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Qingqing Zhu

Publications and source records attributed to Qingqing Zhu.

At least 19 recordsLinked to original sources

A Unified 2D Framework for DeepLesion Detection, Segmentation and Short Report Generation

In previous work, we integrated large language models (LLMs) into the lesion segmentation model based on the ULS23 DeepLesion dataset, using short-form findings from the reports. In this study, we developed a unified 2D lesion analysis framework that integrates LLM-based reasoning, lesion bounding box detection, segmentation, and radiology report generation from the original DeepLesion dataset. In the testing phase, we achieved relatively high lesion bounding box detection accuracy with mAP50 of 70.1%, mAP50-95 of 46.4%; Lesion segmentation performance with a Dice score of 62.6%; short report generation accuracy with BLEU_1 score of 64.3%, BLEU_4 score of 49.6%, METEOR of 34.7%, and ROUGE_L of 60.1%. In this work, we address the challenging issue of segmentation in the original DeepLesion dataset and achieve a 28.5% Dice score improvement over the nnUNet lesion segmentation model. We also integrated spatial and anatomical context into the DeepLesion short report generation. We released the implementation, dataset, and models on Github. https://github.com/ruida/2D_DeepLesion_Foundation

cs.CV

Entry-level guide to the use of large language models for medical research

Frontier large language models (LLMs), such as GPT-5, Claude 4.5, Gemini 3, Llama 4, and DeepSeek-R1, represent a transformative class of AI tools capable of revolutionizing various aspects of healthcare by generating human-like responses across diverse contexts and adapting to novel tasks following human instructions. Their potential application spans a broad range of medical tasks, such as clinical documentation, matching patients to clinical trials, and answering medical questions. In this paper, we propose an actionable guideline to help healthcare professionals more effectively and efficiently utilize LLMs in their work, along with a set of best practices. The overall workflow consists of several main phases, including formulating the task, choosing LLMs, prompt engineering, fine-tuning, and model deployment. We start with the discussion of critical considerations in identifying medical tasks that align with the core capabilities of LLMs and selecting models based on the selected task and data, performance requirements, and model interface. We then review the strategies, such as prompt engineering and fine-tuning, to adapt standard LLMs to specialized medical tasks. Deployment considerations, including regulatory compliance, ethical guidelines, and continuous monitoring for fairness and bias, are also discussed. By providing a structured step-by-step methodology, this entry-level tutorial aims to equip healthcare professionals with the tools necessary to effectively integrate LLMs into clinical practice, ensuring that these powerful technologies are applied in a safe, reliable, and impactful manner.

cs.AI

MedHopQA: A Disease-Centered Multi-Hop Reasoning Benchmark and Evaluation Framework for LLM-Based Biomedical Question Answering

Evaluating large language models (LLMs) in the biomedical domain requires benchmarks that can distinguish reasoning from pattern matching and remain discriminative as model capabilities improve. Existing biomedical question answering (QA) benchmarks are limited in this respect. Multiple-choice formats can allow models to succeed through answer elimination rather than inference, while widely circulated exam-style datasets are increasingly vulnerable to performance saturation and training data contamination. Multi-hop reasoning, defined as the ability to integrate information across multiple sources to derive an answer, is central to clinically meaningful tasks such as diagnostic support, literature-based discovery, and hypothesis generation, yet remains underrepresented in current biomedical QA benchmarks. MedHopQA is a disease-centered multi-hop reasoning benchmark consisting of 1,000 expert-curated question-answer pairs introduced as a shared task at BioCreative IX. Each question requires synthesis of information across two distinct Wikipedia articles, and answers are provided in an open-ended free-text format. Gold annotations are augmented with ontology-grounded synonym sets from MONDO, NCBI Gene, and NCBI Taxonomy to support both lexical and concept-level evaluation. MedHopQA was constructed through a structured process combining human annotation, triage, iterative verification, and LLM-as-a-judge validation. To reduce leaderboard gaming and contamination risk, the 1,000 scored questions are embedded within a publicly downloadable set of 10,000 questions, with answers withheld, on a CodaBench leaderboard. MedHopQA provides both a benchmark and a reusable framework for constructing future biomedical QA datasets that prioritize compositional reasoning, saturation resistance, and contamination resistance as core design constraints.

cs.CL

ReLay: Personalized LLM-Generated Plain-Language Summaries for Better Understanding, but at What Cost?

Plain Language Summaries (PLS) aim to make research accessible to lay readers, but they are typically written in a one-size-fits-all style that ignores differences in readers' information needs and comprehension. In health contexts, this limitation is particularly important because misunderstanding scientific information can affect real-world decisions. Large language models (LLMs) offer new opportunities for personalizing PLS, but it remains unclear whether personalization helps, which strategies are most effective, and how to balance personalization with safety. We introduce ReLay, a dataset of 300 participant--PLS pairs from 50 lay participants in both static (expert-written) and interactive (LLM-personalized) settings. ReLay includes user characteristics, health information needs, information-seeking behavior, comprehension outcomes, interaction logs, and quality ratings. We use ReLay to evaluate five LLMs across two personalization methods. Personalization improves comprehension and perceived quality, but it also raises the risk of reinforcing user biases and introducing hallucinations, revealing a trade-off between personalization and safety. These findings highlight the need for personalization methods that are both effective and trustworthy for diverse lay audiences.

cs.CL

CT-Bench: A Benchmark for Multimodal Lesion Understanding in Computed Tomography

Artificial intelligence (AI) can automatically delineate lesions on computed tomography (CT) and generate radiology report content, yet progress is limited by the scarcity of publicly available CT datasets with lesion-level annotations. To bridge this gap, we introduce CT-Bench, a first-of-its-kind benchmark dataset comprising two components: a Lesion Image and Metadata Set containing 20,335 lesions from 7,795 CT studies with bounding boxes, descriptions, and size information, and a multitask visual question answering benchmark with 2,850 QA pairs covering lesion localization, description, size estimation, and attribute categorization. Hard negative examples are included to reflect real-world diagnostic challenges. We evaluate multiple state-of-the-art multimodal models, including vision-language and medical CLIP variants, by comparing their performance to radiologist assessments, demonstrating the value of CT-Bench as a comprehensive benchmark for lesion analysis. Moreover, fine-tuning models on the Lesion Image and Metadata Set yields significant performance gains across both components, underscoring the clinical utility of CT-Bench.

cs.CV

Text Embedded Swin-UMamba for DeepLesion Segmentation

Segmentation of lesions on CT enables automatic measurement for clinical assessment of chronic diseases (e.g., lymphoma). Integrating large language models (LLMs) into the lesion segmentation workflow has the potential to combine imaging features with descriptions of lesion characteristics from the radiology reports. In this study, we investigate the feasibility of integrating text into the Swin-UMamba architecture for the task of lesion segmentation. The publicly available ULS23 DeepLesion dataset was used along with short-form descriptions of the findings from the reports. On the test dataset, our method achieved a high Dice score of 82.64, and a low Hausdorff distance of 6.34 pixels was obtained for lesion segmentation. The proposed Text-Swin-U/Mamba model outperformed prior approaches: 37.79% improvement over the LLM-driven LanGuideMedSeg model (p < 0.001), and surpassed the purely image-based XLSTM-UNet and nnUNet models by 2.58% and 1.01%, respectively. The dataset and code can be accessed at https://github.com/ruida/LLM-Swin-UMamba

cs.CV

LLM-CoT Enhanced Graph Neural Recommendation with Harmonized Group Policy Optimization

Graph neural networks (GNNs) have advanced recommender systems by modeling interaction relationships. However, existing graph-based recommenders rely on sparse ID features and do not fully exploit textual information, resulting in low information density within representations. Furthermore, graph contrastive learning faces challenges. Random negative sampling can introduce false negative samples, while fixed temperature coefficients cannot adapt to the heterogeneity of different nodes. In addition, current efforts to enhance recommendations with large language models (LLMs) have not fully utilized their Chain-of-Thought (CoT) reasoning capabilities to guide representation learning. To address these limitations, we introduces LGHRec (LLM-CoT Enhanced Graph Neural Recommendation with Harmonized Group Policy Optimization). This framework leverages the CoT reasoning ability of LLMs to generate semantic IDs, enriching reasoning processes and improving information density and semantic quality of representations. Moreover, we design a reinforcement learning algorithm, Harmonized Group Policy Optimization (HGPO), to optimize negative sampling strategies and temperature coefficients in contrastive learning. This approach enhances long-tail recommendation performance and ensures optimization consistency across different groups. Experimental results on three datasets demonstrate that LGHRec improves representation quality through semantic IDs generated by LLM's CoT reasoning and effectively boosts contrastive learning with HGPO. Our method outperforms several baseline models. The code is available at: https://anonymous.4open.science/r/LLM-Rec.

cs.IR

Knowledge-guided Contextual Gene Set Analysis Using Large Language Models

Gene set analysis (GSA) is a foundational approach for interpreting genomic data of diseases by linking genes to biological processes. However, conventional GSA methods overlook clinical context of the analyses, often generating long lists of enriched pathways with redundant, nonspecific, or irrelevant results. Interpreting these requires extensive, ad-hoc manual effort, reducing both reliability and reproducibility. To address this limitation, we introduce cGSA, a novel AI-driven framework that enhances GSA by incorporating context-aware pathway prioritization. cGSA integrates gene cluster detection, enrichment analysis, and large language models to identify pathways that are not only statistically significant but also biologically meaningful. Benchmarking on 102 manually curated gene sets across 19 diseases and ten disease-related biological mechanisms shows that cGSA outperforms baseline methods by over 30%, with expert validation confirming its increased precision and interpretability. Two independent case studies in melanoma and breast cancer further demonstrate its potential to uncover context-specific insights and support targeted hypothesis generation.

q-bio.GN

Rethinking Scientific Summarization Evaluation: Grounding Explainable Metrics on Facet-aware Benchmark

The summarization capabilities of pretrained and large language models (LLMs) have been widely validated in general areas, but their use in scientific corpus, which involves complex sentences and specialized knowledge, has been less assessed. This paper presents conceptual and experimental analyses of scientific summarization, highlighting the inadequacies of traditional evaluation methods, such as $n$-gram, embedding comparison, and QA, particularly in providing explanations, grasping scientific concepts, or identifying key content. Subsequently, we introduce the Facet-aware Metric (FM), employing LLMs for advanced semantic matching to evaluate summaries based on different aspects. This facet-aware approach offers a thorough evaluation of abstracts by decomposing the evaluation task into simpler subtasks.Recognizing the absence of an evaluation benchmark in this domain, we curate a Facet-based scientific summarization Dataset (FD) with facet-level annotations. Our findings confirm that FM offers a more logical approach to evaluating scientific summaries. In addition, fine-tuned smaller models can compete with LLMs in scientific contexts, while LLMs have limitations in learning from in-context information in scientific domains. This suggests an area for future enhancement of LLMs.

cs.CL

Beyond Multiple-Choice Accuracy: Real-World Challenges of Implementing Large Language Models in Healthcare

Large Language Models (LLMs) have gained significant attention in the medical domain for their human-level capabilities, leading to increased efforts to explore their potential in various healthcare applications. However, despite such a promising future, there are multiple challenges and obstacles that remain for their real-world uses in practical settings. This work discusses key challenges for LLMs in medical applications from four unique aspects: operational vulnerabilities, ethical and social considerations, performance and assessment difficulties, and legal and regulatory compliance. Addressing these challenges is crucial for leveraging LLMs to their full potential and ensuring their responsible integration into healthcare.

cs.AI

How Well Do Multi-modal LLMs Interpret CT Scans? An Auto-Evaluation Framework for Analyses

Automatically interpreting CT scans can ease the workload of radiologists. However, this is challenging mainly due to the scarcity of adequate datasets and reference standards for evaluation. This study aims to bridge this gap by introducing a novel evaluation framework, named ``GPTRadScore''. This framework assesses the capabilities of multi-modal LLMs, such as GPT-4 with Vision (GPT-4V), Gemini Pro Vision, LLaVA-Med, and RadFM, in generating descriptions for prospectively-identified findings. By employing a decomposition technique based on GPT-4, GPTRadScore compares these generated descriptions with gold-standard report sentences, analyzing their accuracy in terms of body part, location, and type of finding. Evaluations demonstrated a high correlation with clinician assessments and highlighted its potential over traditional metrics, such as BLEU, METEOR, and ROUGE. Furthermore, to contribute to future studies, we plan to release a benchmark dataset annotated by clinicians. Using GPTRadScore, we found that while GPT-4V and Gemini Pro Vision fare better, their performance revealed significant areas for improvement, primarily due to limitations in the dataset used for training these models. To demonstrate this potential, RadFM was fine-tuned and it resulted in significant accuracy improvements: location accuracy rose from 3.41\% to 12.8\%, body part accuracy from 29.12\% to 53\%, and type accuracy from 9.24\% to 30\%, thereby validating our hypothesis.

cs.AI

Flexible and Adaptable Summarization via Expertise Separation

A proficient summarization model should exhibit both flexibility -- the capacity to handle a range of in-domain summarization tasks, and adaptability -- the competence to acquire new knowledge and adjust to unseen out-of-domain tasks. Unlike large language models (LLMs) that achieve this through parameter scaling, we propose a more parameter-efficient approach in this study. Our motivation rests on the principle that the general summarization ability to capture salient information can be shared across different tasks, while the domain-specific summarization abilities need to be distinct and tailored. Concretely, we propose MoeSumm, a Mixture-of-Expert Summarization architecture, which utilizes a main expert for gaining the general summarization capability and deputy experts that selectively collaborate to meet specific summarization task requirements. We further propose a max-margin loss to stimulate the separation of these abilities. Our model's distinct separation of general and domain-specific summarization abilities grants it with notable flexibility and adaptability, all while maintaining parameter efficiency. MoeSumm achieves flexibility by managing summarization across multiple domains with a single model, utilizing a shared main expert and selected deputy experts. It exhibits adaptability by tailoring deputy experts to cater to out-of-domain few-shot and zero-shot scenarios. Experimental results on 11 datasets show the superiority of our model compared with recent baselines and LLMs. We also provide statistical and visual evidence of the distinct separation of the two abilities in MoeSumm (https://github.com/iriscxy/MoE_Summ).

cs.CL

Write Summary Step-by-Step: A Pilot Study of Stepwise Summarization

Nowadays, neural text generation has made tremendous progress in abstractive summarization tasks. However, most of the existing summarization models take in the whole document all at once, which sometimes cannot meet the needs in practice. Practically, social text streams such as news events and tweets keep growing from time to time, and can only be fed to the summarization system step by step. Hence, in this paper, we propose the task of Stepwise Summarization, which aims to generate a new appended summary each time a new document is proposed. The appended summary should not only summarize the newly added content but also be coherent with the previous summary, to form an up-to-date complete summary. To tackle this challenge, we design an adversarial learning model, named Stepwise Summary Generator (SSG). First, SSG selectively processes the new document under the guidance of the previous summary, obtaining polished document representation. Next, SSG generates the summary considering both the previous summary and the document. Finally, a convolutional-based discriminator is employed to determine whether the newly generated summary is coherent with the previous summary. For the experiment, we extend the traditional two-step update summarization setting to a multi-step stepwise setting, and re-propose a large-scale stepwise summarization dataset based on a public story generation dataset. Extensive experiments on this dataset show that SSG achieves state-of-the-art performance in terms of both automatic metrics and human evaluations. Ablation studies demonstrate the effectiveness of each module in our framework. We also discuss the benefits and limitations of recent large language models on this task.

cs.CL

Shadow and Light: Digitally Reconstructed Radiographs for Disease Classification

In this paper, we introduce DRR-RATE, a large-scale synthetic chest X-ray dataset derived from the recently released CT-RATE dataset. DRR-RATE comprises of 50,188 frontal Digitally Reconstructed Radiographs (DRRs) from 21,304 unique patients. Each image is paired with a corresponding radiology text report and binary labels for 18 pathology classes. Given the controllable nature of DRR generation, it facilitates the inclusion of lateral view images and images from any desired viewing position. This opens up avenues for research into new and novel multimodal applications involving paired CT, X-ray images from various views, text, and binary labels. We demonstrate the applicability of DRR-RATE alongside existing large-scale chest X-ray resources, notably the CheXpert dataset and CheXnet model. Experiments demonstrate that CheXnet, when trained and tested on the DRR-RATE dataset, achieves sufficient to high AUC scores for the six common pathologies cited in common literature: Atelectasis, Cardiomegaly, Consolidation, Lung Lesion, Lung Opacity, and Pleural Effusion. Additionally, CheXnet trained on the CheXpert dataset can accurately identify several pathologies, even when operating out of distribution. This confirms that the generated DRR images effectively capture the essential pathology features from CT images. The dataset and labels are publicly accessible at https://huggingface.co/datasets/farrell236/DRR-RATE.

eess.IV

GeneAgent: Self-verification Language Agent for Gene Set Knowledge Discovery using Domain Databases

Gene set knowledge discovery is essential for advancing human functional genomics. Recent studies have shown promising performance by harnessing the power of Large Language Models (LLMs) on this task. Nonetheless, their results are subject to several limitations common in LLMs such as hallucinations. In response, we present GeneAgent, a first-of-its-kind language agent featuring self-verification capability. It autonomously interacts with various biological databases and leverages relevant domain knowledge to improve accuracy and reduce hallucination occurrences. Benchmarking on 1,106 gene sets from different sources, GeneAgent consistently outperforms standard GPT-4 by a significant margin. Moreover, a detailed manual review confirms the effectiveness of the self-verification module in minimizing hallucinations and generating more reliable analytical narratives. To demonstrate its practical utility, we apply GeneAgent to seven novel gene sets derived from mouse B2905 melanoma cell lines, with expert evaluations showing that GeneAgent offers novel insights into gene functions and subsequently expedites knowledge discovery.

cs.AI

AgentMD: Empowering Language Agents for Risk Prediction with Large-Scale Clinical Tool Learning

Clinical calculators play a vital role in healthcare by offering accurate evidence-based predictions for various purposes such as prognosis. Nevertheless, their widespread utilization is frequently hindered by usability challenges, poor dissemination, and restricted functionality. Augmenting large language models with extensive collections of clinical calculators presents an opportunity to overcome these obstacles and improve workflow efficiency, but the scalability of the manual curation process poses a significant challenge. In response, we introduce AgentMD, a novel language agent capable of curating and applying clinical calculators across various clinical contexts. Using the published literature, AgentMD has automatically curated a collection of 2,164 diverse clinical calculators with executable functions and structured documentation, collectively named RiskCalcs. Manual evaluations show that RiskCalcs tools achieve an accuracy of over 80% on three quality metrics. At inference time, AgentMD can automatically select and apply the relevant RiskCalcs tools given any patient description. On the newly established RiskQA benchmark, AgentMD significantly outperforms chain-of-thought prompting with GPT-4 (87.7% vs. 40.9% in accuracy). Additionally, we also applied AgentMD to real-world clinical notes for analyzing both population-level and risk-level patient characteristics. In summary, our study illustrates the utility of language agents augmented with clinical calculators for healthcare analytics and patient care.

cs.CL

Leveraging Professional Radiologists' Expertise to Enhance LLMs' Evaluation for Radiology Reports

In radiology, Artificial Intelligence (AI) has significantly advanced report generation, but automatic evaluation of these AI-produced reports remains challenging. Current metrics, such as Conventional Natural Language Generation (NLG) and Clinical Efficacy (CE), often fall short in capturing the semantic intricacies of clinical contexts or overemphasize clinical details, undermining report clarity. To overcome these issues, our proposed method synergizes the expertise of professional radiologists with Large Language Models (LLMs), like GPT-3.5 and GPT-4 1. Utilizing In-Context Instruction Learning (ICIL) and Chain of Thought (CoT) reasoning, our approach aligns LLM evaluations with radiologist standards, enabling detailed comparisons between human and AI generated reports. This is further enhanced by a Regression model that aggregates sentence evaluation scores. Experimental results show that our "Detailed GPT-4 (5-shot)" model achieves a 0.48 score, outperforming the METEOR metric by 0.19, while our "Regressed GPT-4" model shows even greater alignment with expert evaluations, exceeding the best existing metric by a 0.35 margin. Moreover, the robustness of our explanations has been validated through a thorough iterative strategy. We plan to publicly release annotations from radiology experts, setting a new standard for accuracy in future assessments. This underscores the potential of our approach in enhancing the quality assessment of AI-driven medical reports.

cs.CL

A scoping review on multimodal deep learning in biomedical images and texts

Computer-assisted diagnostic and prognostic systems of the future should be capable of simultaneously processing multimodal data. Multimodal deep learning (MDL), which involves the integration of multiple sources of data, such as images and text, has the potential to revolutionize the analysis and interpretation of biomedical data. However, it only caught researchers' attention recently. To this end, there is a critical need to conduct a systematic review on this topic, identify the limitations of current work, and explore future directions. In this scoping review, we aim to provide a comprehensive overview of the current state of the field and identify key concepts, types of studies, and research gaps with a focus on biomedical images and texts joint learning, mainly because these two were the most commonly available data types in MDL research. This study reviewed the current uses of multimodal deep learning on five tasks: (1) Report generation, (2) Visual question answering, (3) Cross-modal retrieval, (4) Computer-aided diagnosis, and (5) Semantic segmentation. Our results highlight the diverse applications and potential of MDL and suggest directions for future research in the field. We hope our review will facilitate the collaboration of natural language processing (NLP) and medical imaging communities and support the next generation of decision-making and computer-assisted diagnostic system development.

cs.CV