arXiv subjects

Qixiang Zhang

Publications and source records attributed to Qixiang Zhang.

14 recordsLinked to original sources

arXiv2026

Synergistic Vision-Language Reinforcement Enables Scalable On-Demand Analysis across Diverse Clinical Tasks

Accurate delineation of tumors and surrounding organs-at-risk is essential for radiotherapy, surgery and treatment response assessment, yet remains time-consuming and expertise-intensive. Existing artificial intelligence systems often require manual spatial prompts or task-specific retraining, while generic class labels provide limited semantic grounding for heterogeneous disease targets. Here we present SyRe, a promptable segmentation foundation model based on Synergistic vision-language Reinforcement. SyRe strengthens bidirectional interaction between visual and linguistic representations to improve semantically grounded spatial understanding. To support large-scale training, we introduce the Color Region Description strategy and construct SyReData, comprising 20 million image-mask-description triplets across 9 modalities and 229 segmentation tasks. Training with diversified prompt forms further enables open-ended prompting, invalid-prompt rejection and flexible switching between single- and multi-target analysis. SyRe achieves accurate text-prompted segmentation across diverse clinical scenarios, with particularly strong performance on disease-related targets. Across 28 unseen external datasets, including 20 cancer types and multinational in-house cohorts, SyRe generalizes robustly under real-world distribution shifts. SyRe-generated masks also preserve clinically relevant quantitative information in pathology and yield radiomics features that stratify survival and improve prognostic modeling across five retrospective CT and MRI tumor cohorts. Finally, clinician-in-the-loop refinement enables efficient case-level correction when greater precision is required. These results establish SyRe as a generalizable foundation for scalable quantitative oncology and clinician-guided segmentation refinement.

cs.CV↗

arXiv2026

Benchmarking Vision-Language Models for Automated Pathology Diagnosis and Report Generation

The rapid advancement of vision-language models (VLMs) has accelerated progress in computational pathology; however, whole-slide image (WSI)-based pathology report generation remains limited by the scarcity of large-scale WSI--report datasets and the complexity of mapping spatially distributed visual patterns to structured clinical text. To address this, we introduce a clinically curated Pan-Asia WSI--report dataset of approximately 10,500 pairs from five institutions and establish the REG 2025 benchmark through a MICCAI challenge for systematic evaluation of multimodal models. We analyze submitted methods spanning pretrained VLMs, multiple-instance learning frameworks, hierarchical expert models, retrieval-augmented generation, and cross-modal Transformers. Rather than indicating that VLM use alone was sufficient for superior performance, the results suggest that top-performing methods benefited from structured report representations, hierarchical diagnostic decomposition, and effective multimodal grounding. We identify key limitations, including instability in quantitative attribute estimation (e.g., numeric hallucination) and a tendency toward diagnostic overspecification, with some errors resembling known diagnostic pitfalls in routine pathology. These findings establish REG 2025 as a benchmark for evaluating WSI-based structured report generation and vision-language understanding in computational pathology, providing insights for the design of clinically grounded multimodal pathology models.

cs.CV↗

arXiv2026

PathoArgus: Advancing Evidence-Grounded Long-Context Visual Reasoning across Gigapixel Whole-Slide and Multi-Slide Case Contexts

Whole-slide pathology reasoning requires models to integrate gigapixel-scale visual evidence across complete case-linked slides, yet current question-answering benchmarks primarily measure final answer accuracy--a metric vulnerable to linguistic priors and benchmark regularities, and insufficient to establish that predictions are grounded in the supplied tissue. We introduce PathoArgus-Bench, a benchmark and evaluation protocol that explicitly tests the full evidence chain: availability, accessibility, use, and responsiveness. PathoArgus-Bench comprises 22,078 four-choice questions from 4,913 patients across 15 TCGA projects, covering six pathology capabilities across three levels of evidence demand, and operates under a fixed reader budget that retains only a small fraction of the gigapixel context. To further isolate evidence-grounded reasoning, we contribute ESG (Evidence State Quartets), a controlled set of 483 quartets where the question text is fixed while the target WSI set is moved, replaced, or removed, requiring consistent predictions across all states. Evaluating 20 general-purpose, medical, and pathology-specific systems reveals a stark gap: while GPT-5.6 achieves 57.09% overall accuracy and 57.04% on ESG, it correctly completes only 19 of 483 quartets (3.93% QExact), exposing that row-level accuracy does not translate into reliable evidence grounding. We also introduce PathoArgus, a fixed-budget reader that allocates context via question relevance and spatial coverage, attaining 50.39% overall accuracy yet only 1.86% QExact--demonstrating that improved context access alone does not ensure consistent evidence-based prediction. Our benchmark and diagnostics establish that acquiring useful whole-slide context is necessary but far from sufficient, and call for a shift from answer-centric to evidence-grounded evaluation in computational pathology.

cs.CV↗

arXiv2026

CACSurv: Concordance-Aligned Comparative Learning with Large Language Models for Cancer Survival Prediction

Cancer survival prediction supports treatment planning, risk stratification, and follow-up management. Existing methods use structured clinical variables, whole-slide images, genomic profiles, or multimodal inputs, while patient reports remain underexplored. We study report-centric survival prediction using reports that organize pathological, clinical, and molecular evidence. Large language models (LLMs) can reason over such reports, but case-wise time regression introduces two mismatches. First, a formulation mismatch arises because survival evaluation depends on ordering comparable patients, whereas independent time predictions do not enforce ranking consistency. Second, a supervision mismatch arises because a censored patient's observed time indicates survival beyond that point and cannot serve as an exact regression target, although it still implies orderings relative to patients who died earlier. To address these mismatches, we propose CACSurv, a Concordance-Aligned Comparative framework for report-centric survival prediction. CACSurv reformulates survival modeling as mini-cohort comparative reasoning, where an LLM predicts relative prognostic orderings. We introduce concordance-aligned rewards derived from comparable relations under right censoring, enabling censored outcomes to provide ranking supervision without exact event-time targets. At inference, Monte Carlo Reference Aggregation compares each patient with sampled references and aggregates positions into a cohort-level ranking. We establish TCGA-SurvReport, a benchmark covering six TCGA cancer cohorts. CACSurv achieves the highest C-index on all six cohorts and an average C-index of 0.722, outperforming the strongest published survival model by 6.5 percentage points and the strongest LLM time-regression baseline by 4.2 percentage points. Our code, models, and dataset will be available at https://github.com/xmed-lab/CACSurv.

cs.AI↗

arXiv2026

KHiM-Mamba: Injecting Pathology Knowledge into Mamba via Hidden-State Modulation for Whole Slide Image Analysis

Whole slide image analysis is commonly formulated as multiple instance learning (MIL), where instance features are contextually updated and aggregated into a slide representation, a process we term slide encoding dynamics. Recently, selective state-space models (SSM) have emerged as promising MIL architectures due to their long-sequence modeling capability and linear complexity. However, existing SSM-based MIL methods rely solely on visual features during MIL. Meanwhile, in large-scale WSIs, where sparse diagnostically decisive regions are surrounded by abundant irrelevant information, such purely vision-driven selective dynamics can misallocate state updates and readouts, causing the evolving SSM state to accumulate task-irrelevant evidence and dilute critical diagnostic cues over long scan trajectories. In this work, we propose the Knowledge-Aware Hidden-State Modulation architecture (KHiM-Mamba), which innovatively regulates Mamba's core selective state-space mechanism with explicit knowledge priors, steering slide encoding dynamics toward diagnostically meaningful evidence accumulation. Specifically, we redesign the original SSM layer to perform knowledge modulation operations during the evolution of hidden states, thereby guiding what visual evidence is accumulated and retrieved from the hidden state at each encoding step. Furthermore, we additionally introduce a local-adaptive vocabulary retrieval module that uses large language models to assign each patch fine-grained, tissue-specific semantic descriptions, enabling precise modulation across diverse tasks. Experiments on 11 public benchmarks across 4 tasks show that KHiM-Mamba consistently achieves state-of-the-art performance.

eess.IV↗

arXiv2026

Video2Track: From Real-World Interaction Videos to Steerable Adversarial Closed-Track Testing for Automated Driving Systems

Closed-track testing plays a fundamental role in the verification and validation of automated driving systems (ADS), particularly for safety-critical scenarios, by enabling reproducible evaluation under controlled conditions. However, most existing approaches still rely on standardized protocols or predefined trajectories, leading to overly scripted interactions and limited ability to reproduce the natural complexity of public-road traffic. To address this limitation, we propose Video2Track, a framework that transfers real-world interactive driving scenarios from videos into steerable adversarial closed-track testing. The framework consists of two tightly coupled modules. The first is a scenario semantic mapping module, which extracts structured semantics from driving videos using a vision-language model and grounds them onto a closed-track topology library via retrieval-augmented generation, thereby identifying compatible map segments and interaction anchors. The second is a dynamic interactive testing module, which conditions on the grounded topology and anchors to generate diverse multi-agent trajectories through a conditional diffusion model, while regulating interaction intensity via a Stackelberg game with a parameterized adversarial objective. Closed-track experiments demonstrate that the proposed framework can faithfully reproduce representative real-world interaction scenarios and generate executable scenario variants with controllable risk levels and interaction styles, providing a scalable approach for realistic and steerable ADS validation.

cs.RO↗

arXiv2026

A Cognitive Process-Inspired Architecture for Subject-Agnostic Brain Visual Decoding

Subject-agnostic brain decoding, which aims to reconstruct continuous visual experiences from fMRI without subject-specific training, holds great potential for clinical applications. However, this direction remains underexplored due to challenges in cross-subject generalization and the complex nature of brain signals. In this work, we propose Visual Cortex Flow Architecture (VCFlow), a novel hierarchical decoding framework that explicitly models the ventral-dorsal architecture of the human visual system to learn multi-dimensional representations. By disentangling and leveraging features from early visual cortex, ventral, and dorsal streams, VCFlow captures diverse and complementary cognitive information essential for visual reconstruction. Furthermore, we introduce a feature-level contrastive learning strategy to enhance the extraction of subject-invariant semantic representations, thereby enhancing subject-agnostic applicability to previously unseen subjects. Unlike conventional pipelines that need more than 12 hours of per-subject data and heavy computation, VCFlow sacrifices only 7\% accuracy on average yet generates each reconstructed video in 10 seconds without any retraining, offering a fast and clinically scalable solution. The source code will be released upon acceptance of the paper.

cs.CV↗

arXiv2025

MOC: Meta-Optimized Classifier for Few-Shot Whole Slide Image Classification

Recent advances in histopathology vision-language foundation models (VLFMs) have shown promise in addressing data scarcity for whole slide image (WSI) classification via zero-shot adaptation. However, these methods remain outperformed by conventional multiple instance learning (MIL) approaches trained on large datasets, motivating recent efforts to enhance VLFM-based WSI classification through fewshot learning paradigms. While existing few-shot methods improve diagnostic accuracy with limited annotations, their reliance on conventional classifier designs introduces critical vulnerabilities to data scarcity. To address this problem, we propose a Meta-Optimized Classifier (MOC) comprising two core components: (1) a meta-learner that automatically optimizes a classifier configuration from a mixture of candidate classifiers and (2) a classifier bank housing diverse candidate classifiers to enable a holistic pathological interpretation. Extensive experiments demonstrate that MOC outperforms prior arts in multiple few-shot benchmarks. Notably, on the TCGA-NSCLC benchmark, MOC improves AUC by 10.4% over the state-of-the-art few-shot VLFM-based methods, with gains up to 26.25% under 1-shot conditions, offering a critical advancement for clinical deployments where diagnostic training data is severely limited. Code is available at https://github.com/xmed-lab/MOC.

cs.CV↗

arXiv2025

Neurons: Emulating the Human Visual Cortex Improves Fidelity and Interpretability in fMRI-to-Video Reconstruction

Decoding visual stimuli from neural activity is essential for understanding the human brain. While fMRI methods have successfully reconstructed static images, fMRI-to-video reconstruction faces challenges due to the need for capturing spatiotemporal dynamics like motion and scene transitions. Recent approaches have improved semantic and perceptual alignment but struggle to integrate coarse fMRI data with detailed visual features. Inspired by the hierarchical organization of the visual system, we propose NEURONS, a novel framework that decouples learning into four correlated sub-tasks: key object segmentation, concept recognition, scene description, and blurry video reconstruction. This approach simulates the visual cortex's functional specialization, allowing the model to capture diverse video content. In the inference stage, NEURONS generates robust conditioning signals for a pre-trained text-to-video diffusion model to reconstruct the videos. Extensive experiments demonstrate that NEURONS outperforms state-of-the-art baselines, achieving solid improvements in video consistency (26.6%) and semantic-level accuracy (19.1%). Notably, NEURONS shows a strong functional correlation with the visual cortex, highlighting its potential for brain-computer interfaces and clinical applications. Code and model weights are available at: https://github.com/xmed-lab/NEURONS.

cs.CV↗

arXiv2025

UniEval: Unified Holistic Evaluation for Unified Multimodal Understanding and Generation

The emergence of unified multimodal understanding and generation models is rapidly attracting attention because of their ability to enhance instruction-following capabilities while minimizing model redundancy. However, there is a lack of a unified evaluation framework for these models, which would enable an elegant, simplified, and overall evaluation. Current models conduct evaluations on multiple task-specific benchmarks, but there are significant limitations, such as the lack of overall results, errors from extra evaluation models, reliance on extensive labeled images, benchmarks that lack diversity, and metrics with limited capacity for instruction-following evaluation. To tackle these challenges, we introduce UniEval, the first evaluation framework designed for unified multimodal models without extra models, images, or annotations. This facilitates a simplified and unified evaluation process. The UniEval framework contains a holistic benchmark, UniBench (supports both unified and visual generation models), along with the corresponding UniScore metric. UniBench includes 81 fine-grained tags contributing to high diversity. Experimental results indicate that UniBench is more challenging than existing benchmarks, and UniScore aligns closely with human evaluations, surpassing current metrics. Moreover, we extensively evaluated SoTA unified and visual generation models, uncovering new insights into Univeral's unique values.

cs.CV↗

arXiv2025

Multi-Modal Explainable Medical AI Assistant for Trustworthy Human-AI Collaboration

Generalist Medical AI (GMAI) systems have demonstrated expert-level performance in biomedical perception tasks, yet their clinical utility remains limited by inadequate multi-modal explainability and suboptimal prognostic capabilities. Here, we present XMedGPT, a clinician-centric, multi-modal AI assistant that integrates textual and visual interpretability to support transparent and trustworthy medical decision-making. XMedGPT not only produces accurate diagnostic and descriptive outputs, but also grounds referenced anatomical sites within medical images, bridging critical gaps in interpretability and enhancing clinician usability. To support real-world deployment, we introduce a reliability indexing mechanism that quantifies uncertainty through consistency-based assessment via interactive question-answering. We validate XMedGPT across four pillars: multi-modal interpretability, uncertainty quantification, and prognostic modeling, and rigorous benchmarking. The model achieves an IoU of 0.703 across 141 anatomical regions, and a Kendall's tau-b of 0.479, demonstrating strong alignment between visual rationales and clinical outcomes. For uncertainty estimation, it attains an AUC of 0.862 on visual question answering and 0.764 on radiology report generation. In survival and recurrence prediction for lung and glioma cancers, it surpasses prior leading models by 26.9%, and outperforms GPT-4o by 25.0%. Rigorous benchmarking across 347 datasets covers 40 imaging modalities and external validation spans 4 anatomical systems confirming exceptional generalizability, with performance gains surpassing existing GMAI by 20.7% for in-domain evaluation and 16.7% on 11,530 in-house data evaluation. Together, XMedGPT represents a significant leap forward in clinician-centric AI integration, offering trustworthy and scalable support for diverse healthcare applications.

cs.CV↗

arXiv2024

S&D Messenger: Exchanging Semantic and Domain Knowledge for Generic Semi-Supervised Medical Image Segmentation

Semi-supervised medical image segmentation (SSMIS) has emerged as a promising solution to tackle the challenges of time-consuming manual labeling in the medical field. However, in practical scenarios, there are often domain variations within the datasets, leading to derivative scenarios like semi-supervised medical domain generalization (Semi-MDG) and unsupervised medical domain adaptation (UMDA). In this paper, we aim to develop a generic framework that masters all three tasks. We notice a critical shared challenge across three scenarios: the explicit semantic knowledge for segmentation performance and rich domain knowledge for generalizability exclusively exist in the labeled set and unlabeled set respectively. Such discrepancy hinders existing methods from effectively comprehending both types of knowledge under semi-supervised settings. To tackle this challenge, we develop a Semantic & Domain Knowledge Messenger (S&D Messenger) which facilitates direct knowledge delivery between the labeled and unlabeled set, and thus allowing the model to comprehend both of them in each individual learning flow. Equipped with our S&D Messenger, a naive pseudo-labeling method can achieve huge improvement on six benchmark datasets for SSMIS (+7.5%), UMDA (+5.6%), and Semi-MDG tasks (+1.14%), compared with state-of-the-art methods designed for specific tasks.

cs.CV↗

arXiv2024

AllSpark: Reborn Labeled Features from Unlabeled in Transformer for Semi-Supervised Semantic Segmentation

Semi-supervised semantic segmentation (SSSS) has been proposed to alleviate the burden of time-consuming pixel-level manual labeling, which leverages limited labeled data along with larger amounts of unlabeled data. Current state-of-the-art methods train the labeled data with ground truths and unlabeled data with pseudo labels. However, the two training flows are separate, which allows labeled data to dominate the training process, resulting in low-quality pseudo labels and, consequently, sub-optimal results. To alleviate this issue, we present AllSpark, which reborns the labeled features from unlabeled ones with the channel-wise cross-attention mechanism. We further introduce a Semantic Memory along with a Channel Semantic Grouping strategy to ensure that unlabeled features adequately represent labeled features. The AllSpark shed new light on the architecture level designs of SSSS rather than framework level, which avoids increasingly complicated training pipeline designs. It can also be regarded as a flexible bottleneck module that can be seamlessly integrated into a general transformer-based segmentation model. The proposed AllSpark outperforms existing methods across all evaluation protocols on Pascal, Cityscapes and COCO benchmarks without bells-and-whistles. Code and model weights are available at: https://github.com/xmed-lab/AllSpark.

cs.CV↗

arXiv2023

Morphology-inspired Unsupervised Gland Segmentation via Selective Semantic Grouping

Designing deep learning algorithms for gland segmentation is crucial for automatic cancer diagnosis and prognosis, yet the expensive annotation cost hinders the development and application of this technology. In this paper, we make a first attempt to explore a deep learning method for unsupervised gland segmentation, where no manual annotations are required. Existing unsupervised semantic segmentation methods encounter a huge challenge on gland images: They either over-segment a gland into many fractions or under-segment the gland regions by confusing many of them with the background. To overcome this challenge, our key insight is to introduce an empirical cue about gland morphology as extra knowledge to guide the segmentation process. To this end, we propose a novel Morphology-inspired method via Selective Semantic Grouping. We first leverage the empirical cue to selectively mine out proposals for gland sub-regions with variant appearances. Then, a Morphology-aware Semantic Grouping module is employed to summarize the overall information about the gland by explicitly grouping the semantics of its sub-region proposals. In this way, the final segmentation network could learn comprehensive knowledge about glands and produce well-delineated, complete predictions. We conduct experiments on GlaS dataset and CRAG dataset. Our method exceeds the second-best counterpart over 10.56% at mIOU.

cs.CV↗