arXiv subjects

Kuang Gong

Publications and source records attributed to Kuang Gong.

At least 19 recordsLinked to original sources

arXiv2026

Flow Matching-Based PET Image Reconstruction

Generative models have shown strong potential for positron emission tomography (PET) image reconstruction. Although diffusion model-based reconstruction methods have demonstrated promising performance, they often require many reverse sampling steps with data-consistency updates incorporated into the sampling process. Flow matching offers an attractive alternative because it can directly estimate clean images from intermediate states, allowing data-consistency refinement to be separated from flow propagation. In this work, we proposed flow matching-based PET image reconstruction methods. We first established PET-FlowDPS by incorporating Poisson likelihood guidance with an expectation-maximization (EM)-based preconditioner into the FlowDPS framework. We then proposed a model-based PET reconstruction method that used a pretrained flow matching model as a prior, in which the flow-based prior, PET data refinement, and stochastic propagation were interpreted within an approximate Bayesian framework. Experimental results using [$^{\text{18}}\text{F}$]FDG brain PET datasets showed that the proposed method achieved better bias-variance trade-offs across different dose levels compared with other reference methods. These results demonstrated the potential of flow matching as a generative prior for quantitative PET image reconstruction.

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arXiv2026

VLM- and LLM-Driven Multi-Agent System for PET Image Denoising

Positron emission tomography (PET) imaging suffers from limited spatial resolution and low signal-to-noise ratio, which can compromise quantitative accuracy and lesion detectability. Deep learning-based denoising methods have demonstrated strong potential for improving PET image quality. However, their practical deployment in real-world settings remains challenging, often requiring multiple specialized models and expert interventions, such as identifying motion-induced misregistration artifacts, estimating noise levels to select an appropriate denoiser, and performing lesion-focused quantitative assessment after denoising. Recent advances in vision-language models (VLMs) for image quality understanding and large language models (LLMs) for contextual reasoning provide new opportunities for automated, decision-driven workflows. Inspired by expert workflows for PET image quality enhancement, we propose an VLM- and LLM-driven multi-agent PET denoising framework that dynamically assesses image quality and lesion status, autonomously selects optimal denoising models and parameters, and enables closed-loop feedback with rollback mechanisms. Experiments were conducted on Siemens Biograph Vision Quadra PET/CT data with 1/20 and 1/50 low-dose settings. Individual module evaluations demonstrated the reliability of the agentic components, while the complete framework achieved higher PSNR and SSIM than UNet, GAN, and DDPM baselines at both dose levels. These preliminary results demonstrate the feasibility of using a closed-loop multi-agent framework to adapt PET denoising strategies to different image conditions.

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arXiv2026

ESICA: A Scalable Framework for Text-Guided 3D Medical Image Segmentation

Text guided 3D medical image segmentation offers a flexible alternative to class based and spatial prompt based models by allowing users to specify regions of interest directly in natural language. This paradigm avoids reliance on predefined label sets, reduces ambiguous outputs, and aligns more naturally with clinical workflows. However, existing text guided frameworks are often computationally expensive, exhibit weak text volume feature alignment, and fail to capture fine anatomical details. We propose ESICA, a lightweight and scalable framework that addresses these challenges through three innovations: (1) a similarity matrix based mask prediction formulation that enhances semantic alignment, (2) an efficient decomposed decoder with adapter modules for accurate volumetric decoding, and (3) a two pass refinement strategy that sharpens boundaries and resolves uncertain regions. To improve training stability and generalization, ESICA adopts a two stage scheme consisting of positive only pretraining followed by balanced fine tuning. On the CVPR BiomedSegFM benchmark spanning five imaging modalities (CT, MRI, PET, ultrasound, and microscopy), ESICA achieves state of the art segmentation accuracy, while the compact ESICA4 Lite variant attains similar segmentation performance with substantially fewer parameters, yielding a superior efficiency accuracy trade off. Our framework advances text guided segmentation toward efficient, scalable, and clinically deployable systems. Code will be made publicly available at https://github.com/mirthAI/ESICA.

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arXiv2026

Structure-Adaptive Sparse Diffusion in Voxel Space for 3D Medical Image Enhancement

Three-dimensional (3D) medical image enhancement, including denoising and super-resolution, is critical for clinical diagnosis in CT, PET, and MRI. Although diffusion models have shown remarkable success in 2D medical imaging, scaling them to high-resolution 3D volumes remains computationally prohibitive due to lengthy diffusion trajectories over high-dimensional volumetric data. We observe that in conditional enhancement, strong anatomical priors in the degraded input render dense noise schedules largely redundant. Leveraging this insight, we propose a sparse voxel-space diffusion framework that trains and samples on a compact set of uniformly subsampled timesteps. The network predicts clean data directly on the data manifold, supervised in velocity space for stable gradient scaling. A lightweight Structure-aware Trajectory Modulation (STM) module recalibrates time embeddings at each network block based on local anatomical content, enabling structure-adaptive denoising over the shared sparse schedule. Operating directly in voxel space, our framework preserves fine anatomical detail without lossy compression while achieving up to $10\times$ training acceleration. Experiments on four datasets spanning CT, PET, and MRI demonstrate state-of-the-art performance on both denoising and super-resolution tasks. Our code is publicly available at: https://github.com/mirthAI/sparse-3d-diffusion.

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arXiv2026

REVEAL: Multimodal Vision-Language Alignment of Retinal Morphometry and Clinical Risks for Incident AD and Dementia Prediction

The retina provides a unique, noninvasive window into Alzheimer's disease (AD) and dementia, capturing early structural changes through morphometric features, while systemic and lifestyle risk factors reflect well-established contributors to disease susceptibility long before clinical symptom onset. However, current retinal analysis frameworks typically model imaging and risk factors separately, limiting their ability to capture joint multimodal patterns critical for early risk prediction. Moreover, existing methods rarely incorporate mechanisms to organize or align patients with similar retinal and clinical characteristics, constraining the learning of coherent cross-modal associations. To address these limitations, we introduce REVEAL (REtinal-risk Vision-Language Early Alzheimer's Learning), a framework that aligns color fundus photographs with individualized disease-specific risk profiles for predicting incident AD and dementia, on average 8 years before diagnosis (range: 1-11 years). Because real-world risk factors are structured questionnaire data, we translate them into clinically interpretable narratives compatible with pretrained vision-language models (VLMs). We further propose a group-aware contrastive learning (GACL) strategy that clusters patients with similar retinal morphometry and risk factors as positive pairs, strengthening multimodal alignment. This unified representation learning framework substantially outperforms state-of-the-art retinal imaging models paired with clinical text encoders, as well as general-purpose VLMs, demonstrating the value of jointly modeling retinal biomarkers and clinical risk factors. By providing a generalizable and noninvasive approach for early AD and dementia risk stratification, REVEAL has the potential to enable earlier intervention and improve preventive care at the population level.

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arXiv2026

Beyond the Embedding Bottleneck: Adaptive Retrieval-Augmented 3D CT Report Generation

Automated radiology report generation from 3D CT volumes often suffers from incomplete pathology coverage. We provide empirical evidence that this limitation stems from a representational bottleneck: contrastive 3D CT embeddings encode discriminative pathology signals, yet exhibit severe dimensional concentration, with as few as 2 effective dimensions out of 512. Corroborating this, scaling the language model yields no measurable improvement, suggesting that the bottleneck lies in the visual representation rather than the generator. This bottleneck limits both generation and retrieval; naive static retrieval fails to improve clinical efficacy and can even degrade performance. We propose \textbf{AdaRAG-CT}, an adaptive augmentation framework that compensates for this visual bottleneck by introducing supplementary textual information through controlled retrieval and selectively integrating it during generation. On the CT-RATE benchmark, AdaRAG-CT achieves state-of-the-art clinical efficacy, improving Clinical F1 from 0.420 (CT-Agent) to 0.480 (+6 points); ablation studies confirm that both the retrieval and generation components contribute to the improvement. Code is available at https://github.com/renjie-liang/Adaptive-RAG-for-3DCT-Report-Generation.

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arXiv2026

MedVL-SAM2: A unified 3D medical vision-language model for multimodal reasoning and prompt-driven segmentation

Recent progress in medical vision-language models (VLMs) has achieved strong performance on image-level text-centric tasks such as report generation and visual question answering (VQA). However, achieving fine-grained visual grounding and volumetric spatial reasoning in 3D medical VLMs remains challenging, particularly when aiming to unify these capabilities within a single, generalizable framework. To address this challenge, we proposed MedVL-SAM2, a unified 3D medical multimodal model that concurrently supports report generation, VQA, and multi-paradigm segmentation, including semantic, referring, and interactive segmentation. MedVL-SAM2 integrates image-level reasoning and pixel-level perception through a cohesive architecture tailored for 3D medical imaging, and incorporates a SAM2-based volumetric segmentation module to enable precise multi-granular spatial reasoning. The model is trained in a multi-stage pipeline: it is first pre-trained on a large-scale corpus of 3D CT image-text pairs to align volumetric visual features with radiology-language embeddings. It is then jointly optimized with both language-understanding and segmentation objectives using a comprehensive 3D CT segmentation dataset. This joint training enables flexible interaction via language, point, or box prompts, thereby unifying high-level visual reasoning with spatially precise localization. Our unified architecture delivers state-of-the-art performance across report generation, VQA, and multiple 3D segmentation tasks. Extensive analyses further show that the model provides reliable 3D visual grounding, controllable interactive segmentation, and robust cross-modal reasoning, demonstrating that high-level semantic reasoning and precise 3D localization can be jointly achieved within a unified 3D medical VLM.

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arXiv2025

Patlak Parametric Image Estimation from Dynamic PET Using Diffusion Model Prior

Dynamic PET enables the quantitative estimation of physiology-related parameters and is widely utilized in research and increasingly adopted in clinical settings. Parametric imaging in dynamic PET requires kinetic modeling to estimate voxel-wise physiological parameters based on specific kinetic models. However, parametric images estimated through kinetic model fitting often suffer from low image quality due to the inherently ill-posed nature of the fitting process and the limited counts resulting from non-continuous data acquisition across multiple bed positions in whole-body PET. In this work, we proposed a diffusion model-based kinetic modeling framework for parametric image estimation, using the Patlak model as an example. The score function of the diffusion model was pre-trained on static total-body PET images and served as a prior for both Patlak slope and intercept images by leveraging their patch-wise similarity. During inference, the kinetic model was incorporated as a data-consistency constraint to guide the parametric image estimation. The proposed framework was evaluated on total-body dynamic PET datasets with different dose levels, demonstrating the feasibility and promising performance of the proposed framework in improving parametric image quality.

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arXiv2025

TauGenNet: Plasma-Driven Tau PET Image Synthesis via Text-Guided 3D Diffusion Models

Accurate quantification of tau pathology via tau positron emission tomography (PET) scan is crucial for diagnosing and monitoring Alzheimer's disease (AD). However, the high cost and limited availability of tau PET restrict its widespread use. In contrast, structural magnetic resonance imaging (MRI) and plasma-based biomarkers provide non-invasive and widely available complementary information related to brain anatomy and disease progression. In this work, we propose a text-guided 3D diffusion model for 3D tau PET image synthesis, leveraging multimodal conditions from both structural MRI and plasma measurement. Specifically, the textual prompt is from the plasma p-tau217 measurement, which is a key indicator of AD progression, while MRI provides anatomical structure constraints. The proposed framework is trained and evaluated using clinical AV1451 tau PET data from the Alzheimer's Disease Neuroimaging Initiative (ADNI) database. Experimental results demonstrate that our approach can generate realistic, clinically meaningful 3D tau PET across a range of disease stages. The proposed framework can help perform tau PET data augmentation under different settings, provide a non-invasive, cost-effective alternative for visualizing tau pathology, and support the simulation of disease progression under varying plasma biomarker levels and cognitive conditions.

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arXiv2025

PET Image Reconstruction Using Deep Diffusion Image Prior

Diffusion models have shown great promise in medical image denoising and reconstruction, but their application to Positron Emission Tomography (PET) imaging remains limited by tracer-specific contrast variability and high computational demands. In this work, we proposed an anatomical prior-guided PET image reconstruction method based on diffusion models, inspired by the deep diffusion image prior (DDIP) framework. The proposed method alternated between diffusion sampling and model fine-tuning guided by the PET sinogram, enabling the reconstruction of high-quality images from various PET tracers using a score function pretrained on a dataset of another tracer. To improve computational efficiency, the half-quadratic splitting (HQS) algorithm was adopted to decouple network optimization from iterative PET reconstruction. The proposed method was evaluated using one simulation and two clinical datasets. For the simulation study, a model pretrained on [$^{18}$F]FDG data was tested on [$^{18}$F]FDG data and amyloid-negative PET data to assess out-of-distribution (OOD) performance. For the clinical-data validation, ten low-dose [$^{18}$F]FDG datasets and one [$^{18}$F]Florbetapir dataset were tested on a model pretrained on data from another tracer. Experiment results show that the proposed PET reconstruction method can generalize robustly across tracer distributions and scanner types, providing an efficient and versatile reconstruction framework for low-dose PET imaging.

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arXiv2025

SAM2-SGP: Enhancing SAM2 for Medical Image Segmentation via Support-Set Guided Prompting

Although new vision foundation models such as Segment Anything Model 2 (SAM2) have significantly enhanced zero-shot image segmentation capabilities, reliance on human-provided prompts poses significant challenges in adapting SAM2 to medical image segmentation tasks. Moreover, SAM2's performance in medical image segmentation was limited by the domain shift issue, since it was originally trained on natural images and videos. To address these challenges, we proposed SAM2 with support-set guided prompting (SAM2-SGP), a framework that eliminated the need for manual prompts. The proposed model leveraged the memory mechanism of SAM2 to generate pseudo-masks using image-mask pairs from a support set via a Pseudo-mask Generation (PMG) module. We further introduced a novel Pseudo-mask Attention (PMA) module, which used these pseudo-masks to automatically generate bounding boxes and enhance localized feature extraction by guiding attention to relevant areas. Furthermore, a low-rank adaptation (LoRA) strategy was adopted to mitigate the domain shift issue. The proposed framework was evaluated on both 2D and 3D datasets across multiple medical imaging modalities, including fundus photography, X-ray, computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET), and ultrasound. The results demonstrated a significant performance improvement over state-of-the-art models, such as nnUNet and SwinUNet, as well as foundation models, such as SAM2 and MedSAM2, underscoring the effectiveness of the proposed approach. Our code is publicly available at https://github.com/astlian9/SAM_Support.

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arXiv2025

CDPDNet: Integrating Text Guidance with Hybrid Vision Encoders for Medical Image Segmentation

Most publicly available medical segmentation datasets are only partially labeled, with annotations provided for a subset of anatomical structures. When multiple datasets are combined for training, this incomplete annotation poses challenges, as it limits the model's ability to learn shared anatomical representations among datasets. Furthermore, vision-only frameworks often fail to capture complex anatomical relationships and task-specific distinctions, leading to reduced segmentation accuracy and poor generalizability to unseen datasets. In this study, we proposed a novel CLIP-DINO Prompt-Driven Segmentation Network (CDPDNet), which combined a self-supervised vision transformer with CLIP-based text embedding and introduced task-specific text prompts to tackle these challenges. Specifically, the framework was constructed upon a convolutional neural network (CNN) and incorporated DINOv2 to extract both fine-grained and global visual features, which were then fused using a multi-head cross-attention module to overcome the limited long-range modeling capability of CNNs. In addition, CLIP-derived text embeddings were projected into the visual space to help model complex relationships among organs and tumors. To further address the partial label challenge and enhance inter-task discriminative capability, a Text-based Task Prompt Generation (TTPG) module that generated task-specific prompts was designed to guide the segmentation. Extensive experiments on multiple medical imaging datasets demonstrated that CDPDNet consistently outperformed existing state-of-the-art segmentation methods. Code and pretrained model are available at: https://github.com/wujiong-hub/CDPDNet.git.

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arXiv2025

Med3DVLM: An Efficient Vision-Language Model for 3D Medical Image Analysis

Vision-language models (VLMs) have shown promise in 2D medical image analysis, but extending them to 3D remains challenging due to the high computational demands of volumetric data and the difficulty of aligning 3D spatial features with clinical text. We present Med3DVLM, a 3D VLM designed to address these challenges through three key innovations: (1) DCFormer, an efficient encoder that uses decomposed 3D convolutions to capture fine-grained spatial features at scale; (2) SigLIP, a contrastive learning strategy with pairwise sigmoid loss that improves image-text alignment without relying on large negative batches; and (3) a dual-stream MLP-Mixer projector that fuses low- and high-level image features with text embeddings for richer multi-modal representations. We evaluate our model on the M3D dataset, which includes radiology reports and VQA data for 120,084 3D medical images. Results show that Med3DVLM achieves superior performance across multiple benchmarks. For image-text retrieval, it reaches 61.00% R@1 on 2,000 samples, significantly outperforming the current state-of-the-art M3D model (19.10%). For report generation, it achieves a METEOR score of 36.42% (vs. 14.38%). In open-ended visual question answering (VQA), it scores 36.76% METEOR (vs. 33.58%), and in closed-ended VQA, it achieves 79.95% accuracy (vs. 75.78%). These results highlight Med3DVLM's ability to bridge the gap between 3D imaging and language, enabling scalable, multi-task reasoning across clinical applications. Our code is publicly available at https://github.com/mirthAI/Med3DVLM.

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arXiv2025

Geodesic Diffusion Models for Efficient Medical Image Enhancement

Diffusion models generate data by learning to reverse a forward process, where samples are progressively perturbed with Gaussian noise according to a predefined noise schedule. From a geometric perspective, each noise schedule corresponds to a unique trajectory in probability space from the data distribution to a Gaussian prior. However, prior diffusion models rely on empirically chosen schedules that may not be optimal. This inefficiency necessitates many intermediate time steps, resulting in high computational costs during both training and sampling. To address this, we derive a family of geodesic noise schedules corresponding to the shortest paths in probability space under the Fisher-Rao metric. Based on these schedules, we propose Geodesic Diffusion Models (GDMs), which significantly improve training and sampling efficiency by minimizing the energy required to transform between probability distributions. This efficiency further enables sampling to start from an intermediate distribution in conditional image generation, achieving state-of-the-art results with as few as 6 steps. We evaluated GDM on two medical image enhancement tasks: CT image denoising and MRI image super-resolution. Experimental results show that GDM achieved state-of-the-art performance while reducing training time by 20- to 30-fold compared to Denoising Diffusion Probabilistic Models (DDPMs) and 4- to 6-fold compared to Fast-DDPM, and accelerating sampling by 160- to 170-fold and 1.6-fold, respectively. These gains support the use of GDM for efficient model development and real-time clinical applications. Our code is publicly available at: https://github.com/mirthAI/GDM-VE.

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arXiv2025

PET Image Denoising via Text-Guided Diffusion: Integrating Anatomical Priors through Text Prompts

Low-dose Positron Emission Tomography (PET) imaging presents a significant challenge due to increased noise and reduced image quality, which can compromise its diagnostic accuracy and clinical utility. Denoising diffusion probabilistic models (DDPMs) have demonstrated promising performance for PET image denoising. However, existing DDPM-based methods typically overlook valuable metadata such as patient demographics, anatomical information, and scanning parameters, which should further enhance the denoising performance if considered. Recent advances in vision-language models (VLMs), particularly the pre-trained Contrastive Language-Image Pre-training (CLIP) model, have highlighted the potential of incorporating text-based information into visual tasks to improve downstream performance. In this preliminary study, we proposed a novel text-guided DDPM for PET image denoising that integrated anatomical priors through text prompts. Anatomical text descriptions were encoded using a pre-trained CLIP text encoder to extract semantic guidance, which was then incorporated into the diffusion process via the cross-attention mechanism. Evaluations based on paired 1/20 low-dose and normal-dose 18F-FDG PET datasets demonstrated that the proposed method achieved better quantitative performance than conventional UNet and standard DDPM methods at both the whole-body and organ levels. These results underscored the potential of leveraging VLMs to integrate rich metadata into the diffusion framework to enhance the image quality of low-dose PET scans.

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arXiv2025

DCFormer: Efficient 3D Vision-Language Modeling with Decomposed Convolutions

Vision-language models (VLMs) have been widely applied to 2D medical image analysis due to their ability to align visual and textual representations. However, extending VLMs to 3D imaging remains computationally challenging. Existing 3D VLMs often rely on Vision Transformers (ViTs), which are computationally expensive due to the quadratic complexity of self-attention, or on 3D convolutions, which require large numbers of parameters and FLOPs as kernel size increases. We introduce DCFormer, an efficient 3D image encoder that factorizes 3D convolutions into three parallel 1D convolutions along the depth, height, and width dimensions. This design preserves spatial information while significantly reducing computational cost. Integrated into a CLIP-based vision-language framework, DCFormer is trained and evaluated on CT-RATE, a dataset of 50,188 paired 3D chest CT volumes and radiology reports. In zero-shot and fine-tuned detection of 18 pathologies, as well as in image-text retrieval tasks, DCFormer consistently outperforms state-of-the-art 3D vision encoders, including CT-ViT, ViT, ConvNeXt, PoolFormer, and TransUNet. These results highlight DCFormer's potential for scalable, clinically deployable 3D medical VLMs. Our code is available at: https://github.com/mirthAI/DCFormer.

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arXiv2024

LDM-Morph: Latent diffusion model guided deformable image registration

Deformable image registration plays an essential role in various medical image tasks. Existing deep learning-based deformable registration frameworks primarily utilize convolutional neural networks (CNNs) or Transformers to learn features to predict the deformations. However, the lack of semantic information in the learned features limits the registration performance. Furthermore, the similarity metric of the loss function is often evaluated only in the pixel space, which ignores the matching of high-level anatomical features and can lead to deformation folding. To address these issues, in this work, we proposed LDM-Morph, an unsupervised deformable registration algorithm for medical image registration. LDM-Morph integrated features extracted from the latent diffusion model (LDM) to enrich the semantic information. Additionally, a latent and global feature-based cross-attention module (LGCA) was designed to enhance the interaction of semantic information from LDM and global information from multi-head self-attention operations. Finally, a hierarchical metric was proposed to evaluate the similarity of image pairs in both the original pixel space and latent-feature space, enhancing topology preservation while improving registration accuracy. Extensive experiments on four public 2D cardiac image datasets show that the proposed LDM-Morph framework outperformed existing state-of-the-art CNNs- and Transformers-based registration methods regarding accuracy and topology preservation with comparable computational efficiency. Our code is publicly available at https://github.com/wujiong-hub/LDM-Morph.

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arXiv2024

Adaptive Whole-Body PET Image Denoising Using 3D Diffusion Models with ControlNet

Positron Emission Tomography (PET) is a vital imaging modality widely used in clinical diagnosis and preclinical research but faces limitations in image resolution and signal-to-noise ratio due to inherent physical degradation factors. Current deep learning-based denoising methods face challenges in adapting to the variability of clinical settings, influenced by factors such as scanner types, tracer choices, dose levels, and acquisition times. In this work, we proposed a novel 3D ControlNet-based denoising method for whole-body PET imaging. We first pre-trained a 3D Denoising Diffusion Probabilistic Model (DDPM) using a large dataset of high-quality normal-dose PET images. Following this, we fine-tuned the model on a smaller set of paired low- and normal-dose PET images, integrating low-dose inputs through a 3D ControlNet architecture, thereby making the model adaptable to denoising tasks in diverse clinical settings. Experimental results based on clinical PET datasets show that the proposed framework outperformed other state-of-the-art PET image denoising methods both in visual quality and quantitative metrics. This plug-and-play approach allows large diffusion models to be fine-tuned and adapted to PET images from diverse acquisition protocols.

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