arXiv subjects

Changmiao Wang

Publications and source records attributed to Changmiao Wang.

At least 19 recordsLinked to original sources

arXiv2026

MedGEN-Bench: A Contextually Entangled Benchmark for Open-ended Multimodal Medical Generation

Medical vision-language models (VLMs) are increasingly expected to support clinical workflows through diagnostic text and relevant medical images. However, current medical visual benchmarks have three recurring limitations: query-image misalignment from queries weakly grounded in specific image instances, closed-ended formats that narrow answer space and encourage shortcut-based prediction, and text-centric output paradigms that limit evaluation of image-generation and image-editing capabilities. We introduce MedGEN-Bench, a benchmark for open-ended multimodal medical generation. The evaluation snapshot reported in this manuscript comprises 6,422 image-text pairs reviewed by clinical experts and models, spanning 6 canonical imaging modalities, 15 clinical tasks, and 27 named subtasks. It includes 1,100 Visual Question Answering (VQA) pairs, 3,872 Image Editing pairs, and 1,450 Contextual Multimodal Generation pairs. MedGEN-Bench centers on contextual entanglement: dependence of an instruction's intended output on the particular image instance rather than on task wording alone. The benchmark operationalizes this concept through image-grounded instructions and extends evaluation to open-ended multimodal outputs. Its tiered evaluation protocol combines reproducible reference-based fidelity and similarity measures with a structured, checklist-guided assessment by a medical VLM judge. We evaluate 10 compositional frameworks, 2 dedicated image-editing models, 3 unified models, and 5 VLMs. The results show image-output tasks remain unsaturated. Contextual augmentation increases mean image-instruction similarity from 0.273 to 0.372, while a 1,000-case medical-expert audit shows moderate agreement between judge scores and clinician ratings. Source code and dataset are available at https://yangjj007.github.io/medgen.

cs.CV↗

arXiv2026

Multimodal Feature Prototype Learning for Interpretable and Discriminative Cancer Survival Prediction

Survival analysis plays a vital role in making clinical decisions. However, the models currently in use are often difficult to interpret, which reduces their usefulness in clinical settings. Prototype learning presents a potential solution, yet traditional methods focus on local similarities and static matching, neglecting the broader tumor context and lacking strong semantic alignment with genomic data. To overcome these issues, we introduce an innovative prototype-based multimodal framework, FeatProto, aimed at enhancing cancer survival prediction by addressing significant limitations in current prototype learning methodologies within pathology. Our framework establishes a unified feature prototype space that integrates both global and local features of whole slide images (WSI) with genomic profiles. This integration facilitates traceable and interpretable decision-making processes. Our approach includes three main innovations: (1) A robust phenotype representation that merges critical patches with global context, harmonized with genomic data to minimize local bias. (2) An Exponential Prototype Update Strategy (EMA ProtoUp) that sustains stable cross-modal associations and employs a wandering mechanism to adapt prototypes flexibly to tumor heterogeneity. (3) A hierarchical prototype matching scheme designed to capture global centrality, local typicality, and cohort-level trends, thereby refining prototype inference. Comprehensive evaluations on four publicly available cancer datasets indicate that our method surpasses current leading unimodal and multimodal survival prediction techniques in both accuracy and interpretability, providing a new perspective on prototype learning for critical medical applications. Our source code is available at https://github.com/JSLiam94/FeatProto.

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arXiv2026

R2AoP: Reliable and Robust Angle of Progression Estimation from Intrapartum Ultrasound

Accurate estimation of the Angle of Progression (AoP) from intrapartum transperineal ultrasound is critical for objective assessment of labor progression, yet remains highly sensitive to imaging noise, boundary ambiguities, and the geometric amplification of local segmentation errors. We propose R2AoP, a reliable and robust AoP estimation framework that integrates structurally informed segmentation and confidence-guided geometric modeling to achieve stable and reproducible measurements. A three-branch local-structure-enhanced backbone improves the delineation of the pubic symphysis (PS) and fetal head (FH), while confidence-weighted contour fitting explicitly suppresses the influence of unreliable boundary points in AoP computation. To further improve performance under heterogeneous acquisition conditions, we introduce a lightweight geometry-reliable test-time adaptation strategy as an auxiliary component, enabling stable inference without target annotations. Extensive evaluations on multi-center benchmarks demonstrate consistent reductions in AoP error and boundary metrics compared with state-of-the-art AoP methods. Our source code is available at https://github.com/baiyou1234/R2AoP.

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arXiv2026

No Modality Left Behind: Adapting to Missing Modalities via Knowledge Distillation for Brain Tumor Segmentation

Accurate brain tumor segmentation is essential for preoperative evaluation and personalized treatment. Multi-modal MRI is widely used due to its ability to capture complementary tumor features across different sequences. However, in clinical practice, missing modalities are common, limiting the robustness and generalizability of existing deep learning methods that rely on complete inputs, especially under non-dominant modality combinations. To address this, we propose AdaMM, a multi-modal brain tumor segmentation framework tailored for missing-modality scenarios, centered on knowledge distillation and composed of three synergistic modules. The Graph-guided Adaptive Refinement Module explicitly models semantic associations between generalizable and modality-specific features, enhancing adaptability to modality absence. The Bi-Bottleneck Distillation Module transfers structural and textural knowledge from teacher to student models via global style matching and adversarial feature alignment. The Lesion-Presence-Guided Reliability Module predicts prior probabilities of lesion types through an auxiliary classification task, effectively suppressing false positives under incomplete inputs. Extensive experiments on the Pretreat-MetsToBrain-Masks and BraTS 2018, 2024 datasets demonstrate that AdaMM consistently outperforms existing methods, exhibiting superior segmentation accuracy and robustness, particularly in single-modality and weak-modality configurations. In addition, we conduct a systematic evaluation of six categories of missing-modality strategies, supporting the superiority of knowledge distillation and offering practical guidance for method selection and future research. Our source code is available at https://github.com/Quanato607/AdaMM.

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arXiv2026

RxEval: A Prescription-Level Benchmark for Evaluating LLM Medication Recommendation

Inpatient medication recommendation requires clinicians to repeatedly select specific medications, doses, and routes as a patient's condition evolves. Existing benchmarks formulate this task as admission-level prediction over coarse drug codes with multi-hot diagnostic and procedure code inputs, failing to capture the per-timepoint, information-rich nature of real prescribing. We propose RxEval, a prescription-level benchmark that evaluates LLM prescribing capability by multiple-choice questions: each question presents a detailed patient profile and time-ordered clinical trajectory, requiring selection of specific medication-dose-route triples from real prescriptions and patient-specific distractors generated via reasoning-chain perturbation. RxEval comprises 1,547 questions spanning 584 patients, 18 diagnostic categories, and 969 unique medications. Evaluation of 16 LLMs shows that RxEval is both challenging and discriminative: F1 ranges from 45.18 to 77.10 across models, and the best Exact Match is only 46.10%. Error analysis reveals that even frontier models may overlook stated patient information and fail to derive clinical conclusions.

cs.LG↗

arXiv2026

USCNet: Transformer-Based Multimodal Fusion with Segmentation Guidance for Urolithiasis Classification

Kidney stone disease ranks among the most prevalent conditions in urology, and understanding the composition of these stones is essential for creating personalized treatment plans and preventing recurrence. Current methods for analyzing kidney stones depend on postoperative specimens, which prevents rapid classification before surgery. To overcome this limitation, we introduce a new approach called the Urinary Stone Segmentation and Classification Network (USCNet). This innovative method allows for precise preoperative classification of kidney stones by integrating Computed Tomography (CT) images with clinical data from Electronic Health Records (EHR). USCNet employs a Transformer-based multimodal fusion framework with CT-EHR attention and segmentation-guided attention modules for accurate classification. Moreover, a dynamic loss function is introduced to effectively balance the dual objectives of segmentation and classification. Experiments on an in-house kidney stone dataset show that USCNet demonstrates outstanding performance across all evaluation metrics, with its classification efficacy significantly surpassing existing mainstream methods. This study presents a promising solution for the precise preoperative classification of kidney stones, offering substantial clinical benefits. The source code has been made publicly available: https://github.com/ZhangSongqi0506/KidneyStone.

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arXiv2026

WeatherRemover: All-in-one Adverse Weather Removal with Multi-scale Feature Map Compression

Photographs taken in adverse weather conditions often suffer from blurriness, occlusion, and low brightness due to interference from rain, snow, and fog. These issues can significantly hinder the performance of subsequent computer vision tasks, making the removal of weather effects a crucial step in image enhancement. Existing methods primarily target specific weather conditions, with only a few capable of handling multiple weather scenarios. However, mainstream approaches often overlook performance considerations, resulting in large parameter sizes, long inference times, and high memory costs. In this study, we introduce the WeatherRemover model, designed to enhance the restoration of images affected by various weather conditions while balancing performance. Our model adopts a UNet-like structure with a gating mechanism and a multi-scale pyramid vision Transformer. It employs channel-wise attention derived from convolutional neural networks to optimize feature extraction, while linear spatial reduction helps curtail the computational demands of attention. The gating mechanisms, strategically placed within the feed-forward and downsampling phases, refine the processing of information by selectively addressing redundancy and mitigating its influence on learning. This approach facilitates the adaptive selection of essential data, ensuring superior restoration and maximizing efficiency. Additionally, our lightweight model achieves an optimal balance between restoration quality, parameter efficiency, computational overhead, and memory usage, distinguishing it from other multi-weather models, thereby meeting practical application demands effectively. The source code is available at https://github.com/RICKand-MORTY/WeatherRemover.

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arXiv2026

Balancing Efficiency and Restoration: Lightweight Mamba-Based Model for CT Metal Artifact Reduction

In computed tomography imaging, metal implants frequently generate severe artifacts that compromise image quality and hinder diagnostic accuracy. There are three main challenges in the existing methods: the deterioration of organ and tissue structures, dependence on sinogram data, and an imbalance between resource use and restoration efficiency. Addressing these issues, we introduce MARMamba, which effectively eliminates artifacts caused by metals of different sizes while maintaining the integrity of the original anatomical structures of the image. Furthermore, this model only focuses on CT images affected by metal artifacts, thus negating the requirement for additional input data. The model is a streamlined UNet architecture, which incorporates multi-scale Mamba (MS-Mamba) as its core module. Within MS-Mamba, a flip mamba block captures comprehensive contextual information by analyzing images from multiple orientations. Subsequently, the average maximum feed-forward network integrates critical features with average features to suppress the artifacts. This combination allows MARMamba to reduce artifacts efficiently. The experimental results demonstrate that our model excels in reducing metal artifacts, offering distinct advantages over other models. It also strikes an optimal balance between computational demands, memory usage, and the number of parameters, highlighting its practical utility in the real world. The code of the presented model is available at: https://github.com/RICKand-MORTY/MARMamba.

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arXiv2026

Cross-Slice Knowledge Transfer via Masked Multi-Modal Heterogeneous Graph Contrastive Learning for Spatial Gene Expression Inference

While spatial transcriptomics (ST) has advanced our understanding of gene expression in tissue context, its high experimental cost limits its large-scale application. Predicting ST from pathology images is a promising, cost-effective alternative, but existing methods struggle to capture complex cross-slide spatial relationships. To address the challenge, we propose SpaHGC, a multi-modal heterogeneous graph-based model that captures both intra-slice and inter-slice spot-spot relationships from histology images. It integrates local spatial context within the target slide and cross-slide similarities computed from image embeddings extracted by a pathology foundation model. These embeddings enable inter-slice knowledge transfer, and SpaHGC further incorporates Masked Graph Contrastive Learning to enhance feature representation and transfer spatial gene expression knowledge from reference to target slides, enabling it to model complex spatial dependencies and significantly improve prediction accuracy. We conducted comprehensive benchmarking on seven matched histology-ST datasets from different platforms, tissues, and cancer subtypes. The results demonstrate that SpaHGC significantly outperforms the existing nine state-of-the-art methods across all evaluation metrics. Additionally, the predictions are significantly enriched in multiple cancer-related pathways, thereby highlighting its strong biological relevance and application potential.

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arXiv2026

Towards Accurate and Interpretable Time-series Forecasting: A Polynomial Learning Approach

Time series forecasting enables early warning and has driven asset performance management from traditional planned maintenance to predictive maintenance. However, the lack of interpretability in forecasting methods undermines users' trust and complicates debugging for developers. Consequently, interpretable time-series forecasting has attracted increasing research attention. Nevertheless, existing methods suffer from several limitations, including insufficient modeling of temporal dependencies, lack of feature-level interpretability to support early warning, and difficulty in simultaneously achieving the accuracy and interpretability. This paper proposes the interpretable polynomial learning (IPL) method, which integrates interpretability into the model structure by explicitly modeling original features and their interactions of arbitrary order through polynomial representations. This design preserves temporal dependencies, provides feature-level interpretability, and offers a flexible trade-off between prediction accuracy and interpretability by adjusting the polynomial degree. We evaluate IPL on simulated and Bitcoin price data, showing that it achieves high prediction accuracy with superior interpretability compared with widely used explainability methods. Experiments on field-collected antenna data further demonstrate that IPL yields simpler and more efficient early warning mechanisms.

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arXiv2026

Brain-HGCN: A Hyperbolic Graph Convolutional Network for Brain Functional Network Analysis

Functional magnetic resonance imaging (fMRI) reveals complex brain functional networks with hierarchical topologies crucial for cognitive processing. Standard Euclidean Graph Neural Networks (GNNs) often struggle to represent these hierarchical structures without high distortion due to inherent spatial constraints. We propose Brain-HGCN, a geometric deep learning framework based on hyperbolic geometry, which leverages negatively curved space to model brain network hierarchy with high fidelity. Grounded in the Lorentz model, our framework employs a novel hyperbolic graph attention layer with a signed aggregation mechanism to distinctly process excitatory and inhibitory connections. Furthermore, we learn robust graph-level representations via a geometrically principled Fréchet mean for graph readout. Experiments on two large-scale fMRI datasets for psychiatric disorder classification demonstrate that Brain-HGCN significantly outperforms state-of-the-art Euclidean baselines. This work highlights the potential of hyperbolic GNNs in computational psychiatry by pioneering a new geometric paradigm for fMRI analysis.

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arXiv2026

Geodesic Prototype Matching via Diffusion Maps for Interpretable Fine-Grained Recognition

Nonlinear manifolds are pervasive in deep visual features, where Euclidean distances can misrepresent true similarity. This mismatch is particularly detrimental to prototype-based interpretable fine-grained recognition, where even subtle semantic distinctions are crucial. To mitigate this issue, this work presents a novel paradigm for prototype-based recognition by grounding similarity in the intrinsic geometry of deep features. Concretely, we distill the latent manifold structure of each class into a diffusion space and, critically, devise a differentiable Nyström interpolation to make this geometry accessible to both unseen samples and learnable prototypes. To maintain efficiency, we employ compact per-class landmark sets with periodic updates. This strategy keeps the embedding synchronized with the evolving backbone, enabling fast inference at scale. Comprehensive experiments on two benchmark datasets demonstrate that our GeoProto yields prototypes focusing on semantically corresponding parts, significantly outperforming Euclidean prototype networks.

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arXiv2026

RTGMFF: Enhanced fMRI-based Brain Disorder Diagnosis via ROI-driven Text Generation and Multimodal Feature Fusion

Functional magnetic resonance imaging (fMRI) is a powerful tool for probing brain function, yet reliable clinical diagnosis is hampered by low signal-to-noise ratios, inter-subject variability, and the limited frequency awareness of prevailing CNN- and Transformer-based models. Moreover, most fMRI datasets lack textual annotations that could contextualize regional activation and connectivity patterns. We introduce RTGMFF, a framework that unifies automatic ROI-level text generation with multimodal feature fusion for brain-disorder diagnosis. RTGMFF consists of three components: (i) ROI-driven fMRI text generation deterministically condenses each subject's activation, connectivity, age, and sex into reproducible text tokens; (ii) Hybrid frequency-spatial encoder fuses a hierarchical wavelet-mamba branch with a cross-scale Transformer encoder to capture frequency-domain structure alongside long-range spatial dependencies; and (iii) Adaptive semantic alignment module embeds the ROI token sequence and visual features in a shared space, using a regularized cosine-similarity loss to narrow the modality gap. Extensive experiments on the ADHD-200 and ABIDE benchmarks show that RTGMFF surpasses current methods in diagnostic accuracy, achieving notable gains in sensitivity, specificity, and area under the ROC curve. Code is available at https://github.com/BeistMedAI/RTGMFF.

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arXiv2025

DGSAN: Dual-Graph Spatiotemporal Attention Network for Pulmonary Nodule Malignancy Prediction

Lung cancer continues to be the leading cause of cancer-related deaths globally. Early detection and diagnosis of pulmonary nodules are essential for improving patient survival rates. Although previous research has integrated multimodal and multi-temporal information, outperforming single modality and single time point, the fusion methods are limited to inefficient vector concatenation and simple mutual attention, highlighting the need for more effective multimodal information fusion. To address these challenges, we introduce a Dual-Graph Spatiotemporal Attention Network, which leverages temporal variations and multimodal data to enhance the accuracy of predictions. Our methodology involves developing a Global-Local Feature Encoder to better capture the local, global, and fused characteristics of pulmonary nodules. Additionally, a Dual-Graph Construction method organizes multimodal features into inter-modal and intra-modal graphs. Furthermore, a Hierarchical Cross-Modal Graph Fusion Module is introduced to refine feature integration. We also compiled a novel multimodal dataset named the NLST-cmst dataset as a comprehensive source of support for related research. Our extensive experiments, conducted on both the NLST-cmst and curated CSTL-derived datasets, demonstrate that our DGSAN significantly outperforms state-of-the-art methods in classifying pulmonary nodules with exceptional computational efficiency.

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arXiv2025

Towards Practical Alzheimer's Disease Diagnosis: A Lightweight and Interpretable Spiking Neural Model

Early diagnosis of Alzheimer's Disease (AD), particularly at the mild cognitive impairment stage, is essential for timely intervention. However, this process faces significant barriers, including reliance on subjective assessments and the high cost of advanced imaging techniques. While deep learning offers automated solutions to improve diagnostic accuracy, its widespread adoption remains constrained due to high energy requirements and computational demands, particularly in resource-limited settings. Spiking neural networks (SNNs) provide a promising alternative, as their brain-inspired design is well-suited to model the sparse and event-driven patterns characteristic of neural degeneration in AD. These networks offer the potential for developing interpretable, energy-efficient diagnostic tools. Despite their advantages, existing SNNs often suffer from limited expressiveness and challenges in stable training, which reduce their effectiveness in handling complex medical tasks. To address these shortcomings, we introduce FasterSNN, a hybrid neural architecture that combines biologically inspired Leaky Integrate-and-Fire (LIF) neurons with region-adaptive convolution and multi-scale spiking attention mechanisms. This approach facilitates efficient, sparse processing of 3D MRI data while maintaining high diagnostic accuracy. Experimental results on benchmark datasets reveal that FasterSNN delivers competitive performance with significantly enhanced efficiency and training stability, highlighting its potential for practical application in AD screening. Our source code is available at https://github.com/wuchangw/FasterSNN.

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arXiv2025

WDT-MD: Wavelet Diffusion Transformers for Microaneurysm Detection in Fundus Images

Microaneurysms (MAs), the earliest pathognomonic signs of Diabetic Retinopathy (DR), present as sub-60 $μm$ lesions in fundus images with highly variable photometric and morphological characteristics, rendering manual screening not only labor-intensive but inherently error-prone. While diffusion-based anomaly detection has emerged as a promising approach for automated MA screening, its clinical application is hindered by three fundamental limitations. First, these models often fall prey to "identity mapping", where they inadvertently replicate the input image. Second, they struggle to distinguish MAs from other anomalies, leading to high false positives. Third, their suboptimal reconstruction of normal features hampers overall performance. To address these challenges, we propose a Wavelet Diffusion Transformer framework for MA Detection (WDT-MD), which features three key innovations: a noise-encoded image conditioning mechanism to avoid "identity mapping" by perturbing image conditions during training; pseudo-normal pattern synthesis via inpainting to introduce pixel-level supervision, enabling discrimination between MAs and other anomalies; and a wavelet diffusion Transformer architecture that combines the global modeling capability of diffusion Transformers with multi-scale wavelet analysis to enhance reconstruction of normal retinal features. Comprehensive experiments on the IDRiD and e-ophtha MA datasets demonstrate that WDT-MD outperforms state-of-the-art methods in both pixel-level and image-level MA detection. This advancement holds significant promise for improving early DR screening.

cs.CV↗

arXiv2025

A Large Scale Benchmark for Test Time Adaptation Methods in Medical Image Segmentation

Test time Adaptation is a promising approach for mitigating domain shift in medical image segmentation; however, current evaluations remain limited in terms of modality coverage, task diversity, and methodological consistency. We present MedSeg-TTA, a comprehensive benchmark that examines twenty representative adaptation methods across seven imaging modalities, including MRI, CT, ultrasound, pathology, dermoscopy, OCT, and chest X-ray, under fully unified data preprocessing, backbone configuration, and test time protocols. The benchmark encompasses four significant adaptation paradigms: Input-level Transformation, Feature-level Alignment, Output-level Regularization, and Prior Estimation, enabling the first systematic cross-modality comparison of their reliability and applicability. The results show that no single paradigm performs best in all conditions. Input-level methods are more stable under mild appearance shifts. Feature-level and Output-level methods offer greater advantages in boundary-related metrics, whereas prior-based methods exhibit strong modality dependence. Several methods degrade significantly under large inter-center and inter-device shifts, which highlights the importance of principled method selection for clinical deployment. MedSeg-TTA provides standardized datasets, validated implementations, and a public leaderboard, establishing a rigorous foundation for future research on robust, clinically reliable test-time adaptation. All source codes and open-source datasets are available at https://github.com/wenjing-gg/MedSeg-TTA.

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arXiv2025

LungNoduleAgent: A Collaborative Multi-Agent System for Precision Diagnosis of Lung Nodules

Diagnosing lung cancer typically involves physicians identifying lung nodules in Computed tomography (CT) scans and generating diagnostic reports based on their morphological features and medical expertise. Although advancements have been made in using multimodal large language models for analyzing lung CT scans, challenges remain in accurately describing nodule morphology and incorporating medical expertise. These limitations affect the reliability and effectiveness of these models in clinical settings. Collaborative multi-agent systems offer a promising strategy for achieving a balance between generality and precision in medical applications, yet their potential in pathology has not been thoroughly explored. To bridge these gaps, we introduce LungNoduleAgent, an innovative collaborative multi-agent system specifically designed for analyzing lung CT scans. LungNoduleAgent streamlines the diagnostic process into sequential components, improving precision in describing nodules and grading malignancy through three primary modules. The first module, the Nodule Spotter, coordinates clinical detection models to accurately identify nodules. The second module, the Radiologist, integrates localized image description techniques to produce comprehensive CT reports. Finally, the Doctor Agent System performs malignancy reasoning by using images and CT reports, supported by a pathology knowledge base and a multi-agent system framework. Extensive testing on two private datasets and the public LIDC-IDRI dataset indicates that LungNoduleAgent surpasses mainstream vision-language models, agent systems, and advanced expert models. These results highlight the importance of region-level semantic alignment and multi-agent collaboration in diagnosing nodules. LungNoduleAgent stands out as a promising foundational tool for supporting clinical analyses of lung nodules.

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