview of the current state of the art, laying the groundwork for future MLLMs.

Positron emission tomography (PET) is a cornerstone of modern oncologic and neurologic imaging, distinguished by its unique ability to illuminate dynamic metabolic processes that transcend the anatomical focus of traditional imaging technologies. Radiology reports are essential for clinical decision making, yet their manual creation is labor-intensive and time-consuming. Recent advancements of vision-language models (VLMs) have shown strong potential in medical applications, presenting a promising avenue for automating report generation. However, existing applications of VLMs in the medical domain have predominantly focused on structural imaging modalities, while the unique characteristics of molecular PET imaging have largely been overlooked. To bridge the gap, we introduce PET2Rep, a large-scale comprehensive benchmark for evaluation of general and medical VLMs for radiology report generation for PET images. PET2Rep stands out as the first dedicated dataset for PET report generation with metabolic information, uniquely capturing whole-body image-report pairs that cover dozens of organs to fill the critical gap in existing benchmarks and mirror real-world clinical comprehensiveness. In addition to widely recognized natural language generation metrics, we introduce a series of clinical efficiency metrics to evaluate the quality of radiotracer uptake pattern description in key organs in generated reports. We conduct a head-to-head comparison of 30 cutting-edge general-purpose and medical-specialized VLMs. The results show that the current state-of-the-art VLMs perform poorly on PET report generation task, falling considerably short of fulfilling practical needs. Moreover, we identify several key insufficiency that need to be addressed to advance the development in medical applications.

Research on autonomous surgery has largely focused on simple task automation in controlled environments. However, real-world surgical applications demand dexterous manipulation over extended durations and generalization to the inherent variability of human tissue. These challenges remain difficult to address using existing logic-based or conventional end-to-end learning approaches. To address this gap, we propose a hierarchical framework for performing dexterous, long-horizon surgical steps. Our approach utilizes a high-level policy for task planning and a low-level policy for generating robot trajectories. The high-level planner plans in language space, generating task-level or corrective instructions that guide the robot through the long-horizon steps and correct for the low-level policy's errors. We validate our framework through ex vivo experiments on cholecystectomy, a commonly-practiced minimally invasive procedure, and conduct ablation studies to evaluate key components of the system. Our method achieves a 100\% success rate across eight unseen ex vivo gallbladders, operating fully autonomously without human intervention. This work demonstrates step-level autonomy in a surgical procedure, marking a milestone toward clinical deployment of autonomous surgical systems.

Recently, ChatGPT, along with DALL-E-2 and Codex,has been gaining significant attention from society. As a result, many individuals have become interested in related resources and are seeking to uncover the background and secrets behind its impressive performance. In fact, ChatGPT and other Generative AI (GAI) techniques belong to the category of Artificial Intelligence Generated Content (AIGC), which involves the creation of digital content, such as images, music, and natural language, through AI models. The goal of AIGC is to make the content creation process more efficient and accessible, allowing for the production of high-quality content at a faster pace. AIGC is achieved by extracting and understanding intent information from instructions provided by human, and generating the content according to its knowledge and the intent information. In recent years, large-scale models have become increasingly important in AIGC as they provide better intent extraction and thus, improved generation results. With the growth of data and the size of the models, the distribution that the model can learn becomes more comprehensive and closer to reality, leading to more realistic and high-quality content generation. This survey provides a comprehensive review on the history of generative models, and basic components, recent advances in AIGC from unimodal interaction and multimodal interaction. From the perspective of unimodality, we introduce the generation tasks and relative models of text and image. From the perspective of multimodality, we introduce the cross-application between the modalities mentioned above. Finally, we discuss the existing open problems and future challenges in AIGC.

Multimodal learning has developed very fast in recent years. However, during the multimodal training process, the model tends to rely on only one modality based on which it could learn faster, thus leading to inadequate use of other modalities. Existing methods to balance the training process always have some limitations on the loss functions, optimizers and the number of modalities and only consider modulating the magnitude of the gradients while ignoring the directions of the gradients. To solve these problems, in this paper, we present a novel method to balance multimodal learning with Classifier-Guided Gradient Modulation (CGGM), considering both the magnitude and directions of the gradients. We conduct extensive experiments on four multimodal datasets: UPMC-Food 101, CMU-MOSI, IEMOCAP and BraTS 2021, covering classification, regression and segmentation tasks. The results show that CGGM outperforms all the baselines and other state-of-the-art methods consistently, demonstrating its effectiveness and versatility. Our code is available at https://github.com/zrguo/CGGM.

With the rapid advances in high-throughput sequencing technologies, the focus of survival analysis has shifted from examining clinical indicators to incorporating genomic profiles with pathological images. However, existing methods either directly adopt a straightforward fusion of pathological features and genomic profiles for survival prediction, or take genomic profiles as guidance to integrate the features of pathological images. The former would overlook intrinsic cross-modal correlations. The latter would discard pathological information irrelevant to gene expression. To address these issues, we present a Cross-Modal Translation and Alignment (CMTA) framework to explore the intrinsic cross-modal correlations and transfer potential complementary information. Specifically, we construct two parallel encoder-decoder structures for multi-modal data to integrate intra-modal information and generate cross-modal representation. Taking the generated cross-modal representation to enhance and recalibrate intra-modal representation can significantly improve its discrimination for comprehensive survival analysis. To explore the intrinsic crossmodal correlations, we further design a cross-modal attention module as the information bridge between different modalities to perform cross-modal interactions and transfer complementary information. Our extensive experiments on five public TCGA datasets demonstrate that our proposed framework outperforms the state-of-the-art methods.

In this work, we focus on the task of procedure planning from instructional videos with text supervision, where a model aims to predict an action sequence to transform the initial visual state into the goal visual state. A critical challenge of this task is the large semantic gap between observed visual states and unobserved intermediate actions, which is ignored by previous works. Specifically, this semantic gap refers to that the contents in the observed visual states are semantically different from the elements of some action text labels in a procedure. To bridge this semantic gap, we propose a novel event-guided paradigm, which first infers events from the observed states and then plans out actions based on both the states and predicted events. Our inspiration comes from that planning a procedure from an instructional video is to complete a specific event and a specific event usually involves specific actions. Based on the proposed paradigm, we contribute an Event-guided Prompting-based Procedure Planning (E3P) model, which encodes event information into the sequential modeling process to support procedure planning. To further consider the strong action associations within each event, our E3P adopts a mask-and-predict approach for relation mining, incorporating a probabilistic masking scheme for regularization. Extensive experiments on three datasets demonstrate the effectiveness of our proposed model.

In this work we propose a blackbox intervention method for visual dialog models, with the aim of assessing the contribution of individual linguistic or visual components. Concretely, we conduct structured or randomized interventions that aim to impair an individual component of the model, and observe changes in task performance. We reproduce a state-of-the-art visual dialog model and demonstrate that our methodology yields surprising insights, namely that both dialog and image information have minimal contributions to task performance. The intervention method presented here can be applied as a sanity check for the strength and robustness of each component in visual dialog systems.

Urban region profiling from web-sourced data is of utmost importance for urban planning and sustainable development. We are witnessing a rising trend of LLMs for various fields, especially dealing with multi-modal data research such as vision-language learning, where the text modality serves as a supplement information for the image. Since textual modality has never been introduced into modality combinations in urban region profiling, we aim to answer two fundamental questions in this paper: i) Can textual modality enhance urban region profiling? ii) and if so, in what ways and with regard to which aspects? To answer the questions, we leverage the power of Large Language Models (LLMs) and introduce the first-ever LLM-enhanced framework that integrates the knowledge of textual modality into urban imagery profiling, named LLM-enhanced Urban Region Profiling with Contrastive Language-Image Pretraining (UrbanCLIP). Specifically, it first generates a detailed textual description for each satellite image by an open-source Image-to-Text LLM. Then, the model is trained on the image-text pairs, seamlessly unifying natural language supervision for urban visual representation learning, jointly with contrastive loss and language modeling loss. Results on predicting three urban indicators in four major Chinese metropolises demonstrate its superior performance, with an average improvement of 6.1% on R^2 compared to the state-of-the-art methods. Our code and the image-language dataset will be released upon paper notification.

Multi-modal large language models have garnered significant interest recently. Though, most of the works focus on vision-language multi-modal models providing strong capabilities in following vision-and-language instructions. However, we claim that speech is also an important modality through which humans interact with the world. Hence, it is crucial for a general-purpose assistant to be able to follow multi-modal speech-and-language instructions. In this work, we propose Large Language and Speech Model (LLaSM). LLaSM is an end-to-end trained large multi-modal speech-language model with cross-modal conversational abilities, capable of following speech-and-language instructions. Our early experiments show that LLaSM demonstrates a more convenient and natural way for humans to interact with artificial intelligence. Specifically, we also release a large Speech Instruction Following dataset LLaSM-Audio-Instructions. Code and demo are available at https://github.com/LinkSoul-AI/LLaSM and https://huggingface.co/spaces/LinkSoul/LLaSM. The LLaSM-Audio-Instructions dataset is available at https://huggingface.co/datasets/LinkSoul/LLaSM-Audio-Instructions.

Alzheimer's Disease (AD) is the most common form of dementia and often difficult to diagnose due to the multifactorial etiology of dementia. Recent works on neuroimaging-based computer-aided diagnosis with deep neural networks (DNNs) showed that fusing structural magnetic resonance images (sMRI) and fluorodeoxyglucose positron emission tomography (FDG-PET) leads to improved accuracy in a study population of healthy controls and subjects with AD. However, this result conflicts with the established clinical knowledge that FDG-PET better captures AD-specific pathologies than sMRI. Therefore, we propose a framework for the systematic evaluation of multi-modal DNNs and critically re-evaluate single- and multi-modal DNNs based on FDG-PET and sMRI for binary healthy vs. AD, and three-way healthy/mild cognitive impairment/AD classification. Our experiments demonstrate that a single-modality network using FDG-PET performs better than MRI (accuracy 0.91 vs 0.87) and does not show improvement when combined. This conforms with the established clinical knowledge on AD biomarkers, but raises questions about the true benefit of multi-modal DNNs. We argue that future work on multi-modal fusion should systematically assess the contribution of individual modalities following our proposed evaluation framework. Finally, we encourage the community to go beyond healthy vs. AD classification and focus on differential diagnosis of dementia, where fusing multi-modal image information conforms with a clinical need.

Multimodal large language models (MLLMs) have gained significant attention due to their strong multimodal understanding capability. However, existing works rely heavily on modality-specific encoders, which usually differ in architecture and are limited to common modalities. In this paper, we present OneLLM, an MLLM that aligns eight modalities to language using a unified framework. We achieve this through a unified multimodal encoder and a progressive multimodal alignment pipeline. In detail, we first train an image projection module to connect a vision encoder with LLM. Then, we build a universal projection module (UPM) by mixing multiple image projection modules and dynamic routing. Finally, we progressively align more modalities to LLM with the UPM. To fully leverage the potential of OneLLM in following instructions, we also curated a comprehensive multimodal instruction dataset, including 2M items from image, audio, video, point cloud, depth/normal map, IMU and fMRI brain activity. OneLLM is evaluated on 25 diverse benchmarks, encompassing tasks such as multimodal captioning, question answering and reasoning, where it delivers excellent performance. Code, data, model and online demo are available at https://github.com/csuhan/OneLLM

In-context learning (ICL) involves reasoning from given contextual examples. As more modalities comes, this procedure is becoming more challenging as the interleaved input modalities convolutes the understanding process. This is exemplified by the observation that multimodal models often struggle to effectively extrapolate from contextual examples to perform ICL. To address these challenges, we introduce MultiModal In-conteXt Tuning (M^2IXT), a lightweight module to enhance the ICL capabilities of multimodal unified models. The proposed M^2IXT module perceives an expandable context window to incorporate various labeled examples of multiple modalities (e.g., text, image, and coordinates). It can be prepended to various multimodal unified models (e.g., OFA, Unival, LLaVA) of different architectures and trained via a mixed-tasks strategy to enable rapid few-shot adaption on multiple tasks and datasets. When tuned on as little as 50K multimodal data, M^2IXT can boost the few-shot ICL performance significantly (e.g., 18\% relative increase for OFA), and obtained state-of-the-art results across an array of tasks including visual question answering, image captioning, visual grounding, and visual entailment, while being considerably small in terms of model parameters (e.g., sim20times smaller than Flamingo or MMICL), highlighting the flexibility and effectiveness of M^2IXT as a multimodal in-context learner.

Every day, countless surgeries are performed worldwide, each within the distinct settings of operating rooms (ORs) that vary not only in their setups but also in the personnel, tools, and equipment used. This inherent diversity poses a substantial challenge for achieving a holistic understanding of the OR, as it requires models to generalize beyond their initial training datasets. To reduce this gap, we introduce ORacle, an advanced vision-language model designed for holistic OR domain modeling, which incorporates multi-view and temporal capabilities and can leverage external knowledge during inference, enabling it to adapt to previously unseen surgical scenarios. This capability is further enhanced by our novel data augmentation framework, which significantly diversifies the training dataset, ensuring ORacle's proficiency in applying the provided knowledge effectively. In rigorous testing, in scene graph generation, and downstream tasks on the 4D-OR dataset, ORacle not only demonstrates state-of-the-art performance but does so requiring less data than existing models. Furthermore, its adaptability is displayed through its ability to interpret unseen views, actions, and appearances of tools and equipment. This demonstrates ORacle's potential to significantly enhance the scalability and affordability of OR domain modeling and opens a pathway for future advancements in surgical data science. We will release our code and data upon acceptance.

Large language models (LLMs) have shown impressive performance on complex reasoning by leveraging chain-of-thought (CoT) prompting to generate intermediate reasoning chains as the rationale to infer the answer. However, existing CoT studies have focused on the language modality. We propose Multimodal-CoT that incorporates language (text) and vision (images) modalities into a two-stage framework that separates rationale generation and answer inference. In this way, answer inference can leverage better generated rationales that are based on multimodal information. With Multimodal-CoT, our model under 1 billion parameters outperforms the previous state-of-the-art LLM (GPT-3.5) by 16 percentage points (75.17%->91.68% accuracy) on the ScienceQA benchmark and even surpasses human performance. Code is publicly available available at https://github.com/amazon-science/mm-cot.

While language-guided image manipulation has made remarkable progress, the challenge of how to instruct the manipulation process faithfully reflecting human intentions persists. An accurate and comprehensive description of a manipulation task using natural language is laborious and sometimes even impossible, primarily due to the inherent uncertainty and ambiguity present in linguistic expressions. Is it feasible to accomplish image manipulation without resorting to external cross-modal language information? If this possibility exists, the inherent modality gap would be effortlessly eliminated. In this paper, we propose a novel manipulation methodology, dubbed ImageBrush, that learns visual instructions for more accurate image editing. Our key idea is to employ a pair of transformation images as visual instructions, which not only precisely captures human intention but also facilitates accessibility in real-world scenarios. Capturing visual instructions is particularly challenging because it involves extracting the underlying intentions solely from visual demonstrations and then applying this operation to a new image. To address this challenge, we formulate visual instruction learning as a diffusion-based inpainting problem, where the contextual information is fully exploited through an iterative process of generation. A visual prompting encoder is carefully devised to enhance the model's capacity in uncovering human intent behind the visual instructions. Extensive experiments show that our method generates engaging manipulation results conforming to the transformations entailed in demonstrations. Moreover, our model exhibits robust generalization capabilities on various downstream tasks such as pose transfer, image translation and video inpainting.

Images and structured tables are essential parts of real-world databases. Though tabular-image representation learning is promising to create new insights, it remains a challenging task, as tabular data is typically heterogeneous and incomplete, presenting significant modality disparities with images. Earlier works have mainly focused on simple modality fusion strategies in complete data scenarios, without considering the missing data issue, and thus are limited in practice. In this paper, we propose TIP, a novel tabular-image pre-training framework for learning multimodal representations robust to incomplete tabular data. Specifically, TIP investigates a novel self-supervised learning (SSL) strategy, including a masked tabular reconstruction task for tackling data missingness, and image-tabular matching and contrastive learning objectives to capture multimodal information. Moreover, TIP proposes a versatile tabular encoder tailored for incomplete, heterogeneous tabular data and a multimodal interaction module for inter-modality representation learning. Experiments are performed on downstream multimodal classification tasks using both natural and medical image datasets. The results show that TIP outperforms state-of-the-art supervised/SSL image/multimodal algorithms in both complete and incomplete data scenarios. Our code is available at https://github.com/siyi-wind/TIP.

Multimodal learning typically relies on the assumption that all modalities are fully available during both the training and inference phases. However, in real-world scenarios, consistently acquiring complete multimodal data presents significant challenges due to various factors. This often leads to the issue of missing modalities, where data for certain modalities are absent, posing considerable obstacles not only for the availability of multimodal pretrained models but also for their fine-tuning and the preservation of robustness in downstream tasks. To address these challenges, we propose a novel framework integrating parameter-efficient fine-tuning of unimodal pretrained models with a self-supervised joint-embedding learning method. This framework enables the model to predict the embedding of a missing modality in the representation space during inference. Our method effectively predicts the missing embedding through prompt tuning, leveraging information from available modalities. We evaluate our approach on several multimodal benchmark datasets and demonstrate its effectiveness and robustness across various scenarios of missing modalities.

In clinical radiology reports, doctors capture important information about the patient's health status. They convey their observations from raw medical imaging data about the inner structures of a patient. As such, formulating reports requires medical experts to possess wide-ranging knowledge about anatomical regions with their normal, healthy appearance as well as the ability to recognize abnormalities. This explicit grasp on both the patient's anatomy and their appearance is missing in current medical image-processing systems as annotations are especially difficult to gather. This renders the models to be narrow experts e.g. for identifying specific diseases. In this work, we recover this missing link by adding human anatomy into the mix and enable the association of content in medical reports to their occurrence in associated imagery (medical phrase grounding). To exploit anatomical structures in this scenario, we present a sophisticated automatic pipeline to gather and integrate human bodily structures from computed tomography datasets, which we incorporate in our PAXRay: A Projected dataset for the segmentation of Anatomical structures in X-Ray data. Our evaluation shows that methods that take advantage of anatomical information benefit heavily in visually grounding radiologists' findings, as our anatomical segmentations allow for up to absolute 50% better grounding results on the OpenI dataset as compared to commonly used region proposals. The PAXRay dataset is available at https://constantinseibold.github.io/paxray/.

Multimodal learning with incomplete modality is practical and challenging. Recently, researchers have focused on enhancing the robustness of pre-trained MultiModal Transformers (MMTs) under missing modality conditions by applying learnable prompts. However, these prompt-based methods face several limitations: (1) incomplete modalities provide restricted modal cues for task-specific inference, (2) dummy imputation for missing content causes information loss and introduces noise, and (3) static prompts are instance-agnostic, offering limited knowledge for instances with various missing conditions. To address these issues, we propose RAGPT, a novel Retrieval-AuGmented dynamic Prompt Tuning framework. RAGPT comprises three modules: (I) the multi-channel retriever, which identifies similar instances through a within-modality retrieval strategy, (II) the missing modality generator, which recovers missing information using retrieved contexts, and (III) the context-aware prompter, which captures contextual knowledge from relevant instances and generates dynamic prompts to largely enhance the MMT's robustness. Extensive experiments conducted on three real-world datasets show that RAGPT consistently outperforms all competitive baselines in handling incomplete modality problems. The code of our work and prompt-based baselines is available at https://github.com/Jian-Lang/RAGPT.