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Liyue Shen

Publications and source records attributed to Liyue Shen.

At least 19 recordsLinked to original sources
arXiv2026

MedCache: Efficient and Temporally Valid Memory for Longitudinal Clinical Agents

Longitudinal clinical agents must maintain an evolving patient state from evidence distributed across visits, time points, and specialties. However, how agent memory should be designed for this setting remains unclear. We introduce a benchmark of multi-visit, multi-specialty patient records that evaluates long-context evidence retrieval, cross-time evidence aggregation, and cross-specialty clinical reasoning. Using this benchmark, we systematically study four memory design choices: curation, organization, retrieval, and memory-augmented reasoning. We find that temporal validity is more important than simply retaining more history; specialty-factorized memory reduces context but can hide shared evidence; and multiple agents help when specialists must reason together, not merely when evidence comes from multiple memories. Guided by these findings, we propose \textit{MedCache}, a hybrid framework that constructs temporally valid patient memory, organizes evidence into overlapping specialty views, routes each query to relevant memories, and adaptively invokes one or multiple specialists. Experiments show that MedCache improves reasoning accuracy and memory efficiency over strong single-agent and multi-agent baselines, while generalizing across model backbones and external datasets.

cs.LG↗
arXiv2026

A Cloud-Edge System for Multimodal Clinical Screening in Resource-Constrained Rural Settings

Medical AI has demonstrated specialist-level diagnostic accuracy, yet these capabilities remain largely inaccessible in resource-constrained rural settings where bandwidth is scarce, compute is limited, and clinical decision-making requires integrating heterogeneous modalities. We introduce a cloud--edge collaborative architecture that addresses these constraints: lightweight, domain-specific models on the edge transform raw medical data into compact structured outputs, while a cloud LLM synthesizes these outputs into clinical summaries. An LLM-based orchestrator dynamically selects diagnostic tools based on patient context, promoting comprehensive modality coverage without processing irrelevant inputs. We evaluate on 20 multimodal clinical cases spanning cardiac, obstetric, trauma, and screening scenarios under three simulated network profiles (500,kbps--5,Mbps). The hybrid system achieves 98--99% diagnostic tool recall with 92--96% precision, matches or exceeds cloud-only baselines on clinical accuracy, and maintains bandwidth-invariant latency (25--35,s) at 4--15x lower token cost. These results highlight the role of architectural design in enabling efficient multimodal integration and improving factual grounding compared to cloud-only approaches under deployment constraints.

cs.LG↗
arXiv2026

TIER-MoE: Trust-Informed Expert Routing via Conditional Modality Risk for Multimodal Fusion in Biomedical Classification

The promise of multimodal fusion lies in combining complementary sources of evidence, yet more evidence does not always yield a better prediction. Recent multimodal models have advanced fusion through richer cross-modal interaction and sample-adaptive fusion. However, the influence assigned to a modality during fusion does not reveal whether that source is unreliable, redundant, or poorly matched to a specialized expert. To address this limitation, we introduce TIER-MoE, a risk-guided subspace mixture-of-experts model that defines sample-specific modality reliability as the prediction loss its unimodal predictor is expected to incur. This risk is learned from out-of-fold predictions generated by models that were not trained on the corresponding sample. TIER-MoE combines the estimated risk with expert-specific subspace compatibility for sparse modality-expert routing, while an always-active shared path preserves multimodal complementarity. We evaluate TIER-MoE on four public multimodal biomedical datasets spanning Alzheimer's disease status, skin-lesion malignancy, and retinal classification. Results demonstrate its superiority over state-of-the-art methods in predictive performance and probability calibration, with consistent improvements in Macro-F1 and Brier score and strong zero-shot generalization to an external cohort.

cs.LG↗
arXiv2026

NAMD: Virtual Follow-up Computed Tomography Synthesis via Nodule-Aligned Multimodal Diffusion Models for Early Lung Cancer Diagnosis

Lung cancer remains the leading cause of cancer-related mortality worldwide, with survival outcomes critically dependent on early and accurate detection. When low-dose computed tomography (LDCT) findings are indeterminate, clinicians typically defer diagnosis pending follow-up CT imaging obtained up to 12 months later, inevitably delaying treatment for patients with malignant nodules. To address this clinical gap, we propose Nodule-Aligned Multimodal (Latent) Diffusion (NAMD), a novel generative framework that synthesizes one-year follow-up nodule CT images conditioned on the baseline CT scan, quantitative nodule biomarkers, and patient-level Electronic Health Records (EHR), enabling timely prediction of nodule malignant progression without requiring actual follow-up scans. NAMD introduces two key contributions: (i) a nodule-aligned latent space regularized so that embedding distances reflect clinically meaningful biomarker changes, and (ii) an LLM-driven multimodal conditioning mechanism encoding heterogeneous EHR data into the diffusion backbone. Evaluated on the National Lung Screening Trial (NLST), our method's synthetic follow-up images achieve an AUROC of 0.805 and an AUPRC of 0.346 for lung nodule malignancy prediction, outperforming both the baseline LDCT performance without virtual follow-up generation, and existing state-of-the-art conditional generation methods, while maintaining competitive image quality. These findings suggest that NAMD enables earlier and more accurate lung cancer diagnosis by capturing clinically meaningful features of nodule progression.

cs.CV↗
arXiv2026

Evaluating and Understanding Model Editing for Medical Vision Language Models

Model editing promises a fast, targeted way to correct post-deployment mistakes in medical vision-language models (VLMs) without costly retraining. However, existing multimodal model editing benchmarks focus on general-purpose tasks and do not reflect realistic clinical domain requirements and variability. To address this, we introduce M3Bench, a clinically grounded benchmark for multimodal model editing that evaluates whether an edit remains reliable, precise, and generalizable under the challenges of image and text variation, modality and protocol shifts, clinical knowledge composition, and temporal progression. M3Bench contains 16,276 questions spanning diverse anatomy, modalities, and specialties, and supports both single and sequential edits. By evaluating 4 representative editors across 6 medical and general VLMs, we find that no method excels across all criteria. Gradient-based editors achieve strong transfer but suffer from catastrophic locality violations, whereas memory-based methods preserve locality but lack compositional generality and exhibit high backbone-dependent hyperparameter sensitivity. We further attribute these failures to the latent space geometry of VLMs and how different editing methods shift its landscape. Overall, M3Bench establishes a rigorous clinical stress test for multimodal model editing and offers actionable guidance for safer post-deployment adaptation. The benchmark is publicly available at https://github.com/BioMed-AI-Lab-U-Michgan/M3Bench .

cs.AI↗
arXiv2026

Beyond Time Series: Spatial Reasoning for Epidemic Forecasting via Multimodal Learning

Epidemic forecasting models typically rely on surveillance data reported over administrative regions, treating them as atomic units, thereby obscuring sub-regional spatial structure that shapes disease dynamics. We introduce a spatially structured multimodal epidemic forecasting setting that integrates region-level temporal surveillance data with spatially localized auxiliary signals that are misaligned in resolution and structure, reflecting realistic public health reporting constraints. Building on this formulation, we propose M-SPICE (Multimodal SPatIal Context for Epidemic Forecasting), a structure-aware spatiotemporal forecasting framework that performs joint reasoning over temporal disease dynamics and spatial context via attention-based multimodal fusion, allowing spatial signals to selectively condition temporal representations across forecast horizons. We evaluate our approach on real-world COVID-19, influenza, and influenza-like illness (ILI) forecasting tasks under realistic real-time evaluation protocols. Across all forecasting settings, our method consistently outperforms state-of-the-art multivariate time-series, multimodal, and epidemiological forecasting baselines while maintaining strong probabilistic forecasting performance. Finally, interpretability analyses reveal when, where, and how spatial signals are leveraged, highlighting settings in which purely temporal, region-aggregated models are most likely to fail.

cs.LG↗
arXiv2026

The Emergence of Reproducibility and Generalizability in Diffusion Models

In this work, we investigate an intriguing and prevalent phenomenon of diffusion models which we term as "consistent model reproducibility": given the same starting noise input and a deterministic sampler, different diffusion models often yield remarkably similar outputs. We confirm this phenomenon through comprehensive experiments, implying that different diffusion models consistently reach the same data distribution and scoring function regardless of diffusion model frameworks, model architectures, or training procedures. More strikingly, our further investigation implies that diffusion models are learning distinct distributions affected by the training data size. This is supported by the fact that the model reproducibility manifests in two distinct training regimes: (i) "memorization regime", where the diffusion model overfits to the training data distribution, and (ii) "generalization regime", where the model learns the underlying data distribution. Our study also finds that this valuable property generalizes to many variants of diffusion models, including those for conditional use, solving inverse problems, and model fine-tuning. Finally, our work raises numerous intriguing theoretical questions for future investigation and highlights practical implications regarding training efficiency, model privacy, and the controlled generation of diffusion models.

cs.LG↗
arXiv2026

Evaluating the Representation Space of Diffusion Models via Self-Supervised Principles

Diffusion models have demonstrated remarkable generative capabilities and have also emerged as powerful self-supervised representation learners, yet the connection between these two abilities remains less explored. Drawing inspiration from self-supervised learning (SSL), we introduce a framework for jointly evaluating the representation and generation capabilities of diffusion models. Specifically, we decompose features into invariant and residual components and derive the Invariant Contamination Ratio (ICR), a Fisher-based metric that quantifies how residual variation contaminates invariant signal in feature space. We use this framework to analyze both discriminative and generative behavior of diffusion models. On the representation side, we find that invariance peaks at intermediate noise levels, which also yield the best downstream classification performance. On the generative side, we study how training transitions from genuine generalization to memorization in data-limited regimes, and show that ICR serves as a sensitive training-time indicator of early learning: increasing residual energy along Fisher directions marks the onset of memorization, detectable from training features alone without external evaluators or held-out test sets. Overall, our results show that diffusion models can be monitored from a self-supervised perspective through the geometry of their learned representations.

cs.LG↗
arXiv2026

Weak Diffusion Priors Can Still Achieve Strong Inverse-Problem Performance

Can a diffusion model trained on bedrooms recover human faces? Diffusion models are widely used as priors for inverse problems, but standard approaches usually assume a high-fidelity model trained on data that closely match the unknown signal. In practice, one often must use a mismatched or low-fidelity diffusion prior. Surprisingly, these weak priors often perform nearly as well as full-strength, in-domain baselines. We study when and why inverse solvers are robust to weak diffusion priors. Through extensive experiments, we find that weak priors succeed when measurements are highly informative (e.g., many observed pixels), and we identify regimes where they fail. To explain this behavior, we combine Bayesian-consistency theory with local-correlation analysis: the theory gives conditions under which high-dimensional measurements make the posterior concentrate near the true signal, while the correlation analysis shows that weak and stronger natural-image priors can share similar local spatial structure. These results provide a principled justification on when weak diffusion priors can be used reliably. Code is available at https://github.com/jjia131/weak-diffusion-priors-inverse-problem.

cs.LG↗
arXiv2026

Prospective Dynamic 3D MRI Reconstruction via Latent-Space Motion Tracking from Single Measurement

Prospective reconstruction is crucial in many clinical applications such as MRI-guided radiotherapy, which demands accurate image reconstruction and fast motion estimation from currently acquired measurements. However, prospective reconstruction remains challenging due to ultra-sparse sampling and stringent latency requirements. In this work, we propose PDMR, a Prospective Dynamic 3D MRI Reconstruction framework with latent-space motion tracking. Our core idea is to learn an efficient and generalizable latent manifold of motion fields offline, enabling rapid online adaptation for prospective reconstruction. Specifically, we parameterize the deformation vector fields (DVFs) on a low-dimensional manifold, effectively reducing the search space for fast online adaptation, and employ a tri-plane representation to achieve geometry-aware and memory-efficient encoding of 3D motion. Experiments on both XCAT digital phantoms and in-house abdominal MRI datasets demonstrate that PDMR achieves high-fidelity and temporally consistent reconstruction across multiple prospective scenarios (Immediate and After-2min), outperforming state-of-the-art retrospective and online methods. Our results suggest a promising pathway toward ultra-fast, motion-aware prospective MRI reconstruction in clinical practice.

cs.CV↗
arXiv2026

Fractional-gradient Sparsity with Autoencoding Sequential Deep Image Prior for 3D CT Reconstruction

3D volumetric reconstruction from incomplete or noisy measurements is a fundamental problem in medical imaging and computational tomography. Deep image prior (DIP)-based methods have recently shown strong capability for solving inverse problems without requiring large training datasets. However, directly extending DIP to 3D reconstruction by fully 3D networks can incur high computational cost, while slice-by-slice 2D DIP approaches may lead to inter-slice inconsistencies due to the lack of explicit regularization along the third direction. In this paper, we propose a novel volumetric reconstruction framework, Fractional-gradient Autoencoding Sequential Tomography DIP (FAST-DIP), which integrates input-adaptive sequential deep image prior modeling of slices with fractional sparsity regularization to capture inter-slice dependencies. Specifically, we introduce a fractional l1/l2-based sparsity prior on the gradients along the slice (z) direction to explicitly enforce inter-slice structural consistency. We further provide theoretical analysis of the proposed alternating minimization algorithm under the majorization-minimization (MM) framework, establishing monotonic descent of the objective function and convergence to a critical point under the Kurdyka-Lojasiewicz (KL) property. Experimental results for 3D X-ray computed tomography (CT) reconstruction demonstrate that the proposed method improved reconstruction quality and structural consistency compared with existing DIP-based approaches.

cs.CE↗
arXiv2026

Beyond Accuracy: Evaluating Posterior Fidelity of Diffusion Inverse Solvers

Uncertainty evaluation is critical in scientific and engineering inverse problems. However, existing benchmarks on Diffusion Inverse Solvers (DIS) primarily focus on reconstruction accuracy but overlook uncertainty and distributional behavior. Since stochastic inverse solvers represent uncertainty through diffusion-based posterior samples, evaluating how well their generated samples capture the target posterior distribution becomes an important aspect of uncertainty quantification. To address this limitation and better understand the distributional behavior of diffusion samplers, we conduct a systematic study to investigate the posterior fidelity of a broad range of existing DIS methods in controlled simulation settings with a known analytical true posterior. Furthermore, to enable posterior-aware evaluation on real-world inverse problems where ground-truth posterior is unavailable, we propose score-based Kernel Stein Discrepancy (score-KSD), a theoretically-grounded and ground-truth-free metric that measures the consistency of the distribution of generated samples from a DIS method with the target posterior score field, induced by the forward model and learned diffusion prior. Through both simulation experiments and real-world inverse problem solving, we validate the effectiveness of the proposed score-KSD and demonstrate that it provides meaningful posterior fidelity diagnostics beyond reconstruction accuracy, revealing that higher reconstruction accuracy does not necessarily imply better posterior consistency.

cs.LG↗
arXiv2026

Couple to Control: Joint Initial Noise Design in Diffusion Models

Diffusion models typically generate image batches from independent Gaussian initial noises. We argue that this independence assumption is only one choice within a broader class of valid joint noise designs. Instead, one can specify a coupling of the initial noises: each noise remains marginally standard Gaussian, so the pretrained diffusion model receives the same single-sample input distribution, while the dependence across samples is chosen by design. This reframes initial-noise control from selecting or optimizing individual seeds to designing the dependence structure of a multi-sample gallery. This view gives a general framework for initial-noise design, covering several existing methods as special cases and leading naturally to new coupled-noise constructions. Coupled noise can improve generation on its own without adding sampling cost, and it is flexible enough to serve as a structured initialization for optimization-based pipelines when additional computation is available. Empirically, repulsive Gaussian coupling improves gallery diversity on SD1.5, SDXL, and SD3 while largely preserving prompt alignment and image quality. It matches or outperforms recent test-time noise-optimization baselines on several diversity metrics at the same sampling cost as independent generation. Subspace couplings also support fixed-object background generation, producing diverse, natural backgrounds compared with specialized inpainting baselines, with a tunable trade-off in foreground fidelity.

cs.LG↗
arXiv2026

MedAction: Towards Active Multi-turn Clinical Diagnostic LLMs

Most existing LLM diagnoses are evaluated on static, single-turn settings where complete patient information is provided upfront, an oversimplification of real clinical practice. We study active diagnosis: the real-life clinical process of starting from initial observation, ordering tests, interpreting results, and updating a differential diagnosis across multiple turns. Through systematic analysis, we identify three recurring failure modes in current LLMs: ungrounded test ordering, unreliable diagnostic update, and degraded multi-turn coherence. Together, these failures reveal a core deficit: existing medical training data teaches models to reason from complete information but not to act under evolving, partial evidence. To address this gap, we introduce MedAction, a tree-structured distillation pipeline that synthesizes diverse and high-quality multi-turn diagnostic trajectories via LLM-environment interaction. We propose two knowledge-graph-grounded metrics to filter trajectory quality: Disease Trajectory Consistency (DTC), which tracks whether the model's hypothesis converges toward the correct diagnosis, and Reasoning-Action Consistency (RAC), which verifies that belief updates are driven by gathered evidence. Using this pipeline, we construct MedAction-32K, a dataset of 32,681 trajectories from 2,896 PMC cases. Fine-tuning an 8B model on MedAction-32K achieves state-of-the-art performance among open-source models on both MedR-Bench and our curated MedAction-300-Hard benchmark, pushing the edge for open-source medical LLMs.

cs.CL↗
arXiv2026

REMIND: Rethinking Medical High-Modality Learning under Missingness--A Long-Tailed Distribution Perspective

Medical multi-modal learning is critical for integrating information from a large set of diverse modalities. However, when leveraging a high number of modalities in real clinical applications, it is often impractical to obtain full-modality observations for every patient due to data collection constraints, a problem we refer to as 'High-Modality Learning under Missingness'. In this study, we identify that such missingness inherently induces an exponential growth in possible modality combinations, followed by long-tail distributions of modality combinations due to varying modality availability. While prior work overlooked this critical phenomenon, we find this long-tailed distribution leads to significant underperformance on tail modality combination groups. Our empirical analysis attributes this problem to two fundamental issues: 1) gradient inconsistency, where tail groups' gradient updates diverge from the overall optimization direction; 2) concept shifts, where each modality combination requires distinct fusion functions. To address these challenges, we propose REMIND, a unified framework that REthinks MultImodal learNing under high-moDality missingness from a long-tail perspective. Our core idea is to propose a novel group-specialized Mixture-of-Experts architecture that scalably learns group-specific multi-modal fusion functions for arbitrary modality combinations, while simultaneously leveraging a group distributionally robust optimization strategy to upweight underrepresented modality combinations. Extensive experiments on real-world medical datasets show that our framework consistently outperforms state-of-the-art methods, and robustly generalizes across various medical multi-modal learning applications under high-modality missingness.

cs.LG↗
arXiv2026

Antithetic Noise in Diffusion Models

We systematically study antithetic initial noise in diffusion models, discovering that pairing each noise sample with its negation consistently produces strong negative correlation. This universal phenomenon holds across datasets, model architectures, conditional and unconditional sampling, and even other generative models such as VAEs and Normalizing Flows. To explain it, we combine experiments and theory and propose a \textit{symmetry conjecture} that the learned score function is approximately affine antisymmetric (odd symmetry up to a constant shift), supported by empirical evidence. This negative correlation leads to substantially more reliable uncertainty quantification with up to $90\%$ narrower confidence intervals. We demonstrate these gains on tasks including estimating pixel-wise statistics and evaluating diffusion inverse solvers. We also provide extensions with randomized quasi-Monte Carlo noise designs for uncertainty quantification, and explore additional applications of the antithetic noise design to improve image editing and generation diversity. Our framework is training-free, model-agnostic, and adds no runtime overhead. Code is available at https://github.com/jjia131/Antithetic-Noise-in-Diffusion-Models-page.

cs.LG↗
arXiv2025

Local Patches Meet Global Context: Scalable 3D Diffusion Priors for Computed Tomography Reconstruction

Diffusion models learn strong image priors that can be leveraged to solve inverse problems like medical image reconstruction. However, for real-world applications such as 3D Computed Tomography (CT) imaging, directly training diffusion models on 3D data presents significant challenges due to the high computational demands of extensive GPU resources and large-scale datasets. Existing works mostly reuse 2D diffusion priors to address 3D inverse problems, but fail to fully realize and leverage the generative capacity of diffusion models for high-dimensional data. In this study, we propose a novel 3D patch-based diffusion model that can learn a fully 3D diffusion prior from limited data, enabling scalable generation of high-resolution 3D images. Our core idea is to learn the prior of 3D patches to achieve scalable efficiency, while coupling local and global information to guarantee high-quality 3D image generation, by modeling the joint distribution of position-aware 3D local patches and downsampled 3D volume as global context. Our approach not only enables high-quality 3D generation, but also offers an unprecedentedly efficient and accurate solution to high-resolution 3D inverse problems. Experiments on 3D CT reconstruction across multiple datasets show that our method outperforms state-of-the-art methods in both performance and efficiency, notably achieving high-resolution 3D reconstruction of $512 \times 512 \times 256$ ($\sim$20 mins).

cs.CV↗
arXiv2025

Learning Image Priors through Patch-based Diffusion Models for Solving Inverse Problems

Diffusion models can learn strong image priors from underlying data distribution and use them to solve inverse problems, but the training process is computationally expensive and requires lots of data. Such bottlenecks prevent most existing works from being feasible for high-dimensional and high-resolution data such as 3D images. This paper proposes a method to learn an efficient data prior for the entire image by training diffusion models only on patches of images. Specifically, we propose a patch-based position-aware diffusion inverse solver, called PaDIS, where we obtain the score function of the whole image through scores of patches and their positional encoding and utilize this as the prior for solving inverse problems. First of all, we show that this diffusion model achieves an improved memory efficiency and data efficiency while still maintaining the capability to generate entire images via positional encoding. Additionally, the proposed PaDIS model is highly flexible and can be plugged in with different diffusion inverse solvers (DIS). We demonstrate that the proposed PaDIS approach enables solving various inverse problems in both natural and medical image domains, including CT reconstruction, deblurring, and superresolution, given only patch-based priors. Notably, PaDIS outperforms previous DIS methods trained on entire image priors in the case of limited training data, demonstrating the data efficiency of our proposed approach by learning patch-based prior.

cs.CV↗