arXiv subjects

Suyang Xi

Publications and source records attributed to Suyang Xi.

4 recordsLinked to original sources

arXiv2026

A radiographic world model for clinical reasoning and evidence generation

Medical imaging artificial intelligence (AI) is commonly developed as separate mappings from radiographs to diagnostic outputs or from clinical descriptions to generated images, although both arise from the same underlying radiographic state. A world-model formulation instead seeks to learn an internal representation of this state that can support both clinical readout and conditional simulation of radiographic observations. Here we introduce MedDream, a radiographic world model that learns a shared continuous latent state from paired chest radiograph-text observations for diagnostic reasoning and report-conditioned evidence generation. MedDream was pretrained on 2.65 million leakage-controlled chest radiograph-text pairs curated from 4.40 million candidates. Across eight clinical datasets and two independent reader cohorts, MedDream outperformed leading diagnostic and generative comparators. For diagnostic reasoning, MedDream showed strong generalization across disease recognition, label-scarce adaptation, severity assessment, and localization, while MedDream-supported review increased mean resident concordance with independent radiologist consensus from 56.3% to 63.0%. For evidence generation, MedDream produced radiographs that preserved clinically relevant pathology and improved downstream performance on held-out real data, with synthetic augmentation increasing external VinDr-CXR macro-AUROC from 76.4% to 81.4%. More importantly, conditioning generation on prespecified subgroup performance gaps enabled targeted evidence construction, increasing weighted F1 by 3.1 percentage points in Asian patients, whereas matched-volume unguided augmentation decreased it by 2.3 points. These findings establish radiographic world models as a path toward medical AI that learns clinically meaningful internal states for interpreting, simulating, and constructing evidence for clinical use.

cs.AI↗

arXiv2026

MedLVR: Latent Visual Reasoning for Reliable Medical Visual Question Answering

Medical vision--language models (VLMs) have shown strong potential for medical visual question answering (VQA), yet their reasoning remains largely text-centric: images are encoded once as static context, and subsequent inference is dominated by language. This paradigm is fundamentally limited in clinical scenarios, where accurate answers often depend on subtle, localized visual evidence that cannot be reliably preserved in static embeddings. We propose \textsc{MedLVR}, a latent visual reasoning framework that introduces an explicit visual evidence state into autoregressive decoding. Instead of relying solely on text-based intermediate reasoning, \textsc{MedLVR} interleaves a short latent reasoning segment within the decoder by reusing hidden states as continuous latent steps, enabling iterative preservation and refinement of query-relevant visual evidence before answer generation. To support effective visual supervision, we adopt a two-stage training strategy: region of interest (ROI)-supervised fine-tuning aligns latent states with clinically relevant image evidence, and Visual-Latent Policy Optimization (VLPO) further optimizes latent reasoning and answer generation under outcome-level rewards. Experiments on OmniMedVQA and five external medical VQA benchmarks show that \textsc{MedLVR} consistently outperforms recent reasoning baselines and improves the average score over the Qwen2.5-VL-7B backbone from 48.3\% to 53.4\%. These results show that latent visual reasoning provides an effective mechanism for preserving diagnostically relevant visual evidence and improving the reliability of medical VQA.

cs.CV↗

arXiv2025

Taming a Retrieval Framework to Read Images in Humanlike Manner for Augmenting Generation of MLLMs

Multimodal large language models (MLLMs) often fail in fine-grained visual question answering, producing hallucinations about object identities, positions, and relations because textual queries are not explicitly anchored to visual referents. Retrieval-augmented generation (RAG) alleviates some errors, but it fails to align with human-like processing at both the retrieval and augmentation levels. Specifically, it focuses only on global-level image information but lacks local detail and limits reasoning about fine-grained interactions. To overcome this limitation, we present Human-Like Retrieval-Augmented Generation (HuLiRAG), a framework that stages multimodal reasoning as a ``what--where--reweight'' cascade. Queries are first anchored to candidate referents via open-vocabulary detection (what), then spatially resolved with SAM-derived masks to recover fine-grained precision (where), and adaptively prioritized through the trade-off between local and global alignment (reweight). Mask-guided fine-tuning further injects spatial evidence into the generation process, transforming grounding from a passive bias into an explicit constraint on answer formulation. Extensive experiments demonstrate that this human-like cascade improves grounding fidelity and factual consistency while reducing hallucinations, advancing multimodal question answering toward trustworthy reasoning.

cs.CV↗

arXiv2025

Multimodal Medical Image Binding via Shared Text Embeddings

Medical image analysis increasingly relies on the integration of multiple imaging modalities to capture complementary anatomical and functional information, enabling more accurate diagnosis and treatment planning. Achieving aligned feature representations across these diverse modalities is therefore important for effective multimodal analysis. While contrastive language-image pre-training (CLIP) and its variant have enabled image-text alignments, they require explicitly paired data between arbitrary two modalities, which is difficult to acquire in medical contexts. To address the gap, we present Multimodal Medical Image Binding with Text (M\textsuperscript{3}Bind), a novel pre-training framework that enables seamless alignment of multiple medical imaging modalities through a shared text representation space without requiring explicit paired data between any two medical image modalities. Specifically, based on the insight that different images can naturally bind with text, M\textsuperscript{3}Bind first fine-tunes pre-trained CLIP-like image-text models to align their modality-specific text embedding space while preserving their original image-text alignments. Subsequently, we distill these modality-specific text encoders into a unified model, creating a shared text embedding space. Experiments on X-ray, CT, retina, ECG, and pathological images on multiple downstream tasks demonstrate that M\textsuperscript{3}Bind achieves state-of-the-art performance in zero-shot, few-shot classification and cross-modal retrieval tasks compared to its CLIP-like counterparts. These results validate M\textsuperscript{3}Bind's effectiveness in achieving cross-image-modal alignment for medical analysis.

eess.IV↗