Daily Papers

We propose a novel framework for retinal feature point alignment, designed for learning cross-modality features to enhance matching and registration across multi-modality retinal images. Our model draws on the success of previous learning-based feature detection and description methods. To better leverage unlabeled data and constrain the model to reproduce relevant keypoints, we integrate a keypoint-based segmentation task. It is trained in a self-supervised manner by enforcing segmentation consistency between different augmentations of the same image. By incorporating a keypoint augmented self-supervised layer, we achieve robust feature extraction across modalities. Extensive evaluation on two public datasets and one in-house dataset demonstrates significant improvements in performance for modality-agnostic retinal feature alignment. Our code and model weights are publicly available at https://github.com/MedICL-VU/RetinaIPA.

Color fundus photography and Optical Coherence Tomography (OCT) are the two most cost-effective tools for glaucoma screening. Both two modalities of images have prominent biomarkers to indicate glaucoma suspected. Clinically, it is often recommended to take both of the screenings for a more accurate and reliable diagnosis. However, although numerous algorithms are proposed based on fundus images or OCT volumes in computer-aided diagnosis, there are still few methods leveraging both of the modalities for the glaucoma assessment. Inspired by the success of Retinal Fundus Glaucoma Challenge (REFUGE) we held previously, we set up the Glaucoma grAding from Multi-Modality imAges (GAMMA) Challenge to encourage the development of fundus \& OCT-based glaucoma grading. The primary task of the challenge is to grade glaucoma from both the 2D fundus images and 3D OCT scanning volumes. As part of GAMMA, we have publicly released a glaucoma annotated dataset with both 2D fundus color photography and 3D OCT volumes, which is the first multi-modality dataset for glaucoma grading. In addition, an evaluation framework is also established to evaluate the performance of the submitted methods. During the challenge, 1272 results were submitted, and finally, top-10 teams were selected to the final stage. We analysis their results and summarize their methods in the paper. Since all these teams submitted their source code in the challenge, a detailed ablation study is also conducted to verify the effectiveness of the particular modules proposed. We find many of the proposed techniques are practical for the clinical diagnosis of glaucoma. As the first in-depth study of fundus \& OCT multi-modality glaucoma grading, we believe the GAMMA Challenge will be an essential starting point for future research.

Different medical imaging modalities capture diagnostic information at varying spatial resolutions, from coarse global patterns to fine-grained localized structures. However, most existing vision-language frameworks in the medical domain apply a uniform strategy for local feature extraction, overlooking the modality-specific demands. In this work, we present MedMoE, a modular and extensible vision-language processing framework that dynamically adapts visual representation based on the diagnostic context. MedMoE incorporates a Mixture-of-Experts (MoE) module conditioned on the report type, which routes multi-scale image features through specialized expert branches trained to capture modality-specific visual semantics. These experts operate over feature pyramids derived from a Swin Transformer backbone, enabling spatially adaptive attention to clinically relevant regions. This framework produces localized visual representations aligned with textual descriptions, without requiring modality-specific supervision at inference. Empirical results on diverse medical benchmarks demonstrate that MedMoE improves alignment and retrieval performance across imaging modalities, underscoring the value of modality-specialized visual representations in clinical vision-language systems.

Many keypoint detection and description methods have been proposed for image matching or registration. While these methods demonstrate promising performance for single-modality image matching, they often struggle with multimodal data because the descriptors trained on single-modality data tend to lack robustness against the non-linear variations present in multimodal data. Extending such methods to multimodal image matching often requires well-aligned multimodal data to learn modality-invariant descriptors. However, acquiring such data is often costly and impractical in many real-world scenarios. To address this challenge, we propose a modality-invariant feature learning network (MIFNet) to compute modality-invariant features for keypoint descriptions in multimodal image matching using only single-modality training data. Specifically, we propose a novel latent feature aggregation module and a cumulative hybrid aggregation module to enhance the base keypoint descriptors trained on single-modality data by leveraging pre-trained features from Stable Diffusion models. We validate our method with recent keypoint detection and description methods in three multimodal retinal image datasets (CF-FA, CF-OCT, EMA-OCTA) and two remote sensing datasets (Optical-SAR and Optical-NIR). Extensive experiments demonstrate that the proposed MIFNet is able to learn modality-invariant feature for multimodal image matching without accessing the targeted modality and has good zero-shot generalization ability. The source code will be made publicly available.

The scarcity of high-quality, labelled retinal imaging data, which presents a significant challenge in the development of machine learning models for ophthalmology, hinders progress in the field. Existing methods for synthesising Colour Fundus Photographs (CFPs) largely rely on predefined disease labels, which restricts their ability to generate images that reflect fine-grained anatomical variations, subtle disease stages, and diverse pathological features beyond coarse class categories. To overcome these challenges, we first introduce an innovative pipeline that creates a large-scale, captioned retinal dataset comprising 1.4 million entries, called RetinaLogos-1400k. Specifically, RetinaLogos-1400k uses the visual language model(VLM) to describe retinal conditions and key structures, such as optic disc configuration, vascular distribution, nerve fibre layers, and pathological features. Building on this dataset, we employ a novel three-step training framework, RetinaLogos, which enables fine-grained semantic control over retinal images and accurately captures different stages of disease progression, subtle anatomical variations, and specific lesion types. Through extensive experiments, our method demonstrates superior performance across multiple datasets, with 62.07% of text-driven synthetic CFPs indistinguishable from real ones by ophthalmologists. Moreover, the synthetic data improves accuracy by 5%-10% in diabetic retinopathy grading and glaucoma detection. Codes are available at https://github.com/uni-medical/retina-text2cfp.

Vision foundation models like DINOv2 demonstrate remarkable potential in medical imaging despite their origin in natural image domains. However, their design inherently works best for uni-modal image analysis, limiting their effectiveness for multi-modal imaging tasks that are common in many medical fields, such as neurology and oncology. While supervised models perform well in this setting, they fail to leverage unlabeled datasets and struggle with missing modalities, a frequent challenge in clinical settings. To bridge these gaps, we introduce MM-DINOv2, a novel and efficient framework that adapts the pre-trained vision foundation model DINOv2 for multi-modal medical imaging. Our approach incorporates multi-modal patch embeddings, enabling vision foundation models to effectively process multi-modal imaging data. To address missing modalities, we employ full-modality masking, which encourages the model to learn robust cross-modality relationships. Furthermore, we leverage semi-supervised learning to harness large unlabeled datasets, enhancing both the accuracy and reliability of medical predictions. Applied to glioma subtype classification from multi-sequence brain MRI, our method achieves a Matthews Correlation Coefficient (MCC) of 0.6 on an external test set, surpassing state-of-the-art supervised approaches by +11.1%. Our work establishes a scalable and robust solution for multi-modal medical imaging tasks, leveraging powerful vision foundation models pre-trained on natural images while addressing real-world clinical challenges such as missing data and limited annotations.

Effectively representing medical images, especially retinal images, presents a considerable challenge due to variations in appearance, size, and contextual information of pathological signs called lesions. Precise discrimination of these lesions is crucial for diagnosing vision-threatening issues such as diabetic retinopathy. While visual attention-based neural networks have been introduced to learn spatial context and channel correlations from retinal images, they often fall short in capturing localized lesion context. Addressing this limitation, we propose a novel attention mechanism called Guided Context Gating, an unique approach that integrates Context Formulation, Channel Correlation, and Guided Gating to learn global context, spatial correlations, and localized lesion context. Our qualitative evaluation against existing attention mechanisms emphasize the superiority of Guided Context Gating in terms of explainability. Notably, experiments on the Zenodo-DR-7 dataset reveal a substantial 2.63% accuracy boost over advanced attention mechanisms & an impressive 6.53% improvement over the state-of-the-art Vision Transformer for assessing the severity grade of retinopathy, even with imbalanced and limited training samples for each class.

Retinal foundation models aim to learn generalizable representations from diverse retinal images, facilitating label-efficient model adaptation across various ophthalmic tasks. Despite their success, current retinal foundation models are generally restricted to a single imaging modality, such as Color Fundus Photography (CFP) or Optical Coherence Tomography (OCT), limiting their versatility. Moreover, these models may struggle to fully leverage expert annotations and overlook the valuable domain knowledge essential for domain-specific representation learning. To overcome these limitations, we introduce UrFound, a retinal foundation model designed to learn universal representations from both multimodal retinal images and domain knowledge. UrFound is equipped with a modality-agnostic image encoder and accepts either CFP or OCT images as inputs. To integrate domain knowledge into representation learning, we encode expert annotation in text supervision and propose a knowledge-guided masked modeling strategy for model pre-training. It involves reconstructing randomly masked patches of retinal images while predicting masked text tokens conditioned on the corresponding retinal image. This approach aligns multimodal images and textual expert annotations within a unified latent space, facilitating generalizable and domain-specific representation learning. Experimental results demonstrate that UrFound exhibits strong generalization ability and data efficiency when adapting to various tasks in retinal image analysis. By training on ~180k retinal images, UrFound significantly outperforms the state-of-the-art retinal foundation model trained on up to 1.6 million unlabelled images across 8 public retinal datasets. Our code and data are available at https://github.com/yukkai/UrFound.

Foundation vision-language models are currently transforming computer vision, and are on the rise in medical imaging fueled by their very promising generalization capabilities. However, the initial attempts to transfer this new paradigm to medical imaging have shown less impressive performances than those observed in other domains, due to the significant domain shift and the complex, expert domain knowledge inherent to medical-imaging tasks. Motivated by the need for domain-expert foundation models, we present FLAIR, a pre-trained vision-language model for universal retinal fundus image understanding. To this end, we compiled 37 open-access, mostly categorical fundus imaging datasets from various sources, with up to 97 different target conditions and 284,660 images. We integrate the expert's domain knowledge in the form of descriptive textual prompts, during both pre-training and zero-shot inference, enhancing the less-informative categorical supervision of the data. Such a textual expert's knowledge, which we compiled from the relevant clinical literature and community standards, describes the fine-grained features of the pathologies as well as the hierarchies and dependencies between them. We report comprehensive evaluations, which illustrate the benefit of integrating expert knowledge and the strong generalization capabilities of FLAIR under difficult scenarios with domain shifts or unseen categories. When adapted with a lightweight linear probe, FLAIR outperforms fully-trained, dataset-focused models, more so in the few-shot regimes. Interestingly, FLAIR outperforms by a large margin more generalist, larger-scale image-language models, which emphasizes the potential of embedding experts' domain knowledge and the limitations of generalist models in medical imaging.

In real-world scenarios, using multiple modalities like visible (RGB) and infrared (IR) can greatly improve the performance of a predictive task such as object detection (OD). Multimodal learning is a common way to leverage these modalities, where multiple modality-specific encoders and a fusion module are used to improve performance. In this paper, we tackle a different way to employ RGB and IR modalities, where only one modality or the other is observed by a single shared vision encoder. This realistic setting requires a lower memory footprint and is more suitable for applications such as autonomous driving and surveillance, which commonly rely on RGB and IR data. However, when learning a single encoder on multiple modalities, one modality can dominate the other, producing uneven recognition results. This work investigates how to efficiently leverage RGB and IR modalities to train a common transformer-based OD vision encoder, while countering the effects of modality imbalance. For this, we introduce a novel training technique to Mix Patches (MiPa) from the two modalities, in conjunction with a patch-wise modality agnostic module, for learning a common representation of both modalities. Our experiments show that MiPa can learn a representation to reach competitive results on traditional RGB/IR benchmarks while only requiring a single modality during inference. Our code is available at: https://github.com/heitorrapela/MiPa.

Previous research on retinal vessel segmentation is targeted at a specific image domain, mostly color fundus photography (CFP). In this paper we make a brave attempt to attack a more challenging task of broad-domain retinal vessel segmentation (BD-RVS), which is to develop a unified model applicable to varied domains including CFP, SLO, UWF, OCTA and FFA. To that end, we propose Dual Convoltuional Prompting (DCP) that learns to extract domain-specific features by localized prompting along both position and channel dimensions. DCP is designed as a plug-in module that can effectively turn a R2AU-Net based vessel segmentation network to a unified model, yet without the need of modifying its network structure. For evaluation we build a broad-domain set using five public domain-specific datasets including ROSSA, FIVES, IOSTAR, PRIME-FP20 and VAMPIRE. In order to benchmark BD-RVS on the broad-domain dataset, we re-purpose a number of existing methods originally developed in other contexts, producing eight baseline methods in total. Extensive experiments show the the proposed method compares favorably against the baselines for BD-RVS.

In this paper, we introduce a novel Multi-Modal Contrastive Pre-training Framework that synergistically combines X-rays, electrocardiograms (ECGs), and radiology/cardiology reports. Our approach leverages transformers to encode these diverse modalities into a unified representation space, aiming to enhance diagnostic accuracy and facilitate comprehensive patient assessments. We utilize LoRA-Peft to significantly reduce trainable parameters in the LLM and incorporate recent linear attention dropping strategy in the Vision Transformer(ViT) for smoother attention. Furthermore, we provide novel multimodal attention explanations and retrieval for our model. To the best of our knowledge, we are the first to propose an integrated model that combines X-ray, ECG, and Radiology/Cardiology Report with this approach. By utilizing contrastive loss, MoRE effectively aligns modality-specific features into a coherent embedding, which supports various downstream tasks such as zero-shot classification and multimodal retrieval. Employing our proposed methodology, we achieve state-of-the-art (SOTA) on the Mimic-IV, CheXpert, Edema Severity, and PtbXl downstream datasets, surpassing existing multimodal approaches. Our proposed framework shows significant improvements in capturing intricate inter-modal relationships and its robustness in medical diagnosis that establishes a framework for future research in multimodal learning in the healthcare sector.

Image matching for both cross-view and cross-modality plays a critical role in multimodal perception. In practice, the modality gap caused by different imaging systems/styles poses great challenges to the matching task. Existing works try to extract invariant features for specific modalities and train on limited datasets, showing poor generalization. In this paper, we present MINIMA, a unified image matching framework for multiple cross-modal cases. Without pursuing fancy modules, our MINIMA aims to enhance universal performance from the perspective of data scaling up. For such purpose, we propose a simple yet effective data engine that can freely produce a large dataset containing multiple modalities, rich scenarios, and accurate matching labels. Specifically, we scale up the modalities from cheap but rich RGB-only matching data, by means of generative models. Under this setting, the matching labels and rich diversity of the RGB dataset are well inherited by the generated multimodal data. Benefiting from this, we construct MD-syn, a new comprehensive dataset that fills the data gap for general multimodal image matching. With MD-syn, we can directly train any advanced matching pipeline on randomly selected modality pairs to obtain cross-modal ability. Extensive experiments on in-domain and zero-shot matching tasks, including 19 cross-modal cases, demonstrate that our MINIMA can significantly outperform the baselines and even surpass modality-specific methods. The dataset and code are available at https://github.com/LSXI7/MINIMA .

Image modality is not perfect as it often fails in certain conditions, e.g., night and fast motion. This significantly limits the robustness and versatility of existing multi-modal (i.e., Image+X) semantic segmentation methods when confronting modality absence or failure, as often occurred in real-world applications. Inspired by the open-world learning capability of multi-modal vision-language models (MVLMs), we explore a new direction in learning the modality-agnostic representation via knowledge distillation (KD) from MVLMs. Intuitively, we propose Any2Seg, a novel framework that can achieve robust segmentation from any combination of modalities in any visual conditions. Specifically, we first introduce a novel language-guided semantic correlation distillation (LSCD) module to transfer both inter-modal and intra-modal semantic knowledge in the embedding space from MVLMs, e.g., LanguageBind. This enables us to minimize the modality gap and alleviate semantic ambiguity to combine any modalities in any visual conditions. Then, we introduce a modality-agnostic feature fusion (MFF) module that reweights the multi-modal features based on the inter-modal correlation and selects the fine-grained feature. This way, our Any2Seg finally yields an optimal modality-agnostic representation. Extensive experiments on two benchmarks with four modalities demonstrate that Any2Seg achieves the state-of-the-art under the multi-modal setting (+3.54 mIoU) and excels in the challenging modality-incomplete setting(+19.79 mIoU).

Multimodal large language models (MLLMs) have recently demonstrated remarkable reasoning abilities with reinforcement learning paradigm. Although several multimodal reasoning models have been explored in the medical domain, most of them focus exclusively on basic reasoning, which refers to shallow inference based on visual feature matching. However, real-world clinical diagnosis extends beyond basic reasoning, demanding reasoning processes that integrate heterogeneous clinical information (such as chief complaints and medical history) with multimodal medical imaging data. To bridge this gap, we introduce MM-Retinal-Reason, the first ophthalmic multimodal dataset with the full spectrum of perception and reasoning. It encompasses both basic reasoning tasks and complex reasoning tasks, aiming to enhance visual-centric fundamental reasoning capabilities and emulate realistic clinical thinking patterns. Building upon MM-Retinal-Reason, we propose OphthaReason, the first ophthalmology-specific multimodal reasoning model with step-by-step reasoning traces. To enable flexible adaptation to both basic and complex reasoning tasks, we specifically design a novel method called Uncertainty-Aware Dynamic Thinking (UADT), which estimates sample-level uncertainty via entropy and dynamically modulates the model's exploration depth using a shaped advantage mechanism. Comprehensive experiments demonstrate that our model achieves state-of-the-art performance on both basic and complex reasoning tasks, outperforming general-purpose MLLMs, medical MLLMs, RL-based medical MLLMs, and ophthalmic MLLMs by at least 24.92\%, 15.00\%, 21.20\%, and 17.66\%. Project Page: https://github.com/lxirich/OphthaReason{link}.

Large vision-language models (LVLMs) have recently achieved rapid progress, sparking numerous studies to evaluate their multi-modal capabilities. However, we dig into current evaluation works and identify two primary issues: 1) Visual content is unnecessary for many samples. The answers can be directly inferred from the questions and options, or the world knowledge embedded in LLMs. This phenomenon is prevalent across current benchmarks. For instance, GeminiPro achieves 42.9% on the MMMU benchmark without any visual input, and outperforms the random choice baseline across six benchmarks over 20% on average. 2) Unintentional data leakage exists in LLM and LVLM training. LLM and LVLM could still answer some visual-necessary questions without visual content, indicating the memorizing of these samples within large-scale training data. For example, Sphinx-X-MoE gets 43.6% on MMMU without accessing images, surpassing its LLM backbone with 17.9%. Both problems lead to misjudgments of actual multi-modal gains and potentially misguide the study of LVLM. To this end, we present MMStar, an elite vision-indispensable multi-modal benchmark comprising 1,500 samples meticulously selected by humans. MMStar benchmarks 6 core capabilities and 18 detailed axes, aiming to evaluate LVLMs' multi-modal capacities with carefully balanced and purified samples. These samples are first roughly selected from current benchmarks with an automated pipeline, human review is then involved to ensure each curated sample exhibits visual dependency, minimal data leakage, and requires advanced multi-modal capabilities. Moreover, two metrics are developed to measure data leakage and actual performance gain in multi-modal training. We evaluate 16 leading LVLMs on MMStar to assess their multi-modal capabilities, and on 7 benchmarks with the proposed metrics to investigate their data leakage and actual multi-modal gain.

Medical Vision-Language Models (MVLMs) have achieved par excellence generalization in medical image analysis, yet their performance under noisy, corrupted conditions remains largely untested. Clinical imaging is inherently susceptible to acquisition artifacts and noise; however, existing evaluations predominantly assess generally clean datasets, overlooking robustness -- i.e., the model's ability to perform under real-world distortions. To address this gap, we first introduce MediMeta-C, a corruption benchmark that systematically applies several perturbations across multiple medical imaging datasets. Combined with MedMNIST-C, this establishes a comprehensive robustness evaluation framework for MVLMs. We further propose RobustMedCLIP, a visual encoder adaptation of a pretrained MVLM that incorporates few-shot tuning to enhance resilience against corruptions. Through extensive experiments, we benchmark 5 major MVLMs across 5 medical imaging modalities, revealing that existing models exhibit severe degradation under corruption and struggle with domain-modality tradeoffs. Our findings highlight the necessity of diverse training and robust adaptation strategies, demonstrating that efficient low-rank adaptation when paired with few-shot tuning, improves robustness while preserving generalization across modalities.

This paper introduces MedTrinity-25M, a comprehensive, large-scale multimodal dataset for medicine, covering over 25 million images across 10 modalities, with multigranular annotations for more than 65 diseases. These enriched annotations encompass both global textual information, such as disease/lesion type, modality, region-specific descriptions, and inter-regional relationships, as well as detailed local annotations for regions of interest (ROIs), including bounding boxes, segmentation masks. Unlike existing approach which is limited by the availability of image-text pairs, we have developed the first automated pipeline that scales up multimodal data by generating multigranular visual and texual annotations (in the form of image-ROI-description triplets) without the need for any paired text descriptions. Specifically, data from over 90 different sources have been collected, preprocessed, and grounded using domain-specific expert models to identify ROIs related to abnormal regions. We then build a comprehensive knowledge base and prompt multimodal large language models to perform retrieval-augmented generation with the identified ROIs as guidance, resulting in multigranular texual descriptions. Compared to existing datasets, MedTrinity-25M provides the most enriched annotations, supporting a comprehensive range of multimodal tasks such as captioning and report generation, as well as vision-centric tasks like classification and segmentation. Pretraining on MedTrinity-25M, our model achieves state-of-the-art performance on VQA-RAD and PathVQA, surpassing both multimodal large language models and other representative SoTA approaches. This dataset can also be utilized to support large-scale pre-training of multimodal medical AI models, contributing to the development of future foundation models in the medical domain.

Diabetic Retinopathy (DR), induced by diabetes, poses a significant risk of visual impairment. Accurate and effective grading of DR aids in the treatment of this condition. Yet existing models experience notable performance degradation on unseen domains due to domain shifts. Previous methods address this issue by simulating domain style through simple visual transformation and mitigating domain noise via learning robust representations. However, domain shifts encompass more than image styles. They overlook biases caused by implicit factors such as ethnicity, age, and diagnostic criteria. In our work, we propose a novel framework where representations of paired data from different domains are decoupled into semantic features and domain noise. The resulting augmented representation comprises original retinal semantics and domain noise from other domains, aiming to generate enhanced representations aligned with real-world clinical needs, incorporating rich information from diverse domains. Subsequently, to improve the robustness of the decoupled representations, class and domain prototypes are employed to interpolate the disentangled representations while data-aware weights are designed to focus on rare classes and domains. Finally, we devise a robust pixel-level semantic alignment loss to align retinal semantics decoupled from features, maintaining a balance between intra-class diversity and dense class features. Experimental results on multiple benchmarks demonstrate the effectiveness of our method on unseen domains. The code implementations are accessible on https://github.com/richard-peng-xia/DECO.

Medical image retrieval is essential for clinical decision-making and translational research, relying on discriminative visual representations. Yet, current methods remain fragmented, relying on separate architectures and training strategies for 2D, 3D, and video-based medical data. This modality-specific design hampers scalability and inhibits the development of unified representations. To enable unified learning, we curate a large-scale hybrid-modality dataset comprising 867,653 medical imaging samples, including 2D X-rays and ultrasounds, RGB endoscopy videos, and 3D CT scans. Leveraging this dataset, we train M3Ret, a unified visual encoder without any modality-specific customization. It successfully learns transferable representations using both generative (MAE) and contrastive (SimDINO) self-supervised learning (SSL) paradigms. Our approach sets a new state-of-the-art in zero-shot image-to-image retrieval across all individual modalities, surpassing strong baselines such as DINOv3 and the text-supervised BMC-CLIP. More remarkably, strong cross-modal alignment emerges without paired data, and the model generalizes to unseen MRI tasks, despite never observing MRI during pretraining, demonstrating the generalizability of purely visual self-supervision to unseen modalities. Comprehensive analyses further validate the scalability of our framework across model and data sizes. These findings deliver a promising signal to the medical imaging community, positioning M3Ret as a step toward foundation models for visual SSL in multimodal medical image understanding.

Though the success of CLIP-based training recipes in vision-language models, their scalability to more modalities (e.g., 3D, audio, etc.) is limited to large-scale data, which is expensive or even inapplicable for rare modalities. In this paper, we present ViT-Lens that facilitates efficient omni-modal representation learning by perceiving novel modalities with a pretrained ViT and aligning to a pre-defined space. Specifically, the modality-specific lens is tuned to project multimodal signals to the shared embedding space, which are then processed by a strong ViT that carries pre-trained image knowledge. The encoded multimodal representations are optimized toward aligning with the modal-independent space, pre-defined by off-the-shelf foundation models. A well-trained lens with a ViT backbone has the potential to serve as one of these foundation models, supervising the learning of subsequent modalities. ViT-Lens provides a unified solution for representation learning of increasing modalities with two appealing benefits: (i) Exploiting the pretrained ViT across tasks and domains effectively with efficient data regime; (ii) Emergent downstream capabilities of novel modalities are demonstrated due to the modality alignment space. We evaluate ViT-Lens in the context of 3D as an initial verification. In zero-shot 3D classification, ViT-Lens achieves substantial improvements over previous state-of-the-art, showing 52.0% accuracy on Objaverse-LVIS, 87.4% on ModelNet40, and 60.6% on ScanObjectNN. Furthermore, we enable zero-shot 3D question-answering by simply integrating the trained 3D lens into the InstructBLIP model without any adaptation. We will release the results of ViT-Lens on more modalities in the near future.

Large-scale multi-modal deep learning models have revolutionized domains such as healthcare, highlighting the importance of computational power. However, in resource-constrained regions like Low and Middle-Income Countries (LMICs), limited access to GPUs and data poses significant challenges, often leaving CPUs as the sole resource. To address this, we advocate for leveraging vector embeddings to enable flexible and efficient computational methodologies, democratizing multimodal deep learning across diverse contexts. Our paper investigates the efficiency and effectiveness of using vector embeddings from single-modal foundation models and multi-modal Vision-Language Models (VLMs) for multimodal deep learning in low-resource environments, particularly in healthcare. Additionally, we propose a simple yet effective inference-time method to enhance performance by aligning image-text embeddings. Comparing these approaches with traditional methods, we assess their impact on computational efficiency and model performance using metrics like accuracy, F1-score, inference time, training time, and memory usage across three medical modalities: BRSET (ophthalmology), HAM10000 (dermatology), and SatelliteBench (public health). Our findings show that embeddings reduce computational demands without compromising model performance. Furthermore, our alignment method improves performance in medical tasks. This research promotes sustainable AI practices by optimizing resources in constrained environments, highlighting the potential of embedding-based approaches for efficient multimodal learning. Vector embeddings democratize multimodal deep learning in LMICs, particularly in healthcare, enhancing AI adaptability in varied use cases.

Automatic radiology report generation is booming due to its huge application potential for the healthcare industry. However, existing computer vision and natural language processing approaches to tackle this problem are limited in two aspects. First, when extracting image features, most of them neglect multi-view reasoning in vision and model single-view structure of medical images, such as space-view or channel-view. However, clinicians rely on multi-view imaging information for comprehensive judgment in daily clinical diagnosis. Second, when generating reports, they overlook context reasoning with multi-modal information and focus on pure textual optimization utilizing retrieval-based methods. We aim to address these two issues by proposing a model that better simulates clinicians' perspectives and generates more accurate reports. Given the above limitation in feature extraction, we propose a Globally-intensive Attention (GIA) module in the medical image encoder to simulate and integrate multi-view vision perception. GIA aims to learn three types of vision perception: depth view, space view, and pixel view. On the other hand, to address the above problem in report generation, we explore how to involve multi-modal signals to generate precisely matched reports, i.e., how to integrate previously predicted words with region-aware visual content in next word prediction. Specifically, we design a Visual Knowledge-guided Decoder (VKGD), which can adaptively consider how much the model needs to rely on visual information and previously predicted text to assist next word prediction. Hence, our final Intensive Vision-guided Network (IVGN) framework includes a GIA-guided Visual Encoder and the VKGD. Experiments on two commonly-used datasets IU X-Ray and MIMIC-CXR demonstrate the superior ability of our method compared with other state-of-the-art approaches.

In medical vision, different imaging modalities provide complementary information. However, in practice, not all modalities may be available during inference or even training. Previous approaches, e.g., knowledge distillation or image synthesis, often assume the availability of full modalities for all patients during training; this is unrealistic and impractical due to the variability in data collection across sites. We propose a novel approach to learn enhanced modality-agnostic representations by employing a meta-learning strategy in training, even when only limited full modality samples are available. Meta-learning enhances partial modality representations to full modality representations by meta-training on partial modality data and meta-testing on limited full modality samples. Additionally, we co-supervise this feature enrichment by introducing an auxiliary adversarial learning branch. More specifically, a missing modality detector is used as a discriminator to mimic the full modality setting. Our segmentation framework significantly outperforms state-of-the-art brain tumor segmentation techniques in missing modality scenarios.

Current machine learning models for vision are often highly specialized and limited to a single modality and task. In contrast, recent large language models exhibit a wide range of capabilities, hinting at a possibility for similarly versatile models in computer vision. In this paper, we take a step in this direction and propose a multimodal training scheme called 4M. It consists of training a single unified Transformer encoder-decoder using a masked modeling objective across a wide range of input/output modalities - including text, images, geometric, and semantic modalities, as well as neural network feature maps. 4M achieves scalability by unifying the representation space of all modalities through mapping them into discrete tokens and performing multimodal masked modeling on a small randomized subset of tokens. 4M leads to models that exhibit several key capabilities: (1) they can perform a diverse set of vision tasks out of the box, (2) they excel when fine-tuned for unseen downstream tasks or new input modalities, and (3) they can function as a generative model that can be conditioned on arbitrary modalities, enabling a wide variety of expressive multimodal editing capabilities with remarkable flexibility. Through experimental analyses, we demonstrate the potential of 4M for training versatile and scalable foundation models for vision tasks, setting the stage for further exploration in multimodal learning for vision and other domains.

Medical decision-making requires integrating diverse medical information, from imaging to clinical narratives. These medical modalities are often acquired in a many-to-many manner. However, current medical vision-language pretraining models (Med-VLPMs) fail to directly account for this many-to-many mapping in their model training and embeddings. To address this, we present Probabilistic Modality-Enhanced Diagnosis (ProbMED), a multimodal Med-VLPM that employs probabilistic contrastive learning to model distributions over embeddings rather than deterministic estimates. ProbMED aligns four distinct modalities -- chest X-rays, electrocardiograms, echocardiograms, and clinical text -- into a unified probabilistic embedding space. We use InfoNCE loss with Hellinger distance to integrate inter-modality distributions. We introduce a probabilistic synthetic sampling loss that captures modality-specific mean and variance to improve intra-modality binding. Extensive experiments across 13 medical datasets demonstrate that our model outperforms current Med-VLPMs in cross-modality retrieval, zero-shot, and few-shot classification. We also demonstrate the robust integration of multiple modalities for prognostication, showing improved intra- and inter-medical modality binding.

Retinal imaging has emerged as a powerful, non-invasive modality for detecting and quantifying biomarkers of systemic diseases-ranging from diabetes and hypertension to Alzheimer's disease and cardiovascular disorders but current insights remain dispersed across platforms and specialties. Recent technological advances in optical coherence tomography (OCT/OCTA) and adaptive optics (AO) now deliver ultra-high-resolution scans (down to 5 {\mu}m ) with superior contrast and spatial integration, allowing early identification of microvascular abnormalities and neurodegenerative changes. At the same time, AI-driven and machine learning (ML) algorithms have revolutionized the analysis of large-scale retinal datasets, increasing sensitivity and specificity; for example, deep learning models achieve > 90 \% sensitivity for diabetic retinopathy and AUC = 0.89 for the prediction of cardiovascular risk from fundus photographs. The proliferation of mobile health technologies and telemedicine platforms further extends access, reduces costs, and facilitates community-based screening and longitudinal monitoring. Despite these breakthroughs, translation into routine practice is hindered by heterogeneous imaging protocols, limited external validation of AI models, and integration challenges within clinical workflows. In this review, we systematically synthesize the latest OCT/OCT and AO developments, AI/ML approaches, and mHealth/Tele-ophthalmology initiatives and quantify their diagnostic performance across disease domains. Finally, we propose a roadmap for multicenter protocol standardization, prospective validation trials, and seamless incorporation of retinal screening into primary and specialty care pathways-paving the way for precision prevention, early intervention, and ongoing treatment of life-threatening systemic diseases.

In the diverse field of medical imaging, automatic segmentation has numerous applications and must handle a wide variety of input domains, such as different types of Computed Tomography (CT) scans and Magnetic Resonance (MR) images. This heterogeneity challenges automatic segmentation algorithms to maintain consistent performance across different modalities due to the requirement for spatially aligned and paired images. Typically, segmentation models are trained using a single modality, which limits their ability to generalize to other types of input data without employing transfer learning techniques. Additionally, leveraging complementary information from different modalities to enhance segmentation precision often necessitates substantial modifications to popular encoder-decoder designs, such as introducing multiple branched encoding or decoding paths for each modality. In this work, we propose a simple Multi-Modal Segmentation (MulModSeg) strategy to enhance medical image segmentation across multiple modalities, specifically CT and MR. It incorporates two key designs: a modality-conditioned text embedding framework via a frozen text encoder that adds modality awareness to existing segmentation frameworks without significant structural modifications or computational overhead, and an alternating training procedure that facilitates the integration of essential features from unpaired CT and MR inputs. Through extensive experiments with both Fully Convolutional Network and Transformer-based backbones, MulModSeg consistently outperforms previous methods in segmenting abdominal multi-organ and cardiac substructures for both CT and MR modalities. The code is available in this {https://github.com/ChengyinLee/MulModSeg_2024{link}}.

Low-light image enhancement (LLIE) is a fundamental yet challenging task due to the presence of noise, loss of detail, and poor contrast in images captured under insufficient lighting conditions. Recent methods often rely solely on pixel-level transformations of RGB images, neglecting the rich contextual information available from multiple visual modalities. In this paper, we present ModalFormer, the first large-scale multimodal framework for LLIE that fully exploits nine auxiliary modalities to achieve state-of-the-art performance. Our model comprises two main components: a Cross-modal Transformer (CM-T) designed to restore corrupted images while seamlessly integrating multimodal information, and multiple auxiliary subnetworks dedicated to multimodal feature reconstruction. Central to the CM-T is our novel Cross-modal Multi-headed Self-Attention mechanism (CM-MSA), which effectively fuses RGB data with modality-specific features--including deep feature embeddings, segmentation information, geometric cues, and color information--to generate information-rich hybrid attention maps. Extensive experiments on multiple benchmark datasets demonstrate ModalFormer's state-of-the-art performance in LLIE. Pre-trained models and results are made available at https://github.com/albrateanu/ModalFormer.

Accurate disease interpretation from radiology remains challenging due to imaging heterogeneity. Achieving expert-level diagnostic decisions requires integration of subtle image features with clinical knowledge. Yet major vision-language models (VLMs) treat images as holistic entities and overlook fine-grained image details that are vital for disease diagnosis. Clinicians analyze images by utilizing their prior medical knowledge and identify anatomical structures as important region of interests (ROIs). Inspired from this human-centric workflow, we introduce Anatomy-VLM, a fine-grained, vision-language model that incorporates multi-scale information. First, we design a model encoder to localize key anatomical features from entire medical images. Second, these regions are enriched with structured knowledge for contextually-aware interpretation. Finally, the model encoder aligns multi-scale medical information to generate clinically-interpretable disease prediction. Anatomy-VLM achieves outstanding performance on both in- and out-of-distribution datasets. We also validate the performance of Anatomy-VLM on downstream image segmentation tasks, suggesting that its fine-grained alignment captures anatomical and pathology-related knowledge. Furthermore, the Anatomy-VLM's encoder facilitates zero-shot anatomy-wise interpretation, providing its strong expert-level clinical interpretation capabilities.

In medical imaging, vision-language models face a critical duality: pretrained networks offer broad robustness but lack subtle, modality-specific characteristics, while fine-tuned expert models achieve high in-distribution accuracy yet falter under modality shift. Existing model-merging techniques, designed for natural-image benchmarks, are simple and efficient but fail to deliver consistent gains across diverse medical modalities; their static interpolation limits reliability in varied clinical tasks. To address this, we introduce Test-Time Task adaptive merging (T^3), a backpropagation-free framework that computes per-sample interpolation coefficients via the Jensen-Shannon divergence between the two models' output distributions. T^3 dynamically preserves local precision when models agree and defers to generalist robustness under drift. To overcome the inference costs of sample-wise merging, we further propose a batch-wise extension, T^3_B, that computes a merging coefficient across a batch of samples, dramatically reducing computational bottleneck. Recognizing the lack of a standardized medical-merging benchmark, we present a rigorous cross-evaluation protocol spanning in-domain, base-to-novel, and corruptions across four modalities. Empirically, T^3 sets new state-of-the-art in Top-1 accuracy and error reduction, outperforming strong baselines while maintaining efficiency, paving the way for adaptive MVLM deployment in clinical settings. Our code is available at https://github.com/Razaimam45/TCube.

Vision-Language Models (VLMs) trained via contrastive learning have achieved notable success in natural image tasks. However, their application in the medical domain remains limited due to the scarcity of openly accessible, large-scale medical image-text datasets. Existing medical VLMs either train on closed-source proprietary or relatively small open-source datasets that do not generalize well. Similarly, most models remain specific to a single or limited number of medical imaging domains, again restricting their applicability to other modalities. To address this gap, we introduce UniMed, a large-scale, open-source multi-modal medical dataset comprising over 5.3 million image-text pairs across six diverse imaging modalities: X-ray, CT, MRI, Ultrasound, Pathology, and Fundus. UniMed is developed using a data-collection framework that leverages Large Language Models (LLMs) to transform modality-specific classification datasets into image-text formats while incorporating existing image-text data from the medical domain, facilitating scalable VLM pretraining. Using UniMed, we trained UniMed-CLIP, a unified VLM for six modalities that significantly outperforms existing generalist VLMs and matches modality-specific medical VLMs, achieving notable gains in zero-shot evaluations. For instance, UniMed-CLIP improves over BiomedCLIP (trained on proprietary data) by an absolute gain of +12.61, averaged over 21 datasets, while using 3x less training data. To facilitate future research, we release UniMed dataset, training codes, and models at https://github.com/mbzuai-oryx/UniMed-CLIP.

We present OCTCube-M, a 3D OCT-based multi-modal foundation model for jointly analyzing OCT and en face images. OCTCube-M first developed OCTCube, a 3D foundation model pre-trained on 26,685 3D OCT volumes encompassing 1.62 million 2D OCT images. It then exploits a novel multi-modal contrastive learning framework COEP to integrate other retinal imaging modalities, such as fundus autofluorescence and infrared retinal imaging, into OCTCube, efficiently extending it into multi-modal foundation models. OCTCube achieves best performance on predicting 8 retinal diseases, demonstrating strong generalizability on cross-cohort, cross-device and cross-modality prediction. OCTCube can also predict cross-organ nodule malignancy (CT) and low cardiac ejection fraction as well as systemic diseases, such as diabetes and hypertension, revealing its wide applicability beyond retinal diseases. We further develop OCTCube-IR using COEP with 26,685 OCT and IR image pairs. OCTCube-IR can accurately retrieve between OCT and IR images, allowing joint analysis between 3D and 2D retinal imaging modalities. Finally, we trained a tri-modal foundation model OCTCube-EF from 4 million 2D OCT images and 400K en face retinal images. OCTCube-EF attains the best performance on predicting the growth rate of geographic atrophy (GA) across datasets collected from 6 multi-center global trials conducted in 23 countries. This improvement is statistically equivalent to running a clinical trial with more than double the size of the original study. Our analysis based on another retrospective case study reveals OCTCube-EF's ability to avoid false positive Phase-III results according to its accurate treatment effect estimation on the Phase-II results. In sum, OCTCube-M is a 3D multi-modal foundation model framework that integrates OCT and other retinal imaging modalities revealing substantial diagnostic and prognostic benefits.

Image matching, which aims to identify corresponding pixel locations between images, is crucial in a wide range of scientific disciplines, aiding in image registration, fusion, and analysis. In recent years, deep learning-based image matching algorithms have dramatically outperformed humans in rapidly and accurately finding large amounts of correspondences. However, when dealing with images captured under different imaging modalities that result in significant appearance changes, the performance of these algorithms often deteriorates due to the scarcity of annotated cross-modal training data. This limitation hinders applications in various fields that rely on multiple image modalities to obtain complementary information. To address this challenge, we propose a large-scale pre-training framework that utilizes synthetic cross-modal training signals, incorporating diverse data from various sources, to train models to recognize and match fundamental structures across images. This capability is transferable to real-world, unseen cross-modality image matching tasks. Our key finding is that the matching model trained with our framework achieves remarkable generalizability across more than eight unseen cross-modality registration tasks using the same network weight, substantially outperforming existing methods, whether designed for generalization or tailored for specific tasks. This advancement significantly enhances the applicability of image matching technologies across various scientific disciplines and paves the way for new applications in multi-modality human and artificial intelligence analysis and beyond.

Neural Radiance Fields (NeRFs) quickly evolved as the new de-facto standard for the task of novel view synthesis when trained on a set of RGB images. In this paper, we conduct a comprehensive evaluation of neural scene representations, such as NeRFs, in the context of multi-modal learning. Specifically, we present four different strategies of how to incorporate a second modality, other than RGB, into NeRFs: (1) training from scratch independently on both modalities; (2) pre-training on RGB and fine-tuning on the second modality; (3) adding a second branch; and (4) adding a separate component to predict (color) values of the additional modality. We chose thermal imaging as second modality since it strongly differs from RGB in terms of radiosity, making it challenging to integrate into neural scene representations. For the evaluation of the proposed strategies, we captured a new publicly available multi-view dataset, ThermalMix, consisting of six common objects and about 360 RGB and thermal images in total. We employ cross-modality calibration prior to data capturing, leading to high-quality alignments between RGB and thermal images. Our findings reveal that adding a second branch to NeRF performs best for novel view synthesis on thermal images while also yielding compelling results on RGB. Finally, we also show that our analysis generalizes to other modalities, including near-infrared images and depth maps. Project page: https://mert-o.github.io/ThermalNeRF/.

The capability to process multiple images is crucial for Large Vision-Language Models (LVLMs) to develop a more thorough and nuanced understanding of a scene. Recent multi-image LVLMs have begun to address this need. However, their evaluation has not kept pace with their development. To fill this gap, we introduce the Multimodal Multi-image Understanding (MMIU) benchmark, a comprehensive evaluation suite designed to assess LVLMs across a wide range of multi-image tasks. MMIU encompasses 7 types of multi-image relationships, 52 tasks, 77K images, and 11K meticulously curated multiple-choice questions, making it the most extensive benchmark of its kind. Our evaluation of 24 popular LVLMs, including both open-source and proprietary models, reveals significant challenges in multi-image comprehension, particularly in tasks involving spatial understanding. Even the most advanced models, such as GPT-4o, achieve only 55.7% accuracy on MMIU. Through multi-faceted analytical experiments, we identify key performance gaps and limitations, providing valuable insights for future model and data improvements. We aim for MMIU to advance the frontier of LVLM research and development, moving us toward achieving sophisticated multimodal multi-image user interactions.

With the rapid development of artificial intelligence (AI) in medical image processing, deep learning in color fundus photography (CFP) analysis is also evolving. Although there are some open-source, labeled datasets of CFPs in the ophthalmology community, large-scale datasets for screening only have labels of disease categories, and datasets with annotations of fundus structures are usually small in size. In addition, labeling standards are not uniform across datasets, and there is no clear information on the acquisition device. Here we release a multi-annotation, multi-quality, and multi-device color fundus image dataset for glaucoma analysis on an original challenge -- Retinal Fundus Glaucoma Challenge 2nd Edition (REFUGE2). The REFUGE2 dataset contains 2000 color fundus images with annotations of glaucoma classification, optic disc/cup segmentation, as well as fovea localization. Meanwhile, the REFUGE2 challenge sets three sub-tasks of automatic glaucoma diagnosis and fundus structure analysis and provides an online evaluation framework. Based on the characteristics of multi-device and multi-quality data, some methods with strong generalizations are provided in the challenge to make the predictions more robust. This shows that REFUGE2 brings attention to the characteristics of real-world multi-domain data, bridging the gap between scientific research and clinical application.

Multimodal Large Language Models (MLLMs) have shown significant potential in medical image analysis. However, their capabilities in interpreting fundus images, a critical skill for ophthalmology, remain under-evaluated. Existing benchmarks lack fine-grained task divisions and fail to provide modular analysis of its two key modules, i.e., large language model (LLM) and vision encoder (VE). This paper introduces FunBench, a novel visual question answering (VQA) benchmark designed to comprehensively evaluate MLLMs' fundus reading skills. FunBench features a hierarchical task organization across four levels (modality perception, anatomy perception, lesion analysis, and disease diagnosis). It also offers three targeted evaluation modes: linear-probe based VE evaluation, knowledge-prompted LLM evaluation, and holistic evaluation. Experiments on nine open-source MLLMs plus GPT-4o reveal significant deficiencies in fundus reading skills, particularly in basic tasks such as laterality recognition. The results highlight the limitations of current MLLMs and emphasize the need for domain-specific training and improved LLMs and VEs.

Artificial Intelligence (AI) has demonstrated significant potential in healthcare, particularly in disease diagnosis and treatment planning. Recent progress in Medical Large Vision-Language Models (Med-LVLMs) has opened up new possibilities for interactive diagnostic tools. However, these models often suffer from factual hallucination, which can lead to incorrect diagnoses. Fine-tuning and retrieval-augmented generation (RAG) have emerged as methods to address these issues. However, the amount of high-quality data and distribution shifts between training data and deployment data limit the application of fine-tuning methods. Although RAG is lightweight and effective, existing RAG-based approaches are not sufficiently general to different medical domains and can potentially cause misalignment issues, both between modalities and between the model and the ground truth. In this paper, we propose a versatile multimodal RAG system, MMed-RAG, designed to enhance the factuality of Med-LVLMs. Our approach introduces a domain-aware retrieval mechanism, an adaptive retrieved contexts selection method, and a provable RAG-based preference fine-tuning strategy. These innovations make the RAG process sufficiently general and reliable, significantly improving alignment when introducing retrieved contexts. Experimental results across five medical datasets (involving radiology, ophthalmology, pathology) on medical VQA and report generation demonstrate that MMed-RAG can achieve an average improvement of 43.8% in the factual accuracy of Med-LVLMs. Our data and code are available in https://github.com/richard-peng-xia/MMed-RAG.

Optical coherence tomography (OCT) is a non-invasive imaging modality which is widely used in clinical ophthalmology. OCT images are capable of visualizing deep retinal layers which is crucial for early diagnosis of retinal diseases. In this paper, we describe a comprehensive open-access database containing more than 500 highresolution images categorized into different pathological conditions. The image classes include Normal (NO), Macular Hole (MH), Age-related Macular Degeneration (AMD), Central Serous Retinopathy (CSR), and Diabetic Retinopathy (DR). The images were obtained from a raster scan protocol with a 2mm scan length and 512x1024 pixel resolution. We have also included 25 normal OCT images with their corresponding ground truth delineations which can be used for an accurate evaluation of OCT image segmentation. In addition, we have provided a user-friendly GUI which can be used by clinicians for manual (and semi-automated) segmentation.

Clinical diagnosis of the eye is performed over multifarious data modalities including scalar clinical labels, vectorized biomarkers, two-dimensional fundus images, and three-dimensional Optical Coherence Tomography (OCT) scans. Clinical practitioners use all available data modalities for diagnosing and treating eye diseases like Diabetic Retinopathy (DR) or Diabetic Macular Edema (DME). Enabling usage of machine learning algorithms within the ophthalmic medical domain requires research into the relationships and interactions between all relevant data over a treatment period. Existing datasets are limited in that they neither provide data nor consider the explicit relationship modeling between the data modalities. In this paper, we introduce the Ophthalmic Labels for Investigating Visual Eye Semantics (OLIVES) dataset that addresses the above limitation. This is the first OCT and near-IR fundus dataset that includes clinical labels, biomarker labels, disease labels, and time-series patient treatment information from associated clinical trials. The dataset consists of 1268 near-IR fundus images each with at least 49 OCT scans, and 16 biomarkers, along with 4 clinical labels and a disease diagnosis of DR or DME. In total, there are 96 eyes' data averaged over a period of at least two years with each eye treated for an average of 66 weeks and 7 injections. We benchmark the utility of OLIVES dataset for ophthalmic data as well as provide benchmarks and concrete research directions for core and emerging machine learning paradigms within medical image analysis.

Multi-modal (vision-language) models, such as CLIP, are replacing traditional supervised pre-training models (e.g., ImageNet-based pre-training) as the new generation of visual foundation models. These models with robust and aligned semantic representations learned from billions of internet image-text pairs and can be applied to various downstream tasks in a zero-shot manner. However, in some fine-grained domains like medical imaging and remote sensing, the performance of multi-modal foundation models often leaves much to be desired. Consequently, many researchers have begun to explore few-shot adaptation methods for these models, gradually deriving three main technical approaches: 1) prompt-based methods, 2) adapter-based methods, and 3) external knowledge-based methods. Nevertheless, this rapidly developing field has produced numerous results without a comprehensive survey to systematically organize the research progress. Therefore, in this survey, we introduce and analyze the research advancements in few-shot adaptation methods for multi-modal models, summarizing commonly used datasets and experimental setups, and comparing the results of different methods. In addition, due to the lack of reliable theoretical support for existing methods, we derive the few-shot adaptation generalization error bound for multi-modal models. The theorem reveals that the generalization error of multi-modal foundation models is constrained by three factors: domain gap, model capacity, and sample size. Based on this, we propose three possible solutions from the following aspects: 1) adaptive domain generalization, 2) adaptive model selection, and 3) adaptive knowledge utilization.

An image, especially with high-resolution, typically consists of numerous visual elements, ranging from dominant large objects to fine-grained detailed objects. When perceiving such images, multimodal large language models~(MLLMs) face limitations due to the restricted input resolution of the pretrained vision encoder and the cluttered, dense context of the image, resulting in a focus on primary objects while easily overlooking detailed ones. In this paper, we propose Zoom Eye, a tree search algorithm designed to navigate the hierarchical and visual nature of images to capture relevant information. Zoom Eye conceptualizes an image as a tree, with each children node representing a zoomed sub-patch of the parent node and the root represents the overall image. Moreover, Zoom Eye is model-agnostic and training-free, so it enables any MLLMs to simulate human zooming actions by searching along the image tree from root to leaf nodes, seeking out pertinent information, and accurately responding to related queries. We experiment on a series of elaborate high-resolution benchmarks and the results demonstrate that Zoom Eye not only consistently improves the performance of a series base MLLMs with large margin~(e.g., LLaVA-v1.5-7B increases by 34.57\% on V^* Bench and 17.88\% on HR-Bench), but also enables small 7B MLLMs to outperform strong large models such as GPT-4o. Our code is available at https://github.com/om-ai-lab/ZoomEye{https://github.com/om-ai-lab/ZoomEye}.

Understanding how the brain represents visual information is a fundamental challenge in neuroscience and artificial intelligence. While AI-driven decoding of neural data has provided insights into the human visual system, integrating multimodal neuroimaging signals, such as EEG, MEG, and fMRI, remains a critical hurdle due to their inherent spatiotemporal misalignment. Current approaches often analyze these modalities in isolation, limiting a holistic view of neural representation. In this study, we introduce BrainFLORA, a unified framework for integrating cross-modal neuroimaging data to construct a shared neural representation. Our approach leverages multimodal large language models (MLLMs) augmented with modality-specific adapters and task decoders, achieving state-of-the-art performance in joint-subject visual retrieval task and has the potential to extend multitasking. Combining neuroimaging analysis methods, we further reveal how visual concept representations align across neural modalities and with real world object perception. We demonstrate that the brain's structured visual concept representations exhibit an implicit mapping to physical-world stimuli, bridging neuroscience and machine learning from different modalities of neural imaging. Beyond methodological advancements, BrainFLORA offers novel implications for cognitive neuroscience and brain-computer interfaces (BCIs). Our code is available at https://github.com/ncclab-sustech/BrainFLORA.

We propose a pre-training strategy called Multi-modal Multi-task Masked Autoencoders (MultiMAE). It differs from standard Masked Autoencoding in two key aspects: I) it can optionally accept additional modalities of information in the input besides the RGB image (hence "multi-modal"), and II) its training objective accordingly includes predicting multiple outputs besides the RGB image (hence "multi-task"). We make use of masking (across image patches and input modalities) to make training MultiMAE tractable as well as to ensure cross-modality predictive coding is indeed learned by the network. We show this pre-training strategy leads to a flexible, simple, and efficient framework with improved transfer results to downstream tasks. In particular, the same exact pre-trained network can be flexibly used when additional information besides RGB images is available or when no information other than RGB is available - in all configurations yielding competitive to or significantly better results than the baselines. To avoid needing training datasets with multiple modalities and tasks, we train MultiMAE entirely using pseudo labeling, which makes the framework widely applicable to any RGB dataset. The experiments are performed on multiple transfer tasks (image classification, semantic segmentation, depth estimation) and datasets (ImageNet, ADE20K, Taskonomy, Hypersim, NYUv2). The results show an intriguingly impressive capability by the model in cross-modal/task predictive coding and transfer.

Medical vision-and-language models (MVLMs) have attracted substantial interest due to their capability to offer a natural language interface for interpreting complex medical data. Their applications are versatile and have the potential to improve diagnostic accuracy and decision-making for individual patients while also contributing to enhanced public health monitoring, disease surveillance, and policy-making through more efficient analysis of large data sets. MVLMS integrate natural language processing with medical images to enable a more comprehensive and contextual understanding of medical images alongside their corresponding textual information. Unlike general vision-and-language models trained on diverse, non-specialized datasets, MVLMs are purpose-built for the medical domain, automatically extracting and interpreting critical information from medical images and textual reports to support clinical decision-making. Popular clinical applications of MVLMs include automated medical report generation, medical visual question answering, medical multimodal segmentation, diagnosis and prognosis and medical image-text retrieval. Here, we provide a comprehensive overview of MVLMs and the various medical tasks to which they have been applied. We conduct a detailed analysis of various vision-and-language model architectures, focusing on their distinct strategies for cross-modal integration/exploitation of medical visual and textual features. We also examine the datasets used for these tasks and compare the performance of different models based on standardized evaluation metrics. Furthermore, we highlight potential challenges and summarize future research trends and directions. The full collection of papers and codes is available at: https://github.com/YtongXie/Medical-Vision-and-Language-Tasks-and-Methodologies-A-Survey.

Medical imaging provides critical evidence for clinical diagnosis, treatment planning, and surgical decisions, yet most existing imaging models are narrowly focused and require multiple specialized networks, limiting their generalization. Although large-scale language and multimodal models exhibit strong reasoning and multi-task capabilities, real-world clinical applications demand precise visual grounding, multimodal integration, and chain-of-thought reasoning. We introduce Citrus-V, a multimodal medical foundation model that combines image analysis with textual reasoning. The model integrates detection, segmentation, and multimodal chain-of-thought reasoning, enabling pixel-level lesion localization, structured report generation, and physician-like diagnostic inference in a single framework. We propose a novel multimodal training approach and release a curated open-source data suite covering reasoning, detection, segmentation, and document understanding tasks. Evaluations demonstrate that Citrus-V outperforms existing open-source medical models and expert-level imaging systems across multiple benchmarks, delivering a unified pipeline from visual grounding to clinical reasoning and supporting precise lesion quantification, automated reporting, and reliable second opinions.

Vision-language models (VLMs) excel in semantic tasks but falter at a core human capability: detecting hidden content in optical illusions or AI-generated images through perceptual adjustments like zooming. We introduce HC-Bench, a benchmark of 112 images with hidden text, objects, and illusions, revealing that leading VLMs achieve near-zero accuracy (0-5.36%)-even with explicit prompting. Humans resolve such ambiguities instinctively, yet VLMs fail due to an overreliance on high-level semantics. Strikingly, we propose SemVink (Semantic Visual Thinking) by simply scaling images to low resolutions (32-128 pixels), which unlocks >99% accuracy by eliminating redundant visual noise. This exposes a critical architectural flaw: VLMs prioritize abstract reasoning over low-level visual operations crucial for real-world robustness. Our work urges a shift toward hybrid models integrating multi-scale processing, bridging the gap between computational vision and human cognition for applications in medical imaging, security, and beyond.

Medical vision-and-language pre-training (Med-VLP) has shown promising improvements on many downstream medical tasks owing to its applicability to extracting generic representations from medical images and texts. Practically, there exist two typical types, i.e., the fusion-encoder type and the dual-encoder type, depending on whether a heavy fusion module is used. The former is superior at multi-modal tasks owing to the sufficient interaction between modalities; the latter is good at uni-modal and cross-modal tasks due to the single-modality encoding ability. To take advantage of these two types, we propose an effective yet straightforward scheme named PTUnifier to unify the two types. We first unify the input format by introducing visual and textual prompts, which serve as a feature bank that stores the most representative images/texts. By doing so, a single model could serve as a foundation model that processes various tasks adopting different input formats (i.e., image-only, text-only, and image-text-pair). Furthermore, we construct a prompt pool (instead of static ones) to improve diversity and scalability. Experimental results show that our approach achieves state-of-the-art results on a broad range of tasks, spanning uni-modal tasks (i.e., image/text classification and text summarization), cross-modal tasks (i.e., image-to-text generation and image-text/text-image retrieval), and multi-modal tasks (i.e., visual question answering), demonstrating the effectiveness of our approach. Note that the adoption of prompts is orthogonal to most existing Med-VLP approaches and could be a beneficial and complementary extension to these approaches.

Multi-modal brain tumor segmentation is critical for clinical diagnosis, and it requires accurate identification of distinct internal anatomical subregions. While the recent prompt-based segmentation paradigms enable interactive experiences for clinicians, existing methods ignore cross-modal correlations and rely on labor-intensive category-specific prompts, limiting their applicability in real-world scenarios. To address these issues, we propose a MSM-Seg framework for multi-modal brain tumor segmentation. The MSM-Seg introduces a novel dual-memory segmentation paradigm that synergistically integrates multi-modal and inter-slice information with the efficient category-agnostic prompt for brain tumor understanding. To this end, we first devise a modality-and-slice memory attention (MSMA) to exploit the cross-modal and inter-slice relationships among the input scans. Then, we propose a multi-scale category-agnostic prompt encoder (MCP-Encoder) to provide tumor region guidance for decoding. Moreover, we devise a modality-adaptive fusion decoder (MF-Decoder) that leverages the complementary decoding information across different modalities to improve segmentation accuracy. Extensive experiments on different MRI datasets demonstrate that our MSM-Seg framework outperforms state-of-the-art methods in multi-modal metastases and glioma tumor segmentation. The code is available at https://github.com/xq141839/MSM-Seg.

Current vision-language models (VLMs) in medicine are primarily designed for categorical question answering (e.g., "Is this normal or abnormal?") or qualitative descriptive tasks. However, clinical decision-making often relies on quantitative assessments, such as measuring the size of a tumor or the angle of a joint, from which physicians draw their own diagnostic conclusions. This quantitative reasoning capability remains underexplored and poorly supported in existing VLMs. In this work, we introduce MedVision, a large-scale dataset and benchmark specifically designed to evaluate and improve VLMs on quantitative medical image analysis. MedVision spans 22 public datasets covering diverse anatomies and modalities, with 30.8 million image-annotation pairs. We focus on three representative quantitative tasks: (1) detection of anatomical structures and abnormalities, (2) tumor/lesion (T/L) size estimation, and (3) angle/distance (A/D) measurement. Our benchmarks show that current off-the-shelf VLMs perform poorly on these tasks. However, with supervised fine-tuning on MedVision, we significantly enhance their performance across detection, T/L estimation, and A/D measurement, demonstrating reduced error rates and improved precision. This work provides a foundation for developing VLMs with robust quantitative reasoning capabilities in medical imaging. Code and data are available at https://medvision-vlm.github.io.

Mixed modality search -- retrieving information across a heterogeneous corpus composed of images, texts, and multimodal documents -- is an important yet underexplored real-world application. In this work, we investigate how contrastive vision-language models, such as CLIP, perform on the mixed modality search task. Our analysis reveals a critical limitation: these models exhibit a pronounced modality gap in the embedding space, where image and text embeddings form distinct clusters, leading to intra-modal ranking bias and inter-modal fusion failure. To address this issue, we propose GR-CLIP, a lightweight post-hoc calibration method that removes the modality gap in CLIP's embedding space. Evaluated on MixBench -- the first benchmark specifically designed for mixed modality search -- GR-CLIP improves NDCG@10 by up to 26 percentage points over CLIP, surpasses recent vision-language generative embedding models by 4 percentage points, while using 75x less compute.

With the bloom of Large Language Models (LLMs), Multimodal Large Language Models (MLLMs) that incorporate LLMs with pre-trained vision models have recently demonstrated impressive performance across diverse vision-language tasks. However, they fall short to comprehend context involving multiple images. A primary reason for this shortcoming is that the visual features for each images are encoded individually by frozen encoders before feeding into the LLM backbone, lacking awareness of other images and the multimodal instructions. We term this issue as prior-LLM modality isolation and propose a two phase paradigm, browse-and-concentrate, to enable in-depth multimodal context fusion prior to feeding the features into LLMs. This paradigm initially "browses" through the inputs for essential insights, and then revisits the inputs to "concentrate" on crucial details, guided by these insights, to achieve a more comprehensive understanding of the multimodal inputs. Additionally, we develop training strategies specifically to enhance the understanding of multi-image inputs. Our method markedly boosts the performance on 7 multi-image scenarios, contributing to increments on average accuracy by 2.13% and 7.60% against strong MLLMs baselines with 3B and 11B LLMs, respectively.

In recent years, the incidence of vision-threatening eye diseases has risen dramatically, necessitating scalable and accurate screening solutions. This paper presents a comprehensive study on deep learning architectures for the automated diagnosis of ocular conditions. To mitigate the "black-box" limitations of standard convolutional neural networks (CNNs), we implement a pipeline that combines deep feature extraction with interpretable image processing modules. Specifically, we focus on high-fidelity retinal vessel segmentation as an auxiliary task to guide the classification process. By grounding the model's predictions in clinically relevant morphological features, we aim to bridge the gap between algorithmic output and expert medical validation, thereby reducing false positives and improving deployment viability in clinical settings.

Is vision good enough for language? Recent advancements in multimodal models primarily stem from the powerful reasoning abilities of large language models (LLMs). However, the visual component typically depends only on the instance-level contrastive language-image pre-training (CLIP). Our research reveals that the visual capabilities in recent multimodal LLMs (MLLMs) still exhibit systematic shortcomings. To understand the roots of these errors, we explore the gap between the visual embedding space of CLIP and vision-only self-supervised learning. We identify ''CLIP-blind pairs'' - images that CLIP perceives as similar despite their clear visual differences. With these pairs, we construct the Multimodal Visual Patterns (MMVP) benchmark. MMVP exposes areas where state-of-the-art systems, including GPT-4V, struggle with straightforward questions across nine basic visual patterns, often providing incorrect answers and hallucinated explanations. We further evaluate various CLIP-based vision-and-language models and found a notable correlation between visual patterns that challenge CLIP models and those problematic for multimodal LLMs. As an initial effort to address these issues, we propose a Mixture of Features (MoF) approach, demonstrating that integrating vision self-supervised learning features with MLLMs can significantly enhance their visual grounding capabilities. Together, our research suggests visual representation learning remains an open challenge, and accurate visual grounding is crucial for future successful multimodal systems.

The advancement of Large Vision-Language Models (LVLMs) has propelled their application in the medical field. However, Medical LVLMs (Med-LVLMs) encounter factuality challenges due to modality misalignment, where the models prioritize textual knowledge over visual input, leading to hallucinations that contradict information in medical images. Previous attempts to enhance modality alignment in Med-LVLMs through preference optimization have inadequately mitigated clinical relevance in preference data, making these samples easily distinguishable and reducing alignment effectiveness. To address this challenge, we propose MMedPO, a novel multimodal medical preference optimization approach that considers the clinical relevance of preference samples to enhance Med-LVLM alignment. MMedPO curates multimodal preference data by introducing two types of dispreference: (1) plausible hallucinations injected through target Med-LVLMs or GPT-4o to produce medically inaccurate responses, and (2) lesion region neglect achieved through local lesion-noising, disrupting visual understanding of critical areas. We then calculate clinical relevance for each sample based on scores from multiple Med-LLMs and visual tools, and integrate these scores into the preference optimization process as weights, enabling effective alignment. Our experiments demonstrate that MMedPO significantly enhances factual accuracy in Med-LVLMs, achieving substantial improvements over existing preference optimization methods by averaging 14.2% and 51.7% across the Med-VQA and report generation tasks. Our code are available in https://github.com/aiming-lab/MMedPO.

Multi-modal semantic segmentation (MMSS) addresses the limitations of single-modality data by integrating complementary information across modalities. Despite notable progress, a significant gap persists between research and real-world deployment due to variability and uncertainty in multi-modal data quality. Robustness has thus become essential for practical MMSS applications. However, the absence of standardized benchmarks for evaluating robustness hinders further advancement. To address this, we first survey existing MMSS literature and categorize representative methods to provide a structured overview. We then introduce a robustness benchmark that evaluates MMSS models under three scenarios: Entire-Missing Modality (EMM), Random-Missing Modality (RMM), and Noisy Modality (NM). From a probabilistic standpoint, we model modality failure under two conditions: (1) all damaged combinations are equally probable; (2) each modality fails independently following a Bernoulli distribution. Based on these, we propose four metrics-mIoU^{Avg}_{EMM}, mIoU^{E}_{EMM}, mIoU^{Avg}_{RMM}, and mIoU^{E}_{RMM}-to assess model robustness under EMM and RMM. This work provides the first dedicated benchmark for MMSS robustness, offering new insights and tools to advance the field. Source code is available at https://github.com/Chenfei-Liao/Multi-Modal-Semantic-Segmentation-Robustness-Benchmark.

This tutorial note summarizes the presentation on ``Large Multimodal Models: Towards Building and Surpassing Multimodal GPT-4'', a part of CVPR 2023 tutorial on ``Recent Advances in Vision Foundation Models''. The tutorial consists of three parts. We first introduce the background on recent GPT-like large models for vision-and-language modeling to motivate the research in instruction-tuned large multimodal models (LMMs). As a pre-requisite, we describe the basics of instruction-tuning in large language models, which is further extended to the multimodal space. Lastly, we illustrate how to build the minimum prototype of multimodal GPT-4 like models with the open-source resource, and review the recently emerged topics.

The rise of imaging techniques such as optical coherence tomography (OCT) and advances in deep learning (DL) have enabled clinicians and researchers to streamline retinal disease staging. A popular DL approach is self-supervised learning (SSL), where models learn from vast amounts of unlabeled data, avoiding costly annotation. SSL has allowed the development of foundation models (FMs), large models that can be used for a variety of downstream tasks. However, existing FMs for OCT, trained solely on image data, lack a comprehensive and robust semantic understanding of images, as evidenced by their downstream performance (especially for complex tasks), and thus require supervised fine-tuning (which may be unfeasible) to better adapt to specific applications and populations. To address this, we propose RetFiner, an SSL vision-language refinement scheme that improves the representations of existing FMs and enables their efficient and direct adaptation to specific populations for improved downstream performance. Our method uses a diverse set of training objectives which take advantage of the rich supervisory signal found in textual data. We tested RetFiner on the retinal FMs RETFound, UrFound, and VisionFM, showing significant improvements in linear probing performance on seven highly diverse OCT classification tasks, with an average increase of 5.8, 3.9, and 2.1 percentage points over their baselines, respectively. Our code and model weights are publicly available at https://github.com/ronnief1/RetFiner.

The retinal vasculature provides important clues in the diagnosis and monitoring of systemic diseases including hypertension and diabetes. The microvascular system is of primary involvement in such conditions, and the retina is the only anatomical site where the microvasculature can be directly observed. The objective assessment of retinal vessels has long been considered a surrogate biomarker for systemic vascular diseases, and with recent advancements in retinal imaging and computer vision technologies, this topic has become the subject of renewed attention. In this paper, we present a novel dataset, dubbed RAVIR, for the semantic segmentation of Retinal Arteries and Veins in Infrared Reflectance (IR) imaging. It enables the creation of deep learning-based models that distinguish extracted vessel type without extensive post-processing. We propose a novel deep learning-based methodology, denoted as SegRAVIR, for the semantic segmentation of retinal arteries and veins and the quantitative measurement of the widths of segmented vessels. Our extensive experiments validate the effectiveness of SegRAVIR and demonstrate its superior performance in comparison to state-of-the-art models. Additionally, we propose a knowledge distillation framework for the domain adaptation of RAVIR pretrained networks on color images. We demonstrate that our pretraining procedure yields new state-of-the-art benchmarks on the DRIVE, STARE, and CHASE_DB1 datasets. Dataset link: https://ravirdataset.github.io/data/

Vision-and-language models (VLMs) have been increasingly explored in the medical domain, particularly following the success of CLIP in general domain. However, unlike the relatively straightforward pairing of 2D images and text, curating large-scale paired data in the medical field for volumetric modalities such as CT scans remains a challenging and time-intensive process. This difficulty often limits the performance on downstream tasks. To address these challenges, we propose a novel vision-language pre-training (VLP) framework, termed as VELVET-Med, specifically designed for limited volumetric data such as 3D CT and associated radiology reports. Instead of relying on large-scale data collection, our method focuses on the development of effective pre-training objectives and model architectures. The key contributions are: 1) We incorporate uni-modal self-supervised learning into VLP framework, which are often underexplored in the existing literature. 2) We propose a novel language encoder, termed as TriBERT, for learning multi-level textual semantics. 3) We devise the hierarchical contrastive learning to capture multi-level vision-language correspondence. Using only 38,875 scan-report pairs, our approach seeks to uncover rich spatial and semantic relationships embedded in volumetric medical images and corresponding clinical narratives, thereby enhancing the generalization ability of the learned encoders. The resulting encoders exhibit strong transferability, achieving state-of-the-art performance across a wide range of downstream tasks, including 3D segmentation, cross-modal retrieval, visual question answering, and report generation.

In the field of multi-modal language models, the majority of methods are built on an architecture similar to LLaVA. These models use a single-layer ViT feature as a visual prompt, directly feeding it into the language models alongside textual tokens. However, when dealing with long sequences of visual signals or inputs such as videos, the self-attention mechanism of language models can lead to significant computational overhead. Additionally, using single-layer ViT features makes it challenging for large language models to perceive visual signals fully. This paper proposes an efficient multi-modal language model to minimize computational costs while enabling the model to perceive visual signals as comprehensively as possible. Our method primarily includes: (1) employing cross-attention to image-text interaction similar to Flamingo. (2) utilize hierarchical ViT features. (3) introduce the Mixture of Experts (MoE) mechanism to enhance model effectiveness. Our model achieves competitive scores on public multi-modal benchmarks and performs well in tasks such as image captioning and video captioning.

Multi-organ medical segmentation is a crucial component of medical image processing, essential for doctors to make accurate diagnoses and develop effective treatment plans. Despite significant progress in this field, current multi-organ segmentation models often suffer from inaccurate details, dependence on geometric prompts and loss of spatial information. Addressing these challenges, we introduce a novel model named CRISP-SAM2 with CRoss-modal Interaction and Semantic Prompting based on SAM2. This model represents a promising approach to multi-organ medical segmentation guided by textual descriptions of organs. Our method begins by converting visual and textual inputs into cross-modal contextualized semantics using a progressive cross-attention interaction mechanism. These semantics are then injected into the image encoder to enhance the detailed understanding of visual information. To eliminate reliance on geometric prompts, we use a semantic prompting strategy, replacing the original prompt encoder to sharpen the perception of challenging targets. In addition, a similarity-sorting self-updating strategy for memory and a mask-refining process is applied to further adapt to medical imaging and enhance localized details. Comparative experiments conducted on seven public datasets indicate that CRISP-SAM2 outperforms existing models. Extensive analysis also demonstrates the effectiveness of our method, thereby confirming its superior performance, especially in addressing the limitations mentioned earlier. Our code is available at: https://github.com/YU-deep/CRISP\_SAM2.git.

Leveraging information across diverse modalities is known to enhance performance on multimodal segmentation tasks. However, effectively fusing information from different modalities remains challenging due to the unique characteristics of each modality. In this paper, we propose a novel fusion strategy that can effectively fuse information from different modality combinations. We also propose a new model named Multi-Modal Segmentation TransFormer (MMSFormer) that incorporates the proposed fusion strategy to perform multimodal material and semantic segmentation tasks. MMSFormer outperforms current state-of-the-art models on three different datasets. As we begin with only one input modality, performance improves progressively as additional modalities are incorporated, showcasing the effectiveness of the fusion block in combining useful information from diverse input modalities. Ablation studies show that different modules in the fusion block are crucial for overall model performance. Furthermore, our ablation studies also highlight the capacity of different input modalities to improve performance in the identification of different types of materials. The code and pretrained models will be made available at https://github.com/csiplab/MMSFormer.

Accurate retinal vessel (RV) segmentation is a crucial step in the quantitative assessment of retinal vasculature, which is needed for the early detection of retinal diseases and other conditions. Numerous studies have been conducted to tackle the problem of segmenting vessels automatically using a pixel-wise classification approach. The common practice of creating ground truth labels is to categorize pixels as foreground and background. This approach is, however, biased, and it ignores the uncertainty of a human annotator when it comes to annotating e.g. thin vessels. In this work, we propose a simple and effective method that casts the RV segmentation task as an image-level regression. For this purpose, we first introduce a novel Segmentation Annotation Uncertainty-Aware (SAUNA) transform, which adds pixel uncertainty to the ground truth using the pixel's closeness to the annotation boundary and vessel thickness. To train our model with soft labels, we generalize the earlier proposed Jaccard metric loss to arbitrary hypercubes for soft Jaccard index (Intersection-over-Union) optimization. Additionally, we employ a stable version of the Focal-L1 loss for pixel-wise regression. We conduct thorough experiments and compare our method to a diverse set of baselines across 5 retinal image datasets. Our empirical results indicate that the integration of the SAUNA transform and these segmentation losses led to significant performance boosts for different segmentation models. Particularly, our methodology enables UNet-like architectures to substantially outperform computational-intensive baselines. Our implementation is available at https://github.com/Oulu-IMEDS/SAUNA.

The rapid advancement of large-scale vision-language models has showcased remarkable capabilities across various tasks. However, the lack of extensive and high-quality image-text data in medicine has greatly hindered the development of large-scale medical vision-language models. In this work, we present a diagnosis-guided bootstrapping strategy that exploits both image and label information to construct vision-language datasets. Based on the constructed dataset, we developed MedDr, a generalist foundation model for healthcare capable of handling diverse medical data modalities, including radiology, pathology, dermatology, retinography, and endoscopy. Moreover, during inference, we propose a simple but effective retrieval-augmented medical diagnosis strategy, which enhances the model's generalization ability. Extensive experiments on visual question answering, medical report generation, and medical image diagnosis demonstrate the superiority of our method.

Pre-trained multi-modal Vision-Language Models like CLIP are widely used off-the-shelf for a variety of applications. In this paper, we show that the common practice of individually exploiting the text or image encoders of these powerful multi-modal models is highly suboptimal for intra-modal tasks like image-to-image retrieval. We argue that this is inherently due to the CLIP-style inter-modal contrastive loss that does not enforce any intra-modal constraints, leading to what we call intra-modal misalignment. To demonstrate this, we leverage two optimization-based modality inversion techniques that map representations from their input modality to the complementary one without any need for auxiliary data or additional trained adapters. We empirically show that, in the intra-modal tasks of image-to-image and text-to-text retrieval, approaching these tasks inter-modally significantly improves performance with respect to intra-modal baselines on more than fifteen datasets. Additionally, we demonstrate that approaching a native inter-modal task (e.g. zero-shot image classification) intra-modally decreases performance, further validating our findings. Finally, we show that incorporating an intra-modal term in the pre-training objective or narrowing the modality gap between the text and image feature embedding spaces helps reduce the intra-modal misalignment. The code is publicly available at: https://github.com/miccunifi/Cross-the-Gap.

Scarcity of large publicly available retinal fundus image datasets for automated glaucoma detection has been the bottleneck for successful application of artificial intelligence towards practical Computer-Aided Diagnosis (CAD). A few small datasets that are available for research community usually suffer from impractical image capturing conditions and stringent inclusion criteria. These shortcomings in already limited choice of existing datasets make it challenging to mature a CAD system so that it can perform in real-world environment. In this paper we present a large publicly available retinal fundus image dataset for glaucoma classification called G1020. The dataset is curated by conforming to standard practices in routine ophthalmology and it is expected to serve as standard benchmark dataset for glaucoma detection. This database consists of 1020 high resolution colour fundus images and provides ground truth annotations for glaucoma diagnosis, optic disc and optic cup segmentation, vertical cup-to-disc ratio, size of neuroretinal rim in inferior, superior, nasal and temporal quadrants, and bounding box location for optic disc. We also report baseline results by conducting extensive experiments for automated glaucoma diagnosis and segmentation of optic disc and optic cup.

Vision Transformer (ViT) has emerged as a powerful architecture in the realm of modern computer vision. However, its application in certain imaging fields, such as microscopy and satellite imaging, presents unique challenges. In these domains, images often contain multiple channels, each carrying semantically distinct and independent information. Furthermore, the model must demonstrate robustness to sparsity in input channels, as they may not be densely available during training or testing. In this paper, we propose a modification to the ViT architecture that enhances reasoning across the input channels and introduce Hierarchical Channel Sampling (HCS) as an additional regularization technique to ensure robustness when only partial channels are presented during test time. Our proposed model, ChannelViT, constructs patch tokens independently from each input channel and utilizes a learnable channel embedding that is added to the patch tokens, similar to positional embeddings. We evaluate the performance of ChannelViT on ImageNet, JUMP-CP (microscopy cell imaging), and So2Sat (satellite imaging). Our results show that ChannelViT outperforms ViT on classification tasks and generalizes well, even when a subset of input channels is used during testing. Across our experiments, HCS proves to be a powerful regularizer, independent of the architecture employed, suggesting itself as a straightforward technique for robust ViT training. Lastly, we find that ChannelViT generalizes effectively even when there is limited access to all channels during training, highlighting its potential for multi-channel imaging under real-world conditions with sparse sensors. Our code is available at https://github.com/insitro/ChannelViT.

Accurate and interpretable multi-disease diagnosis remains a critical challenge in medical research, particularly when leveraging heterogeneous multimodal medical data. Current approaches often rely on single-modal data, limiting their ability to comprehensively understand complex diseases. To address this, we propose MedTVT-R1, a novel Multimodal Large Language Model (MLLM) framework designed to integrate clinical multimodal data for reasoning and diagnosing multiple diseases. We construct MedTVT-QA, a curated instruction dataset that provides question-answer pairs for physiological-level interpretations and disease-level diagnoses with a Chain of Evidence approach. MedTVT-R1 incorporates a modality perception layer to capture inter-modal dependencies and adaptively weight modality contributions. Additionally, we employ Group Relative Policy Optimization (GRPO)-based Reinforcement Fine-Tuning with a Jaccard Reward function to enhance diagnostic reasoning. Experimental results demonstrate MedTVT-R1's superiority in multimodal feature utilization and multi-disease diagnosis, offering significant potential for clinical applications such as diagnostic report generation and comorbidity reasoning. The dataset and code are available at https://github.com/keke-nice/MedTVT-R1.

Existing medical reasoning benchmarks for vision-language models primarily focus on analyzing a patient's condition based on an image from a single visit. However, this setting deviates significantly from real-world clinical practice, where doctors typically refer to a patient's historical conditions to provide a comprehensive assessment by tracking their changes over time. In this paper, we introduce TemMed-Bench, the first benchmark designed for analyzing changes in patients' conditions between different clinical visits, which challenges large vision-language models (LVLMs) to reason over temporal medical images. TemMed-Bench consists of a test set comprising three tasks - visual question-answering (VQA), report generation, and image-pair selection - and a supplementary knowledge corpus of over 17,000 instances. With TemMed-Bench, we conduct an evaluation of six proprietary and six open-source LVLMs. Our results show that most LVLMs lack the ability to analyze patients' condition changes over temporal medical images, and a large proportion perform only at a random-guessing level in the closed-book setting. In contrast, GPT o3, o4-mini and Claude 3.5 Sonnet demonstrate comparatively decent performance, though they have yet to reach the desired level. Furthermore, we explore augmenting the input with both retrieved visual and textual modalities in the medical domain. We also show that multi-modal retrieval augmentation yields notably higher performance gains than no retrieval and textual retrieval alone across most models on our benchmark, with the VQA task showing an average improvement of 2.59%. Overall, we compose a benchmark grounded on real-world clinical practice, and it reveals LVLMs' limitations in temporal medical image reasoning, as well as highlighting the use of multi-modal retrieval augmentation as a potentially promising direction worth exploring to address this challenge.

Most current medical vision language models struggle to jointly generate diagnostic text and pixel-level segmentation masks in response to complex visual questions. This represents a major limitation towards clinical application, as assistive systems that fail to provide both modalities simultaneously offer limited value to medical practitioners. To alleviate this limitation, we first introduce RadDiagSeg-D, a dataset combining abnormality detection, diagnosis, and multi-target segmentation into a unified and hierarchical task. RadDiagSeg-D covers multiple imaging modalities and is precisely designed to support the development of models that produce descriptive text and corresponding segmentation masks in tandem. Subsequently, we leverage the dataset to propose a novel vision-language model, RadDiagSeg-M, capable of joint abnormality detection, diagnosis, and flexible segmentation. RadDiagSeg-M provides highly informative and clinically useful outputs, effectively addressing the need to enrich contextual information for assistive diagnosis. Finally, we benchmark RadDiagSeg-M and showcase its strong performance across all components involved in the task of multi-target text-and-mask generation, establishing a robust and competitive baseline.

Glaucoma is the leading cause of irreversible blindness worldwide and poses significant diagnostic challenges due to its reliance on subjective evaluation. However, recent advances in computer vision and deep learning have demonstrated the potential for automated assessment. In this paper, we survey recent studies on AI-based glaucoma diagnosis using fundus, optical coherence tomography, and visual field images, with a particular emphasis on deep learning-based methods. We provide an updated taxonomy that organizes methods into architectural paradigms and includes links to available source code to enhance the reproducibility of the methods. Through rigorous benchmarking on widely-used public datasets, we reveal performance gaps in generalizability, uncertainty estimation, and multimodal integration. Additionally, our survey curates key datasets while highlighting limitations such as scale, labeling inconsistencies, and bias. We outline open research challenges and detail promising directions for future studies. This survey is expected to be useful for both AI researchers seeking to translate advances into practice and ophthalmologists aiming to improve clinical workflows and diagnosis using the latest AI outcomes.

Multi-modality image fusion is a technique that combines information from different sensors or modalities, enabling the fused image to retain complementary features from each modality, such as functional highlights and texture details. However, effective training of such fusion models is challenging due to the scarcity of ground truth fusion data. To tackle this issue, we propose the Equivariant Multi-Modality imAge fusion (EMMA) paradigm for end-to-end self-supervised learning. Our approach is rooted in the prior knowledge that natural imaging responses are equivariant to certain transformations. Consequently, we introduce a novel training paradigm that encompasses a fusion module, a pseudo-sensing module, and an equivariant fusion module. These components enable the net training to follow the principles of the natural sensing-imaging process while satisfying the equivariant imaging prior. Extensive experiments confirm that EMMA yields high-quality fusion results for infrared-visible and medical images, concurrently facilitating downstream multi-modal segmentation and detection tasks. The code is available at https://github.com/Zhaozixiang1228/MMIF-EMMA.

In this paper, we present OtterHD-8B, an innovative multimodal model evolved from Fuyu-8B, specifically engineered to interpret high-resolution visual inputs with granular precision. Unlike conventional models that are constrained by fixed-size vision encoders, OtterHD-8B boasts the ability to handle flexible input dimensions, ensuring its versatility across various inference requirements. Alongside this model, we introduce MagnifierBench, an evaluation framework designed to scrutinize models' ability to discern minute details and spatial relationships of small objects. Our comparative analysis reveals that while current leading models falter on this benchmark, OtterHD-8B, particularly when directly processing high-resolution inputs, outperforms its counterparts by a substantial margin. The findings illuminate the structural variances in visual information processing among different models and the influence that the vision encoders' pre-training resolution disparities have on model effectiveness within such benchmarks. Our study highlights the critical role of flexibility and high-resolution input capabilities in large multimodal models and also exemplifies the potential inherent in the Fuyu architecture's simplicity for handling complex visual data.

The ability to accurately interpret complex visual information is a crucial topic of multimodal large language models (MLLMs). Recent work indicates that enhanced visual perception significantly reduces hallucinations and improves performance on resolution-sensitive tasks, such as optical character recognition and document analysis. A number of recent MLLMs achieve this goal using a mixture of vision encoders. Despite their success, there is a lack of systematic comparisons and detailed ablation studies addressing critical aspects, such as expert selection and the integration of multiple vision experts. This study provides an extensive exploration of the design space for MLLMs using a mixture of vision encoders and resolutions. Our findings reveal several underlying principles common to various existing strategies, leading to a streamlined yet effective design approach. We discover that simply concatenating visual tokens from a set of complementary vision encoders is as effective as more complex mixing architectures or strategies. We additionally introduce Pre-Alignment to bridge the gap between vision-focused encoders and language tokens, enhancing model coherence. The resulting family of MLLMs, Eagle, surpasses other leading open-source models on major MLLM benchmarks. Models and code: https://github.com/NVlabs/Eagle

Medical image analysis is a fundamental component. As deep learning progresses, the focus has shifted from single-task applications, such as classification and segmentation, to more complex multimodal tasks, including medical visual question answering and report generation. Traditional shallow and task-specific models are increasingly limited in addressing the complexity and scalability required in clinical practice. The emergence of large language models (LLMs) has driven the development of medical Large Vision-Language Models (LVLMs), offering a unified solution for diverse vision-language tasks. In this study, we investigate various architectural designs for medical LVLMs based on the widely adopted LLaVA framework, which follows an encoder-connector-LLM paradigm. We construct two distinct models targeting 2D and 3D modalities, respectively. These models are designed to support both general-purpose medical tasks and domain-specific fine-tuning, thereby serving as effective foundation models. To facilitate reproducibility and further research, we develop a modular and extensible codebase, MedM-VL, and release two LVLM variants: MedM-VL-2D for 2D medical image analysis and MedM-VL-CT-Chest for 3D CT-based applications. The code and models are available at: https://github.com/MSIIP/MedM-VL

Multi-modality image fusion and segmentation play a vital role in autonomous driving and robotic operation. Early efforts focus on boosting the performance for only one task, e.g., fusion or segmentation, making it hard to reach~`Best of Both Worlds'. To overcome this issue, in this paper, we propose a Multi-interactive Feature learning architecture for image fusion and Segmentation, namely SegMiF, and exploit dual-task correlation to promote the performance of both tasks. The SegMiF is of a cascade structure, containing a fusion sub-network and a commonly used segmentation sub-network. By slickly bridging intermediate features between two components, the knowledge learned from the segmentation task can effectively assist the fusion task. Also, the benefited fusion network supports the segmentation one to perform more pretentiously. Besides, a hierarchical interactive attention block is established to ensure fine-grained mapping of all the vital information between two tasks, so that the modality/semantic features can be fully mutual-interactive. In addition, a dynamic weight factor is introduced to automatically adjust the corresponding weights of each task, which can balance the interactive feature correspondence and break through the limitation of laborious tuning. Furthermore, we construct a smart multi-wave binocular imaging system and collect a full-time multi-modality benchmark with 15 annotated pixel-level categories for image fusion and segmentation. Extensive experiments on several public datasets and our benchmark demonstrate that the proposed method outputs visually appealing fused images and perform averagely 7.66% higher segmentation mIoU in the real-world scene than the state-of-the-art approaches. The source code and benchmark are available at https://github.com/JinyuanLiu-CV/SegMiF.

Weakly-supervised methods for video anomaly detection (VAD) are conventionally based merely on RGB spatio-temporal features, which continues to limit their reliability in real-world scenarios. This is due to the fact that RGB-features are not sufficiently distinctive in setting apart categories such as shoplifting from visually similar events. Therefore, towards robust complex real-world VAD, it is essential to augment RGB spatio-temporal features by additional modalities. Motivated by this, we introduce the Poly-modal Induced framework for VAD: "PI-VAD", a novel approach that augments RGB representations by five additional modalities. Specifically, the modalities include sensitivity to fine-grained motion (Pose), three dimensional scene and entity representation (Depth), surrounding objects (Panoptic masks), global motion (optical flow), as well as language cues (VLM). Each modality represents an axis of a polygon, streamlined to add salient cues to RGB. PI-VAD includes two plug-in modules, namely Pseudo-modality Generation module and Cross Modal Induction module, which generate modality-specific prototypical representation and, thereby, induce multi-modal information into RGB cues. These modules operate by performing anomaly-aware auxiliary tasks and necessitate five modality backbones -- only during training. Notably, PI-VAD achieves state-of-the-art accuracy on three prominent VAD datasets encompassing real-world scenarios, without requiring the computational overhead of five modality backbones at inference.

Visual understanding is inherently contextual -- what we focus on in an image depends on the task at hand. For instance, given an image of a person holding a bouquet of flowers, we may focus on either the person such as their clothing, or the type of flowers, depending on the context of interest. Yet, most existing image encoding paradigms represent an image as a fixed, generic feature vector, overlooking the potential needs of prioritizing varying visual information for different downstream use cases. In this work, we introduce FocalLens, a conditional visual encoding method that produces different representations for the same image based on the context of interest, expressed flexibly through natural language. We leverage vision instruction tuning data and contrastively finetune a pretrained vision encoder to take natural language instructions as additional inputs for producing conditional image representations. Extensive experiments validate that conditional image representation from FocalLens better pronounce the visual features of interest compared to generic features produced by standard vision encoders like CLIP. In addition, we show FocalLens further leads to performance improvements on a range of downstream tasks including image-image retrieval, image classification, and image-text retrieval, with an average gain of 5 and 10 points on the challenging SugarCrepe and MMVP-VLM benchmarks, respectively.

This book is the result of a seminar in which we reviewed multimodal approaches and attempted to create a solid overview of the field, starting with the current state-of-the-art approaches in the two subfields of Deep Learning individually. Further, modeling frameworks are discussed where one modality is transformed into the other, as well as models in which one modality is utilized to enhance representation learning for the other. To conclude the second part, architectures with a focus on handling both modalities simultaneously are introduced. Finally, we also cover other modalities as well as general-purpose multi-modal models, which are able to handle different tasks on different modalities within one unified architecture. One interesting application (Generative Art) eventually caps off this booklet.

We introduce eCLIP, an enhanced version of the CLIP model that integrates expert annotations in the form of radiologist eye-gaze heatmaps. It tackles key challenges in contrastive multi-modal medical imaging analysis, notably data scarcity and the "modality gap" -- a significant disparity between image and text embeddings that diminishes the quality of representations and hampers cross-modal interoperability. eCLIP integrates a heatmap processor and leverages mixup augmentation to efficiently utilize the scarce expert annotations, thus boosting the model's learning effectiveness. eCLIP is designed to be generally applicable to any variant of CLIP without requiring any modifications of the core architecture. Through detailed evaluations across several tasks, including zero-shot inference, linear probing, cross-modal retrieval, and Retrieval Augmented Generation (RAG) of radiology reports using a frozen Large Language Model, eCLIP showcases consistent improvements in embedding quality. The outcomes reveal enhanced alignment and uniformity, affirming eCLIP's capability to harness high-quality annotations for enriched multi-modal analysis in the medical imaging domain.

Medical diagnostic applications require models that can process multimodal medical inputs (images, patient histories, lab results) and generate diverse outputs including both textual reports and visual content (annotations, segmentation masks, and images). Despite this need, existing medical AI systems disrupt this unified process: medical image understanding models interpret images but cannot generate visual outputs, while medical image generation models synthesize images but cannot provide textual explanations. This leads to gaps in data representation, feature integration, and task-level multimodal capabilities. To this end, we propose a multi-level framework that draws inspiration from diagnostic workflows through the Observation-Knowledge-Analysis (OKA) paradigm. Specifically, at the observation level, we construct UniMed-5M, a dataset comprising over 5.6M samples that reformat diverse unimodal data into multimodal pairs for foundational observation. At the knowledge level, we propose Progressive Curriculum Learning that systematically introduces medical multimodal knowledge. At the analysis level, we introduce UniMedVL, the first medical unified multimodal model for the simultaneous analysis of image understanding and generation tasks within a single architecture. UniMedVL achieves superior performance on five medical image understanding benchmarks, while matching specialized models in generation quality across eight medical imaging modalities. Crucially, our unified architecture enables bidirectional knowledge sharing: generation tasks enhance visual understanding features, demonstrating that integrating traditionally separate capabilities within a single medical framework unlocks improvements across diverse medical vision-language tasks. Code is available at https://github.com/uni-medical/UniMedVL.

Learning to reliably perceive and understand the scene is an integral enabler for robots to operate in the real-world. This problem is inherently challenging due to the multitude of object types as well as appearance changes caused by varying illumination and weather conditions. Leveraging complementary modalities can enable learning of semantically richer representations that are resilient to such perturbations. Despite the tremendous progress in recent years, most multimodal convolutional neural network approaches directly concatenate feature maps from individual modality streams rendering the model incapable of focusing only on relevant complementary information for fusion. To address this limitation, we propose a mutimodal semantic segmentation framework that dynamically adapts the fusion of modality-specific features while being sensitive to the object category, spatial location and scene context in a self-supervised manner. Specifically, we propose an architecture consisting of two modality-specific encoder streams that fuse intermediate encoder representations into a single decoder using our proposed self-supervised model adaptation fusion mechanism which optimally combines complementary features. As intermediate representations are not aligned across modalities, we introduce an attention scheme for better correlation. In addition, we propose a computationally efficient unimodal segmentation architecture termed AdapNet++ that incorporates a new encoder with multiscale residual units and an efficient atrous spatial pyramid pooling that has a larger effective receptive field with more than 10x fewer parameters, complemented with a strong decoder with a multi-resolution supervision scheme that recovers high-resolution details. Comprehensive empirical evaluations on several benchmarks demonstrate that both our unimodal and multimodal architectures achieve state-of-the-art performance.

Optical coherence tomography angiography (OCTA) is a novel imaging modality that has been widely utilized in ophthalmology and neuroscience studies to observe retinal vessels and microvascular systems. However, publicly available OCTA datasets remain scarce. In this paper, we introduce the largest and most comprehensive OCTA dataset dubbed OCTA-500, which contains OCTA imaging under two fields of view (FOVs) from 500 subjects. The dataset provides rich images and annotations including two modalities (OCT/OCTA volumes), six types of projections, four types of text labels (age / gender / eye / disease) and seven types of segmentation labels (large vessel/capillary/artery/vein/2D FAZ/3D FAZ/retinal layers). Then, we propose a multi-object segmentation task called CAVF, which integrates capillary segmentation, artery segmentation, vein segmentation, and FAZ segmentation under a unified framework. In addition, we optimize the 3D-to-2D image projection network (IPN) to IPN-V2 to serve as one of the segmentation baselines. Experimental results demonstrate that IPN-V2 achieves an ~10% mIoU improvement over IPN on CAVF task. Finally, we further study the impact of several dataset characteristics: the training set size, the model input (OCT/OCTA, 3D volume/2D projection), the baseline networks, and the diseases. The dataset and code are publicly available at: https://ieee-dataport.org/open-access/octa-500.

OpenAI's CLIP, released in early 2021, have long been the go-to choice of vision encoder for building multimodal foundation models. Although recent alternatives such as SigLIP have begun to challenge this status quo, to our knowledge none are fully open: their training data remains proprietary and/or their training recipes are not released. This paper fills this gap with OpenVision, a fully-open, cost-effective family of vision encoders that match or surpass the performance of OpenAI's CLIP when integrated into multimodal frameworks like LLaVA. OpenVision builds on existing works -- e.g., CLIPS for training framework and Recap-DataComp-1B for training data -- while revealing multiple key insights in enhancing encoder quality and showcasing practical benefits in advancing multimodal models. By releasing vision encoders spanning from 5.9M to 632.1M parameters, OpenVision offers practitioners a flexible trade-off between capacity and efficiency in building multimodal models: larger models deliver enhanced multimodal performance, while smaller versions enable lightweight, edge-ready multimodal deployments.

Starting from the resurgence of deep learning, vision-language models (VLMs) benefiting from large language models (LLMs) have never been so popular. However, while LLMs can utilize extensive background knowledge and task information with in-context learning, most VLMs still struggle with understanding complex multi-modal prompts with multiple images. The issue can traced back to the architectural design of VLMs or pre-training data. Specifically, the current VLMs primarily emphasize utilizing multi-modal data with a single image some, rather than multi-modal prompts with interleaved multiple images and text. Even though some newly proposed VLMs could handle user prompts with multiple images, pre-training data does not provide more sophisticated multi-modal prompts than interleaved image and text crawled from the web. We propose MMICL to address the issue by considering both the model and data perspectives. We introduce a well-designed architecture capable of seamlessly integrating visual and textual context in an interleaved manner and MIC dataset to reduce the gap between the training data and the complex user prompts in real-world applications, including: 1) multi-modal context with interleaved images and text, 2) textual references for each image, and 3) multi-image data with spatial, logical, or temporal relationships. Our experiments confirm that MMICL achieves new stat-of-the-art zero-shot and few-shot performance on a wide range of general vision-language tasks, especially for complex reasoning benchmarks including MME and MMBench. Our analysis demonstrates that MMICL effectively deals with the challenge of complex multi-modal prompt understanding. The experiments on ScienceQA-IMG also show that MMICL successfully alleviates the issue of language bias in VLMs, which we believe is the reason behind the advanced performance of MMICL.

The goal of this work is to characterize the representational impact that foveation operations have for machine vision systems, inspired by the foveated human visual system, which has higher acuity at the center of gaze and texture-like encoding in the periphery. To do so, we introduce models consisting of a first-stage fixed image transform followed by a second-stage learnable convolutional neural network, and we varied the first stage component. The primary model has a foveated-textural input stage, which we compare to a model with foveated-blurred input and a model with spatially-uniform blurred input (both matched for perceptual compression), and a final reference model with minimal input-based compression. We find that: 1) the foveated-texture model shows similar scene classification accuracy as the reference model despite its compressed input, with greater i.i.d. generalization than the other models; 2) the foveated-texture model has greater sensitivity to high-spatial frequency information and greater robustness to occlusion, w.r.t the comparison models; 3) both the foveated systems, show a stronger center image-bias relative to the spatially-uniform systems even with a weight sharing constraint. Critically, these results are preserved over different classical CNN architectures throughout their learning dynamics. Altogether, this suggests that foveation with peripheral texture-based computations yields an efficient, distinct, and robust representational format of scene information, and provides symbiotic computational insight into the representational consequences that texture-based peripheral encoding may have for processing in the human visual system, while also potentially inspiring the next generation of computer vision models via spatially-adaptive computation. Code + Data available here: https://github.com/ArturoDeza/EmergentProperties

Glaucoma is one of the leading causes of irreversible but preventable blindness in working age populations. Color fundus photography (CFP) is the most cost-effective imaging modality to screen for retinal disorders. However, its application to glaucoma has been limited to the computation of a few related biomarkers such as the vertical cup-to-disc ratio. Deep learning approaches, although widely applied for medical image analysis, have not been extensively used for glaucoma assessment due to the limited size of the available data sets. Furthermore, the lack of a standardize benchmark strategy makes difficult to compare existing methods in a uniform way. In order to overcome these issues we set up the Retinal Fundus Glaucoma Challenge, REFUGE (https://refuge.grand-challenge.org), held in conjunction with MICCAI 2018. The challenge consisted of two primary tasks, namely optic disc/cup segmentation and glaucoma classification. As part of REFUGE, we have publicly released a data set of 1200 fundus images with ground truth segmentations and clinical glaucoma labels, currently the largest existing one. We have also built an evaluation framework to ease and ensure fairness in the comparison of different models, encouraging the development of novel techniques in the field. 12 teams qualified and participated in the online challenge. This paper summarizes their methods and analyzes their corresponding results. In particular, we observed that two of the top-ranked teams outperformed two human experts in the glaucoma classification task. Furthermore, the segmentation results were in general consistent with the ground truth annotations, with complementary outcomes that can be further exploited by ensembling the results.

Predicting multiple real-world tasks in a single model often requires a particularly diverse feature space. Multimodal (MM) models aim to extract the synergistic predictive potential of multiple data types to create a shared feature space with aligned semantic meaning across inputs of drastically varying sizes (i.e. images, text, sound). Most current MM architectures fuse these representations in parallel, which not only limits their interpretability but also creates a dependency on modality availability. We present MultiModN, a multimodal, modular network that fuses latent representations in a sequence of any number, combination, or type of modality while providing granular real-time predictive feedback on any number or combination of predictive tasks. MultiModN's composable pipeline is interpretable-by-design, as well as innately multi-task and robust to the fundamental issue of biased missingness. We perform four experiments on several benchmark MM datasets across 10 real-world tasks (predicting medical diagnoses, academic performance, and weather), and show that MultiModN's sequential MM fusion does not compromise performance compared with a baseline of parallel fusion. By simulating the challenging bias of missing not-at-random (MNAR), this work shows that, contrary to MultiModN, parallel fusion baselines erroneously learn MNAR and suffer catastrophic failure when faced with different patterns of MNAR at inference. To the best of our knowledge, this is the first inherently MNAR-resistant approach to MM modeling. In conclusion, MultiModN provides granular insights, robustness, and flexibility without compromising performance.

Recent research in medical image analysis with deep learning almost exclusively focuses on grid- or voxel-based data representations. We challenge this common choice by introducing MedFuncta, a modality-agnostic continuous data representation based on neural fields. We demonstrate how to scale neural fields from single instances to large datasets by exploiting redundancy in medical signals and by applying an efficient meta-learning approach with a context reduction scheme. We further address the spectral bias in commonly used SIREN activations, by introducing an omega_0-schedule, improving reconstruction quality and convergence speed. We validate our proposed approach on a large variety of medical signals of different dimensions and modalities (1D: ECG; 2D: Chest X-ray, Retinal OCT, Fundus Camera, Dermatoscope, Colon Histopathology, Cell Microscopy; 3D: Brain MRI, Lung CT) and successfully demonstrate that we can solve relevant downstream tasks on these representations. We additionally release a large-scale dataset of > 550k annotated neural fields to promote research in this direction.

Recent Multimodal Large Language Models (MLLMs) have demonstrated significant progress in perceiving and reasoning over multimodal inquiries, ushering in a new research era for foundation models. However, vision-language misalignment in MLLMs has emerged as a critical challenge, where the textual responses generated by these models are not factually aligned with the given text-image inputs. Existing efforts to address vision-language misalignment have focused on developing specialized vision-language connectors or leveraging visual instruction tuning from diverse domains. In this paper, we tackle this issue from a fundamental yet unexplored perspective by revisiting the core architecture of MLLMs. Most MLLMs are typically built on decoder-only LLMs consisting of a causal attention mechanism, which limits the ability of earlier modalities (e.g., images) to incorporate information from later modalities (e.g., text). To address this problem, we propose AKI, a novel MLLM that unlocks causal attention into modality-mutual attention (MMA) to enable image tokens to attend to text tokens. This simple yet effective design allows AKI to achieve superior performance in 12 multimodal understanding benchmarks (+7.2% on average) without introducing additional parameters and increasing training time. Our MMA design is intended to be generic, allowing for application across various modalities, and scalable to accommodate diverse multimodal scenarios. The code is publicly available at https://github.com/sony/aki, and we will release our AKI-4B model to encourage further advancements in MLLMs across various directions.

Large vision-language models (LVLMs) have shown great promise in medical applications, particularly in visual question answering (MedVQA) and diagnosis from medical images. However, existing datasets and models often fail to consider critical aspects of medical diagnostics, such as the integration of historical records and the analysis of disease progression over time. In this paper, we introduce MMXU (Multimodal and MultiX-ray Understanding), a novel dataset for MedVQA that focuses on identifying changes in specific regions between two patient visits. Unlike previous datasets that primarily address single-image questions, MMXU enables multi-image questions, incorporating both current and historical patient data. We demonstrate the limitations of current LVLMs in identifying disease progression on MMXU-test, even those that perform well on traditional benchmarks. To address this, we propose a MedRecord-Augmented Generation (MAG) approach, incorporating both global and regional historical records. Our experiments show that integrating historical records significantly enhances diagnostic accuracy by at least 20\%, bridging the gap between current LVLMs and human expert performance. Additionally, we fine-tune models with MAG on MMXU-dev, which demonstrates notable improvements. We hope this work could illuminate the avenue of advancing the use of LVLMs in medical diagnostics by emphasizing the importance of historical context in interpreting medical images. Our dataset is released at https://github.com/linjiemu/MMXU{https://github.com/linjiemu/MMXU}.

The multi-modal nature of many vision problems calls for neural network architectures that can perform multiple tasks concurrently. Typically, such architectures have been handcrafted in the literature. However, given the size and complexity of the problem, this manual architecture exploration likely exceeds human design abilities. In this paper, we propose a principled approach, rooted in differentiable neural architecture search, to automatically define branching (tree-like) structures in the encoding stage of a multi-task neural network. To allow flexibility within resource-constrained environments, we introduce a proxyless, resource-aware loss that dynamically controls the model size. Evaluations across a variety of dense prediction tasks show that our approach consistently finds high-performing branching structures within limited resource budgets.

In this paper, we present a novel methodology we call MDS-ViTNet (Multi Decoder Saliency by Vision Transformer Network) for enhancing visual saliency prediction or eye-tracking. This approach holds significant potential for diverse fields, including marketing, medicine, robotics, and retail. We propose a network architecture that leverages the Vision Transformer, moving beyond the conventional ImageNet backbone. The framework adopts an encoder-decoder structure, with the encoder utilizing a Swin transformer to efficiently embed most important features. This process involves a Transfer Learning method, wherein layers from the Vision Transformer are converted by the Encoder Transformer and seamlessly integrated into a CNN Decoder. This methodology ensures minimal information loss from the original input image. The decoder employs a multi-decoding technique, utilizing dual decoders to generate two distinct attention maps. These maps are subsequently combined into a singular output via an additional CNN model. Our trained model MDS-ViTNet achieves state-of-the-art results across several benchmarks. Committed to fostering further collaboration, we intend to make our code, models, and datasets accessible to the public.

Medical vision-and-language pre-training (Med-VLP) has received considerable attention owing to its applicability to extracting generic vision-and-language representations from medical images and texts. Most existing methods mainly contain three elements: uni-modal encoders (i.e., a vision encoder and a language encoder), a multi-modal fusion module, and pretext tasks, with few studies considering the importance of medical domain expert knowledge and explicitly exploiting such knowledge to facilitate Med-VLP. Although there exist knowledge-enhanced vision-and-language pre-training (VLP) methods in the general domain, most require off-the-shelf toolkits (e.g., object detectors and scene graph parsers), which are unavailable in the medical domain. In this paper, we propose a systematic and effective approach to enhance Med-VLP by structured medical knowledge from three perspectives. First, considering knowledge can be regarded as the intermediate medium between vision and language, we align the representations of the vision encoder and the language encoder through knowledge. Second, we inject knowledge into the multi-modal fusion model to enable the model to perform reasoning using knowledge as the supplementation of the input image and text. Third, we guide the model to put emphasis on the most critical information in images and texts by designing knowledge-induced pretext tasks. To perform a comprehensive evaluation and facilitate further research, we construct a medical vision-and-language benchmark including three tasks. Experimental results illustrate the effectiveness of our approach, where state-of-the-art performance is achieved on all downstream tasks. Further analyses explore the effects of different components of our approach and various settings of pre-training.

In large multimodal models (LMMs), the perception of non-language modalities (e.g., visual representations) is usually not on par with the large language models (LLMs)' powerful reasoning capabilities, deterring LMMs' performance on challenging downstream tasks. This weakness has been recently mitigated by replacing the vision encoder with a mixture-of-experts (MoE), which provides rich, multi-granularity, and diverse representations required by diverse downstream tasks. The performance of multimodal MoE largely depends on its router, which reweights and mixes the representations of different experts for each input. However, we find that the end-to-end trained router does not always produce the optimal routing weights for every test sample. To bridge the gap, we propose a novel and efficient method "Re-Routing in Test-Time(R2-T2) that locally optimizes the vector of routing weights in test-time by moving it toward those vectors of the correctly predicted samples in a neighborhood of the test sample. We propose three R2-T2 strategies with different optimization objectives and neighbor-search spaces. R2-T2 consistently and greatly improves state-of-the-art LMMs' performance on challenging benchmarks of diverse tasks, without training any base-model parameters.

Image-text multimodal representation learning aligns data across modalities and enables important medical applications, e.g., image classification, visual grounding, and cross-modal retrieval. In this work, we establish a connection between multimodal representation learning and multiple instance learning. Based on this connection, we propose a generic framework for constructing permutation-invariant score functions with many existing multimodal representation learning approaches as special cases. Furthermore, we use the framework to derive a novel contrastive learning approach and demonstrate that our method achieves state-of-the-art results in several downstream tasks.

The exponential growth of Large Multimodal Models (LMMs) has driven advancements in cross-modal reasoning but at significant computational costs. In this work, we focus on visual language models. We highlight the redundancy and inefficiency in current vision encoders, and seek to construct an adaptive compression method for multimodal data. In this work, we characterize a panoply of visual token selection and merging approaches through both benchmarking and qualitative analysis. In particular, we demonstrate that simple cluster-level token aggregation outperforms prior state-of-the-art works in token selection and merging, including merging at the vision encoder level and attention-based approaches. We underline the redundancy in current vision encoders, and shed light on several puzzling trends regarding principles of visual token selection through cross-modal attention visualizations. This work is a first effort towards more effective encoding and processing of high-dimensional data, and paves the way for more scalable and sustainable multimodal systems.

Human perception of the world is shaped by a multitude of viewpoints and modalities. While many existing datasets focus on scene understanding from a certain perspective (e.g. egocentric or third-person views), our dataset offers a panoptic perspective (i.e. multiple viewpoints with multiple data modalities). Specifically, we encapsulate third-person panoramic and front views, as well as egocentric monocular/binocular views with rich modalities including video, multi-channel audio, directional binaural delay, location data and textual scene descriptions within each scene captured, presenting comprehensive observation of the world. Figure 1 offers a glimpse of all 28 scene categories of our 360+x dataset. To the best of our knowledge, this is the first database that covers multiple viewpoints with multiple data modalities to mimic how daily information is accessed in the real world. Through our benchmark analysis, we presented 5 different scene understanding tasks on the proposed 360+x dataset to evaluate the impact and benefit of each data modality and perspective in panoptic scene understanding. We hope this unique dataset could broaden the scope of comprehensive scene understanding and encourage the community to approach these problems from more diverse perspectives.

A large-scale labeled dataset is a key factor for the success of supervised deep learning in computer vision. However, a limited number of annotated data is very common, especially in ophthalmic image analysis, since manual annotation is time-consuming and labor-intensive. Self-supervised learning (SSL) methods bring huge opportunities for better utilizing unlabeled data, as they do not need massive annotations. With an attempt to use as many as possible unlabeled ophthalmic images, it is necessary to break the dimension barrier, simultaneously making use of both 2D and 3D images. In this paper, we propose a universal self-supervised Transformer framework, named Uni4Eye, to discover the inherent image property and capture domain-specific feature embedding in ophthalmic images. Uni4Eye can serve as a global feature extractor, which builds its basis on a Masked Image Modeling task with a Vision Transformer (ViT) architecture. We employ a Unified Patch Embedding module to replace the origin patch embedding module in ViT for jointly processing both 2D and 3D input images. Besides, we design a dual-branch multitask decoder module to simultaneously perform two reconstruction tasks on the input image and its gradient map, delivering discriminative representations for better convergence. We evaluate the performance of our pre-trained Uni4Eye encoder by fine-tuning it on six downstream ophthalmic image classification tasks. The superiority of Uni4Eye is successfully established through comparisons to other state-of-the-art SSL pre-training methods.

Recently, Large Vision-Language Models (LVLMs) have demonstrated impressive capabilities in multi-modal context comprehension. However, they still suffer from hallucination problems referring to generating inconsistent outputs with the image content. To mitigate hallucinations, previous studies mainly focus on retraining LVLMs with custom datasets. Although effective, they inherently come with additional computational costs. In this paper, we propose a training-free framework, MVP, that aims to reduce hallucinations by making the most of the innate capabilities of the LVLMs via Multi-View Multi-Path Reasoning. Specifically, we first devise a multi-view information-seeking strategy to thoroughly perceive the comprehensive information in the image, which enriches the general global information captured by the original vision encoder in LVLMs. Furthermore, during the answer decoding, we observe that the occurrence of hallucinations has a strong correlation with the certainty of the answer tokens. Thus, we propose multi-path reasoning for each information view to quantify and aggregate the certainty scores for each potential answer among multiple decoding paths and finally decide the output answer. By fully grasping the information in the image and carefully considering the certainty of the potential answers when decoding, our MVP can effectively reduce hallucinations in LVLMs.The extensive experiments verify that our proposed MVP significantly mitigates the hallucination problem across four well-known LVLMs. The source code is available at: https://github.com/GasolSun36/MVP.

When we look around and perform complex tasks, how we see and selectively process what we see is crucial. However, the lack of this visual search mechanism in current multimodal LLMs (MLLMs) hinders their ability to focus on important visual details, especially when handling high-resolution and visually crowded images. To address this, we introduce V*, an LLM-guided visual search mechanism that employs the world knowledge in LLMs for efficient visual querying. When combined with an MLLM, this mechanism enhances collaborative reasoning, contextual understanding, and precise targeting of specific visual elements. This integration results in a new MLLM meta-architecture, named Show, sEArch, and TelL (SEAL). We further create V*Bench, a benchmark specifically designed to evaluate MLLMs in their ability to process high-resolution images and focus on visual details. Our study highlights the necessity of incorporating visual search capabilities into multimodal systems. The code is available https://github.com/penghao-wu/vstar.

Multimodal large language models (MLLMs) demonstrate significant potential in the field of medical diagnosis. However, they face critical challenges in specialized domains such as ophthalmology, particularly the fragmentation of annotation granularity and inconsistencies in clinical reasoning logic, which hinder precise cross-modal understanding. This paper introduces FundusExpert, an ophthalmology-specific MLLM with integrated positioning-diagnosis reasoning capabilities, along with FundusGen, a dataset constructed through the intelligent Fundus-Engine system. Fundus-Engine automates localization and leverages MLLM-based semantic expansion to integrate global disease classification, local object detection, and fine-grained feature analysis within a single fundus image. Additionally, by constructing a clinically aligned cognitive chain, it guides the model to generate interpretable reasoning paths. FundusExpert, fine-tuned with instruction data from FundusGen, achieves the best performance in ophthalmic question-answering tasks, surpassing the average accuracy of the 40B MedRegA by 26.6%. It also excels in zero-shot report generation tasks, achieving a clinical consistency of 77.0%, significantly outperforming GPT-4o's 47.6%. Furthermore, we reveal a scaling law between data quality and model capability (L propto N^{0.068}), demonstrating that the cognitive alignment annotations in FundusGen enhance data utilization efficiency. By integrating region-level localization with diagnostic reasoning chains, our work develops a scalable, clinically-aligned MLLM and explores a pathway toward bridging the visual-language gap in specific MLLMs. Our project can be found at https://github.com/MeteorElf/FundusExpert.

Large Vision-Language Models (LVLMs) have demonstrated remarkable performance across multi-modal tasks by scaling model size and training data. However, these dense LVLMs incur significant computational costs and motivate the exploration of sparse Mixture of Experts (MoE) architectures. While MoE improve parameter efficiency, effectively applying MoE to simultaneously model modality-specific features and cross-modal associations in LVLMs remains challenging. In this work, we propose to incorporate Mixture of Intra- and Inter-Modality Experts (MoIIE) to LVLMs. For each token, expert routing is guided by its modality, directing tokens to their respective intra-modality experts as well as a shared pool of inter-modality experts, enabling the model to jointly learn rich intra-modal features and cross-modal interactions. We further introduce an effective and straightforward two-stage training strategy, which facilitates the direct activation of both MoE and multi-modal capabilities. Extensive experiments across different data scales and LLM backbone demonstrate the effectiveness, efficiency and generality of our approach. Notably, our MoIIE models with 5.5B and 11.3B activated parameters match or even surpass the performance of existing advanced open-source MoE-LLMs based multi-modal models that involve more activated parameters. The code is available at https://github.com/AlenjandroWang/MoIIE.

Diabetic retinopathy (DR) is a leading cause of vision loss in working-age adults. While screening reduces the risk of blindness, traditional imaging is often costly and inaccessible. Artificial intelligence (AI) algorithms present a scalable diagnostic solution, but concerns regarding fairness and generalization persist. This work evaluates the fairness and performance of image-trained models in DR prediction, as well as the impact of disentanglement as a bias mitigation technique, using the diverse mBRSET fundus dataset. Three models, ConvNeXt V2, DINOv2, and Swin V2, were trained on macula images to predict DR and sensitive attributes (SAs) (e.g., age and gender/sex). Fairness was assessed between subgroups of SAs, and disentanglement was applied to reduce bias. All models achieved high DR prediction performance in diagnosing (up to 94% AUROC) and could reasonably predict age and gender/sex (91% and 77% AUROC, respectively). Fairness assessment suggests disparities, such as a 10% AUROC gap between age groups in DINOv2. Disentangling SAs from DR prediction had varying results, depending on the model selected. Disentanglement improved DINOv2 performance (2% AUROC gain), but led to performance drops in ConvNeXt V2 and Swin V2 (7% and 3%, respectively). These findings highlight the complexity of disentangling fine-grained features in fundus imaging and emphasize the importance of fairness in medical imaging AI to ensure equitable and reliable healthcare solutions.

Artificial intelligence (AI) has become a fundamental tool for assisting clinicians in analyzing ophthalmic images, such as optical coherence tomography (OCT). However, developing AI models often requires extensive annotation, and existing models tend to underperform on independent, unseen data. Foundation models (FMs), large AI models trained on vast unlabeled datasets, have shown promise in overcoming these challenges. Nonetheless, available FMs for ophthalmology lack extensive validation, especially for segmentation tasks, and focus on a single imaging modality. In this context, we propose MIRAGE, a novel multimodal FM for the analysis of OCT and scanning laser ophthalmoscopy (SLO) images. Additionally, we propose a new evaluation benchmark with OCT/SLO classification and segmentation tasks. The comparison with general and specialized FMs and segmentation methods shows the superiority of MIRAGE in both types of tasks, highlighting its suitability as a basis for the development of robust AI systems for retinal OCT image analysis. Both MIRAGE and the evaluation benchmark are publicly available: https://github.com/j-morano/MIRAGE.

We introduce Cambrian-1, a family of multimodal LLMs (MLLMs) designed with a vision-centric approach. While stronger language models can enhance multimodal capabilities, the design choices for vision components are often insufficiently explored and disconnected from visual representation learning research. This gap hinders accurate sensory grounding in real-world scenarios. Our study uses LLMs and visual instruction tuning as an interface to evaluate various visual representations, offering new insights into different models and architectures -- self-supervised, strongly supervised, or combinations thereof -- based on experiments with over 20 vision encoders. We critically examine existing MLLM benchmarks, addressing the difficulties involved in consolidating and interpreting results from various tasks, and introduce a new vision-centric benchmark, CV-Bench. To further improve visual grounding, we propose the Spatial Vision Aggregator (SVA), a dynamic and spatially-aware connector that integrates high-resolution vision features with LLMs while reducing the number of tokens. Additionally, we discuss the curation of high-quality visual instruction-tuning data from publicly available sources, emphasizing the importance of data source balancing and distribution ratio. Collectively, Cambrian-1 not only achieves state-of-the-art performance but also serves as a comprehensive, open cookbook for instruction-tuned MLLMs. We provide model weights, code, supporting tools, datasets, and detailed instruction-tuning and evaluation recipes. We hope our release will inspire and accelerate advancements in multimodal systems and visual representation learning.

Multimodal Large Language Models (MLLMs) inherit the superior text understanding capabilities of LLMs and extend these capabilities to multimodal scenarios. These models achieve excellent results in the general domain of multimodal tasks. However, in the medical domain, the substantial training costs and the requirement for extensive medical data pose challenges to the development of medical MLLMs. Furthermore, due to the free-text form of answers, tasks such as visual grounding that need to produce output in a prescribed form become difficult for MLLMs. So far, there have been no medical MLLMs works in medical visual grounding area. For the medical vision grounding task, which involves identifying locations in medical images based on short text descriptions, we propose Parameter-efficient Fine-tuning medical multimodal large language models for Medcial Visual Grounding (PFMVG). To validate the performance of the model, we evaluate it on a public benchmark dataset for medical visual grounding, where it achieves competitive results, and significantly outperforming GPT-4v. Our code will be open sourced after peer review.

Prior work has studied different visual modalities in isolation and developed separate architectures for recognition of images, videos, and 3D data. Instead, in this paper, we propose a single model which excels at classifying images, videos, and single-view 3D data using exactly the same model parameters. Our 'Omnivore' model leverages the flexibility of transformer-based architectures and is trained jointly on classification tasks from different modalities. Omnivore is simple to train, uses off-the-shelf standard datasets, and performs at-par or better than modality-specific models of the same size. A single Omnivore model obtains 86.0% on ImageNet, 84.1% on Kinetics, and 67.1% on SUN RGB-D. After finetuning, our models outperform prior work on a variety of vision tasks and generalize across modalities. Omnivore's shared visual representation naturally enables cross-modal recognition without access to correspondences between modalities. We hope our results motivate researchers to model visual modalities together.

Multi-level feature fusion is a fundamental topic in computer vision. It has been exploited to detect, segment and classify objects at various scales. When multi-level features meet multi-modal cues, the optimal feature aggregation and multi-modal learning strategy become a hot potato. In this paper, we leverage the inherent multi-modal and multi-level nature of RGB-D salient object detection to devise a novel cascaded refinement network. In particular, first, we propose to regroup the multi-level features into teacher and student features using a bifurcated backbone strategy (BBS). Second, we introduce a depth-enhanced module (DEM) to excavate informative depth cues from the channel and spatial views. Then, RGB and depth modalities are fused in a complementary way. Our architecture, named Bifurcated Backbone Strategy Network (BBS-Net), is simple, efficient, and backbone-independent. Extensive experiments show that BBS-Net significantly outperforms eighteen SOTA models on eight challenging datasets under five evaluation measures, demonstrating the superiority of our approach (sim 4 % improvement in S-measure vs. the top-ranked model: DMRA-iccv2019). In addition, we provide a comprehensive analysis on the generalization ability of different RGB-D datasets and provide a powerful training set for future research.

Medical imaging plays a crucial role in diagnosis, with radiology reports serving as vital documentation. Automating report generation has emerged as a critical need to alleviate the workload of radiologists. While machine learning has facilitated report generation for 2D medical imaging, extending this to 3D has been unexplored due to computational complexity and data scarcity. We introduce the first method to generate radiology reports for 3D medical imaging, specifically targeting chest CT volumes. Given the absence of comparable methods, we establish a baseline using an advanced 3D vision encoder in medical imaging to demonstrate our method's effectiveness, which leverages a novel auto-regressive causal transformer. Furthermore, recognizing the benefits of leveraging information from previous visits, we augment CT2Rep with a cross-attention-based multi-modal fusion module and hierarchical memory, enabling the incorporation of longitudinal multimodal data. Access our code at https://github.com/ibrahimethemhamamci/CT2Rep

The need for improved diagnostic methods in ophthalmology is acute, especially in the underdeveloped regions with limited access to specialists and advanced equipment. Therefore, we introduce VisionUnite, a novel vision-language foundation model for ophthalmology enhanced with clinical knowledge. VisionUnite has been pretrained on an extensive dataset comprising 1.24 million image-text pairs, and further refined using our proposed MMFundus dataset, which includes 296,379 high-quality fundus image-text pairs and 889,137 simulated doctor-patient dialogue instances. Our experiments indicate that VisionUnite outperforms existing generative foundation models such as GPT-4V and Gemini Pro. It also demonstrates diagnostic capabilities comparable to junior ophthalmologists. VisionUnite performs well in various clinical scenarios including open-ended multi-disease diagnosis, clinical explanation, and patient interaction, making it a highly versatile tool for initial ophthalmic disease screening. VisionUnite can also serve as an educational aid for junior ophthalmologists, accelerating their acquisition of knowledge regarding both common and underrepresented ophthalmic conditions. VisionUnite represents a significant advancement in ophthalmology, with broad implications for diagnostics, medical education, and understanding of disease mechanisms. The source code is at https://github.com/HUANGLIZI/VisionUnite.

Recent advancements in surgical computer vision have been driven by vision-only models, which lack language semantics, relying on manually annotated videos to predict fixed object categories. This limits their generalizability to unseen surgical procedures and tasks. We propose leveraging surgical video lectures from e-learning platforms to provide effective vision and language supervisory signals for multi-modal representation learning, bypassing manual annotations. We address surgery-specific linguistic challenges using multiple automatic speech recognition systems for text transcriptions. We introduce SurgVLP - Surgical Vision Language Pre-training - a novel method for multi-modal representation learning. SurgVLP employs a new contrastive learning objective, aligning video clip embeddings with corresponding multiple text embeddings in a joint latent space. We demonstrate the representational capability of this space through several vision-and-language surgical tasks and vision-only tasks specific to surgery. Unlike current fully supervised approaches, SurgVLP adapts to different surgical procedures and tasks without specific fine-tuning, achieving zero-shot adaptation to tasks such as surgical tool, phase, and triplet recognition without manual annotation. These results highlight the transferability and versatility of the learned multi-modal representations in surgical video analysis. The code is available at https://github.com/CAMMA-public/SurgVLP

Conditional inference on joint textual and visual clues is a multi-modal reasoning task that textual clues provide prior permutation or external knowledge, which are complementary with visual content and pivotal to deducing the correct option. Previous methods utilizing pretrained vision-language models (VLMs) have achieved impressive performances, yet they show a lack of multimodal context reasoning capability, especially for text-modal information. To address this issue, we propose a Multi-modal Context Reasoning approach, named ModCR. Compared to VLMs performing reasoning via cross modal semantic alignment, it regards the given textual abstract semantic and objective image information as the pre-context information and embeds them into the language model to perform context reasoning. Different from recent vision-aided language models used in natural language processing, ModCR incorporates the multi-view semantic alignment information between language and vision by introducing the learnable alignment prefix between image and text in the pretrained language model. This makes the language model well-suitable for such multi-modal reasoning scenario on joint textual and visual clues. We conduct extensive experiments on two corresponding data sets and experimental results show significantly improved performance (exact gain by 4.8% on PMR test set) compared to previous strong baselines. Code Link: https://github.com/YunxinLi/Multimodal-Context-Reasoning.

There is increasing interest in the use of multimodal data in various web applications, such as digital advertising and e-commerce. Typical methods for extracting important information from multimodal data rely on a mid-fusion architecture that combines the feature representations from multiple encoders. However, as the number of modalities increases, several potential problems with the mid-fusion model structure arise, such as an increase in the dimensionality of the concatenated multimodal features and missing modalities. To address these problems, we propose a new concept that considers multimodal inputs as a set of sequences, namely, deep multimodal sequence sets (DM^2S^2). Our set-aware concept consists of three components that capture the relationships among multiple modalities: (a) a BERT-based encoder to handle the inter- and intra-order of elements in the sequences, (b) intra-modality residual attention (IntraMRA) to capture the importance of the elements in a modality, and (c) inter-modality residual attention (InterMRA) to enhance the importance of elements with modality-level granularity further. Our concept exhibits performance that is comparable to or better than the previous set-aware models. Furthermore, we demonstrate that the visualization of the learned InterMRA and IntraMRA weights can provide an interpretation of the prediction results.

Vision transformers (ViTs) are quickly becoming the de-facto architecture for computer vision, yet we understand very little about why they work and what they learn. While existing studies visually analyze the mechanisms of convolutional neural networks, an analogous exploration of ViTs remains challenging. In this paper, we first address the obstacles to performing visualizations on ViTs. Assisted by these solutions, we observe that neurons in ViTs trained with language model supervision (e.g., CLIP) are activated by semantic concepts rather than visual features. We also explore the underlying differences between ViTs and CNNs, and we find that transformers detect image background features, just like their convolutional counterparts, but their predictions depend far less on high-frequency information. On the other hand, both architecture types behave similarly in the way features progress from abstract patterns in early layers to concrete objects in late layers. In addition, we show that ViTs maintain spatial information in all layers except the final layer. In contrast to previous works, we show that the last layer most likely discards the spatial information and behaves as a learned global pooling operation. Finally, we conduct large-scale visualizations on a wide range of ViT variants, including DeiT, CoaT, ConViT, PiT, Swin, and Twin, to validate the effectiveness of our method.

Multi-spectral imagery plays a crucial role in diverse Remote Sensing applications including land-use classification, environmental monitoring and urban planning. These images are widely adopted because their additional spectral bands correlate strongly with physical materials on the ground, such as ice, water, and vegetation. This allows for more accurate identification, and their public availability from missions, such as Sentinel-2 and Landsat, only adds to their value. Currently, the automatic analysis of such data is predominantly managed through machine learning models specifically trained for multi-spectral input, which are costly to train and support. Furthermore, although providing a lot of utility for Remote Sensing, such additional inputs cannot be used with powerful generalist large multimodal models, which are capable of solving many visual problems, but are not able to understand specialized multi-spectral signals. To address this, we propose a training-free approach which introduces new multi-spectral data in a Zero-Shot-only mode, as inputs to generalist multimodal models, trained on RGB-only inputs. Our approach leverages the multimodal models' understanding of the visual space, and proposes to adapt to inputs to that space, and to inject domain-specific information as instructions into the model. We exemplify this idea with the Gemini2.5 model and observe strong Zero-Shot performance gains of the approach on popular Remote Sensing benchmarks for land cover and land use classification and demonstrate the easy adaptability of Gemini2.5 to new inputs. These results highlight the potential for geospatial professionals, working with non-standard specialized inputs, to easily leverage powerful multimodal models, such as Gemini2.5, to accelerate their work, benefiting from their rich reasoning and contextual capabilities, grounded in the specialized sensor data.

Recently a number of studies demonstrated impressive performance on diverse vision-language multi-modal tasks such as image captioning and visual question answering by extending the BERT architecture with multi-modal pre-training objectives. In this work we explore a broad set of multi-modal representation learning tasks in the medical domain, specifically using radiology images and the unstructured report. We propose Medical Vision Language Learner (MedViLL), which adopts a BERT-based architecture combined with a novel multi-modal attention masking scheme to maximize generalization performance for both vision-language understanding tasks (diagnosis classification, medical image-report retrieval, medical visual question answering) and vision-language generation task (radiology report generation). By statistically and rigorously evaluating the proposed model on four downstream tasks with three radiographic image-report datasets (MIMIC-CXR, Open-I, and VQA-RAD), we empirically demonstrate the superior downstream task performance of MedViLL against various baselines, including task-specific architectures. The source code is publicly available at: https://github.com/SuperSupermoon/MedViLL

Multimodal Large Language Models (MLLMs) have achieved remarkable success in vision-language tasks but their remote sensing (RS) counterpart are relatively under explored. Unlike natural images, RS imagery presents unique challenges that current MLLMs struggle to handle, particularly in visual grounding and spatial reasoning. This study investigates the limitations of CLIP-based MLLMs in RS, highlighting their failure to differentiate visually distinct yet semantically similar RS images. To address this, we introduce a remote sensing multimodal visual patterns (RSMMVP) benchmark. It is designed to evaluate MLLMs in RS tasks by identifying the CLIP-blind pairs, where CLIP-based models incorrectly assign high similarity scores to visually distinct RS images. Through a visual question answering (VQA) evaluation, we analyze the performance of state-of-the-art MLLMs, revealing significant limitations in RS specific representation learning. The results provide valuable insights into the weaknesses of CLIP-based visual encoding and offer a foundation for future research to develop more effective MLLMs tailored for remote sensing applications.