arXiv subjects

Haifan Gong

Publications and source records attributed to Haifan Gong.

17 recordsLinked to original sources

arXiv2026

Auditable agentic AI for evidence-grounded thyroid ultrasound diagnosis and reporting

Thyroid ultrasound diagnosis requires coordinated lesion localization, measurement, risk stratification and reporting, yet most AI systems address these tasks in isolation and provide limited support for clinical review. We present ThyroidXAgent, a clinician-interactive agentic AI system that coordinates specialized diagnostic tools and stores their outputs as an auditable case-level evidence record. The system was developed using OpenThyroidDB, a multicentre, multitask resource integrating approximately 0.3 million ultrasound images and 24,000 paired reports, and was evaluated on 28,458 non-overlapping test cases, including 8,721 cases from 35 centres in the private NHC-MISD-TUS cohort. Across heterogeneous datasets, ThyroidXAgent achieved a mean Dice score of 87.21 percent for nodule segmentation and a mean AUROC of 0.9466 for benign-malignant classification. The same workflow supported lymph-node metastasis prediction and follicular versus papillary thyroid carcinoma classification, with AUROCs of 0.864 and 0.805, respectively. For report generation, evidence-grounded assembly outperformed multimodal language-model baselines across three cohorts. ThyClinScore, a lesion-level clinical semantic metric introduced here, showed the strongest correlation with a location-aware language-model judge. ThyroidXAgent improved physician classification accuracy, increased report diagnostic consistency from 70.3 percent to 86.2 percent, and reduced segmentation and reporting time by 35.9 percent and 27.4 percent, respectively. These findings support auditable, clinician-correctable agentic AI for thyroid ultrasound diagnosis and reporting.

cs.AI↗

arXiv2026

Learning How Much, Not Just What: Cross-Patient Burden Order for CT Vision-Language Pretraining

Volumetric CT vision-language pretraining learns 3D representations from scan-report pairs, but global and anatomy-aware objectives supervise only correspondence: they establish what is present and leave how much unconstrained. Nothing separates a mild from an extensive case of the same finding along a consistent direction, so the graded burden language in reports collapses into a present/absent signal. Longitudinal supervision would supply this order, but patient-matched CT pairs are scarce at scale; cross-sectional cohorts already encode weak burden cues across different patients. We introduce Spectrum, an anatomy-conditioned framework that represents each study at whole-study and organ scopes. For each organ-mapped pathology, a rule-based scorer mines confidence-filtered lower-to-higher pairs of different patients, and Burden-Direction Alignment (BDA) aligns the pathology-conditioned image delta with the report delta at each scope, separating that direction from its reverse. Because the endpoints are different people, a target-conditioned aligner first makes them comparable, so the delta reflects burden rather than between-patient variation. BDA further separates the selected direction from its reverse, anchors it to the observed higher-burden endpoint, and enforces consistency across ordered triplets. Since every pair is drawn within a single pathology, BDA is designed to constrain intra-class structure that image-report contrast alone never touches. Spectrum attains 85.6 zero-shot AUROC on CT-RATE and 72.7 on external RAD-ChestCT, with consistent gains in linear probing and retrieval. Weak cross-patient order is thus a scalable complement to anatomy-aware correspondence, yielding burden-aware CT representations without longitudinal data.

cs.CV↗

arXiv2026

Semantically Calibrated Evidence Composition for CT Vision-Language Learning

Learning transferable representations from CT-report pairs requires combining whole-volume context with anatomy-specific evidence. Existing methods typically emphasize either global CT-report alignment or fine-grained anatomy-level correspondence. Global alignment preserves broad study context but leaves the contribution of localized evidence implicit, whereas anatomy-level alignment explicitly grounds local findings but does not specify how independently represented evidence should interact, acquire study-level meaning, and contribute to a global CT representation. To address this gap, we propose SCOPE (Semantic Calibration Of comPosed Evidence), a framework for semantically calibrated evidence composition in CT vision-language learning. Under organ-specific report supervision, mask-guided queries with fixed anatomical identities extract context-aware organ evidence from shared, uncropped volumetric features, while an unrestricted global query retains access to whole-volume context. The global query then drives Local-Global Coupling to compose the organ evidence into a unified evidence representation. The composed evidence is subsequently calibrated using the diagnostic summary, providing study-level semantic supervision beyond local organ descriptions, and is finally integrated as a controlled residual into a context-preserving whole-volume representation aligned with the complete report. This progressive pathway connects localized evidence with study-level semantics without reducing the CT representation to a predefined set of organs. On CT-RATE and RadChestCT, SCOPE achieves macro AUCs of 85.0 and 72.2, respectively, outperforming the previous SOTA by 7.2 and 4.2, while also yielding substantial gains in linear probing and cross-modal retrieval. These results demonstrate the effectiveness of semantically calibrated evidence composition.

cs.CV↗

arXiv2026

AuricularWorld: Hierarchical Action-Guided World Modeling for Fine-Grained Auricular Structure Segmentation from CT Scans

Fine-grained segmentation of auricular structures in CT is challenging because the ear occupies a small image region, cartilage boundaries are highly irregular, and interfaces between cartilage and surrounding soft tissues are often ambiguous. Clinical annotations may also include both composite structures containing cartilage and adjacent skin and their corresponding cartilage-only regions, producing nested and overlapping labels. We propose a world-model-based segmentation framework that enables iterative anatomical reasoning beyond conventional feed-forward prediction. Built on an encoder-decoder architecture, the framework introduces a deterministic recurrent state-space model into the intermediate latent space. Multi-scale encoder features and partially decoded representations are fused to form a structural observation that initializes the latent dynamics. During inference, the model performs a three-step latent rollout without ground-truth guidance. Hierarchical anatomical actions update the recurrent state and progressively refine the latent representation. The resulting latent trajectory is projected back into the decoder and combined with high-resolution features to produce the final segmentation. To learn reliable latent transitions, we introduce a balanced hierarchical action objective that addresses foreground sparsity, missing anatomical groups, and imbalance between add and remove operations. Extensive experiments show that the proposed framework consistently improves segmentation accuracy and reduces HD95 by more than 43% for small, irregular, and overlapping auricular structures in CT. These results demonstrate the effectiveness of latent world-model reasoning for challenging medical image segmentation.

cs.CV↗

arXiv2026

Medical world models in healthcare: foundations, applications, and challenges for trustworthy clinical translation

Medical world models offer a framework for extending medical artificial intelligence beyond static prediction by representing evolving patient states and modelling how they change over time and in response to clinical interventions. This Review defines the conceptual boundaries, technical foundations, application domains, and evidence requirements of the field through a structured narrative synthesis with reproducible evidence mapping. We screened 1,455 unique records and assembled a corpus of 98 sources, including 14 studies that met a strict empirical definition of a medical world model. The field is organised around four capabilities: patient state representation, temporal dynamics modelling, intervention-conditioned simulation, and clinician-supervised planning. Evidence spans medical imaging, longitudinal electronic health records, treatment response modelling, physiological and multimodal state modelling, ultrasound and surgical interaction, and population and health-system simulation; clinical digital twins are treated as a cross-cutting integration framework. Current studies provide early evidence of technical feasibility for trajectory forecasting and comparison of candidate interventions, but most remain retrospective, task-specific, or preclinical. The evidence base is further limited by incomplete longitudinal intervention data, inconsistent action semantics, limited causal identifiability, long-horizon error accumulation, inadequate uncertainty estimation, and limited external validation. Clinical translation will therefore depend on precise intervention representations, robust causal and mechanistic grounding, calibrated trajectory-level uncertainty, safety-constrained planning, and prospective multicentre validation against clinically meaningful endpoints.

cs.CV↗

arXiv2026

Agentic AI in medicine: architectures, applications, evaluation, and challenges for clinical translation

Large language models and multimodal foundation models are enabling medical artificial intelligence (AI) systems to move beyond isolated prediction and undertake multistep clinical tasks that require planning, tool use, memory, iterative correction, and coordination among specialized agents. However, the scope of agentic AI in medicine remains unsettled, and current evaluation practices are not yet aligned with the requirements of clinical use. We conducted a scoping review with systematic evidence mapping across five electronic sources, screened 1,649 exportable records, and provisionally included 557 unique studies that met predefined criteria for goal-directed task execution, tool use, interaction with external resources, feedback-based refinement, or multi-agent collaboration. The included studies describe single agents that use external tools, workflows supported by retrieval and external knowledge, multimodal agents, and multi-agent systems applied to medical question answering, image interpretation, electronic health record analysis, drug safety, and clinical trial prediction. The evidence base remains dominated by public benchmarks, simulated settings, retrospective datasets, and small-scale expert evaluation. Process reliability, evidence traceability, uncertainty, safety, workflow impact, and external validity are evaluated less consistently. Clinical translation will depend on clearer definitions, reproducible evaluation, auditable oversight, interoperable system design, and prospective validation in real-world clinical workflows.

cs.CV↗

arXiv2026

DreamReg: Belief-Driven World Model for 2D-3D Ultrasound Registration

Ultrasound (US) is widely used for surgical navigation, yet real-time registration between intraoperative 2D slices and preoperative 3D volumes remains challenging due to partial observability, speckle noise, and the action-dependent US acquisition. Existing methods are one-shot or short-horizon, making it hard for them to gather evidence over time or capture how surgeons adjust probe motion based on on-screen feedback. We propose DreamReg, a belief-driven world-model framework that formulates 2D-3D registration as belief updating over rigid transformations. DreamReg maintains a latent belief state that summarizes past observations and poses information, and continuously refines the transformation through learned dynamics as new slices arrive. During training, DreamReg is exposed to probe-motion trajectories that mimic clinical scanning behavior and learns to update its belief by conditioning pose refinement on the current US observation. During inference, DreamReg refines registration via internal imagination: it rolls out the learned world model to simulate candidate probe motions and their predicted observations, and integrates these imagined outcomes to converge to an accurate rigid transformation. Experiments on CAMUS and u-RegPro datasets demonstrate improved robustness and competitive registration accuracy for real-time guidance compared with state-of-the-art methods.

cs.CV↗

arXiv2024

Costal Cartilage Segmentation with Topology Guided Deformable Mamba: Method and Benchmark

Costal cartilage segmentation is crucial to various medical applications, necessitating precise and reliable techniques due to its complex anatomy and the importance of accurate diagnosis and surgical planning. We propose a novel deep learning-based approach called topology-guided deformable Mamba (TGDM) for costal cartilage segmentation. The TGDM is tailored to capture the intricate long-range costal cartilage relationships. Our method leverages a deformable model that integrates topological priors to enhance the adaptability and accuracy of the segmentation process. Furthermore, we developed a comprehensive benchmark that contains 165 cases for costal cartilage segmentation. This benchmark sets a new standard for evaluating costal cartilage segmentation techniques and provides a valuable resource for future research. Extensive experiments conducted on both in-domain benchmarks and out-of domain test sets demonstrate the superiority of our approach over existing methods, showing significant improvements in segmentation precision and robustness.

eess.IV↗

arXiv2024

Diffuse-UDA: Addressing Unsupervised Domain Adaptation in Medical Image Segmentation with Appearance and Structure Aligned Diffusion Models

The scarcity and complexity of voxel-level annotations in 3D medical imaging present significant challenges, particularly due to the domain gap between labeled datasets from well-resourced centers and unlabeled datasets from less-resourced centers. This disparity affects the fairness of artificial intelligence algorithms in healthcare. We introduce Diffuse-UDA, a novel method leveraging diffusion models to tackle Unsupervised Domain Adaptation (UDA) in medical image segmentation. Diffuse-UDA generates high-quality image-mask pairs with target domain characteristics and various structures, thereby enhancing UDA tasks. Initially, pseudo labels for target domain samples are generated. Subsequently, a specially tailored diffusion model, incorporating deformable augmentations, is trained on image-label or image-pseudo-label pairs from both domains. Finally, source domain labels guide the diffusion model to generate image-label pairs for the target domain. Comprehensive evaluations on several benchmarks demonstrate that Diffuse-UDA outperforms leading UDA and semi-supervised strategies, achieving performance close to or even surpassing the theoretical upper bound of models trained directly on target domain data. Diffuse-UDA offers a pathway to advance the development and deployment of AI systems in medical imaging, addressing disparities between healthcare environments. This approach enables the exploration of innovative AI-driven diagnostic tools, improves outcomes, saves time, and reduces human error.

cs.CV↗

arXiv2024

Intensity Confusion Matters: An Intensity-Distance Guided Loss for Bronchus Segmentation

Automatic segmentation of the bronchial tree from CT imaging is important, as it provides structural information for disease diagnosis. Despite the merits of previous automatic bronchus segmentation methods, they have paied less attention to the issue we term as \textit{Intensity Confusion}, wherein the intensity values of certain background voxels approach those of the foreground voxels within bronchi. Conversely, the intensity values of some foreground voxels are nearly identical to those of background voxels. This proximity in intensity values introduces significant challenges to neural network methodologies. To address the issue, we introduce a novel Intensity-Distance Guided loss function, which assigns adaptive weights to different image voxels for mining hard samples that cause the intensity confusion. The proposed loss estimates the voxel-level hardness of samples, on the basis of the following intensity and distance priors. We regard a voxel as a hard sample if it is in: (1) the background and has an intensity value close to the bronchus region; (2) the bronchus region and is of higher intensity than most voxels inside the bronchus; (3) the background region and at a short distance from the bronchus. Extensive experiments not only show the superiority of our method compared with the state-of-the-art methods, but also verify that tackling the intensity confusion issue helps to significantly improve bronchus segmentation. Project page: https://github.com/lhaof/ICM.

eess.IV↗

arXiv2024

nnMamba: 3D Biomedical Image Segmentation, Classification and Landmark Detection with State Space Model

In the field of biomedical image analysis, the quest for architectures capable of effectively capturing long-range dependencies is paramount, especially when dealing with 3D image segmentation, classification, and landmark detection. Traditional Convolutional Neural Networks (CNNs) struggle with locality respective field, and Transformers have a heavy computational load when applied to high-dimensional medical images.In this paper, we introduce nnMamba, a novel architecture that integrates the strengths of CNNs and the advanced long-range modeling capabilities of State Space Sequence Models (SSMs). Specifically, we propose the Mamba-In-Convolution with Channel-Spatial Siamese learning (MICCSS) block to model the long-range relationship of the voxels. For the dense prediction and classification tasks, we also design the channel-scaling and channel-sequential learning methods. Extensive experiments on 6 datasets demonstrate nnMamba's superiority over state-of-the-art methods in a suite of challenging tasks, including 3D image segmentation, classification, and landmark detection. nnMamba emerges as a robust solution, offering both the local representation ability of CNNs and the efficient global context processing of SSMs, setting a new standard for long-range dependency modeling in medical image analysis. Code is available at https://github.com/lhaof/nnMamba

cs.CV↗

arXiv2023

Visual-Attribute Prompt Learning for Progressive Mild Cognitive Impairment Prediction

Deep learning (DL) has been used in the automatic diagnosis of Mild Cognitive Impairment (MCI) and Alzheimer's Disease (AD) with brain imaging data. However, previous methods have not fully exploited the relation between brain image and clinical information that is widely adopted by experts in practice. To exploit the heterogeneous features from imaging and tabular data simultaneously, we propose the Visual-Attribute Prompt Learning-based Transformer (VAP-Former), a transformer-based network that efficiently extracts and fuses the multi-modal features with prompt fine-tuning. Furthermore, we propose a Prompt fine-Tuning (PT) scheme to transfer the knowledge from AD prediction task for progressive MCI (pMCI) diagnosis. In details, we first pre-train the VAP-Former without prompts on the AD diagnosis task and then fine-tune the model on the pMCI detection task with PT, which only needs to optimize a small amount of parameters while keeping the backbone frozen. Next, we propose a novel global prompt token for the visual prompts to provide global guidance to the multi-modal representations. Extensive experiments not only show the superiority of our method compared with the state-of-the-art methods in pMCI prediction but also demonstrate that the global prompt can make the prompt learning process more effective and stable. Interestingly, the proposed prompt learning model even outperforms the fully fine-tuning baseline on transferring the knowledge from AD to pMCI.

cs.CV↗

arXiv2023

ASC: Appearance and Structure Consistency for Unsupervised Domain Adaptation in Fetal Brain MRI Segmentation

Automatic tissue segmentation of fetal brain images is essential for the quantitative analysis of prenatal neurodevelopment. However, producing voxel-level annotations of fetal brain imaging is time-consuming and expensive. To reduce labeling costs, we propose a practical unsupervised domain adaptation (UDA) setting that adapts the segmentation labels of high-quality fetal brain atlases to unlabeled fetal brain MRI data from another domain. To address the task, we propose a new UDA framework based on Appearance and Structure Consistency, named ASC. We adapt the segmentation model to the appearances of different domains by constraining the consistency before and after a frequency-based image transformation, which is to swap the appearance between brain MRI data and atlases. Consider that even in the same domain, the fetal brain images of different gestational ages could have significant variations in the anatomical structures. To make the model adapt to the structural variations in the target domain, we further encourage prediction consistency under different structural perturbations. Extensive experiments on FeTA 2021 benchmark demonstrate the effectiveness of our ASC in comparison to registration-based, semi-supervised learning-based, and existing UDA-based methods.

eess.IV↗

arXiv2022

A Survey of Natural Language Generation

This paper offers a comprehensive review of the research on Natural Language Generation (NLG) over the past two decades, especially in relation to data-to-text generation and text-to-text generation deep learning methods, as well as new applications of NLG technology. This survey aims to (a) give the latest synthesis of deep learning research on the NLG core tasks, as well as the architectures adopted in the field; (b) detail meticulously and comprehensively various NLG tasks and datasets, and draw attention to the challenges in NLG evaluation, focusing on different evaluation methods and their relationships; (c) highlight some future emphasis and relatively recent research issues that arise due to the increasing synergy between NLG and other artificial intelligence areas, such as computer vision, text and computational creativity.

cs.CL↗

arXiv2022

Less is More: Adaptive Curriculum Learning for Thyroid Nodule Diagnosis

Thyroid nodule classification aims at determining whether the nodule is benign or malignant based on a given ultrasound image. However, the label obtained by the cytological biopsy which is the golden standard in clinical medicine is not always consistent with the ultrasound imaging TI-RADS criteria. The information difference between the two causes the existing deep learning-based classification methods to be indecisive. To solve the Inconsistent Label problem, we propose an Adaptive Curriculum Learning (ACL) framework, which adaptively discovers and discards the samples with inconsistent labels. Specifically, ACL takes both hard sample and model certainty into account, and could accurately determine the threshold to distinguish the samples with Inconsistent Label. Moreover, we contribute TNCD: a Thyroid Nodule Classification Dataset to facilitate future related research on the thyroid nodules. Extensive experimental results on TNCD based on three different backbone networks not only demonstrate the superiority of our method but also prove that the less-is-more principle which strategically discards the samples with Inconsistent Label could yield performance gains. Source code and data are available at https://github.com/chenghui-666/ACL/.

cs.CV↗

arXiv2022

BCNet: Bronchus Classification via Structure Guided Representation Learning

CT-based bronchial tree analysis is essential for diagnosing lung and airway diseases, yet automatic bronchus classification remains challenging because bronchial topology varies substantially across individuals. We propose the Bronchus Classification Network (BCNet), a structure-guided framework that uses segment-level topological information from point clouds to improve voxel-level representation learning. BCNet contains two jointly trained branches: a Point-Voxel Graph Neural Network (PV-GNN) for segment classification and a Convolutional Neural Network (CNN) for voxel-wise labeling. The branches share a common convolutional backbone, allowing topology-aware supervision from the PV-GNN to enhance voxel-level features. During inference, only the CNN branch is required, so BCNet retains the computational efficiency of its CNN baseline. Experiments on BronAtlas demonstrate that BCNet outperforms state-of-the-art methods by more than 8.0% in F1-score for bronchus classification. We also introduce BronAtlas, an open-access benchmark for bronchial imaging analysis that contains high-quality voxel-wise annotations of anatomical and abnormal bronchial segments. BronAtlas provides a valuable resource for developing and evaluating advanced methods for bronchial tree analysis, disease diagnosis, and surgical planning.

eess.IV↗

arXiv2021

Cross-Modal Self-Attention with Multi-Task Pre-Training for Medical Visual Question Answering

Due to the severe lack of labeled data, existing methods of medical visual question answering usually rely on transfer learning to obtain effective image feature representation and use cross-modal fusion of visual and linguistic features to achieve question-related answer prediction. These two phases are performed independently and without considering the compatibility and applicability of the pre-trained features for cross-modal fusion. Thus, we reformulate image feature pre-training as a multi-task learning paradigm and witness its extraordinary superiority, forcing it to take into account the applicability of features for the specific image comprehension task. Furthermore, we introduce a cross-modal self-attention~(CMSA) module to selectively capture the long-range contextual relevance for more effective fusion of visual and linguistic features. Experimental results demonstrate that the proposed method outperforms existing state-of-the-art methods. Our code and models are available at https://github.com/haifangong/CMSA-MTPT-4-MedicalVQA.

cs.MM↗