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Automated radiology report generation is key for reducing radiologist workload and improving diagnostic consistency, yet generating accurate reports for 3D medical imaging remains challenging. Existing vision-language models face two limitations: they do not leverage segmentation-pretrained encoders, and they inject visual features only at the input layer of language models, losing multi-scale information. We propose U-VLM, which enables hierarchical vision-language modeling in both training and architecture: (1) progressive training from segmentation to classification to report generation, and (2) multi-layer visual injection that routes U-Net encoder features to corresponding language model layers. Each training stage can leverage different datasets without unified annotations. U-VLM achieves state-of-the-art performance on CT-RATE (F1: 0.414 vs 0.258, BLEU-mean: 0.349 vs 0.305) and AbdomenAtlas 3.0 (F1: 0.624 vs 0.518 for segmentation-based detection) using only a 0.1B decoder trained from scratch, demonstrating that well-designed vision encoder pretraining outweighs the benefits of 7B+ pre-trained language models. Ablation studies show that progressive pretraining significantly improves F1, while multi-layer injection improves BLEU-mean. Code is available at https://github.com/yinghemedical/U-VLM.

Automatic summarization of radiology reports is an essential application to reduce the burden on physicians. Previous studies have widely used the "pre-training, fine-tuning" strategy to adapt large language models (LLMs) for summarization. This study proposed a subdomain adaptation through a mid-training method to improve summarization. We explored three adaptation strategies: (1) general-domain pre-training, (2) clinical-domain pre-training, and (3) clinical-domain pre-training followed by subdomain mid-training. We developed models using large-scale clinical text from the University of Florida (UF) Health and conducted mid-training and fine-tuning experiments using widely used benchmark datasets including OpenI and MIMIC-CXR. The experimental results show that the mid-trained model, GatorTronT5-Radio, achieved the best performance, outperforming models without mid-training in both text-based measures (ROUGE-L) and factuality measures (RadGraph-F1). Our mid-training methods also demonstrate better few-shot learning and could alleviate the "cold start" problem reported in previous studies as a learning barrier. Our findings support the use of "pre-training, mid-training, fine-tuning," instead of the widely used direct fine-tuning strategy.

We investigate a quantum-inspired approach to supervised multi-class classification based on the \emph{Pretty Good Measurement} (PGM), viewed as an operator-valued decision rule derived from quantum state discrimination. The method associates each class with an encoded mixed state and performs classification through a single POVM construction, thus providing a genuinely multi-class strategy without reduction to pairwise or one-vs-rest schemes. In this perspective, classification is reformulated as the discrimination of a finite ensemble of class-dependent density operators, with performance governed by the geometry induced by the encoding map and by the overlap structure among classes. To assess the practical scope of this framework, we apply the PGM-based classifier to two biomedical radiomics case studies: histopathological subtyping of non-small-cell lung carcinoma (NSCLC) and prostate cancer (PCa) risk stratification. The evaluation is conducted under protocols aligned with previously reported radiomics studies, enabling direct comparison with established classical baselines. The results show that the PGM-based classifier is consistently competitive and, in several settings, improves upon standard methods. In particular, the method performs especially well in the NSCLC binary and three-class tasks, while remaining competitive in the four-class case, where increased class overlap yields a more demanding discrimination geometry. In the PCa study, the PGM classifier remains close to the strongest ensemble baseline and exhibits clinically relevant sensitivity--specificity trade-offs across feature-selection scenarios.

Batch effects arising from technical variations in histopathology staining protocols, scanners, and acquisition pipelines pose a persistent challenge for computational pathology, hindering cross-batch generalization and limiting reliable deployment of models across clinical sites. In this work, we introduce Latent Manifold Compaction (LMC), an unsupervised representation learning framework that performs image harmonization by learning batch-invariant embeddings from a single source dataset through explicit compaction of stain-induced latent manifolds. This allows LMC to generalize to target domain data unseen during training. Evaluated on three challenging public and in-house benchmarks, LMC substantially reduces batch-induced separations across multiple datasets and consistently outperforms state-of-the-art normalization methods in downstream cross-batch classification and detection tasks, enabling superior generalization.

Modern microscopy routinely produces gigapixel images that contain structures across multiple spatial scales, from fine cellular morphology to broader tissue organization. Many analysis tasks require combining these scales, yet most vision models operate at a single resolution or derive multi-scale features from one view, limiting their ability to exploit the inherently multi-resolution nature of microscopy data. We introduce MuViT, a transformer architecture built to fuse true multi-resolution observations from the same underlying image. MuViT embeds all patches into a shared world-coordinate system and extends rotary positional embeddings to these coordinates, enabling attention to integrate wide-field context with high-resolution detail within a single encoder. Across synthetic benchmarks, kidney histopathology, and high-resolution mouse-brain microscopy, MuViT delivers consistent improvements over strong ViT and CNN baselines. Multi-resolution MAE pretraining further produces scale-consistent representations that enhance downstream tasks. These results demonstrate that explicit world-coordinate modelling provides a simple yet powerful mechanism for leveraging multi-resolution information in large-scale microscopy analysis.

Deformable registration is crucial in medical imaging. Several existing applications include lesion tracking, probabilistic atlas generation, and treatment response evaluation. However, current methods often lack robustness and generalizability across two key factors: spatial resolution and differences in anatomical coverage. We jointly optimize a registration field and a learnable dimensionality reduction module so that compressed VFM embeddings remain registration-relevant, and fuse these global semantic cues with MIND local descriptors. GLIDE-Reg achieves average dice similarity coefficients (DSC) across 6 anatomical structures of 0.859, 0.862, and 0.901 in two public cohorts (Lung250M and NLST) and one institution cohort (UCLA5DCT), and outperforms the state-of-the-art DEEDS (0.834, 0.858, 0.900) with relative improvements of 3.0%, 0.5%, and 0.1%. For target registration errors, GLIDE-Reg achieves 1.58 mm on Lung250M landmarks (compared to 1.25 mm on corrField and 1.91 mm on DEEDS) and 1.11 mm on NLST nodule centers (compared to 1.11 mm on DEEDS). The substantiated performance on the nodule centers also demonstrates its robustness across challenging downstream tasks, such as nodule tracking, which is an essential prior step for early-stage lung cancer diagnosis.

Vision-language models (VLMs) show promise in drafting radiology reports, yet they frequently suffer from logical inconsistencies, generating diagnostic impressions unsupported by their own perceptual findings or missing logically entailed conclusions. Standard lexical metrics heavily penalize clinical paraphrasing and fail to capture these deductive failures in reference-free settings. Toward guarantees for clinical reasoning, we introduce a neurosymbolic verification framework that deterministically audits the internal consistency of VLM-generated reports. Our pipeline autoformalizes free-text radiographic findings into structured propositional evidence, utilizing an SMT solver (Z3) and a clinical knowledge base to verify whether each diagnostic claim is mathematically entailed, hallucinated, or omitted. Evaluating seven VLMs across five chest X-ray benchmarks, our verifier exposes distinct reasoning failure modes, such as conservative observation and stochastic hallucination, that remain invisible to traditional metrics. On labeled datasets, enforcing solver-backed entailment acts as a rigorous post-hoc guarantee, systematically eliminating unsupported hallucinations to significantly increase diagnostic soundness and precision in generative clinical assistants.

We propose an experience-guided cascaded multi-agent framework for Breast Ultrasound Screening and Diagnosis, called BUSD-Agent, that aims to reduce diagnostic escalation and unnecessary biopsy referrals. Our framework models screening and diagnosis as a two-stage, selective decision-making process. A lightweight `screening clinic' agent, restricted to classification models as tools, selectively filters out benign and normal cases from further diagnostic escalation when malignancy risk and uncertainty are estimated as low. Cases that have higher risks are escalated to the `diagnostic clinic' agent, which integrates richer perception and radiological description tools to make a secondary decision on biopsy referral. To improve agent performance, past records of pathology-confirmed outcomes along with image embeddings, model predictions, and historical agent actions are stored in a memory bank as structured decision trajectories. For each new case, BUSD-Agent retrieves similar past cases based on image, model response and confidence similarity to condition the agent's current decision policy. This enables retrieval-conditioned in-context adaptation that dynamically adjusts model trust and escalation thresholds from prior experiences without parameter updates. Evaluation across 10 breast ultrasound datasets shows that the proposed experience-guided workflow reduces diagnostic escalation in BUSD-Agent from 84.95% to 58.72% and overall biopsy referrals from 59.50% to 37.08%, compared to the same architecture without trajectory conditioning, while improving average screening specificity by 68.48% and diagnostic specificity by 6.33%.

Rapid progress in vision-language modeling has enabled pathology report generation from gigapixel whole-slide images, but most approaches assume static training with simultaneous access to all data. In clinical deployment, however, new organs, institutions, and reporting conventions emerge over time, and sequential fine-tuning can cause catastrophic forgetting. We introduce an exemplar-free continual learning framework for WSI-to-report generation that avoids storing raw slides or patch exemplars. The core idea is a compact domain footprint built in a frozen patch-embedding space: a small codebook of representative morphology tokens together with slide-level co-occurrence summaries and lightweight patch-count priors. These footprints support generative replay by synthesizing pseudo-WSI representations that reflect domain-specific morphological mixtures, while a teacher snapshot provides pseudo-reports to supervise the updated model without retaining past data. To address shifting reporting conventions, we distill domain-specific linguistic characteristics into a compact style descriptor and use it to steer generation. At inference, the model identifies the most compatible descriptor directly from the slide signal, enabling domain-agnostic setup without requiring explicit domain identifiers. Evaluated across multiple public continual learning benchmarks, our approach outperforms exemplar-free and limited-buffer rehearsal baselines, highlighting footprint-based generative replay as a practical solution for deployment in evolving clinical settings.

One of the common issues in clinical decision-making is the presence of uncertainty, which often arises due to ambiguity in radiology reports, which often reflect genuine diagnostic uncertainty or limitations of automated label extraction in various complex cases. Especially the case of multilabel datasets such as CheXpert, MIMIC-CXR, etc., which contain labels such as positive, negative, and uncertain. In clinical decision-making, the uncertain label plays a tricky role as the model should not be forced to provide a confident prediction in the absence of sufficient evidence. The ability of the model to say it does not understand whenever it is not confident is crucial, especially in the cases of clinical decision-making involving high risks. Here, we propose AdURA-Net, a geometry-driven adaptive uncertainty-aware framework for reliable thoracic disease classification. The key highlights of the proposed model are: a) Adaptive dilated convolution and multiscale deformable alignment coupled with the backbone Densenet architecture capturing the anatomical complexities of the medical images, and b) Dual Head Loss, which combines masked binary cross entropy with logit and a Dirichlet evidential learning objective.