arXiv subjects

Luping Zhou

Publications and source records attributed to Luping Zhou.

At least 19 recordsLinked to original sources

arXiv2026

DRRG: A Discrete Diffusion Framework for Radiology Report Generation

Purpose: Automatic radiology report generation (RRG) has been widely explored to improve reporting accuracy and reduce radiologists' workload. Most existing methods rely on autoregressive (AR) frameworks that generate reports token by token and cannot revise earlier content, making them prone to error propagation and inconsistent with the iterative refinement process of radiological reporting. In contrast, discrete diffusion large language models (DLLMs) generate text through iterative denoising, naturally enabling report refinement. However, DLLMs have not been extensively investigated for RRG. In this study, we developed and evaluated a discrete diffusion framework for RRG that enables iterative refinement rather than conventional left-to-right autoregressive decoding. Materials and methods: We developed DRRG, a DLLM-based framework that formulates RRG as iterative masked-token denoising. DRRG incorporates a clinical-entities-aware complementary mask to improve token supervision coverage and emphasize clinically important entities, together with a concept-conditioning module that injects image-derived clinical concepts into visual representations. DRRG was trained and evaluated on MIMIC-CXR and CheXpert Plus. Results: On MIMIC-CXR, DRRG achieved BLEU-4 of 0.210, CheXpert-F1 of 0.549, RadGraph-F1 of 0.281, GREEN of 0.360, and RaTEScore of 0.604, outperforming the compared methods on most reported metrics, despite employing a substantially smaller LLM decoder. On CheXpert Plus, DRRG achieved the highest BLEU-4 (0.119) and CheXpert-F1 (0.347) among the compared methods. Conclusion: Discrete diffusion provides an effective alternative to autoregressive radiology report generation by enabling iterative, bidirectional report refinement. Incorporating clinically focused masking and image-derived concept conditioning improves report quality and clinical consistency.

cs.CV↗

arXiv2026

Graph-Supervised Hierarchical Clinical Alignment for Radiology Report Generation with Large Language Models

Radiology report generation (RRG) has recently benefited from large language models, which substantially improve report fluency. However, clinically faithful generation remains challenging because current supervision is still imposed mostly at the report level. This creates a granularity mismatch: radiology reports are composed of disease-grounded findings, while existing methods are trained mainly with whole-report objectives. To address this problem, we propose Graph-Supervised Hierarchical Clinical Alignment, which reformulates image-report supervision as a hierarchical clinical alignment problem. Our method structures this alignment as a disease-conditioned process, where supervision is decomposed into two levels: Disease-Centric Alignment for fine-grained disease-specific correspondence, and Global Clinical Semantic Alignment for report-level semantic coherence. A clinical knowledge graph is used as a training-time-only structural prior that defines disease-specific supervision units and their clinical relationships, introducing no additional overhead at inference. Because standard contrastive alignment could produce false negatives when studies share overlapping pathologies, we combine instance-conditioned discriminative matching with disease-conditioned soft regularization, enabling fine-grained yet clinically consistent cross-modal representations. Experiments on MIMIC-CXR, IU-Xray, and COV-CTR show that our method consistently improves performance on both conventional and clinical metrics. Notably, our 3B model surpasses several prior systems with larger 7B/13B backbones, suggesting that improving supervision structure, rather than increasing model size, can be more effective for RRG.

cs.CV↗

arXiv2026

Surg-UniWorld: A Unified Surgical World Model with Multimodal Control Experts

Controllable surgical world models can provide a generative foundation for surgical artificial intelligence and simulation by synthesizing realistic instrument--tissue interactions. However, existing methods lack a unified multimodal control paradigm, while direct fusion of heterogeneous visual conditions often causes anatomical distortion, instrument appearance drift, and temporally inconsistent interactions. In this work, we propose {Surg-UniWorld}, a unified surgical world model with multimodal control experts. Surg-UniWorld first constructs a {Hierarchical Surgical Anchor} from first-frame appearance and hierarchical semantic masks to preserve persistent scene identity, anatomical organization, and interaction boundaries. {Anchor-Relative Modality Experts} then interpret edge, depth, and optical-flow evidence relative to the shared anchor, capturing complementary boundary, geometric, and motion information. A {Multimodal Control Expert} further performs contribution-preserving stage-wise composition of the activated modality increments and generates control hints for the Wan2.2 video diffusion backbone. To support multimodal surgical world modeling, we further construct Cholec80-SurgWAM, a benchmark for controllable surgical video generation. Extensive experiments demonstrate that Surg-UniWorld consistently outperforms existing controllable video generation methods and surgical world-model baselines in generation quality, temporal consistency, and multimodal controllability.

cs.AI↗

arXiv2026

Recurrent Contrastive Learning for Imbalanced Medical Image Classification

Medical image classification often suffers from class imbalance due to the inherent disparities in disease incidence. Existing approaches, such as class resampling and loss reweighting, mainly improve learning within the observed feature distribution, but do not explicitly enlarge the latent support region of tail classes. As a result, tail-class representations remain overly compact and are easily encroached upon by head classes, leading to biased decision boundaries. In this work, we propose Recurrent Contrastive Learning (RCL) for imbalanced medical image classification. RCL progressively expands the support region of tail classes by recurrently reusing historical feature states across training phases. Specifically, we adopt DINOv3 with LoRA adapters as the backbone to provide robust feature embeddings. We then devise a Temporal Memory Queue (TMQ) to preserve corpus-level features across training phases and provide diversified global references for contrastive learning. Based on TMQ, we construct Temporal Anchors (TARs) to form an anchor field around tail classes. This field enlarges the support region of tail classes, suppresses head-class encroachment, and improves inter-class separation. Extensive experiments on three imbalanced medical datasets demonstrate that RCL achieves consistent improvements over strong baselines. The code is available at https://github.com/dndins/RCL.

cs.CV↗

arXiv2026

ProgFormer: Hierarchical Voxel Diffusion Transformer for Longitudinal Brain MRI Prediction

Predicting future structural MRI of a brain is challenging because longitudinal changes are often subtle and confined to specific anatomical regions, while most subject-specific brain structure remains stable over time. An effective model should therefore preserve global brain structural consistency while remaining sensitive to fine-grained disease progression. Existing latent-space-based methods improve computational efficiency, but suffer from information loss during their compression-reconstruction procedure. In contrast, direct voxel-space methods avoid latent reconstruction but commonly use a unified prediction pathway to model brain structure and progression-related changes. Subtle local changes may therefore be overshadowed by the dominant stable brain structure. To address these challenges, we propose ProgFormer, a hierarchical voxel-space Diffusion Transformer for longitudinal brain MRI prediction. ProgFormer uses a coarse pathway to perform the primary volumetric prediction from 3D patch tokens. This pathway models overall brain structure and longitudinal context. The fine pathway then uses the coarse representations as spatio-temporal grounding for voxel-level refinement within individual patches. The two pathways jointly estimate a velocity field directly in voxel space through conditional flow matching, enabling end-to-end prediction without a separately learned image autoencoder. The predicted future scan is then generated from Gaussian noise by integrating the estimated velocity field over a sequence of Euler steps. Extensive experimental results on three widely used benchmarks, ADNI, AIBL, and OASIS, under both pairwise and trajectory settings demonstrate favourable performance compared against several state-of-the-art methods.

cs.CV↗

arXiv2026

Seeing What Matters: Lesion-Aware High-Resolution Patch Discovery and Fusion for Chest X-ray Report Generation

Despite rapid advances in chest X-ray (CXR) foundation models, most radiology report generation (RRG) systems still rely on heavily downsampled inputs (e.g., 256x256) due to the fixed visual token budgets of pretrained vision encoders, suppressing subtle yet clinically important cues present in native-resolution images. However, enabling high-resolution (high-res) perception remains challenging: naive tiling causes prohibitive token inflation, while global compression suppresses subtle lesions and degrades diagnostic fidelity. Inspired by radiologists' workflow, localizing suspicious regions before detailed high-res assessment. We propose Lesion-Aware High-Resolution Patch Discovery and Fusion for Chest X-ray Reporting (LePaX), the first RRG framework that enables efficient high-res CXR perception (up to 1920x1920) without increasing the vision-token count. LePaX formulates high-res perception as a constrained spatial resolution allocation problem under a fixed token budget and introduces two key components: Learnable Spatial Resolution Allocation (LSRA), which learns a spatial utility map that adaptively allocates limited high-res capacity to diagnostically relevant regions, enabling targeted extraction of high-res patches from native CXRs; and Global-Regional Fusion (GRF), which performs token-preserving region-to-global refinement by projecting high-resolution regional evidence back onto the global feature grid through spatially aligned resolution write-back, avoiding token inflation. Experiments on multiple CXR benchmarks demonstrate that LePaX consistently improves both clinical and linguistic metrics while enabling native-resolution CXR perception with over 10x fewer visual tokens than naive high-res tiling.

cs.CV↗

arXiv2026

Semi-MedRef: Semi-Supervised Medical Referring Image Segmentation with Cross-Modal Alignment

Medical referring image segmentation (MRIS) predicts lesion masks from medical images and natural-language referring expressions, but acquiring paired pixel-level annotations and referring texts is costly. Semi-supervised learning (SSL) can alleviate this burden by exploiting unlabeled data, yet its effectiveness depends on preserving image--text alignment under strong perturbations. Existing SSL methods for referring segmentation rely on independent or simple multimodal perturbations (e.g., left--right flips), while stronger augmentations such as CutMix remain largely unexplored because they can disrupt cross-modal correspondence. We propose Semi-MedRef, a teacher--student SSL framework that explicitly preserves alignment between medical images and positional language through three complementary components: T-PatchMix, an alignment-preserving cross-modal augmentation that synchronizes patch mixing with positional-language and pseudo-mask updates; PosAug, a position-aware text augmentation that regularizes reliance on positional expressions; and Positional Affinity Contrastive Learning (PACL), which exploits coarse positional cues to construct region-aware supervision through anatomically weighted soft positives, encouraging anatomically grounded cross-modal representation learning. Experiments on QaTa-COV19 and MosMedData+ demonstrate that Semi-MedRef consistently outperforms state-of-the-art fully supervised and semi-supervised MRIS methods across all label regimes.

cs.CV↗

arXiv2026

Hierarchical Text-Guided Brain Tumor Segmentation via Sub-Region-Aware Prompts

Brain tumor segmentation remains challenging because the three standard sub-regions, i.e., whole tumor (WT), tumor core (TC), and enhancing tumor (ET), often exhibit ambiguous visual boundaries. Integrating radiological description texts with imaging has shown promise. However, most multimodal approaches typically compress a report into a single global text embedding shared across all sub-regions, overlooking their distinct clinical characteristics. We propose TextCSP (text-modulated soft cascade architecture), a hierarchical text-guided framework that builds on the TextBraTS baseline with three novel components: (1) a text-modulated soft cascade decoder that predicts WT->TC->ET in a coarse-to-fine manner consistent with their anatomical containment hierarchy. (2) sub-region-aware prompt tuning, which uses learnable soft prompts with a LoRA-adapted BioBERT encoder to generate specialized text representations tailored for each sub-region; (3) text-semantic channel modulators that convert the aforementioned representations into channel-wise refinement signals, enabling the decoder to emphasize features aligned with clinically described patterns. Experiments on the TextBraTS dataset demonstrate consistent improvements across all sub-regions against state-of-the-art methods by 1.7% and 6% on the main metrics Dice and HD95.

cs.CV↗

arXiv2025

EndoIR: Degradation-Agnostic All-in-One Endoscopic Image Restoration via Noise-Aware Routing Diffusion

Endoscopic images often suffer from diverse and co-occurring degradations such as low lighting, smoke, and bleeding, which obscure critical clinical details. Existing restoration methods are typically task-specific and often require prior knowledge of the degradation type, limiting their robustness in real-world clinical use. We propose EndoIR, an all-in-one, degradation-agnostic diffusion-based framework that restores multiple degradation types using a single model. EndoIR introduces a Dual-Domain Prompter that extracts joint spatial-frequency features, coupled with an adaptive embedding that encodes both shared and task-specific cues as conditioning for denoising. To mitigate feature confusion in conventional concatenation-based conditioning, we design a Dual-Stream Diffusion architecture that processes clean and degraded inputs separately, with a Rectified Fusion Block integrating them in a structured, degradation-aware manner. Furthermore, Noise-Aware Routing Block improves efficiency by dynamically selecting only noise-relevant features during denoising. Experiments on SegSTRONG-C and CEC datasets demonstrate that EndoIR achieves state-of-the-art performance across multiple degradation scenarios while using fewer parameters than strong baselines, and downstream segmentation experiments confirm its clinical utility.

eess.IV↗

arXiv2025

Medical Referring Image Segmentation via Next-Token Mask Prediction

Medical Referring Image Segmentation (MRIS) involves segmenting target regions in medical images based on natural language descriptions. While achieving promising results, recent approaches usually involve complex design of multimodal fusion or multi-stage decoders. In this work, we propose NTP-MRISeg, a novel framework that reformulates MRIS as an autoregressive next-token prediction task over a unified multimodal sequence of tokenized image, text, and mask representations. This formulation streamlines model design by eliminating the need for modality-specific fusion and external segmentation models, supports a unified architecture for end-to-end training. It also enables the use of pretrained tokenizers from emerging large-scale multimodal models, enhancing generalization and adaptability. More importantly, to address challenges under this formulation-such as exposure bias, long-tail token distributions, and fine-grained lesion edges-we propose three novel strategies: (1) a Next-k Token Prediction (NkTP) scheme to reduce cumulative prediction errors, (2) Token-level Contrastive Learning (TCL) to enhance boundary sensitivity and mitigate long-tail distribution effects, and (3) a memory-based Hard Error Token (HET) optimization strategy that emphasizes difficult tokens during training. Extensive experiments on the QaTa-COV19 and MosMedData+ datasets demonstrate that NTP-MRISeg achieves new state-of-the-art performance, offering a streamlined and effective alternative to traditional MRIS pipelines.

cs.CV↗

arXiv2025

A Renaissance of Explicit Motion Information Mining from Transformers for Action Recognition

Recently, action recognition has been dominated by transformer-based methods, thanks to their spatiotemporal contextual aggregation capacities. However, despite the significant progress achieved on scene-related datasets, they do not perform well on motion-sensitive datasets due to the lack of elaborate motion modeling designs. Meanwhile, we observe that the widely-used cost volume in traditional action recognition is highly similar to the affinity matrix defined in self-attention, but equipped with powerful motion modeling capacities. In light of this, we propose to integrate those effective motion modeling properties into the existing transformer in a unified and neat way, with the proposal of the Explicit Motion Information Mining module (EMIM). In EMIM, we propose to construct the desirable affinity matrix in a cost volume style, where the set of key candidate tokens is sampled from the query-based neighboring area in the next frame in a sliding-window manner. Then, the constructed affinity matrix is used to aggregate contextual information for appearance modeling and is converted into motion features for motion modeling as well. We validate the motion modeling capacities of our method on four widely-used datasets, and our method performs better than existing state-of-the-art approaches, especially on motion-sensitive datasets, i.e., Something-Something V1 & V2. Our project is available at https://github.com/PeiqinZhuang/EMIM .

cs.CV↗

arXiv2025

A Review of Longitudinal Radiology Report Generation: Dataset Composition, Methods, and Performance Evaluation

Chest Xray imaging is a widely used diagnostic tool in modern medicine, and its high utilization creates substantial workloads for radiologists. To alleviate this burden, vision language models are increasingly applied to automate Chest Xray radiology report generation (CXRRRG), aiming for clinically accurate descriptions while reducing manual effort. Conventional approaches, however, typically rely on single images, failing to capture the longitudinal context necessary for producing clinically faithful comparison statements. Recently, growing attention has been directed toward incorporating longitudinal data into CXR RRG, enabling models to leverage historical studies in ways that mirror radiologists diagnostic workflows. Nevertheless, existing surveys primarily address single image CXRRRG and offer limited guidance for longitudinal settings, leaving researchers without a systematic framework for model design. To address this gap, this survey provides the first comprehensive review of longitudinal radiology report generation (LRRG). Specifically, we examine dataset construction strategies, report generation architectures alongside longitudinally tailored designs, and evaluation protocols encompassing both longitudinal specific measures and widely used benchmarks. We further summarize LRRG methods performance, alongside analyses of different ablation studies, which collectively highlight the critical role of longitudinal information and architectural design choices in improving model performance. Finally, we summarize five major limitations of current research and outline promising directions for future development, aiming to lay a foundation for advancing this emerging field.

cs.CV↗

arXiv2025

Understand Before You Generate: Self-Guided Training for Autoregressive Image Generation

Recent studies have demonstrated the importance of high-quality visual representations in image generation and have highlighted the limitations of generative models in image understanding. As a generative paradigm originally designed for natural language, autoregressive models face similar challenges. In this work, we present the first systematic investigation into the mechanisms of applying the next-token prediction paradigm to the visual domain. We identify three key properties that hinder the learning of high-level visual semantics: local and conditional dependence, inter-step semantic inconsistency, and spatial invariance deficiency. We show that these issues can be effectively addressed by introducing self-supervised objectives during training, leading to a novel training framework, Self-guided Training for AutoRegressive models (ST-AR). Without relying on pre-trained representation models, ST-AR significantly enhances the image understanding ability of autoregressive models and leads to improved generation quality. Specifically, ST-AR brings approximately 42% FID improvement for LlamaGen-L and 49% FID improvement for LlamaGen-XL, while maintaining the same sampling strategy.

cs.CV↗

arXiv2025

InfGen: A Resolution-Agnostic Paradigm for Scalable Image Synthesis

Arbitrary resolution image generation provides a consistent visual experience across devices, having extensive applications for producers and consumers. Current diffusion models increase computational demand quadratically with resolution, causing 4K image generation delays over 100 seconds. To solve this, we explore the second generation upon the latent diffusion models, where the fixed latent generated by diffusion models is regarded as the content representation and we propose to decode arbitrary resolution images with a compact generated latent using a one-step generator. Thus, we present the \textbf{InfGen}, replacing the VAE decoder with the new generator, for generating images at any resolution from a fixed-size latent without retraining the diffusion models, which simplifies the process, reducing computational complexity and can be applied to any model using the same latent space. Experiments show InfGen is capable of improving many models into the arbitrary high-resolution era while cutting 4K image generation time to under 10 seconds.

cs.CV↗

arXiv2025

RadReason: Radiology Report Evaluation Metric with Reasons and Sub-Scores

Evaluating automatically generated radiology reports remains a fundamental challenge due to the lack of clinically grounded, interpretable, and fine-grained metrics. Existing methods either produce coarse overall scores or rely on opaque black-box models, limiting their usefulness in real-world clinical workflows. We introduce RadReason, a novel evaluation framework for radiology reports that not only outputs fine-grained sub-scores across six clinically defined error types, but also produces human-readable justifications that explain the rationale behind each score. Our method builds on Group Relative Policy Optimization and incorporates two key innovations: (1) Sub-score Dynamic Weighting, which adaptively prioritizes clinically challenging error types based on live F1 statistics; and (2) Majority-Guided Advantage Scaling, which adjusts policy gradient updates based on prompt difficulty derived from sub-score agreement. Together, these components enable more stable optimization and better alignment with expert clinical judgment. Experiments on the ReXVal benchmark show that RadReason surpasses all prior offline metrics and achieves parity with GPT-4-based evaluations, while remaining explainable, cost-efficient, and suitable for clinical deployment. Code will be released upon publication.

cs.CL↗

arXiv2025

Diversity-enhanced Collaborative Mamba for Semi-supervised Medical Image Segmentation

Acquiring high-quality annotated data for medical image segmentation is tedious and costly. Semi-supervised segmentation techniques alleviate this burden by leveraging unlabeled data to generate pseudo labels. Recently, advanced state space models, represented by Mamba, have shown efficient handling of long-range dependencies. This drives us to explore their potential in semi-supervised medical image segmentation. In this paper, we propose a novel Diversity-enhanced Collaborative Mamba framework (namely DCMamba) for semi-supervised medical image segmentation, which explores and utilizes the diversity from data, network, and feature perspectives. Firstly, from the data perspective, we develop patch-level weak-strong mixing augmentation with Mamba's scanning modeling characteristics. Moreover, from the network perspective, we introduce a diverse-scan collaboration module, which could benefit from the prediction discrepancies arising from different scanning directions. Furthermore, from the feature perspective, we adopt an uncertainty-weighted contrastive learning mechanism to enhance the diversity of feature representation. Experiments demonstrate that our DCMamba significantly outperforms other semi-supervised medical image segmentation methods, e.g., yielding the latest SSM-based method by 6.69% on the Synapse dataset with 20% labeled data.

cs.CV↗

arXiv2025

S-RRG-Bench: Structured Radiology Report Generation with Fine-Grained Evaluation Framework

Radiology report generation (RRG) for diagnostic images, such as chest X-rays, plays a pivotal role in both clinical practice and AI. Traditional free-text reports suffer from redundancy and inconsistent language, complicating the extraction of critical clinical details. Structured radiology report generation (S-RRG) offers a promising solution by organizing information into standardized, concise formats. However, existing approaches often rely on classification or visual question answering (VQA) pipelines that require predefined label sets and produce only fragmented outputs. Template-based approaches, which generate reports by replacing keywords within fixed sentence patterns, further compromise expressiveness and often omit clinically important details. In this work, we present a novel approach to S-RRG that includes dataset construction, model training, and the introduction of a new evaluation framework. We first create a robust chest X-ray dataset (MIMIC-STRUC) that includes disease names, severity levels, probabilities, and anatomical locations, ensuring that the dataset is both clinically relevant and well-structured. We train an LLM-based model to generate standardized, high-quality reports. To assess the generated reports, we propose a specialized evaluation metric (S-Score) that not only measures disease prediction accuracy but also evaluates the precision of disease-specific details, thus offering a clinically meaningful metric for report quality that focuses on elements critical to clinical decision-making and demonstrates a stronger alignment with human assessments. Our approach highlights the effectiveness of structured reports and the importance of a tailored evaluation metric for S-RRG, providing a more clinically relevant measure of report quality.

cs.CV↗

arXiv2025

HiLa: Hierarchical Vision-Language Collaboration for Cancer Survival Prediction

Survival prediction using whole-slide images (WSIs) is crucial in cancer re-search. Despite notable success, existing approaches are limited by their reliance on sparse slide-level labels, which hinders the learning of discriminative repre-sentations from gigapixel WSIs. Recently, vision language (VL) models, which incorporate additional language supervision, have emerged as a promising solu-tion. However, VL-based survival prediction remains largely unexplored due to two key challenges. First, current methods often rely on only one simple lan-guage prompt and basic cosine similarity, which fails to learn fine-grained associ-ations between multi-faceted linguistic information and visual features within WSI, resulting in inadequate vision-language alignment. Second, these methods primarily exploit patch-level information, overlooking the intrinsic hierarchy of WSIs and their interactions, causing ineffective modeling of hierarchical interac-tions. To tackle these problems, we propose a novel Hierarchical vision-Language collaboration (HiLa) framework for improved survival prediction. Specifically, HiLa employs pretrained feature extractors to generate hierarchical visual features from WSIs at both patch and region levels. At each level, a series of language prompts describing various survival-related attributes are constructed and aligned with visual features via Optimal Prompt Learning (OPL). This ap-proach enables the comprehensive learning of discriminative visual features cor-responding to different survival-related attributes from prompts, thereby improv-ing vision-language alignment. Furthermore, we introduce two modules, i.e., Cross-Level Propagation (CLP) and Mutual Contrastive Learning (MCL) to maximize hierarchical cooperation by promoting interactions and consistency be-tween patch and region levels. Experiments on three TCGA datasets demonstrate our SOTA performance.

cs.CV↗