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Qi Dou

Publications and source records attributed to Qi Dou.

At least 37 records · Page 2Linked to original sources

Saliency-R1: Enforcing Interpretable and Faithful Vision-language Reasoning via Saliency-map Alignment Reward

Vision-language models (VLMs) have achieved remarkable success across diverse tasks. However, concerns about their trustworthiness persist, particularly regarding tendencies to lean more on textual cues than visual evidence and the risk of producing ungrounded or fabricated responses. To address these issues, we propose Saliency-R1, a framework for improving the interpretability and faithfulness of VLMs reasoning. Specifically, we introduce a novel saliency map technique that efficiently highlights critical image regions contributing to generated tokens without additional computational overhead. This can further be extended to trace how visual information flows through the reasoning process to the final answers, revealing the alignment between the thinking process and the visual context. We use the overlap between the saliency maps and human-annotated bounding boxes as the reward function, and apply Group Relative Policy Optimization (GRPO) to align the salient parts and critical regions, encouraging models to focus on relevant areas when conduct reasoning. Experiments show Saliency-R1 improves reasoning faithfulness, interpretability, and overall task performance.

cs.CV↗

Surg$Σ$: A Spectrum of Large-Scale Multimodal Data and Foundation Models for Surgical Intelligence

Surgical intelligence has the potential to improve the safety and consistency of surgical care, yet most existing surgical AI frameworks remain task-specific and struggle to generalize across procedures and institutions. Although multimodal foundation models, particularly multimodal large language models, have demonstrated strong cross-task capabilities across various medical domains, their advancement in surgery remains constrained by the lack of large-scale, systematically curated multimodal data. To address this challenge, we introduce Surg$Σ$, a spectrum of large-scale multimodal data and foundation models for surgical intelligence. At the core of this framework lies Surg$Σ$-DB, a large-scale multimodal data foundation designed to support diverse surgical tasks. Surg$Σ$-DB consolidates heterogeneous surgical data sources (including open-source datasets, curated in-house clinical collections and web-source data) into a unified schema, aiming to improve label consistency and data standardization across heterogeneous datasets. Surg$Σ$-DB spans 6 clinical specialties and diverse surgical types, providing rich image- and video-level annotations across 18 practical surgical tasks covering understanding, reasoning, planning, and generation, at an unprecedented scale (over 5.98M conversations). Beyond conventional multimodal conversations, Surg$Σ$-DB incorporates hierarchical reasoning annotations, providing richer semantic cues to support deeper contextual understanding in complex surgical scenarios. We further provide empirical evidence through recently developed surgical foundation models built upon Surg$Σ$-DB, illustrating the practical benefits of large-scale multimodal annotations, unified semantic design, and structured reasoning annotations for improving cross-task generalization and interpretability.

cs.AI↗

WonderVerse: Extendable 3D Scene Generation with Video Generative Models

We introduce \textit{WonderVerse}, a simple but effective framework for generating extendable 3D scenes. Unlike existing methods that rely on iterative depth estimation and image inpainting, often leading to geometric distortions and inconsistencies, WonderVerse leverages the powerful world-level priors embedded within video generative foundation models to create highly immersive and geometrically coherent 3D environments. Furthermore, we propose a new technique for controllable 3D scene extension to substantially increase the scale of the generated environments. Besides, we introduce a novel abnormal sequence detection module that utilizes camera trajectory to address geometric inconsistency in the generated videos. Finally, WonderVerse is compatible with various 3D reconstruction methods, allowing both efficient and high-quality generation. Extensive experiments on 3D scene generation demonstrate that our WonderVerse, with an elegant and simple pipeline, delivers extendable and highly-realistic 3D scenes, markedly outperforming existing works that rely on more complex architectures.

cs.CV↗

Generalized Recognition of Basic Surgical Actions Enables Skill Assessment and Vision-Language-Model-based Surgical Planning

Artificial intelligence, imaging, and large language models have the potential to transform surgical practice, training, and automation. Understanding and modeling of basic surgical actions (BSA), the fundamental unit of operation in any surgery, is important to drive the evolution of this field. In this paper, we present a BSA dataset comprising 10 basic actions across 6 surgical specialties with over 11,000 video clips, which is the largest to date. Based on the BSA dataset, we developed a new foundation model that conducts general-purpose recognition of basic actions. Our approach demonstrates robust cross-specialist performance in experiments validated on datasets from different procedural types and various body parts. Furthermore, we demonstrate downstream applications enabled by the BAS foundation model through surgical skill assessment in prostatectomy using domain-specific knowledge, and action planning in cholecystectomy and nephrectomy using large vision-language models. Multinational surgeons' evaluation of the language model's output of the action planning explainable texts demonstrated clinical relevance. These findings indicate that basic surgical actions can be robustly recognized across scenarios, and an accurate BSA understanding model can essentially facilitate complex applications and speed up the realization of surgical superintelligence.

cs.CV↗

Surg-R1: A Hierarchical Reasoning Foundation Model for Scalable and Interpretable Surgical Decision Support with Multi-Center Clinical Validation

Surgical scene understanding demands not only accurate predictions but also interpretable reasoning that surgeons can verify against clinical expertise. However, existing surgical vision-language models generate predictions without reasoning chains, and general-purpose reasoning models fail on compositional surgical tasks without domain-specific knowledge. We present Surg-R1, a surgical Vision-Language Model that addresses this gap through hierarchical reasoning trained via a four-stage pipeline. Our approach introduces three key contributions: (1) a three-level reasoning hierarchy decomposing surgical interpretation into perceptual grounding, relational understanding, and contextual reasoning; (2) the largest surgical chain-of-thought dataset with 320,000 reasoning pairs; and (3) a four-stage training pipeline progressing from supervised fine-tuning to group relative policy optimization and iterative self-improvement. Evaluation on SurgBench, comprising six public benchmarks and six multi-center external validation datasets from five institutions, demonstrates that Surg-R1 achieves the highest Arena Score (64.9%) on public benchmarks versus Gemini 3.0 Pro (46.1%) and GPT-5.1 (37.9%), outperforming both proprietary reasoning models and specialized surgical VLMs on the majority of tasks spanning instrument localization, triplet recognition, phase recognition, action recognition, and critical view of safety assessment, with a 15.2 percentage point improvement over the strongest surgical baseline on external validation.

cs.CV↗

Diffusion Stabilizer Policy for Automated Surgical Robot Manipulations

Intelligent surgical robots have the potential to revolutionize clinical practice by enabling more precise and automated surgical procedures. However, the automation of such robot for surgical tasks remains under-explored compared to recent advancements in solving household manipulation tasks. These successes have been largely driven by (1) advanced models, such as transformers and diffusion models, and (2) large-scale data utilization. Aiming to extend these successes to the domain of surgical robotics, we propose a diffusion-based policy learning framework, called Diffusion Stabilizer Policy (DSP), which enables training with imperfect or even failed trajectories. Our approach consists of two stages: first, we train the diffusion stabilizer policy using only clean data. Then, the policy is continuously updated using a mixture of clean and perturbed data, with filtering based on the prediction error on actions. Comprehensive experiments conducted in various surgical environments demonstrate the superior performance of our method in perturbation-free settings and its robustness when handling perturbed demonstrations.

cs.RO↗

SSP: Safety-guaranteed Surgical Policy via Joint Optimization of Behavioral and Spatial Constraints

The paradigm of robot-assisted surgery is shifting toward data-driven autonomy, where policies learned via Reinforcement Learning (RL) or Imitation Learning (IL) enable the execution of complex tasks. However, these ``black-box" policies often lack formal safety guarantees, a critical requirement for clinical deployment. In this paper, we propose the Safety-guaranteed Surgical Policy (SSP) framework to bridge the gap between data-driven generality and formal safety. We utilize Neural Ordinary Differential Equations (Neural ODEs) to learn an uncertainty-aware dynamics model from demonstration data. This learned model underpins a robust Control Barrier Function (CBF) safety controller, which minimally alters the actions of a surgical policy to ensure strict safety under uncertainty. Our controller enforces two constraint categories: behavioral constraints (restricting the task space of the agent) and spatial constraints (defining surgical no-go zones). We instantiate the SSP framework with surgical policies derived from RL, IL and Control Lyapunov Functions (CLF). Validation on in both the SurRoL simulation and da Vinci Research Kit (dVRK) demonstrates that our method achieves a near-zero constraint violation rate while maintaining high task success rates compared to unconstrained baselines.

cs.RO↗

CubeComposer: Spatio-Temporal Autoregressive 4K 360° Video Generation from Perspective Video

Generating high-quality 360° panoramic videos from perspective input is one of the crucial applications for virtual reality (VR), whereby high-resolution videos are especially important for immersive experience. Existing methods are constrained by computational limitations of vanilla diffusion models, only supporting $\leq$ 1K resolution native generation and relying on suboptimal post super-resolution to increase resolution. We introduce CubeComposer, a novel spatio-temporal autoregressive diffusion model that natively generates 4K-resolution 360° videos. By decomposing videos into cubemap representations with six faces, CubeComposer autoregressively synthesizes content in a well-planned spatio-temporal order, reducing memory demands while enabling high-resolution output. Specifically, to address challenges in multi-dimensional autoregression, we propose: (1) a spatio-temporal autoregressive strategy that orchestrates 360° video generation across cube faces and time windows for coherent synthesis; (2) a cube face context management mechanism, equipped with a sparse context attention design to improve efficiency; and (3) continuity-aware techniques, including cube-aware positional encoding, padding, and blending to eliminate boundary seams. Extensive experiments on benchmark datasets demonstrate that CubeComposer outperforms state-of-the-art methods in native resolution and visual quality, supporting practical VR application scenarios. Project page: https://lg-li.github.io/project/cubecomposer

cs.CV↗

The Dresden Dataset for 4D Reconstruction of Non-Rigid Abdominal Surgical Scenes

The D4D Dataset provides paired endoscopic video and high-quality structured-light geometry for evaluating 3D reconstruction of deforming abdominal soft tissue in realistic surgical conditions. Data were acquired from six porcine cadaver sessions using a da Vinci Xi stereo endoscope and a Zivid structured-light camera, registered via optical tracking and manually curated iterative alignment methods. Three sequence types - whole deformations, incremental deformations, and moved-camera clips - probe algorithm robustness to non-rigid motion, deformation magnitude, and out-of-view updates. Each clip provides rectified stereo images, per-frame instrument masks, stereo depth, start/end structured-light point clouds, curated camera poses and camera intrinsics. In postprocessing, ICP and semi-automatic registration techniques are used to register data, and instrument masks are created. The dataset enables quantitative geometric evaluation in both visible and occluded regions, alongside photometric view-synthesis baselines. Comprising over 300,000 frames and 369 point clouds across 98 curated recordings, this resource can serve as a comprehensive benchmark for developing and evaluating non-rigid SLAM, 4D reconstruction, and depth estimation methods.

cs.CV↗

Real-time Monocular 2D and 3D Perception of Endoluminal Scenes for Controlling Flexible Robotic Endoscopic Instruments

Endoluminal surgery offers a minimally invasive option for early-stage gastrointestinal and urinary tract cancers but is limited by surgical tools and a steep learning curve. Robotic systems, particularly continuum robots, provide flexible instruments that enable precise tissue resection, potentially improving outcomes. This paper presents a visual perception platform for a continuum robotic system in endoluminal surgery. Our goal is to utilize monocular endoscopic image-based perception algorithms to identify position and orientation of flexible instruments and measure their distances from tissues. We introduce 2D and 3D learning-based perception algorithms and develop a physically-realistic simulator that models flexible instruments dynamics. This simulator generates realistic endoluminal scenes, enabling control of flexible robots and substantial data collection. Using a continuum robot prototype, we conducted module and system-level evaluations. Results show that our algorithms improve control of flexible instruments, reducing manipulation time by over 70% for trajectory-following tasks and enhancing understanding of surgical scenarios, leading to robust endoluminal surgeries.

cs.RO↗

ARport: An Augmented Reality System for Markerless Image-Guided Port Placement in Robotic Surgery

Purpose: Precise port placement is a critical step in robot-assisted surgery, where port configuration influences both visual access to the operative field and instrument maneuverability. To bridge the gap between preoperative planning and intraoperative execution, we present ARport, an augmented reality (AR) system that automatically maps pre-planned trocar layouts onto the patient's body surface, providing intuitive spatial guidance during surgical preparation. Methods: ARport, implemented on an optical see-through head-mounted display (OST-HMD), operates without any external sensors or markers, simplifying setup and enhancing workflow integration. It reconstructs the operative scene from RGB, depth, and pose data captured by the OST-HMD, extracts the patient's body surface using a foundation model, and performs surface-based markerless registration to align preoperative anatomical models to the extracted patient's body surface, enabling in-situ visualization of planned trocar layouts. A demonstration video illustrating the overall workflow is available online. Results: In full-scale human-phantom experiments, ARport accurately overlaid pre-planned trocar sites onto the physical phantom, achieving consistent spatial correspondence between virtual plans and real anatomy. Conclusion: ARport provides a fully marker-free and hardware-minimal solution for visualizing preoperative trocar plans directly on the patient's body surface. The system facilitates efficient intraoperative setup and demonstrates potential for seamless integration into routine clinical workflows.

cs.CV↗

Concepts from Representations: Post-hoc Concept Bottleneck Models via Sparse Decomposition of Visual Representations

Deep learning has achieved remarkable success in image recognition, yet their inherent opacity poses challenges for deployment in critical domains. Concept-based interpretations aim to address this by explaining model reasoning through human-understandable concepts. However, existing post-hoc methods and ante-hoc concept bottleneck models (CBMs), suffer from limitations such as unreliable concept relevance, non-visual or labor-intensive concept definitions, and model or data-agnostic assumptions. This paper introduces Post-hoc Concept Bottleneck Model via Representation Decomposition (PCBM-ReD), a novel pipeline that retrofits interpretability onto pretrained opaque models. PCBM-ReD automatically extracts visual concepts from a pre-trained encoder, employs multimodal large language models (MLLMs) to label and filter concepts based on visual identifiability and task relevance, and selects an independent subset via reconstruction-guided optimization. Leveraging CLIP's visual-text alignment, it decomposes image representations into linear combination of concept embeddings to fit into the CBMs abstraction. Extensive experiments across 11 image classification tasks show PCBM-ReD achieves state-of-the-art accuracy, narrows the performance gap with end-to-end models, and exhibits better interpretability.

cs.CV↗

DSTED: Decoupling Temporal Stabilization and Discriminative Enhancement for Surgical Workflow Recognition

Purpose: Surgical workflow recognition enables context-aware assistance and skill assessment in computer-assisted interventions. Despite recent advances, current methods suffer from two critical challenges: prediction jitter across consecutive frames and poor discrimination of ambiguous phases. This paper aims to develop a stable framework by selectively propagating reliable historical information and explicitly modeling uncertainty for hard sample enhancement. Methods: We propose a dual-pathway framework DSTED with Reliable Memory Propagation (RMP) and Uncertainty-Aware Prototype Retrieval (UPR). RMP maintains temporal coherence by filtering and fusing high-confidence historical features through multi-criteria reliability assessment. UPR constructs learnable class-specific prototypes from high-uncertainty samples and performs adaptive prototype matching to refine ambiguous frame representations. Finally, a confidence-driven gate dynamically balances both pathways based on prediction certainty. Results: Our method achieves state-of-the-art performance on AutoLaparo-hysterectomy with 84.36% accuracy and 65.51% F1-score, surpassing the second-best method by 3.51% and 4.88% respectively. Ablations reveal complementary gains from RMP (2.19%) and UPR (1.93%), with synergistic effects when combined. Extensive analysis confirms substantial reduction in temporal jitter and marked improvement on challenging phase transitions. Conclusion: Our dual-pathway design introduces a novel paradigm for stable workflow recognition, demonstrating that decoupling the modeling of temporal consistency and phase ambiguity yields superior performance and clinical applicability.

cs.CV↗

CP-Env: Evaluating Large Language Models on Clinical Pathways in a Controllable Hospital Environment

Medical care follows complex clinical pathways that extend beyond isolated physician-patient encounters, emphasizing decision-making and transitions between different stages. Current benchmarks focusing on static exams or isolated dialogues inadequately evaluate large language models (LLMs) in dynamic clinical scenarios. We introduce CP-Env, a controllable agentic hospital environment designed to evaluate LLMs across end-to-end clinical pathways. CP-Env simulates a hospital ecosystem with patient and physician agents, constructing scenarios ranging from triage and specialist consultation to diagnostic testing and multidisciplinary team meetings for agent interaction. Following real hospital adaptive flow of healthcare, it enables branching, long-horizon task execution. We propose a three-tiered evaluation framework encompassing Clinical Efficacy, Process Competency, and Professional Ethics. Results reveal that most models struggle with pathway complexity, exhibiting hallucinations and losing critical diagnostic details. Interestingly, excessive reasoning steps can sometimes prove counterproductive, while top models tend to exhibit reduced tool dependency through internalized knowledge. CP-Env advances medical AI agents development through comprehensive end-to-end clinical evaluation. We provide the benchmark and evaluation tools for further research and development at https://github.com/SPIRAL-MED/CP_ENV.

cs.AI↗

Towards Modality- and Sampling-Universal Learning Strategies for Accelerating Cardiovascular Imaging: Summary of the CMRxRecon2024 Challenge

Cardiovascular health is vital to human well-being, and cardiac magnetic resonance (CMR) imaging is considered the {clinical reference standard} for diagnosing cardiovascular disease. However, its adoption is hindered by long scan times, complex contrasts, and inconsistent quality. While deep learning methods perform well on specific CMR imaging {sequences}, they often fail to generalize across modalities and sampling schemes. The lack of benchmarks for high-quality, fast CMR image reconstruction further limits technology comparison and adoption. The CMRxRecon2024 challenge, attracting over 200 teams from 18 countries, addressed these issues with two tasks: generalization to unseen {modalities} and robustness to diverse undersampling patterns. We introduced the largest public multi-{modality} CMR raw dataset, an open benchmarking platform, and shared code. Analysis of the best-performing solutions revealed that prompt-based adaptation and enhanced physics-driven consistency enabled strong cross-scenario performance. These findings establish principles for generalizable reconstruction models and advance clinically translatable AI in cardiovascular imaging.

eess.IV↗

UCAgents: Unidirectional Convergence for Visual Evidence Anchored Multi-Agent Medical Decision-Making

Vision-Language Models (VLMs) show promise in medical diagnosis, yet suffer from reasoning detachment, where linguistically fluent explanations drift from verifiable image evidence, undermining clinical trust. Recent multi-agent frameworks simulate Multidisciplinary Team (MDT) debates to mitigate single-model bias, but open-ended discussions amplify textual noise and computational cost while failing to anchor reasoning to visual evidence, the cornerstone of medical decision-making. We propose UCAgents, a hierarchical multi-agent framework enforcing unidirectional convergence through structured evidence auditing. Inspired by clinical workflows, UCAgents forbids position changes and limits agent interactions to targeted evidence verification, suppressing rhetorical drift while amplifying visual signal extraction. In UCAgents, a one-round inquiry discussion is introduced to uncover potential risks of visual-textual misalignment. This design jointly constrains visual ambiguity and textual noise, a dual-noise bottleneck that we formalize via information theory. Extensive experiments on four medical VQA benchmarks show UCAgents achieves superior accuracy (71.3% on PathVQA, +6.0% over state-of-the-art) with 87.7% lower token cost, the evaluation results further confirm that UCAgents strikes a balance between uncovering more visual evidence and avoiding confusing textual interference. These results demonstrate that UCAgents exhibits both diagnostic reliability and computational efficiency critical for real-world clinical deployment. Code is available at https://github.com/fqhank/UCAgents.

cs.CV↗

Simulated patient systems powered by large language model-based AI agents offer potential for transforming medical education

Background: Simulated patient systems are important in medical education and research, providing safe, integrative training environments and supporting clinical decision making. Advances in artificial intelligence (AI), especially large language models (LLMs), can enhance simulated patients by replicating medical conditions and doctor patient interactions with high fidelity and at low cost, but effectiveness and trustworthiness remain open challenges. Methods: We developed AIPatient, a simulated patient system powered by LLM based AI agents. The system uses a retrieval augmented generation (RAG) framework with six task specific agents for complex reasoning. To improve realism, it is linked to the AIPatient knowledge graph built from de identified real patient data in the MIMIC III intensive care database. Results: We evaluated electronic health record (EHR) based medical question answering (QA), readability, robustness, stability, and user experience. AIPatient reached 94.15 percent QA accuracy when all six agents were enabled, outperforming versions with partial or no agent integration. The knowledge base achieved an F1 score of 0.89. Readability scores showed a median Flesch Reading Ease of 68.77 and a median Flesch Kincaid Grade of 6.4, indicating accessibility for most medical trainees and clinicians. Robustness and stability were supported by non significant variance in repeated trials (analysis of variance F value 0.61, p greater than 0.1; F value 0.78, p greater than 0.1). A user study with medical students showed that AIPatient provides high fidelity, usability, and educational value, comparable to or better than human simulated patients for history taking. Conclusions: LLM based simulated patient systems can deliver accurate, readable, and reliable medical encounters and show strong potential to transform medical education.

cs.CL↗

Systematic Evaluation and Guidelines for Segment Anything Model in Surgical Video Analysis

Surgical video segmentation is critical for AI to interpret spatial-temporal dynamics in surgery, yet model performance is constrained by limited annotated data. The SAM2 model, pretrained on natural videos, offers potential for zero-shot surgical segmentation, but its applicability in complex surgical environments, with challenges like tissue deformation and instrument variability, remains unexplored. We present the first comprehensive evaluation of the zero-shot capability of SAM2 in 9 surgical datasets (17 surgery types), covering laparoscopic, endoscopic, and robotic procedures. We analyze various prompting (points, boxes, mask) and {finetuning (dense, sparse) strategies}, robustness to surgical challenges, and generalization across procedures and anatomies. Key findings reveal that while SAM2 demonstrates notable zero-shot adaptability in structured scenarios (e.g., instrument segmentation, {multi-organ segmentation}, and scene segmentation), its performance varies under dynamic surgical conditions, highlighting gaps in handling temporal coherence and domain-specific artifacts. These results highlight future pathways to adaptive data-efficient solutions for the surgical data science field.

cs.CV↗