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Jianpeng Zhang

Publications and source records attributed to Jianpeng Zhang.

At least 19 recordsLinked to original sources

UniReg: Conditional Unified Model for Medical Image Registration

Learning-based medical image registration has matched the accuracy of conventional methods while offering superior computational efficiency. However, existing approaches suffer from poor generalization across diverse clinical scenarios, requiring the laborious development of multiple isolated networks for specific registration tasks, \emph{e.g.}, inter-/intra-subject registration or anatomical region-specific alignment, leading to cumbersome development pipelines. To overcome this limitation, we propose \textbf{UniReg}, the first conditional unified model for multi-scenario medical image registration, which combines the precision advantages of task-specific learning methods with the generalization of traditional optimization methods. Our key innovation is a unified registration framework that adaptively estimates deformation fields conditioned on: (1) anatomical structure priors, (2) registration type constraints (inter/intra-subject), and (3) instance-specific features, enabling effective alignment across heterogeneous CT and MR registration scenarios within a single model. Through comprehensive experiments on multiple CT/MR registration datasets, UniReg achieves superior average registration accuracy compared with current state-of-the-art learning-based methods while exhibiting strong cross-scenario generalization. Moreover, by replacing multiple isolated task-specific models with a compact unified model, UniReg substantially reduces the overall training burden in terms of total training cost and model redundancy.

cs.CV

RadSight: Towards Perceptually Reliable Multimodal Radiology Image Understanding

Medical multimodal large language models (MLLMs) are increasingly expected to perform complex image understanding tasks, yet their reliability is often compromised by frequent errors in visual interpretation. To systematically trace these failures, we traverse the hierarchy from high-level clinical tasks down to fundamental visual perception. We therefore introduce Perception-Bench, a large-scale benchmark comprising 1.13 million samples that assesses medical MLLMs across six dimensions: attribute judgment, spatial grounding, spatial understanding, disease prediction, anomaly detection, and report generation, spanning both 2D and 3D radiology images. Our analysis on Perception-Bench reveals that existing MLLMs lack the ability to capture even the most basic lesion attributes, such as location, size, and density. This inability to ground clinical outputs in primary visual evidence reveals that the models' diagnostic unreliability is rooted in a critical but overlooked bottleneck in low-level visual perception. Motivated by this, we propose RadSight, a perception-driven MLLM built upon a dual 2D/3D encoder architecture that preserves native imaging spatial structures. RadSight formulates medical image understanding as a four-stage progressive process: visual-language alignment, fine-grained visual perception, clinical diagnosis, and diagnostic interpretation. The model is trained on an 8.37 million perception-oriented corpus using progressive curriculum learning. On Perception-Bench, RadSight consistently outperforms existing MLLMs across all six evaluation dimensions, with particularly strong gains in spatial grounding and clinical diagnosis. It also achieves consistent improvements on public 2D and 3D medical benchmarks, further demonstrating that robust low-level visual perception is a critical foundation for reliable clinical understanding. Code and model will be publicly available.

cs.CV

Super-Generalist: Towards Comprehensive and Accurate Medical Image Understanding via Generalist-Specialist Synergy

Medical images require comprehensive and accurate interpretation to support the diagnosis of diverse clincial conditions. Recent vision-language generalist models offer broad task coverage and promising zero-shot capabilities, yet often lack fine-grained anatomical and lesion awareness for reliable diagnosis and spatial interpretability. In contrast, supervised specialist models achieve strong performance on specific tasks but typically lack generalization across diseases and anatomies. In this work, we present SuG, a Super-Generalist framework that unifies generalist vision-language learning with specialist objectives, enabling both broad generalization and specialist-level diagnostic capability. We perform specialist-enhanced vision-language alignment in SuG by incorporating spatial priors from multiple segmentation experts, including anatomy, class-specific lesion and class-agnostic lesion segmentors that captures lesions beyond anatomies annotated during training. To improve lesion grounding capability, we leverage lesion masks as spatial priors to calibrate text-conditioned visual attention, encouraging disease-related semantics to focus on clinically relevant regions. We evaluate SuG on extensive chest and abdominal CT benchmarks, including CT-RATE, Merlin, MedVL-CT69K, and several in-house tumor datasets. SuG achieves state-of-the-art performance across a wide range of disease diagnosis tasks and surpasses specialist models on several critical tumor diagnosis benchmarks. Furthermore, SuG demonstrates strong lesion grounding capability, including robust generalization to lesion types lacking class-specific supervision.

cs.CV

AtomiMed: Hierarchical Atomic Fact-Checking for Universal Clinical-Aware Medical Report Evaluation

Traditional metrics for Medical Report Generation (MRG) predominantly rely on surface-level n-gram overlap, which fails to capture clinical factual accuracy and often overlooks catastrophic diagnostic errors. We address this fundamental limitation by proposing \textbf{AtomiMed}, a universal, modality-agnostic evaluation framework that decomposes complex medical narratives into a standardized, multi-level hierarchy of Atomic Clinical Facts, encompassing Disease-level entities and Attribute-level descriptors, including location, morphology, and severity. By implementing an Agentic Cross-Verification loop between ground-truth and predicted reports, AtomiMed simulates a multi-radiologist peer-review process to verify clinical consistency, thus enabling the decoupled assessment of diagnostic detection and descriptive accuracy. To facilitate standardized evaluation, we introduce \textbf{MRGEvalKit}, an open-source toolkit for automated hierarchical extraction, and curate \textbf{OmniMRG-Bench}, a comprehensive multi-modal benchmark covering X-ray, CT, MRI, and Ultrasound. Extensive experiments on multiple expert-annotated reader studies demonstrate that AtomiMed achieves significantly higher correlation with human radiologist judgment compared to traditional and model-based metrics. Our code are release at https://github.com/Venn2336/MRGEvalkit

cs.CE

Disease-Centric Vision-Language Pretraining with Hybrid Visual Encoding for 3D Computed Tomography

Vision-language pre-training (VLP) holds great promise for general-purpose medical AI by leveraging radiology reports as rich textual supervision, yet existing methods struggle with 3D CT imaging due to inefficient visual backbones and coarse semantic alignment. To address these issues, we propose a tailored VLP framework featuring three key components: (1) a CNN-ViT hybrid encoder that replaces ViT's patch embedding with a 3D CNN backbone to efficiently capture local anatomical details while preserving global attention and compatibility with pre-trained cross-modal priors; (2) a disease-level contrastive learning mechanism using learnable query tokens to dynamically extract disease-specific semantics from full reports and align them with corresponding visual features, thereby disentangling distinct diseases within the same anatomical region; and (3) a diagnosis-aware prompt strategy that employs real clinical phrases and aggregated disease prototypes to bridge the pre-training-inference gap and enhance zero-shot diagnostic reliability. Our model achieves state-of-the-art performance on CT-RATE (84.4% AUC, +5.1%) and Rad-ChestCT (75.4% AUC, +5.4%), with even larger gains (+9.8% AUC) on a challenging 60-disease benchmark, and demonstrates strong transferability to radiology report generation, underscoring the generality and clinical utility of our approach.

cs.CV

CT-FineBench: A Diagnostic Fidelity Benchmark for Fine-Grained Evaluation of CT Report Generation

The evaluation of generated reports remains a critical challenge in Computed Tomography (CT) report generation, due to the large volume of text, the diversity and complexity of findings, and the presence of fine-grained, disease-oriented attributes. Conventional evaluation metrics offer only coarse measures of lexical overlap or entity matching and fail to reflect the granular diagnostic accuracy required for clinical use. To address this gap, we propose CT-FineBench, a benchmark built from CT-RATE and Merlin to evaluate the fine-grained factual consistency of CT reports, constructed from CT-RATE and Merlin. Our benchmark is constructed through a meticulous, Question-Answering (QA) based process: first, we identify and structure key, finding-specific clinical attributes (like location, size, margin). Second, we systematically transform these attributes into a QA dataset, where questions probe for specific clinical details grounded in gold-standard reports. The evaluation protocol for CT-FineBench involves using this QA dataset to query a machine-generated report and scoring the correctness of the answers. This allows for a comprehensive, interpretable, and clinically-relevant assessment, moving beyond superficial lexical overlap to pinpoint specific clinical errors. Experiments show that CT-FineBench correlates better with expert clinical assessment and is substantially more sensitive to fine-grained factual errors than prior metrics.

cs.AI

Rethinking the Efficiency and Effectiveness of Reinforcement Learning for Radiology Report Generation

Radiologists highly desire fully automated AI for radiology report generation (R2G), yet existing approaches fall short in clinical utility. Reinforcement learning (RL) holds potential to address these shortcomings, but its adoption in this task remains underexplored. In this paper, we revisit RL in terms of data efficiency and optimization effectiveness for R2G tasks. First, we explore the impact of data quantity and quality on the performance of RL in medical contexts, revealing that data quality plays a more critical role than quantity. To this end, we propose a diagnostic diversity-based data sampling strategy that enables comparable performance with fewer samples. Second, we observe that the majority of tokens in radiology reports are template-like and diagnostically uninformative, whereas the low frequency of clinically critical tokens heightens the risk of being overlooked during optimization. To tackle this, we introduce Diagnostic Token-weighted Policy Optimization (DiTPO), which directly optimizes for clinical accuracy by using a diagnostic F1 score as the reward signal. Unlike standard RL approaches that treat all tokens equally, DiTPO explicitly models the varying importance of different tokens through rule- or gradient-based mechanisms to prioritize clinically relevant content. Extensive experiments on the MIMIC-CXR, IU-Xray, and CheXpert Plus datasets demonstrate that our framework achieves state-of-the-art (SOTA) performance while requiring substantially fewer training samples in RL. Notably, on MIMIC-CXR, our framework attains an F1 score of 0.516 using only 20% of the RL training samples.

cs.CV

CT-GLIP: 3D Grounded Language-Image Pretraining with CT Scans and Radiology Reports for Full-Body Scenarios

3D medical vision-language (VL) pretraining has shown potential in radiology by leveraging large-scale multimodal datasets with CT-report pairs. However, existing methods primarily rely on a global VL alignment directly adapted from 2D scenarios. The entire 3D image is transformed into one global embedding, resulting in a loss of sparse but critical semantics essential for accurately aligning with the corresponding diagnosis. To address this limitation, we propose CT-GLIP, a 3D Grounded Language-Image Pretrained model that constructs fine-grained CT-report pairs to enhance \textit{grounded} cross-modal contrastive learning, effectively aligning grounded visual features with precise textual descriptions. Leveraging the grounded cross-modal alignment, CT-GLIP improves performance across diverse downstream tasks and can even identify organs and abnormalities in a zero-shot manner using natural language. CT-GLIP is trained on a multimodal CT dataset comprising 44,011 organ-level CT-report pairs from 17,702 patients, covering 104 organs. Evaluation is conducted on four downstream tasks: zero-shot organ recognition (OR), zero-shot abnormality detection (AD), tumor detection (TD), and tumor segmentation (TS). Empirical results show that it outperforms its counterparts with global VL alignment. Compared to vanilla CLIP, CT-GLIP achieves average performance improvements of 15.1% of F1 score, 1.9% of AUC, and 3.2% of DSC for zero-shot AD, TD, and TS tasks, respectively. This study highlights the significance of grounded VL alignment in enabling 3D medical VL foundation models to understand sparse representations within CT scans.

cs.CV

A Deep Learning System for Rapid and Accurate Warning of Acute Aortic Syndrome on Non-contrast CT in China

The accurate and timely diagnosis of acute aortic syndromes (AAS) in patients presenting with acute chest pain remains a clinical challenge. Aortic CT angiography (CTA) is the imaging protocol of choice in patients with suspected AAS. However, due to economic and workflow constraints in China, the majority of suspected patients initially undergo non-contrast CT as the initial imaging testing, and CTA is reserved for those at higher risk. In this work, we present an artificial intelligence-based warning system, iAorta, using non-contrast CT for AAS identification in China, which demonstrates remarkably high accuracy and provides clinicians with interpretable warnings. iAorta was evaluated through a comprehensive step-wise study. In the multi-center retrospective study (n = 20,750), iAorta achieved a mean area under the receiver operating curve (AUC) of 0.958 (95% CI 0.950-0.967). In the large-scale real-world study (n = 137,525), iAorta demonstrated consistently high performance across various non-contrast CT protocols, achieving a sensitivity of 0.913-0.942 and a specificity of 0.991-0.993. In the prospective comparative study (n = 13,846), iAorta demonstrated the capability to significantly shorten the time to correct diagnostic pathway. For the prospective pilot deployment that we conducted, iAorta correctly identified 21 out of 22 patients with AAS among 15,584 consecutive patients presenting with acute chest pain and under non-contrast CT protocol in the emergency department (ED) and enabled the average diagnostic time of these 21 AAS positive patients to be 102.1 (75-133) mins. Last, the iAorta can help avoid delayed or missed diagnosis of AAS in settings where non-contrast CT remains the unavoidable the initial or only imaging test in resource-constrained regions and in patients who cannot or did not receive intravenous contrast.

eess.IV

Boosting Vision Semantic Density with Anatomy Normality Modeling for Medical Vision-language Pre-training

Vision-language pre-training (VLP) has great potential for developing multifunctional and general medical diagnostic capabilities. However, aligning medical images with a low signal-to-noise ratio (SNR) to reports with a high SNR presents a semantic density gap, leading to visual alignment bias. In this paper, we propose boosting vision semantic density to improve alignment effectiveness. On one hand, we enhance visual semantics through disease-level vision contrastive learning, which strengthens the model's ability to differentiate between normal and abnormal samples for each anatomical structure. On the other hand, we introduce an anatomical normality modeling method to model the distribution of normal samples for each anatomy, leveraging VQ-VAE for reconstructing normal vision embeddings in the latent space. This process amplifies abnormal signals by leveraging distribution shifts in abnormal samples, enhancing the model's perception and discrimination of abnormal attributes. The enhanced visual representation effectively captures the diagnostic-relevant semantics, facilitating more efficient and accurate alignment with the diagnostic report. We conduct extensive experiments on two chest CT datasets, CT-RATE and Rad-ChestCT, and an abdominal CT dataset, MedVL-CT69K, and comprehensively evaluate the diagnosis performance across multiple tasks in the chest and abdominal CT scenarios, achieving state-of-the-art zero-shot performance. Notably, our method achieved an average AUC of 84.9% across 54 diseases in 15 organs, significantly surpassing existing methods. Additionally, we demonstrate the superior transfer learning capabilities of our pre-trained model. Code is available at https://github.com/alibaba-damo-academy/ViSD-Boost.

eess.IV

Learnable Cross-modal Knowledge Distillation for Multi-modal Learning with Missing Modality

The problem of missing modalities is both critical and non-trivial to be handled in multi-modal models. It is common for multi-modal tasks that certain modalities contribute more compared to other modalities, and if those important modalities are missing, the model performance drops significantly. Such fact remains unexplored by current multi-modal approaches that recover the representation from missing modalities by feature reconstruction or blind feature aggregation from other modalities, instead of extracting useful information from the best performing modalities. In this paper, we propose a Learnable Cross-modal Knowledge Distillation (LCKD) model to adaptively identify important modalities and distil knowledge from them to help other modalities from the cross-modal perspective for solving the missing modality issue. Our approach introduces a teacher election procedure to select the most ``qualified'' teachers based on their single modality performance on certain tasks. Then, cross-modal knowledge distillation is performed between teacher and student modalities for each task to push the model parameters to a point that is beneficial for all tasks. Hence, even if the teacher modalities for certain tasks are missing during testing, the available student modalities can accomplish the task well enough based on the learned knowledge from their automatically elected teacher modalities. Experiments on the Brain Tumour Segmentation Dataset 2018 (BraTS2018) shows that LCKD outperforms other methods by a considerable margin, improving the state-of-the-art performance by 3.61% for enhancing tumour, 5.99% for tumour core, and 3.76% for whole tumour in terms of segmentation Dice score.

cs.CV

Large-scale and Fine-grained Vision-language Pre-training for Enhanced CT Image Understanding

Artificial intelligence (AI) shows great potential in assisting radiologists to improve the efficiency and accuracy of medical image interpretation and diagnosis. However, a versatile AI model requires large-scale data and comprehensive annotations, which are often impractical in medical settings. Recent studies leverage radiology reports as a naturally high-quality supervision for medical images, using contrastive language-image pre-training (CLIP) to develop language-informed models for radiological image interpretation. Nonetheless, these approaches typically contrast entire images with reports, neglecting the local associations between imaging regions and report sentences, which may undermine model performance and interoperability. In this paper, we propose a fine-grained vision-language model (fVLM) for anatomy-level CT image interpretation. Specifically, we explicitly match anatomical regions of CT images with corresponding descriptions in radiology reports and perform contrastive pre-training for each anatomy individually. Fine-grained alignment, however, faces considerable false-negative challenges, mainly from the abundance of anatomy-level healthy samples and similarly diseased abnormalities. To tackle this issue, we propose identifying false negatives of both normal and abnormal samples and calibrating contrastive learning from patient-level to disease-aware pairing. We curated the largest CT dataset to date, comprising imaging and report data from 69,086 patients, and conducted a comprehensive evaluation of 54 major and important disease diagnosis tasks across 15 main anatomies. Experimental results demonstrate the substantial potential of fVLM in versatile medical image interpretation. In the zero-shot classification task, we achieved an average AUC of 81.3% on 54 diagnosis tasks, surpassing CLIP and supervised methods by 12.9% and 8.0%, respectively.

cs.CV

Touchstone Benchmark: Are We on the Right Way for Evaluating AI Algorithms for Medical Segmentation?

How can we test AI performance? This question seems trivial, but it isn't. Standard benchmarks often have problems such as in-distribution and small-size test sets, oversimplified metrics, unfair comparisons, and short-term outcome pressure. As a consequence, good performance on standard benchmarks does not guarantee success in real-world scenarios. To address these problems, we present Touchstone, a large-scale collaborative segmentation benchmark of 9 types of abdominal organs. This benchmark is based on 5,195 training CT scans from 76 hospitals around the world and 5,903 testing CT scans from 11 additional hospitals. This diverse test set enhances the statistical significance of benchmark results and rigorously evaluates AI algorithms across various out-of-distribution scenarios. We invited 14 inventors of 19 AI algorithms to train their algorithms, while our team, as a third party, independently evaluated these algorithms on three test sets. In addition, we also evaluated pre-existing AI frameworks--which, differing from algorithms, are more flexible and can support different algorithms--including MONAI from NVIDIA, nnU-Net from DKFZ, and numerous other open-source frameworks. We are committed to expanding this benchmark to encourage more innovation of AI algorithms for the medical domain.

cs.CV

MedUniSeg: 2D and 3D Medical Image Segmentation via a Prompt-driven Universal Model

Universal segmentation models offer significant potential in addressing a wide range of tasks by effectively leveraging discrete annotations. As the scope of tasks and modalities expands, it becomes increasingly important to generate and strategically position task- and modal-specific priors within the universal model. However, existing universal models often overlook the correlations between different priors, and the optimal placement and frequency of these priors remain underexplored. In this paper, we introduce MedUniSeg, a prompt-driven universal segmentation model designed for 2D and 3D multi-task segmentation across diverse modalities and domains. MedUniSeg employs multiple modal-specific prompts alongside a universal task prompt to accurately characterize the modalities and tasks. To generate the related priors, we propose the modal map (MMap) and the fusion and selection (FUSE) modules, which transform modal and task prompts into corresponding priors. These modal and task priors are systematically introduced at the start and end of the encoding process. We evaluate MedUniSeg on a comprehensive multi-modal upstream dataset consisting of 17 sub-datasets. The results demonstrate that MedUniSeg achieves superior multi-task segmentation performance, attaining a 1.2% improvement in the mean Dice score across the 17 upstream tasks compared to nnUNet baselines, while using less than 1/10 of the parameters. For tasks that underperform during the initial multi-task joint training, we freeze MedUniSeg and introduce new modules to re-learn these tasks. This approach yields an enhanced version, MedUniSeg*, which consistently outperforms MedUniSeg across all tasks. Moreover, MedUniSeg surpasses advanced self-supervised and supervised pre-trained models on six downstream tasks, establishing itself as a high-quality, highly generalizable pre-trained segmentation model.

cs.CV

Kernel Adversarial Learning for Real-world Image Super-resolution

Current deep image super-resolution (SR) approaches aim to restore high-resolution images from down-sampled images or by assuming degradation from simple Gaussian kernels and additive noises. However, these techniques only assume crude approximations of the real-world image degradation process, which should involve complex kernels and noise patterns that are difficult to model using simple assumptions. In this paper, we propose a more realistic process to synthesise low-resolution images for real-world image SR by introducing a new Kernel Adversarial Learning Super-resolution (KASR) framework. In the proposed framework, degradation kernels and noises are adaptively modelled rather than explicitly specified. Moreover, we also propose a high-frequency selective objective and an iterative supervision process to further boost the model SR reconstruction accuracy. Extensive experiments validate the effectiveness of the proposed framework on real-world datasets.

cs.CV

Bootstrapping Chest CT Image Understanding by Distilling Knowledge from X-ray Expert Models

Radiologists highly desire fully automated versatile AI for medical imaging interpretation. However, the lack of extensively annotated large-scale multi-disease datasets has hindered the achievement of this goal. In this paper, we explore the feasibility of leveraging language as a naturally high-quality supervision for chest CT imaging. In light of the limited availability of image-report pairs, we bootstrap the understanding of 3D chest CT images by distilling chest-related diagnostic knowledge from an extensively pre-trained 2D X-ray expert model. Specifically, we propose a language-guided retrieval method to match each 3D CT image with its semantically closest 2D X-ray image, and perform pair-wise and semantic relation knowledge distillation. Subsequently, we use contrastive learning to align images and reports within the same patient while distinguishing them from the other patients. However, the challenge arises when patients have similar semantic diagnoses, such as healthy patients, potentially confusing if treated as negatives. We introduce a robust contrastive learning that identifies and corrects these false negatives. We train our model with over 12,000 pairs of chest CT images and radiology reports. Extensive experiments across multiple scenarios, including zero-shot learning, report generation, and fine-tuning processes, demonstrate the model's feasibility in interpreting chest CT images.

cs.CV

Modality-Agnostic Structural Image Representation Learning for Deformable Multi-Modality Medical Image Registration

Establishing dense anatomical correspondence across distinct imaging modalities is a foundational yet challenging procedure for numerous medical image analysis studies and image-guided radiotherapy. Existing multi-modality image registration algorithms rely on statistical-based similarity measures or local structural image representations. However, the former is sensitive to locally varying noise, while the latter is not discriminative enough to cope with complex anatomical structures in multimodal scans, causing ambiguity in determining the anatomical correspondence across scans with different modalities. In this paper, we propose a modality-agnostic structural representation learning method, which leverages Deep Neighbourhood Self-similarity (DNS) and anatomy-aware contrastive learning to learn discriminative and contrast-invariance deep structural image representations (DSIR) without the need for anatomical delineations or pre-aligned training images. We evaluate our method on multiphase CT, abdomen MR-CT, and brain MR T1w-T2w registration. Comprehensive results demonstrate that our method is superior to the conventional local structural representation and statistical-based similarity measures in terms of discriminability and accuracy.

cs.CV

Continual Self-supervised Learning: Towards Universal Multi-modal Medical Data Representation Learning

Self-supervised learning is an efficient pre-training method for medical image analysis. However, current research is mostly confined to specific-modality data pre-training, consuming considerable time and resources without achieving universality across different modalities. A straightforward solution is combining all modality data for joint self-supervised pre-training, which poses practical challenges. Firstly, our experiments reveal conflicts in representation learning as the number of modalities increases. Secondly, multi-modal data collected in advance cannot cover all real-world scenarios. In this paper, we reconsider versatile self-supervised learning from the perspective of continual learning and propose MedCoSS, a continuous self-supervised learning approach for multi-modal medical data. Unlike joint self-supervised learning, MedCoSS assigns different modality data to different training stages, forming a multi-stage pre-training process. To balance modal conflicts and prevent catastrophic forgetting, we propose a rehearsal-based continual learning method. We introduce the k-means sampling strategy to retain data from previous modalities and rehearse it when learning new modalities. Instead of executing the pretext task on buffer data, a feature distillation strategy and an intra-modal mixup strategy are applied to these data for knowledge retention. We conduct continuous self-supervised pre-training on a large-scale multi-modal unlabeled dataset, including clinical reports, X-rays, CT scans, MRI scans, and pathological images. Experimental results demonstrate MedCoSS's exceptional generalization ability across nine downstream datasets and its significant scalability in integrating new modality data. Code and pre-trained weight are available at https://github.com/yeerwen/MedCoSS.

cs.CV