arXiv subjects

Shujian Gao

Publications and source records attributed to Shujian Gao.

13 recordsLinked to original sources

arXiv2026

MedUP: Awakening Unified Understanding and Perception in Medical Vision-Language Models

Medical Vision-Language Models (Med-VLMs) excel at verbalizing visual content, yet precise visual perception, segmentation, and grounding remain challenging. Existing approaches either verbalize regions as coordinate strings or rely on external modules that decouple perception from understanding, creating representation gaps for region-language alignment. We present MedUP, a Med-VLM that natively unifies perception and understanding within a shared token space. At its core lies UniMedTok, a region tokenizer that encodes masks as discrete tokens in the LLM vocabulary, enabling the model to seamlessly interleave mask tokens with text. We curate UniMed-Train, a 1.84M-instance corpus spanning text-guided segmentation, region-grounded understanding, medical VQA and CoT-based segmentation, and introduce UniMed-Bench for unified evaluation. Extensive experiments show that MedUP outperforms native, agentic, and dual-decoder Med-VLMs across all tasks while remaining competitive with specialist segmentors, demonstrating the strong potential of unified understanding and perception modeling.

cs.CV↗

arXiv2026

EvoGraph-R1: Self-Evolving Multimodal Knowledge Hypergraphs for Agentic Retrieval

Retrieval-augmented generation (RAG) has emerged as a critical paradigm for grounding Multimodal Large Language Models (MLLMs) in external knowledge. Recent GraphRAG methods introduce structured entity-relation graphs to improve retrieval and reasoning. However, they remain limited by treating knowledge graphs as static data structures built offline and queried in a single pass. This static paradigm misaligns with the interactive, iterative nature of knowledge-intensive reasoning, creating three bottlenecks: (i) text-centric fragmentation that impedes cross-modal reasoning, (ii) frozen structures unable to incorporate new evidence or correct errors, and (iii) rigid single-pass retrieval without adaptive refinement. To overcome these limitations, we introduce EvoGraph-R1, a self-evolving GraphRAG framework that reconceptualizes knowledge graphs as dynamic environments shaped through agent interactions. We formulate retrieval as a Markov Decision Process (MDP) where the agent observes the graph state and executes actions to query (GraphRetrieve), expand (WebSearch), refine (GraphEdit), or terminate (Answer) the reasoning. These actions reshape the hypergraph structure and generate feedback signals that guide subsequent evolution. Through this closed loop, the hypergraph evolves by integrating new evidence, correcting errors, and refining structure to support multi-hop reasoning. Experiments on multimodal VQA and text QA benchmarks demonstrate substantial improvements over existing RAG baselines in accuracy, coverage, and traceability, establishing self-evolving knowledge graphs as a fundamental paradigm across modalities.

cs.CV↗

arXiv2026

MedStreamBench: A Time-Aware Benchmark for Streaming and Proactive Medical Video Understanding

Existing medical video benchmarks primarily evaluate whether a model produces the correct answer, but rarely assess whether it answers at the right time. In real clinical settings, AI systems must decide not only what to predict, but also when to answer, defer judgment, or proactively raise alerts. This creates a critical gap between benchmark evaluation and deployment requirements. We present MedStreamBench, a benchmark for time-aware medical video understanding. MedStreamBench integrates 22 medical datasets and 5,419 QA instances across four temporal settings: retrospective, present, future, and proactive. Unlike conventional benchmarks that assume full-video access, MedStreamBench restricts models to temporally bounded evidence windows and supports both single-turn and streaming evaluation. We further introduce a proactive monitoring setting that requires models to determine whether and when clinically relevant alerts should be triggered. Beyond answer correctness, MedStreamBench evaluates temporal behavior through responsiveness and post-evidence stability. Experiments on leading general-purpose and medical vision-language models reveal a substantial gap between offline recognition and temporally grounded decision-making, with performance dropping markedly in streaming and proactive settings. Our benchmark is available at https://huggingface.co/datasets/Venn2024/MedStreamBench.

cs.CV↗

arXiv2026

AtomiMed: Hierarchical Atomic Fact-Checking for Universal Clinical-Aware Medical Report Evaluation

Traditional metrics for Medical Report Generation (MRG) predominantly rely on surface-level n-gram overlap, which fails to capture clinical factual accuracy and often overlooks catastrophic diagnostic errors. We address this fundamental limitation by proposing \textbf{AtomiMed}, a universal, modality-agnostic evaluation framework that decomposes complex medical narratives into a standardized, multi-level hierarchy of Atomic Clinical Facts, encompassing Disease-level entities and Attribute-level descriptors, including location, morphology, and severity. By implementing an Agentic Cross-Verification loop between ground-truth and predicted reports, AtomiMed simulates a multi-radiologist peer-review process to verify clinical consistency, thus enabling the decoupled assessment of diagnostic detection and descriptive accuracy. To facilitate standardized evaluation, we introduce \textbf{MRGEvalKit}, an open-source toolkit for automated hierarchical extraction, and curate \textbf{OmniMRG-Bench}, a comprehensive multi-modal benchmark covering X-ray, CT, MRI, and Ultrasound. Extensive experiments on multiple expert-annotated reader studies demonstrate that AtomiMed achieves significantly higher correlation with human radiologist judgment compared to traditional and model-based metrics. Our code are release at https://github.com/Venn2336/MRGEvalkit

cs.CE↗

arXiv2026

Project Imaging-X: A Survey of 1000+ Open-Access Medical Imaging Datasets for Foundation Model Development

Foundation models have demonstrated remarkable success across diverse domains and tasks, primarily due to the thrive of large-scale, diverse, and high-quality datasets. However, in the field of medical imaging, the curation and assembling of such medical datasets are highly challenging due to the reliance on clinical expertise and strict ethical and privacy constraints, resulting in a scarcity of large-scale unified medical datasets and hindering the development of powerful medical foundation models. In this work, we present the largest survey to date of medical image datasets, covering over 1,000 open-access datasets with a systematic catalog of their modalities, tasks, anatomies, annotations, limitations, and potential for integration. Our analysis exposes a landscape that is modest in scale, fragmented across narrowly scoped tasks, and unevenly distributed across organs and modalities, which in turn limits the utility of existing medical image datasets for developing versatile and robust medical foundation models. To turn fragmentation into scale, we propose a metadata-driven fusion paradigm (MDFP) that integrates public datasets with shared modalities or tasks, thereby transforming multiple small data silos into larger, more coherent resources. Building on MDFP, we release an interactive discovery portal that enables end-to-end, automated medical image dataset integration, and compile all surveyed datasets into a unified, structured table that clearly summarizes their key characteristics and provides reference links, offering the community an accessible and comprehensive repository. By charting the current terrain and offering a principled path to dataset consolidation, our survey provides a practical roadmap for scaling medical imaging corpora, supporting faster data discovery, more principled dataset creation, and more capable medical foundation models.

cs.CV↗

arXiv2026

BARL: Bilateral Alignment in Representation and Label Spaces for Semi-Supervised Volumetric Medical Image Segmentation

Semi-supervised medical image segmentation (SSMIS) seeks to match fully supervised performance while sharply reducing annotation cost. Mainstream SSMIS methods rely on \emph{label-space consistency}, yet they overlook the equally critical \emph{representation-space alignment}. Without harmonizing latent features, models struggle to learn representations that are both discriminative and spatially coherent. To this end, we introduce \textbf{Bilateral Alignment in Representation and Label spaces (BARL)}, a unified framework that couples two collaborative branches and enforces alignment in both spaces. For label-space alignment, inspired by co-training and multi-scale decoding, we devise \textbf{Dual-Path Regularization (DPR)} and \textbf{Progressively Cognitive Bias Correction (PCBC)} to impose fine-grained cross-branch consistency while mitigating error accumulation from coarse to fine scales. For representation-space alignment, we conduct region-level and lesion-instance matching between branches, explicitly capturing the fragmented, complex pathological patterns common in medical imagery. Extensive experiments on four public benchmarks and a proprietary CBCT dataset demonstrate that BARL consistently surpasses state-of-the-art SSMIS methods. Ablative studies further validate the contribution of each component. Code will be released soon.

cs.CV↗

arXiv2026

Thinking with Deltas: Incentivizing Reinforcement Learning via Differential Visual Reasoning Policy

Reinforcement Learning with Verifiable Rewards (RLVR) has significantly advanced reasoning capabilities in Large Language Models. However, adapting RLVR to multimodal domains suffers from a critical \textit{perception-reasoning decoupling}. Existing paradigms, driven by text-centric outcome rewards, reasoning in language medium, inadvertently encourage models to bypass visual perception. We empirically validate this through blind experiments: state-of-the-art policies maintain or surprisingly improve performance even when visual inputs are entirely removed. This reveals that these models degenerate into \textit{blind reasoners}, exploiting linguistic priors to generate plausible answers instead of attending to visual evidence. In response, we propose \textbf{Thinking with Deltas}, a framework driven by a \textbf{Differential Visual Reasoning Policy (DVRP)}. DVRP introduces intrinsic supervision via visual triplets, comprising original, masked, and perturbed inputs. It optimizes the model to maximize reasoning divergence from masked inputs (enforcing \textit{visual sensitivity}) while minimizing divergence from perturbed inputs (ensuring \textit{visual robustness}). By aligning reasoning variations strictly with the \textit{Delta} of visual information, DVRP inherently bolsters visual understanding capabilities and significantly outperforms state-of-the-art methods on both general and medical benchmarks, without requiring external annotations or auxiliary tools.

cs.AI↗

arXiv2025

Beyond N-grams: A Hierarchical Reward Learning Framework for Clinically-Aware Medical Report Generation

Automatic medical report generation can greatly reduce the workload of doctors, but it is often unreliable for real-world deployment. Current methods can write formally fluent sentences but may be factually flawed, introducing serious medical errors known as clinical hallucinations, which make them untrustworthy for diagnosis. To bridge this gap, we introduce HiMed-RL, a Hierarchical Medical Reward Learning Framework designed to explicitly prioritize clinical quality. HiMed-RL moves beyond simple text matching by deconstructing reward learning into three synergistic levels: it first ensures linguistic fluency at the token-level, then enforces factual grounding at the concept-level by aligning key medical terms with expert knowledge, and finally assesses high-level diagnostic consistency at the semantic-level using a specialized LLM verifier. This hierarchical reward is implemented via a Human-inspired Dynamic Reward Adjustment, a strategy which first teaches the model to learn basic facts before progressing to more complex diagnostic reasoning. Experimentally, HiMed-3B achieves state-of-the-art performance on both in-domain and out-of-domain benchmarks, particularly on the latter, with an improvement of 12.1% over the second-best baseline. Our work provides a robust paradigm for generating reports that not only improve fluency but clinical fine-grained quality.

cs.CE↗

arXiv2025

A Survey of Scientific Large Language Models: From Data Foundations to Agent Frontiers

Scientific Large Language Models (Sci-LLMs) are transforming how knowledge is represented, integrated, and applied in scientific research, yet their progress is shaped by the complex nature of scientific data. This survey presents a comprehensive, data-centric synthesis that reframes the development of Sci-LLMs as a co-evolution between models and their underlying data substrate. We formulate a unified taxonomy of scientific data and a hierarchical model of scientific knowledge, emphasizing the multimodal, cross-scale, and domain-specific challenges that differentiate scientific corpora from general natural language processing datasets. We systematically review recent Sci-LLMs, from general-purpose foundations to specialized models across diverse scientific disciplines, alongside an extensive analysis of over 270 pre-/post-training datasets, showing why Sci-LLMs pose distinct demands -- heterogeneous, multi-scale, uncertainty-laden corpora that require representations preserving domain invariance and enabling cross-modal reasoning. On evaluation, we examine over 190 benchmark datasets and trace a shift from static exams toward process- and discovery-oriented assessments with advanced evaluation protocols. These data-centric analyses highlight persistent issues in scientific data development and discuss emerging solutions involving semi-automated annotation pipelines and expert validation. Finally, we outline a paradigm shift toward closed-loop systems where autonomous agents based on Sci-LLMs actively experiment, validate, and contribute to a living, evolving knowledge base. Collectively, this work provides a roadmap for building trustworthy, continually evolving artificial intelligence (AI) systems that function as a true partner in accelerating scientific discovery.

cs.CL↗

arXiv2025

UniMedVL: Unifying Medical Multimodal Understanding and Generation through Observation-Knowledge-Analysis

Medical workflows routinely combine reading images with producing visual and textual outputs, making both image understanding and generation central to medical AI. Most existing systems, however, address these abilities in isolated models, losing the shared knowledge that a unified architecture could exploit. To bridge this gap, we present UniMedVL, the first unified medical model that seamlessly integrates multimodal understanding and generation capabilities within a single model without switching weights. We achieve this via a tailored progressive training pipeline where understanding and generation mutually reinforce each other. To effectively train UniMedVL, we curate UniMedVL-5M, the first large-scale medical dataset comprising over 5.6M instances across 8 medical imaging modalities, tailored for multimodal input-output tasks in unified medical understanding and generation. Experimental results demonstrate that UniMedVL achieves competitive performance on five medical understanding benchmarks. Crucially, UniMedVL natively supports diverse interleaved generation tasks, e.g., virtual staining, super-resolution, cross-modal synthesis, essential for complex medical workflows. Our code and dataset are publicly available.

cs.CV↗

arXiv2025

MedQ-Bench: Evaluating and Exploring Medical Image Quality Assessment Abilities in MLLMs

Medical Image Quality Assessment (IQA) serves as the first-mile safety gate for clinical AI, yet existing approaches remain constrained by scalar, score-based metrics and fail to reflect the descriptive, human-like reasoning process central to expert evaluation. To address this gap, we introduce MedQ-Bench, a comprehensive benchmark that establishes a perception-reasoning paradigm for language-based evaluation of medical image quality with Multi-modal Large Language Models (MLLMs). MedQ-Bench defines two complementary tasks: (1) MedQ-Perception, which probes low-level perceptual capability via human-curated questions on fundamental visual attributes; and (2) MedQ-Reasoning, encompassing both no-reference and comparison reasoning tasks, aligning model evaluation with human-like reasoning on image quality. The benchmark spans five imaging modalities and over forty quality attributes, totaling 2,600 perceptual queries and 708 reasoning assessments, covering diverse image sources including authentic clinical acquisitions, images with simulated degradations via physics-based reconstructions, and AI-generated images. To evaluate reasoning ability, we propose a multi-dimensional judging protocol that assesses model outputs along four complementary axes. We further conduct rigorous human-AI alignment validation by comparing LLM-based judgement with radiologists. Our evaluation of 14 state-of-the-art MLLMs demonstrates that models exhibit preliminary but unstable perceptual and reasoning skills, with insufficient accuracy for reliable clinical use. These findings highlight the need for targeted optimization of MLLMs in medical IQA. We hope that MedQ-Bench will catalyze further exploration and unlock the untapped potential of MLLMs for medical image quality evaluation.

cs.CV↗

arXiv2025

FedGSCA: Medical Federated Learning with Global Sample Selector and Client Adaptive Adjuster under Label Noise

Federated Learning (FL) emerged as a solution for collaborative medical image classification while preserving data privacy. However, label noise, which arises from inter-institutional data variability, can cause training instability and degrade model performance. Existing FL methods struggle with noise heterogeneity and the imbalance in medical data. Motivated by these challenges, we propose FedGSCA, a novel framework for enhancing robustness in noisy medical FL. FedGSCA introduces a Global Sample Selector that aggregates noise knowledge from all clients, effectively addressing noise heterogeneity and improving global model stability. Furthermore, we develop a Client Adaptive Adjustment (CAA) mechanism that combines adaptive threshold pseudo-label generation and Robust Credal Labeling Loss. CAA dynamically adjusts to class distributions, ensuring the inclusion of minority samples and carefully managing noisy labels by considering multiple plausible labels. This dual approach mitigates the impact of noisy data and prevents overfitting during local training, which improves the generalizability of the model. We evaluate FedGSCA on one real-world colon slides dataset and two synthetic medical datasets under various noise conditions, including symmetric, asymmetric, extreme, and heterogeneous types. The results show that FedGSCA outperforms the state-of-the-art methods, excelling in extreme and heterogeneous noise scenarios. Moreover, FedGSCA demonstrates significant advantages in improving model stability and handling complex noise, making it well-suited for real-world medical federated learning scenarios.

cs.LG↗

arXiv2025

V2T-CoT: From Vision to Text Chain-of-Thought for Medical Reasoning and Diagnosis

Recent advances in multimodal techniques have led to significant progress in Medical Visual Question Answering (Med-VQA). However, most existing models focus on global image features rather than localizing disease-specific regions crucial for diagnosis. Additionally, current research tends to emphasize answer accuracy at the expense of the reasoning pathway, yet both are crucial for clinical decision-making. To address these challenges, we propose From Vision to Text Chain-of-Thought (V2T-CoT), a novel approach that automates the localization of preference areas within biomedical images and incorporates this localization into region-level pixel attention as knowledge for Vision CoT. By fine-tuning the vision language model on constructed R-Med 39K dataset, V2T-CoT provides definitive medical reasoning paths. V2T-CoT integrates visual grounding with textual rationale generation to establish precise and explainable diagnostic results. Experimental results across four Med-VQA benchmarks demonstrate state-of-the-art performance, achieving substantial improvements in both performance and interpretability.

cs.CE↗