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SubscribeVisionUnite: A Vision-Language Foundation Model for Ophthalmology Enhanced with Clinical Knowledge
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.
CoMT: Chain-of-Medical-Thought Reduces Hallucination in Medical Report Generation
Automatic medical report generation (MRG), which possesses significant research value as it can aid radiologists in clinical diagnosis and report composition, has garnered increasing attention. Despite recent progress, generating accurate reports remains arduous due to the requirement for precise clinical comprehension and disease diagnosis inference. Furthermore, owing to the limited accessibility of medical data and the imbalanced distribution of diseases, the underrepresentation of rare diseases in training data makes large-scale medical visual language models (LVLMs) prone to hallucinations, such as omissions or fabrications, severely undermining diagnostic performance and further intensifying the challenges for MRG in practice. In this study, to effectively mitigate hallucinations in medical report generation, we propose a chain-of-medical-thought approach (CoMT), which intends to imitate the cognitive process of human doctors by decomposing diagnostic procedures. The radiological features with different importance are structured into fine-grained medical thought chains to enhance the inferential ability during diagnosis, thereby alleviating hallucination problems and enhancing the diagnostic accuracy of MRG. The code and dataset have been released at https://github.com/FRENKIE-CHIANG/CoMT.
Sightation Counts: Leveraging Sighted User Feedback in Building a BLV-aligned Dataset of Diagram Descriptions
Often, the needs and visual abilities differ between the annotator group and the end user group. Generating detailed diagram descriptions for blind and low-vision (BLV) users is one such challenging domain. Sighted annotators could describe visuals with ease, but existing studies have shown that direct generations by them are costly, bias-prone, and somewhat lacking by BLV standards. In this study, we ask sighted individuals to assess -- rather than produce -- diagram descriptions generated by vision-language models (VLM) that have been guided with latent supervision via a multi-pass inference. The sighted assessments prove effective and useful to professional educators who are themselves BLV and teach visually impaired learners. We release Sightation, a collection of diagram description datasets spanning 5k diagrams and 137k samples for completion, preference, retrieval, question answering, and reasoning training purposes and demonstrate their fine-tuning potential in various downstream tasks.
GenAssist: Making Image Generation Accessible
Blind and low vision (BLV) creators use images to communicate with sighted audiences. However, creating or retrieving images is challenging for BLV creators as it is difficult to use authoring tools or assess image search results. Thus, creators limit the types of images they create or recruit sighted collaborators. While text-to-image generation models let creators generate high-fidelity images based on a text description (i.e. prompt), it is difficult to assess the content and quality of generated images. We present GenAssist, a system to make text-to-image generation accessible. Using our interface, creators can verify whether generated image candidates followed the prompt, access additional details in the image not specified in the prompt, and skim a summary of similarities and differences between image candidates. To power the interface, GenAssist uses a large language model to generate visual questions, vision-language models to extract answers, and a large language model to summarize the results. Our study with 12 BLV creators demonstrated that GenAssist enables and simplifies the process of image selection and generation, making visual authoring more accessible to all.
On the Importance of Text Preprocessing for Multimodal Representation Learning and Pathology Report Generation
Vision-language models in pathology enable multimodal case retrieval and automated report generation. Many of the models developed so far, however, have been trained on pathology reports that include information which cannot be inferred from paired whole slide images (e.g., patient history), potentially leading to hallucinated sentences in generated reports. To this end, we investigate how the selection of information from pathology reports for vision-language modeling affects the quality of the multimodal representations and generated reports. More concretely, we compare a model trained on full reports against a model trained on preprocessed reports that only include sentences describing the cell and tissue appearances based on the H&E-stained slides. For the experiments, we built upon the BLIP-2 framework and used a cutaneous melanocytic lesion dataset of 42,433 H&E-stained whole slide images and 19,636 corresponding pathology reports. Model performance was assessed using image-to-text and text-to-image retrieval, as well as qualitative evaluation of the generated reports by an expert pathologist. Our results demonstrate that text preprocessing prevents hallucination in report generation. Despite the improvement in the quality of the generated reports, training the vision-language model on full reports showed better cross-modal retrieval performance.
Med-Flamingo: a Multimodal Medical Few-shot Learner
Medicine, by its nature, is a multifaceted domain that requires the synthesis of information across various modalities. Medical generative vision-language models (VLMs) make a first step in this direction and promise many exciting clinical applications. However, existing models typically have to be fine-tuned on sizeable down-stream datasets, which poses a significant limitation as in many medical applications data is scarce, necessitating models that are capable of learning from few examples in real-time. Here we propose Med-Flamingo, a multimodal few-shot learner adapted to the medical domain. Based on OpenFlamingo-9B, we continue pre-training on paired and interleaved medical image-text data from publications and textbooks. Med-Flamingo unlocks few-shot generative medical visual question answering (VQA) abilities, which we evaluate on several datasets including a novel challenging open-ended VQA dataset of visual USMLE-style problems. Furthermore, we conduct the first human evaluation for generative medical VQA where physicians review the problems and blinded generations in an interactive app. Med-Flamingo improves performance in generative medical VQA by up to 20\% in clinician's rating and firstly enables multimodal medical few-shot adaptations, such as rationale generation. We release our model, code, and evaluation app under https://github.com/snap-stanford/med-flamingo.
Intensive Vision-guided Network for Radiology Report Generation
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.
Direct Preference Optimization for Suppressing Hallucinated Prior Exams in Radiology Report Generation
Recent advances in generative vision-language models (VLMs) have exciting potential implications for AI in radiology, yet VLMs are also known to produce hallucinations, nonsensical text, and other unwanted behaviors that can waste clinicians' time and cause patient harm. Drawing on recent work on direct preference optimization (DPO), we propose a simple method for modifying the behavior of pretrained VLMs performing radiology report generation by suppressing unwanted types of generations. We apply our method to the prevention of hallucinations of prior exams, addressing a long-established problem behavior in models performing chest X-ray report generation. Across our experiments, we find that DPO fine-tuning achieves a 3.2-4.8x reduction in lines hallucinating prior exams while maintaining model performance on clinical accuracy metrics. Our work is, to the best of our knowledge, the first work to apply DPO to medical VLMs, providing a data- and compute- efficient way to suppress problem behaviors while maintaining overall clinical accuracy.
A Survey on Hallucination in Large Vision-Language Models
Recent development of Large Vision-Language Models (LVLMs) has attracted growing attention within the AI landscape for its practical implementation potential. However, ``hallucination'', or more specifically, the misalignment between factual visual content and corresponding textual generation, poses a significant challenge of utilizing LVLMs. In this comprehensive survey, we dissect LVLM-related hallucinations in an attempt to establish an overview and facilitate future mitigation. Our scrutiny starts with a clarification of the concept of hallucinations in LVLMs, presenting a variety of hallucination symptoms and highlighting the unique challenges inherent in LVLM hallucinations. Subsequently, we outline the benchmarks and methodologies tailored specifically for evaluating hallucinations unique to LVLMs. Additionally, we delve into an investigation of the root causes of these hallucinations, encompassing insights from the training data and model components. We also critically review existing methods for mitigating hallucinations. The open questions and future directions pertaining to hallucinations within LVLMs are discussed to conclude this survey.
VGA: Vision GUI Assistant -- Minimizing Hallucinations through Image-Centric Fine-Tuning
Recent advances in Large Vision-Language Models (LVLMs) have significantly improve performance in image comprehension tasks, such as formatted charts and rich-content images. Yet, Graphical User Interface (GUI) pose a greater challenge due to their structured format and detailed textual information. Existing LVLMs often overly depend on internal knowledge and neglect image content, resulting in hallucinations and incorrect responses in GUI comprehension. To address these issues, we introduce VGA, a fine-tuned model designed for comprehensive GUI understanding. Our model aims to enhance the interpretation of visual data of GUI and reduce hallucinations. We first construct a Vision Question Answering (VQA) dataset of 63.8k high-quality examples with our propose Referent Method, which ensures the model's responses are highly depend on visual content within the image. We then design a two-stage fine-tuning method called Foundation and Advanced Comprehension (FAC) to enhance both the model's ability to extract information from image content and alignment with human intent. Experiments show that our approach enhances the model's ability to extract information from images and achieves state-of-the-art results in GUI understanding tasks. Our dataset and fine-tuning script will be released soon.
Specialist vision-language models for clinical ophthalmology
Clinicians spend a significant amount of time reviewing medical images and transcribing their findings regarding patient diagnosis, referral and treatment in text form. Vision-language models (VLMs), which automatically interpret images and summarize their findings as text, have enormous potential to alleviate clinical workloads and increase patient access to high-quality medical care. While foundational models have stirred considerable interest in the medical community, it is unclear whether their general capabilities translate to real-world clinical utility. In this work, we show that foundation VLMs markedly underperform compared to practicing ophthalmologists on specialist tasks crucial to the care of patients with age-related macular degeneration (AMD). To address this, we initially identified the essential capabilities required for image-based clinical decision-making, and then developed a curriculum to selectively train VLMs in these skills. The resulting model, RetinaVLM, can be instructed to write reports that significantly outperform those written by leading foundation medical VLMs in disease staging (F1 score of 0.63 vs. 0.11) and patient referral (0.67 vs. 0.39), and approaches the diagnostic performance of junior ophthalmologists (who achieve 0.77 and 0.78 on the respective tasks). Furthermore, in a reader study involving two senior ophthalmologists with up to 32 years of experience, RetinaVLM's reports were found to be similarly correct (78.6% vs. 82.1%) and complete (both 78.6%) as reports written by junior ophthalmologists with up to 10 years of experience. These results demonstrate that our curriculum-based approach provides a blueprint for specializing generalist foundation medical VLMs to handle real-world clinical tasks.
VDGD: Mitigating LVLM Hallucinations in Cognitive Prompts by Bridging the Visual Perception Gap
Recent interest in Large Vision-Language Models (LVLMs) for practical applications is moderated by the significant challenge of hallucination or the inconsistency between the factual information and the generated text. In this paper, we first perform an in-depth analysis of hallucinations and discover several novel insights about how and when LVLMs hallucinate. From our analysis, we show that: (1) The community's efforts have been primarily targeted towards reducing hallucinations related to visual recognition (VR) prompts (e.g., prompts that only require describing the image), thereby ignoring hallucinations for cognitive prompts (e.g., prompts that require additional skills like reasoning on contents of the image). (2) LVLMs lack visual perception, i.e., they can see but not necessarily understand or perceive the input image. We analyze responses to cognitive prompts and show that LVLMs hallucinate due to a perception gap: although LVLMs accurately recognize visual elements in the input image and possess sufficient cognitive skills, they struggle to respond accurately and hallucinate. To overcome this shortcoming, we propose Visual Description Grounded Decoding (VDGD), a simple, robust, and training-free method for alleviating hallucinations. Specifically, we first describe the image and add it as a prefix to the instruction. Next, during auto-regressive decoding, we sample from the plausible candidates according to their KL-Divergence (KLD) to the description, where lower KLD is given higher preference. Experimental results on several benchmarks and LVLMs show that VDGD improves significantly over other baselines in reducing hallucinations. We also propose VaLLu, a benchmark for the comprehensive evaluation of the cognitive capabilities of LVLMs.
CLIPSyntel: CLIP and LLM Synergy for Multimodal Question Summarization in Healthcare
In the era of modern healthcare, swiftly generating medical question summaries is crucial for informed and timely patient care. Despite the increasing complexity and volume of medical data, existing studies have focused solely on text-based summarization, neglecting the integration of visual information. Recognizing the untapped potential of combining textual queries with visual representations of medical conditions, we introduce the Multimodal Medical Question Summarization (MMQS) Dataset. This dataset, a major contribution to our work, pairs medical queries with visual aids, facilitating a richer and more nuanced understanding of patient needs. We also propose a framework, utilizing the power of Contrastive Language Image Pretraining(CLIP) and Large Language Models(LLMs), consisting of four modules that identify medical disorders, generate relevant context, filter medical concepts, and craft visually aware summaries. Our comprehensive framework harnesses the power of CLIP, a multimodal foundation model, and various general-purpose LLMs, comprising four main modules: the medical disorder identification module, the relevant context generation module, the context filtration module for distilling relevant medical concepts and knowledge, and finally, a general-purpose LLM to generate visually aware medical question summaries. Leveraging our MMQS dataset, we showcase how visual cues from images enhance the generation of medically nuanced summaries. This multimodal approach not only enhances the decision-making process in healthcare but also fosters a more nuanced understanding of patient queries, laying the groundwork for future research in personalized and responsive medical care
MentalArena: Self-play Training of Language Models for Diagnosis and Treatment of Mental Health Disorders
Mental health disorders are one of the most serious diseases in the world. Most people with such a disease lack access to adequate care, which highlights the importance of training models for the diagnosis and treatment of mental health disorders. However, in the mental health domain, privacy concerns limit the accessibility of personalized treatment data, making it challenging to build powerful models. In this paper, we introduce MentalArena, a self-play framework to train language models by generating domain-specific personalized data, where we obtain a better model capable of making a personalized diagnosis and treatment (as a therapist) and providing information (as a patient). To accurately model human-like mental health patients, we devise Symptom Encoder, which simulates a real patient from both cognition and behavior perspectives. To address intent bias during patient-therapist interactions, we propose Symptom Decoder to compare diagnosed symptoms with encoded symptoms, and dynamically manage the dialogue between patient and therapist according to the identified deviations. We evaluated MentalArena against 6 benchmarks, including biomedicalQA and mental health tasks, compared to 6 advanced models. Our models, fine-tuned on both GPT-3.5 and Llama-3-8b, significantly outperform their counterparts, including GPT-4o. We hope that our work can inspire future research on personalized care. Code is available in https://github.com/Scarelette/MentalArena/tree/main
PromptMRG: Diagnosis-Driven Prompts for Medical Report Generation
Automatic medical report generation (MRG) is of great research value as it has the potential to relieve radiologists from the heavy burden of report writing. Despite recent advancements, accurate MRG remains challenging due to the need for precise clinical understanding and the identification of clinical findings. Moreover, the imbalanced distribution of diseases makes the challenge even more pronounced, as rare diseases are underrepresented in training data, making their diagnostic performance unreliable. To address these challenges, we propose diagnosis-driven prompts for medical report generation (PromptMRG), a novel framework that aims to improve the diagnostic accuracy of MRG with the guidance of diagnosis-aware prompts. Specifically, PromptMRG is based on encoder-decoder architecture with an extra disease classification branch. When generating reports, the diagnostic results from the classification branch are converted into token prompts to explicitly guide the generation process. To further improve the diagnostic accuracy, we design cross-modal feature enhancement, which retrieves similar reports from the database to assist the diagnosis of a query image by leveraging the knowledge from a pre-trained CLIP. Moreover, the disease imbalanced issue is addressed by applying an adaptive logit-adjusted loss to the classification branch based on the individual learning status of each disease, which overcomes the barrier of text decoder's inability to manipulate disease distributions. Experiments on two MRG benchmarks show the effectiveness of the proposed method, where it obtains state-of-the-art clinical efficacy performance on both datasets.
DreamStruct: Understanding Slides and User Interfaces via Synthetic Data Generation
Enabling machines to understand structured visuals like slides and user interfaces is essential for making them accessible to people with disabilities. However, achieving such understanding computationally has required manual data collection and annotation, which is time-consuming and labor-intensive. To overcome this challenge, we present a method to generate synthetic, structured visuals with target labels using code generation. Our method allows people to create datasets with built-in labels and train models with a small number of human-annotated examples. We demonstrate performance improvements in three tasks for understanding slides and UIs: recognizing visual elements, describing visual content, and classifying visual content types.
MedDr: Diagnosis-Guided Bootstrapping for Large-Scale Medical Vision-Language Learning
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.
VisText: A Benchmark for Semantically Rich Chart Captioning
Captions that describe or explain charts help improve recall and comprehension of the depicted data and provide a more accessible medium for people with visual disabilities. However, current approaches for automatically generating such captions struggle to articulate the perceptual or cognitive features that are the hallmark of charts (e.g., complex trends and patterns). In response, we introduce VisText: a dataset of 12,441 pairs of charts and captions that describe the charts' construction, report key statistics, and identify perceptual and cognitive phenomena. In VisText, a chart is available as three representations: a rasterized image, a backing data table, and a scene graph -- a hierarchical representation of a chart's visual elements akin to a web page's Document Object Model (DOM). To evaluate the impact of VisText, we fine-tune state-of-the-art language models on our chart captioning task and apply prefix-tuning to produce captions that vary the semantic content they convey. Our models generate coherent, semantically rich captions and perform on par with state-of-the-art chart captioning models across machine translation and text generation metrics. Through qualitative analysis, we identify six broad categories of errors that our models make that can inform future work.
A Data-Centric Approach To Generate Faithful and High Quality Patient Summaries with Large Language Models
Patients often face difficulties in understanding their hospitalizations, while healthcare workers have limited resources to provide explanations. In this work, we investigate the potential of large language models to generate patient summaries based on doctors' notes and study the effect of training data on the faithfulness and quality of the generated summaries. To this end, we release (i) a rigorous labeling protocol for errors in medical texts and (ii) a publicly available dataset of annotated hallucinations in 100 doctor-written and 100 generated summaries. We show that fine-tuning on hallucination-free data effectively reduces hallucinations from 2.60 to 1.55 per summary for Llama 2, while preserving relevant information. We observe a similar effect on GPT-4 (0.70 to 0.40), when the few-shot examples are hallucination-free. We also conduct a qualitative evaluation using hallucination-free and improved training data. We find that common quantitative metrics do not correlate well with faithfulness and quality. Finally, we test GPT-4 for automatic hallucination detection, which clearly outperforms common baselines.
Attend-and-Excite: Attention-Based Semantic Guidance for Text-to-Image Diffusion Models
Recent text-to-image generative models have demonstrated an unparalleled ability to generate diverse and creative imagery guided by a target text prompt. While revolutionary, current state-of-the-art diffusion models may still fail in generating images that fully convey the semantics in the given text prompt. We analyze the publicly available Stable Diffusion model and assess the existence of catastrophic neglect, where the model fails to generate one or more of the subjects from the input prompt. Moreover, we find that in some cases the model also fails to correctly bind attributes (e.g., colors) to their corresponding subjects. To help mitigate these failure cases, we introduce the concept of Generative Semantic Nursing (GSN), where we seek to intervene in the generative process on the fly during inference time to improve the faithfulness of the generated images. Using an attention-based formulation of GSN, dubbed Attend-and-Excite, we guide the model to refine the cross-attention units to attend to all subject tokens in the text prompt and strengthen - or excite - their activations, encouraging the model to generate all subjects described in the text prompt. We compare our approach to alternative approaches and demonstrate that it conveys the desired concepts more faithfully across a range of text prompts.
Towards Interpretable Counterfactual Generation via Multimodal Autoregression
Counterfactual medical image generation enables clinicians to explore clinical hypotheses, such as predicting disease progression, facilitating their decision-making. While existing methods can generate visually plausible images from disease progression prompts, they produce silent predictions that lack interpretation to verify how the generation reflects the hypothesized progression -- a critical gap for medical applications that require traceable reasoning. In this paper, we propose Interpretable Counterfactual Generation (ICG), a novel task requiring the joint generation of counterfactual images that reflect the clinical hypothesis and interpretation texts that outline the visual changes induced by the hypothesis. To enable ICG, we present ICG-CXR, the first dataset pairing longitudinal medical images with hypothetical progression prompts and textual interpretations. We further introduce ProgEmu, an autoregressive model that unifies the generation of counterfactual images and textual interpretations. We demonstrate the superiority of ProgEmu in generating progression-aligned counterfactuals and interpretations, showing significant potential in enhancing clinical decision support and medical education. Project page: https://progemu.github.io.
CLARA: Clinical Report Auto-completion
Generating clinical reports from raw recordings such as X-rays and electroencephalogram (EEG) is an essential and routine task for doctors. However, it is often time-consuming to write accurate and detailed reports. Most existing methods try to generate the whole reports from the raw input with limited success because 1) generated reports often contain errors that need manual review and correction, 2) it does not save time when doctors want to write additional information into the report, and 3) the generated reports are not customized based on individual doctors' preference. We propose {\it CL}inic{\it A}l {\it R}eport {\it A}uto-completion (CLARA), an interactive method that generates reports in a sentence by sentence fashion based on doctors' anchor words and partially completed sentences. CLARA searches for most relevant sentences from existing reports as the template for the current report. The retrieved sentences are sequentially modified by combining with the input feature representations to create the final report. In our experimental evaluation, CLARA achieved 0.393 CIDEr and 0.248 BLEU-4 on X-ray reports and 0.482 CIDEr and 0.491 BLEU-4 for EEG reports for sentence-level generation, which is up to 35% improvement over the best baseline. Also via our qualitative evaluation, CLARA is shown to produce reports which have a significantly higher level of approval by doctors in a user study (3.74 out of 5 for CLARA vs 2.52 out of 5 for the baseline).
Multi-Modal Hallucination Control by Visual Information Grounding
Generative Vision-Language Models (VLMs) are prone to generate plausible-sounding textual answers that, however, are not always grounded in the input image. We investigate this phenomenon, usually referred to as "hallucination" and show that it stems from an excessive reliance on the language prior. In particular, we show that as more tokens are generated, the reliance on the visual prompt decreases, and this behavior strongly correlates with the emergence of hallucinations. To reduce hallucinations, we introduce Multi-Modal Mutual-Information Decoding (M3ID), a new sampling method for prompt amplification. M3ID amplifies the influence of the reference image over the language prior, hence favoring the generation of tokens with higher mutual information with the visual prompt. M3ID can be applied to any pre-trained autoregressive VLM at inference time without necessitating further training and with minimal computational overhead. If training is an option, we show that M3ID can be paired with Direct Preference Optimization (DPO) to improve the model's reliance on the prompt image without requiring any labels. Our empirical findings show that our algorithms maintain the fluency and linguistic capabilities of pre-trained VLMs while reducing hallucinations by mitigating visually ungrounded answers. Specifically, for the LLaVA 13B model, M3ID and M3ID+DPO reduce the percentage of hallucinated objects in captioning tasks by 25% and 28%, respectively, and improve the accuracy on VQA benchmarks such as POPE by 21% and 24%.
Pain in 3D: Generating Controllable Synthetic Faces for Automated Pain Assessment
Automated pain assessment from facial expressions is crucial for non-communicative patients, such as those with dementia. Progress has been limited by two challenges: (i) existing datasets exhibit severe demographic and label imbalance due to ethical constraints, and (ii) current generative models cannot precisely control facial action units (AUs), facial structure, or clinically validated pain levels. We present 3DPain, a large-scale synthetic dataset specifically designed for automated pain assessment, featuring unprecedented annotation richness and demographic diversity. Our three-stage framework generates diverse 3D meshes, textures them with diffusion models, and applies AU-driven face rigging to synthesize multi-view faces with paired neutral and pain images, AU configurations, PSPI scores, and the first dataset-level annotations of pain-region heatmaps. The dataset comprises 82,500 samples across 25,000 pain expression heatmaps and 2,500 synthetic identities balanced by age, gender, and ethnicity. We further introduce ViTPain, a Vision Transformer based cross-modal distillation framework in which a heatmap-trained teacher guides a student trained on RGB images, enhancing accuracy, interpretability, and clinical reliability. Together, 3DPain and ViTPain establish a controllable, diverse, and clinically grounded foundation for generalizable automated pain assessment.
Cracking the Code of Hallucination in LVLMs with Vision-aware Head Divergence
Large vision-language models (LVLMs) have made substantial progress in integrating large language models (LLMs) with visual inputs, enabling advanced multimodal reasoning. Despite their success, a persistent challenge is hallucination-where generated text fails to accurately reflect visual content-undermining both accuracy and reliability. Existing methods focus on alignment training or decoding refinements but primarily address symptoms at the generation stage without probing the underlying causes. In this work, we investigate the internal mechanisms driving hallucination in LVLMs, with an emphasis on the multi-head attention module. Specifically, we introduce Vision-aware Head Divergence (VHD), a metric that quantifies the sensitivity of attention head outputs to visual context. Based on this, our findings reveal the presence of vision-aware attention heads that are more attuned to visual information; however, the model's overreliance on its prior language patterns is closely related to hallucinations. Building on these insights, we propose Vision-aware Head Reinforcement (VHR), a training-free approach to mitigate hallucination by enhancing the role of vision-aware attention heads. Extensive experiments demonstrate that our method achieves superior performance compared to state-of-the-art approaches in mitigating hallucinations, while maintaining high efficiency with negligible additional time overhead.
A Survey of Medical Vision-and-Language Applications and Their Techniques
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.
HealthGPT: A Medical Large Vision-Language Model for Unifying Comprehension and Generation via Heterogeneous Knowledge Adaptation
We present HealthGPT, a powerful Medical Large Vision-Language Model (Med-LVLM) that integrates medical visual comprehension and generation capabilities within a unified autoregressive paradigm. Our bootstrapping philosophy is to progressively adapt heterogeneous comprehension and generation knowledge to pre-trained large language models (LLMs). This is achieved through a novel heterogeneous low-rank adaptation (H-LoRA) technique, which is complemented by a tailored hierarchical visual perception approach and a three-stage learning strategy. To effectively learn the HealthGPT, we devise a comprehensive medical domain-specific comprehension and generation dataset called VL-Health. Experimental results demonstrate exceptional performance and scalability of HealthGPT in medical visual unified tasks. Our project can be accessed at https://github.com/DCDmllm/HealthGPT.
MCL: Multi-view Enhanced Contrastive Learning for Chest X-ray Report Generation
Radiology reports are crucial for planning treatment strategies and enhancing doctor-patient communication, yet manually writing these reports is burdensome for radiologists. While automatic report generation offers a solution, existing methods often rely on single-view radiographs, limiting diagnostic accuracy. To address this problem, we propose MCL, a Multi-view enhanced Contrastive Learning method for chest X-ray report generation. Specifically, we first introduce multi-view enhanced contrastive learning for visual representation by maximizing agreements between multi-view radiographs and their corresponding report. Subsequently, to fully exploit patient-specific indications (e.g., patient's symptoms) for report generation, we add a transitional ``bridge" for missing indications to reduce embedding space discrepancies caused by their presence or absence. Additionally, we construct Multi-view CXR and Two-view CXR datasets from public sources to support research on multi-view report generation. Our proposed MCL surpasses recent state-of-the-art methods across multiple datasets, achieving a 5.0% F1 RadGraph improvement on MIMIC-CXR, a 7.3% BLEU-1 improvement on MIMIC-ABN, a 3.1% BLEU-4 improvement on Multi-view CXR, and an 8.2% F1 CheXbert improvement on Two-view CXR.
Visual Instruction Tuning towards General-Purpose Multimodal Model: A Survey
Traditional computer vision generally solves each single task independently by a dedicated model with the task instruction implicitly designed in the model architecture, arising two limitations: (1) it leads to task-specific models, which require multiple models for different tasks and restrict the potential synergies from diverse tasks; (2) it leads to a pre-defined and fixed model interface that has limited interactivity and adaptability in following user' task instructions. To address them, Visual Instruction Tuning (VIT) has been intensively studied recently, which finetunes a large vision model with language as task instructions, aiming to learn from a wide range of vision tasks described by language instructions a general-purpose multimodal model that can follow arbitrary instructions and thus solve arbitrary tasks specified by the user. This work aims to provide a systematic review of visual instruction tuning, covering (1) the background that presents computer vision task paradigms and the development of VIT; (2) the foundations of VIT that introduce commonly used network architectures, visual instruction tuning frameworks and objectives, and evaluation setups and tasks; (3) the commonly used datasets in visual instruction tuning and evaluation; (4) the review of existing VIT methods that categorizes them with a taxonomy according to both the studied vision task and the method design and highlights the major contributions, strengths, and shortcomings of them; (5) the comparison and discussion of VIT methods over various instruction-following benchmarks; (6) several challenges, open directions and possible future works in visual instruction tuning research.
Dr-LLaVA: Visual Instruction Tuning with Symbolic Clinical Grounding
Vision-Language Models (VLM) can support clinicians by analyzing medical images and engaging in natural language interactions to assist in diagnostic and treatment tasks. However, VLMs often exhibit "hallucinogenic" behavior, generating textual outputs not grounded in contextual multimodal information. This challenge is particularly pronounced in the medical domain, where we do not only require VLM outputs to be accurate in single interactions but also to be consistent with clinical reasoning and diagnostic pathways throughout multi-turn conversations. For this purpose, we propose a new alignment algorithm that uses symbolic representations of clinical reasoning to ground VLMs in medical knowledge. These representations are utilized to (i) generate GPT-4-guided visual instruction tuning data at scale, simulating clinician-VLM conversations with demonstrations of clinical reasoning, and (ii) create an automatic reward function that evaluates the clinical validity of VLM generations throughout clinician-VLM interactions. Our algorithm eliminates the need for human involvement in training data generation or reward model construction, reducing costs compared to standard reinforcement learning with human feedback (RLHF). We apply our alignment algorithm to develop Dr-LLaVA, a conversational VLM finetuned for analyzing bone marrow pathology slides, demonstrating strong performance in multi-turn medical conversations.
Enhancing Abnormality Grounding for Vision Language Models with Knowledge Descriptions
Visual Language Models (VLMs) have demonstrated impressive capabilities in visual grounding tasks. However, their effectiveness in the medical domain, particularly for abnormality detection and localization within medical images, remains underexplored. A major challenge is the complex and abstract nature of medical terminology, which makes it difficult to directly associate pathological anomaly terms with their corresponding visual features. In this work, we introduce a novel approach to enhance VLM performance in medical abnormality detection and localization by leveraging decomposed medical knowledge. Instead of directly prompting models to recognize specific abnormalities, we focus on breaking down medical concepts into fundamental attributes and common visual patterns. This strategy promotes a stronger alignment between textual descriptions and visual features, improving both the recognition and localization of abnormalities in medical images.We evaluate our method on the 0.23B Florence-2 base model and demonstrate that it achieves comparable performance in abnormality grounding to significantly larger 7B LLaVA-based medical VLMs, despite being trained on only 1.5% of the data used for such models. Experimental results also demonstrate the effectiveness of our approach in both known and previously unseen abnormalities, suggesting its strong generalization capabilities.
Visual Generation Tuning
Large Vision Language Models (VLMs) effectively bridge the modality gap through extensive pretraining, acquiring sophisticated visual representations aligned with language. However, it remains underexplored whether these representations, optimized for multimodal understanding tasks, harbor an inherent potential for visual generation. In this paper, we propose VGT, Visual Generation Tuning, a novel paradigm designed to stimulate the underlying capabilities of visual generation within any vision language models. By performing efficient visual generation tuning on well-pretrained VLMs, we significantly mitigate the alignment costs and accelerate the convergence of autoregressive modeling in the continuous space (20x speedup). Specifically, we dismiss the entangled pixel-level VAEs designed for diffusion transformers and formulate VGT-AE through aligning the semantic encoders from pretrained VLMs with the latent representations of pixel decoders. In image reconstruction tasks, we achieve 26.67 PSNR and 0.50 rFID at a 28x compression ratio, outperforming specialized VAEs; in visual generation tasks, we achieve state-of-the-art outcomes among autoregressive models, 0.77 on GenEval and 78.73 on DPG-Bench. Furthermore, our proposed VGT showcases significant scaling promise and is versatile for endowing any VLMs trained for multimodal understanding with the capabilities of visual generation, which paves the new avenue to explore next-generation unified multimodal foundation models. Models and codes are available at https://github.com/hustvl/VGT.
Scaling Inference-Time Search with Vision Value Model for Improved Visual Comprehension
Despite significant advancements in vision-language models (VLMs), there lacks effective approaches to enhance response quality by scaling inference-time computation. This capability is known to be a core step towards the self-improving models in recent large language model studies. In this paper, we present Vision Value Model (VisVM) that can guide VLM inference-time search to generate responses with better visual comprehension. Specifically, VisVM not only evaluates the generated sentence quality in the current search step, but also anticipates the quality of subsequent sentences that may result from the current step, thus providing a long-term value. In this way, VisVM steers VLMs away from generating sentences prone to hallucinations or insufficient detail, thereby producing higher quality responses. Experimental results demonstrate that VisVM-guided search significantly enhances VLMs' ability to generate descriptive captions with richer visual details and fewer hallucinations, compared with greedy decoding and search methods with other visual reward signals. Furthermore, we find that self-training the model with the VisVM-guided captions improve VLM's performance across a wide range of multimodal benchmarks, indicating the potential for developing self-improving VLMs. Our value model and code are available at https://github.com/si0wang/VisVM.
Self-Correcting Decoding with Generative Feedback for Mitigating Hallucinations in Large Vision-Language Models
While recent Large Vision-Language Models (LVLMs) have shown remarkable performance in multi-modal tasks, they are prone to generating hallucinatory text responses that do not align with the given visual input, which restricts their practical applicability in real-world scenarios. In this work, inspired by the observation that the text-to-image generation process is the inverse of image-conditioned response generation in LVLMs, we explore the potential of leveraging text-to-image generative models to assist in mitigating hallucinations in LVLMs. We discover that generative models can offer valuable self-feedback for mitigating hallucinations at both the response and token levels. Building on this insight, we introduce self-correcting Decoding with Generative Feedback (DeGF), a novel training-free algorithm that incorporates feedback from text-to-image generative models into the decoding process to effectively mitigate hallucinations in LVLMs. Specifically, DeGF generates an image from the initial response produced by LVLMs, which acts as an auxiliary visual reference and provides self-feedback to verify and correct the initial response through complementary or contrastive decoding. Extensive experimental results validate the effectiveness of our approach in mitigating diverse types of hallucinations, consistently surpassing state-of-the-art methods across six benchmarks. Code is available at https://github.com/zhangce01/DeGF.
Capturing Gaze Shifts for Guidance: Cross-Modal Fusion Enhancement for VLM Hallucination Mitigation
Vision language models (VLMs) often generate hallucination, i.e., content that cannot be substantiated by either textual or visual inputs. Prior work primarily attributes this to over-reliance on linguistic prior knowledge rather than visual inputs. Some methods attempt to mitigate hallucination by amplifying visual token attention proportionally to their attention scores. However, these methods overlook the visual attention sink problem, where attention is frequently misallocated to task-irrelevant visual regions, and neglect cross-modal fusion balance by enhancing only visual attention without adjusting attention to the user query. This can result in amplifying incorrect areas while failing to properly interpret the user query. To address these challenges, we propose a simple yet effective method called Gaze Shift-Guided Cross-modal Fusion Enhancement (GIFT). GIFT pre-computes a holistic visual saliency map by tracking positive changes in visual attention, or "gaze shifts", during user query comprehension, and leverages this map to amplify attention to both salient visual information and the user query at each decoding step. This reduces the impact of visual attention sink, as irrelevant tokens exhibit minimal shifts, while ensuring balanced cross-modal fusion for well-integrated representation. Extensive experiments show that GIFT effectively mitigates hallucination in VLMs across both generative and classification tasks, achieving up to 20.7% improvement over greedy decoding, while maintaining general vision-language performance with low computational overhead.
SAILViT: Towards Robust and Generalizable Visual Backbones for MLLMs via Gradual Feature Refinement
Vision Transformers (ViTs) are essential as foundation backbones in establishing the visual comprehension capabilities of Multimodal Large Language Models (MLLMs). Although most ViTs achieve impressive performance through image-text pair-based contrastive learning or self-supervised mechanisms, they struggle to engage in connector-based co-training directly with LLMs due to potential parameter initialization conflicts and modality semantic gaps. To address the above challenges, this paper proposes SAILViT, a gradual feature learning-enhanced ViT for facilitating MLLMs to break through performance bottlenecks in complex multimodal interactions. SAILViT achieves coarse-to-fine-grained feature alignment and world knowledge infusion with gradual feature refinement, which better serves target training demands. We perform thorough empirical analyses to confirm the powerful robustness and generalizability of SAILViT across different dimensions, including parameter sizes, model architectures, training strategies, and data scales. Equipped with SAILViT, existing MLLMs show significant and consistent performance improvements on the OpenCompass benchmark across extensive downstream tasks. SAILViT series models are released at https://huggingface.co/BytedanceDouyinContent.
Preliminary Explorations with GPT-4o(mni) Native Image Generation
Recently, the visual generation ability by GPT-4o(mni) has been unlocked by OpenAI. It demonstrates a very remarkable generation capability with excellent multimodal condition understanding and varied task instructions. In this paper, we aim to explore the capabilities of GPT-4o across various tasks. Inspired by previous study, we constructed a task taxonomy along with a carefully curated set of test samples to conduct a comprehensive qualitative test. Benefiting from GPT-4o's powerful multimodal comprehension, its image-generation process demonstrates abilities surpassing those of traditional image-generation tasks. Thus, regarding the dimensions of model capabilities, we evaluate its performance across six task categories: traditional image generation tasks, discriminative tasks, knowledge-based generation, commonsense-based generation, spatially-aware image generation, and temporally-aware image generation. These tasks not only assess the quality and conditional alignment of the model's outputs but also probe deeper into GPT-4o's understanding of real-world concepts. Our results reveal that GPT-4o performs impressively well in general-purpose synthesis tasks, showing strong capabilities in text-to-image generation, visual stylization, and low-level image processing. However, significant limitations remain in its ability to perform precise spatial reasoning, instruction-grounded generation, and consistent temporal prediction. Furthermore, when faced with knowledge-intensive or domain-specific scenarios, such as scientific illustrations or mathematical plots, the model often exhibits hallucinations, factual errors, or structural inconsistencies. These findings suggest that while GPT-4o marks a substantial advancement in unified multimodal generation, there is still a long way to go before it can be reliably applied to professional or safety-critical domains.
ProVision: Programmatically Scaling Vision-centric Instruction Data for Multimodal Language Models
With the rise of multimodal applications, instruction data has become critical for training multimodal language models capable of understanding complex image-based queries. Existing practices rely on powerful but costly large language models (LLMs) or multimodal language models (MLMs) to produce instruction data. These are often prone to hallucinations, licensing issues and the generation process is often hard to scale and interpret. In this work, we present a programmatic approach that employs scene graphs as symbolic representations of images and human-written programs to systematically synthesize vision-centric instruction data. Our approach ensures the interpretability and controllability of the data generation process and scales efficiently while maintaining factual accuracy. By implementing a suite of 24 single-image, 14 multi-image instruction generators, and a scene graph generation pipeline, we build a scalable, cost-effective system: ProVision which produces diverse question-answer pairs concerning objects, attributes, relations, depth, etc., for any given image. Applied to Visual Genome and DataComp datasets, we generate over 10 million instruction data points, ProVision-10M, and leverage them in both pretraining and instruction tuning stages of MLMs. When adopted in the instruction tuning stage, our single-image instruction data yields up to a 7% improvement on the 2D split and 8% on the 3D split of CVBench, along with a 3% increase in performance on QBench2, RealWorldQA, and MMMU. Our multi-image instruction data leads to an 8% improvement on Mantis-Eval. Incorporation of our data in both pre-training and fine-tuning stages of xGen-MM-4B leads to an averaged improvement of 1.6% across 11 benchmarks.
Improving Visual Prompt Tuning for Self-supervised Vision Transformers
Visual Prompt Tuning (VPT) is an effective tuning method for adapting pretrained Vision Transformers (ViTs) to downstream tasks. It leverages extra learnable tokens, known as prompts, which steer the frozen pretrained ViTs. Although VPT has demonstrated its applicability with supervised vision transformers, it often underperforms with self-supervised ones. Through empirical observations, we deduce that the effectiveness of VPT hinges largely on the ViT blocks with which the prompt tokens interact. Specifically, VPT shows improved performance on image classification tasks for MAE and MoCo v3 when the prompt tokens are inserted into later blocks rather than the first block. These observations suggest that there exists an optimal location of blocks for the insertion of prompt tokens. Unfortunately, identifying the optimal blocks for prompts within each self-supervised ViT for diverse future scenarios is a costly process. To mitigate this problem, we propose a simple yet effective method that learns a gate for each ViT block to adjust its intervention into the prompt tokens. With our method, prompt tokens are selectively influenced by blocks that require steering for task adaptation. Our method outperforms VPT variants in FGVC and VTAB image classification and ADE20K semantic segmentation. The code is available at https://github.com/ryongithub/GatedPromptTuning.
FG-CXR: A Radiologist-Aligned Gaze Dataset for Enhancing Interpretability in Chest X-Ray Report Generation
Developing an interpretable system for generating reports in chest X-ray (CXR) analysis is becoming increasingly crucial in Computer-aided Diagnosis (CAD) systems, enabling radiologists to comprehend the decisions made by these systems. Despite the growth of diverse datasets and methods focusing on report generation, there remains a notable gap in how closely these models' generated reports align with the interpretations of real radiologists. In this study, we tackle this challenge by initially introducing Fine-Grained CXR (FG-CXR) dataset, which provides fine-grained paired information between the captions generated by radiologists and the corresponding gaze attention heatmaps for each anatomy. Unlike existing datasets that include a raw sequence of gaze alongside a report, with significant misalignment between gaze location and report content, our FG-CXR dataset offers a more grained alignment between gaze attention and diagnosis transcript. Furthermore, our analysis reveals that simply applying black-box image captioning methods to generate reports cannot adequately explain which information in CXR is utilized and how long needs to attend to accurately generate reports. Consequently, we propose a novel explainable radiologist's attention generator network (Gen-XAI) that mimics the diagnosis process of radiologists, explicitly constraining its output to closely align with both radiologist's gaze attention and transcript. Finally, we perform extensive experiments to illustrate the effectiveness of our method. Our datasets and checkpoint is available at https://github.com/UARK-AICV/FG-CXR.
VIGC: Visual Instruction Generation and Correction
The integration of visual encoders and large language models (LLMs) has driven recent progress in multimodal large language models (MLLMs). However, the scarcity of high-quality instruction-tuning data for vision-language tasks remains a challenge. The current leading paradigm, such as LLaVA, relies on language-only GPT-4 to generate data, which requires pre-annotated image captions and detection bounding boxes, suffering from understanding image details. A practical solution to this problem would be to utilize the available multimodal large language models (MLLMs) to generate instruction data for vision-language tasks. However, it's worth noting that the currently accessible MLLMs are not as powerful as their LLM counterparts, as they tend to produce inadequate responses and generate false information. As a solution for addressing the current issue, this paper proposes the Visual Instruction Generation and Correction (VIGC) framework that enables multimodal large language models to generate instruction-tuning data and progressively enhance its quality on-the-fly. Specifically, Visual Instruction Generation (VIG) guides the vision-language model to generate diverse instruction-tuning data. To ensure generation quality, Visual Instruction Correction (VIC) adopts an iterative update mechanism to correct any inaccuracies in data produced by VIG, effectively reducing the risk of hallucination. Leveraging the diverse, high-quality data generated by VIGC, we finetune mainstream models and validate data quality based on various evaluations. Experimental results demonstrate that VIGC not only compensates for the shortcomings of language-only data generation methods, but also effectively enhances the benchmark performance. The models, datasets, and code are available at https://opendatalab.github.io/VIGC.
CCD: Mitigating Hallucinations in Radiology MLLMs via Clinical Contrastive Decoding
Multimodal large language models (MLLMs) have recently achieved remarkable progress in radiology by integrating visual perception with natural language understanding. However, they often generate clinically unsupported descriptions, known as medical hallucinations, which pose serious risks in medical applications that demand accuracy and image-grounded outputs. Through empirical analysis, we find that prompt-induced hallucinations remain prevalent in radiology MLLMs, largely due to over-sensitivity to clinical sections. To address this, we introduce Clinical Contrastive Cecoding (CCD), a training-free and retrieval-free inference framework that integrates structured clinical signals from task-specific radiology expert models. CCD introduces a dual-stage contrastive mechanism to refine token-level logits during generation, thereby enhancing clinical fidelity without modifying the base MLLM. Experiments on three datasets and multiple models demonstrate that CCD consistently improves overall performance on radiology report generation (RRG). On the MIMIC-CXR dataset, it yields up to a 17% improvement in RadGraph-F1 when applied to state-of-the-art RRG models. Our approach provides a lightweight and generalisable solution for mitigating medical hallucinations, effectively bridging expert models and MLLMs in radiology.
RetinaLogos: Fine-Grained Synthesis of High-Resolution Retinal Images Through Captions
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.
Diagnosing Visual Reasoning: Challenges, Insights, and a Path Forward
Multimodal large language models (MLLMs) that integrate visual and textual reasoning leverage chain-of-thought (CoT) prompting to tackle complex visual tasks, yet continue to exhibit visual hallucinations and an over-reliance on textual priors. We present a systematic diagnosis of state-of-the-art vision-language models using a three-stage evaluation framework, uncovering key failure modes. To address these, we propose an agent-based architecture that combines LLM reasoning with lightweight visual modules, enabling fine-grained analysis and iterative refinement of reasoning chains. Our results highlight future visual reasoning models should focus on integrating a broader set of specialized tools for analyzing visual content. Our system achieves significant gains (+10.3 on MMMU, +6.0 on MathVista over a 7B baseline), matching or surpassing much larger models. We will release our framework and evaluation suite to facilitate future research.
PET2Rep: Towards Vision-Language Model-Drived Automated Radiology Report Generation for Positron Emission Tomography
Positron emission tomography (PET) is a cornerstone of modern oncologic and neurologic imaging, distinguished by its unique ability to illuminate dynamic metabolic processes that transcend the anatomical focus of traditional imaging technologies. Radiology reports are essential for clinical decision making, yet their manual creation is labor-intensive and time-consuming. Recent advancements of vision-language models (VLMs) have shown strong potential in medical applications, presenting a promising avenue for automating report generation. However, existing applications of VLMs in the medical domain have predominantly focused on structural imaging modalities, while the unique characteristics of molecular PET imaging have largely been overlooked. To bridge the gap, we introduce PET2Rep, a large-scale comprehensive benchmark for evaluation of general and medical VLMs for radiology report generation for PET images. PET2Rep stands out as the first dedicated dataset for PET report generation with metabolic information, uniquely capturing whole-body image-report pairs that cover dozens of organs to fill the critical gap in existing benchmarks and mirror real-world clinical comprehensiveness. In addition to widely recognized natural language generation metrics, we introduce a series of clinical efficiency metrics to evaluate the quality of radiotracer uptake pattern description in key organs in generated reports. We conduct a head-to-head comparison of 30 cutting-edge general-purpose and medical-specialized VLMs. The results show that the current state-of-the-art VLMs perform poorly on PET report generation task, falling considerably short of fulfilling practical needs. Moreover, we identify several key insufficiency that need to be addressed to advance the development in medical applications.
MedVision: Dataset and Benchmark for Quantitative Medical Image Analysis
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.
VidHalluc: Evaluating Temporal Hallucinations in Multimodal Large Language Models for Video Understanding
Multimodal large language models (MLLMs) have recently shown significant advancements in video understanding, excelling in content reasoning and instruction-following tasks. However, hallucination, where models generate inaccurate or misleading content, remains underexplored in the video domain. Building on the observation that MLLM visual encoders often fail to distinguish visually different yet semantically similar video pairs, we introduce VidHalluc, the largest benchmark designed to examine hallucinations in MLLMs for video understanding. It consists of 5,002 videos, paired to highlight cases prone to hallucinations. VidHalluc assesses hallucinations across three critical dimensions: (1) action, (2) temporal sequence, and (3) scene transition. Comprehensive testing shows that most MLLMs are vulnerable to hallucinations across these dimensions. Furthermore, we propose DINO-HEAL, a training-free method that reduces hallucinations by incorporating spatial saliency from DINOv2 to reweight visual features during inference. Our results show that DINO-HEAL consistently improves performance on VidHalluc, achieving an average improvement of 3.02% in mitigating hallucinations across all tasks. Both the VidHalluc benchmark and DINO-HEAL code are available at https://people-robots.github.io/vidhalluc.
DEEM: Diffusion Models Serve as the Eyes of Large Language Models for Image Perception
The development of large language models (LLMs) has significantly advanced the emergence of large multimodal models (LMMs). While LMMs have achieved tremendous success by promoting the synergy between multimodal comprehension and creation, they often face challenges when confronted with out-of-distribution data. This is primarily due to their reliance on image encoders trained to encode images into task-relevant features, which may lead them to disregard irrelevant details. Delving into the modeling capabilities of diffusion models for images naturally prompts the question: Can diffusion models serve as the eyes of large language models for image perception? In this paper, we propose DEEM, a simple and effective approach that utilizes the generative feedback of diffusion models to align the semantic distributions of the image encoder. This addresses the drawbacks of previous methods that solely relied on image encoders like ViT, thereby enhancing the model's resilience against out-of-distribution samples and reducing visual hallucinations. Importantly, this is achieved without requiring additional training modules and with fewer training parameters. We extensively evaluated DEEM on both our newly constructed RobustVQA benchmark and another well-known benchmark, POPE, for object hallucination. Compared to the state-of-the-art interleaved content generation models, DEEM exhibits enhanced robustness and a superior capacity to alleviate model hallucinations while utilizing fewer trainable parameters, less pre-training data (10%), and a smaller base model size.
VideoA11y: Method and Dataset for Accessible Video Description
Video descriptions are crucial for blind and low vision (BLV) users to access visual content. However, current artificial intelligence models for generating descriptions often fall short due to limitations in the quality of human annotations within training datasets, resulting in descriptions that do not fully meet BLV users' needs. To address this gap, we introduce VideoA11y, an approach that leverages multimodal large language models (MLLMs) and video accessibility guidelines to generate descriptions tailored for BLV individuals. Using this method, we have curated VideoA11y-40K, the largest and most comprehensive dataset of 40,000 videos described for BLV users. Rigorous experiments across 15 video categories, involving 347 sighted participants, 40 BLV participants, and seven professional describers, showed that VideoA11y descriptions outperform novice human annotations and are comparable to trained human annotations in clarity, accuracy, objectivity, descriptiveness, and user satisfaction. We evaluated models on VideoA11y-40K using both standard and custom metrics, demonstrating that MLLMs fine-tuned on this dataset produce high-quality accessible descriptions. Code and dataset are available at https://people-robots.github.io/VideoA11y.
Exploring Typographic Visual Prompts Injection Threats in Cross-Modality Generation Models
Current Cross-Modality Generation Models (GMs) demonstrate remarkable capabilities in various generative tasks. Given the ubiquity and information richness of vision modality inputs in real-world scenarios, Cross-vision, encompassing Vision-Language Perception (VLP) and Image-to-Image (I2I), tasks have attracted significant attention. Large Vision Language Models (LVLMs) and I2I GMs are employed to handle VLP and I2I tasks, respectively. Previous research indicates that printing typographic words into input images significantly induces LVLMs and I2I GMs to generate disruptive outputs semantically related to those words. Additionally, visual prompts, as a more sophisticated form of typography, are also revealed to pose security risks to various applications of VLP tasks when injected into images. In this paper, we comprehensively investigate the performance impact induced by Typographic Visual Prompt Injection (TVPI) in various LVLMs and I2I GMs. To better observe performance modifications and characteristics of this threat, we also introduce the TVPI Dataset. Through extensive explorations, we deepen the understanding of the underlying causes of the TVPI threat in various GMs and offer valuable insights into its potential origins.
Draw-and-Understand: Leveraging Visual Prompts to Enable MLLMs to Comprehend What You Want
The interaction between humans and artificial intelligence (AI) is a crucial factor that reflects the effectiveness of multimodal large language models (MLLMs). However, current MLLMs primarily focus on image-level comprehension and limit interaction to textual instructions, thereby constraining their flexibility in usage and depth of response. In this paper, we introduce the Draw-and-Understand project: a new model, a multi-domain dataset, and a challenging benchmark for visual prompting. Specifically, we propose SPHINX-V, a new end-to-end trained Multimodal Large Language Model (MLLM) that connects a vision encoder, a visual prompt encoder and an LLM for various visual prompts (points, bounding boxes, and free-form shape) and language understanding. To advance visual prompting research for MLLMs, we introduce MDVP-Data and MDVP-Bench. MDVP-Data features a multi-domain dataset containing 1.6M unique image-visual prompt-text instruction-following samples, including natural images, document images, OCR images, mobile screenshots, web screenshots, and multi-panel images. Furthermore, we present MDVP-Bench, a comprehensive and challenging benchmark to assess a model's capability in understanding visual prompting instructions. Our experiments demonstrate SPHINX-V's impressive multimodal interaction capabilities through visual prompting, revealing significant improvements in detailed pixel-level description and question-answering abilities.
NeuroPrompts: An Adaptive Framework to Optimize Prompts for Text-to-Image Generation
Despite impressive recent advances in text-to-image diffusion models, obtaining high-quality images often requires prompt engineering by humans who have developed expertise in using them. In this work, we present NeuroPrompts, an adaptive framework that automatically enhances a user's prompt to improve the quality of generations produced by text-to-image models. Our framework utilizes constrained text decoding with a pre-trained language model that has been adapted to generate prompts similar to those produced by human prompt engineers. This approach enables higher-quality text-to-image generations and provides user control over stylistic features via constraint set specification. We demonstrate the utility of our framework by creating an interactive application for prompt enhancement and image generation using Stable Diffusion. Additionally, we conduct experiments utilizing a large dataset of human-engineered prompts for text-to-image generation and show that our approach automatically produces enhanced prompts that result in superior image quality. We make our code, a screencast video demo and a live demo instance of NeuroPrompts publicly available.
DDXPlus: A New Dataset For Automatic Medical Diagnosis
There has been a rapidly growing interest in Automatic Symptom Detection (ASD) and Automatic Diagnosis (AD) systems in the machine learning research literature, aiming to assist doctors in telemedicine services. These systems are designed to interact with patients, collect evidence about their symptoms and relevant antecedents, and possibly make predictions about the underlying diseases. Doctors would review the interactions, including the evidence and the predictions, collect if necessary additional information from patients, before deciding on next steps. Despite recent progress in this area, an important piece of doctors' interactions with patients is missing in the design of these systems, namely the differential diagnosis. Its absence is largely due to the lack of datasets that include such information for models to train on. In this work, we present a large-scale synthetic dataset of roughly 1.3 million patients that includes a differential diagnosis, along with the ground truth pathology, symptoms and antecedents for each patient. Unlike existing datasets which only contain binary symptoms and antecedents, this dataset also contains categorical and multi-choice symptoms and antecedents useful for efficient data collection. Moreover, some symptoms are organized in a hierarchy, making it possible to design systems able to interact with patients in a logical way. As a proof-of-concept, we extend two existing AD and ASD systems to incorporate the differential diagnosis, and provide empirical evidence that using differentials as training signals is essential for the efficiency of such systems or for helping doctors better understand the reasoning of those systems.
Trust but Verify: Programmatic VLM Evaluation in the Wild
Vision-Language Models (VLMs) often generate plausible but incorrect responses to visual queries. However, reliably quantifying the effect of such hallucinations in free-form responses to open-ended queries is challenging as it requires visually verifying each claim within the response. We propose Programmatic VLM Evaluation (PROVE), a new benchmarking paradigm for evaluating VLM responses to open-ended queries. To construct PROVE, we provide a large language model (LLM) with a high-fidelity scene-graph representation constructed from a hyper-detailed image caption, and prompt it to generate diverse question-answer (QA) pairs, as well as programs that can be executed over the scene graph object to verify each QA pair. We thus construct a benchmark of 10.5k challenging but visually grounded QA pairs. Next, to evaluate free-form model responses to queries in PROVE, we propose a programmatic evaluation strategy that measures both the helpfulness and truthfulness of a response within a unified scene graph-based framework. We benchmark the helpfulness-truthfulness trade-offs of a range of VLMs on PROVE, finding that very few are in-fact able to achieve a good balance between the two. Project page: https://prove-explorer.netlify.app/.
BIOMEDICA: An Open Biomedical Image-Caption Archive, Dataset, and Vision-Language Models Derived from Scientific Literature
The development of vision-language models (VLMs) is driven by large-scale and diverse multimodal datasets. However, progress toward generalist biomedical VLMs is limited by the lack of annotated, publicly accessible datasets across biology and medicine. Existing efforts are restricted to narrow domains, missing the full diversity of biomedical knowledge encoded in scientific literature. To address this gap, we introduce BIOMEDICA, a scalable, open-source framework to extract, annotate, and serialize the entirety of the PubMed Central Open Access subset into an easy-to-use, publicly accessible dataset.Our framework produces a comprehensive archive with over 24 million unique image-text pairs from over 6 million articles. Metadata and expert-guided annotations are also provided. We demonstrate the utility and accessibility of our resource by releasing BMCA-CLIP, a suite of CLIP-style models continuously pre-trained on the BIOMEDICA dataset via streaming, eliminating the need to download 27 TB of data locally.On average, our models achieve state-of-the-art performance across 40 tasks - spanning pathology, radiology, ophthalmology, dermatology, surgery, molecular biology, parasitology, and cell biology - excelling in zero-shot classification with a 6.56% average improvement (as high as 29.8% and 17.5% in dermatology and ophthalmology, respectively), and stronger image-text retrieval, all while using 10x less compute. To foster reproducibility and collaboration, we release our codebase and dataset for the broader research community.
Debiasing Large Visual Language Models
In the realms of computer vision and natural language processing, Large Vision-Language Models (LVLMs) have become indispensable tools, proficient in generating textual descriptions based on visual inputs. Despite their advancements, our investigation reveals a noteworthy bias in the generated content, where the output is primarily influenced by the underlying Large Language Models (LLMs) prior rather than the input image. Our empirical experiments underscore the persistence of this bias, as LVLMs often provide confident answers even in the absence of relevant images or given incongruent visual input. To rectify these biases and redirect the model's focus toward vision information, we introduce two simple, training-free strategies. Firstly, for tasks such as classification or multi-choice question-answering (QA), we propose a ``calibration'' step through affine transformation to adjust the output distribution. This ``Post-Hoc debias'' approach ensures uniform scores for each answer when the image is absent, serving as an effective regularization technique to alleviate the influence of LLM priors. For more intricate open-ended generation tasks, we extend this method to ``Debias sampling'', drawing inspirations from contrastive decoding methods. Furthermore, our investigation sheds light on the instability of LVLMs across various decoding configurations. Through systematic exploration of different settings, we significantly enhance performance, surpassing reported results and raising concerns about the fairness of existing evaluations. Comprehensive experiments substantiate the effectiveness of our proposed strategies in mitigating biases. These strategies not only prove beneficial in minimizing hallucinations but also contribute to the generation of more helpful and precise illustrations.
A Comprehensive Evaluation of GPT-4V on Knowledge-Intensive Visual Question Answering
The emergence of multimodal large models (MLMs) has significantly advanced the field of visual understanding, offering remarkable capabilities in the realm of visual question answering (VQA). Yet, the true challenge lies in the domain of knowledge-intensive VQA tasks, which necessitate not just recognition of visual elements, but also a deep comprehension of the visual information in conjunction with a vast repository of learned knowledge. To uncover such capabilities of MLMs, particularly the newly introduced GPT-4V and Gemini, we provide an in-depth evaluation from three perspectives: 1) Commonsense Knowledge, which assesses how well models can understand visual cues and connect to general knowledge; 2) Fine-grained World Knowledge, which tests the model's skill in reasoning out specific knowledge from images, showcasing their proficiency across various specialized fields; 3) Comprehensive Knowledge with Decision-making Rationales, which examines model's capability to provide logical explanations for its inference, facilitating a deeper analysis from the interpretability perspective. Additionally, we utilize a visual knowledge-enhanced training strategy and multimodal retrieval-augmented generation approach to enhance MLMs, highlighting the future need for advancements in this research direction. Extensive experiments indicate that: a) GPT-4V demonstrates enhanced explanation generation when using composite images as few-shots; b) GPT-4V and other MLMs produce severe hallucinations when dealing with world knowledge; c) Visual knowledge enhanced training and prompting technicals present potential to improve performance. Codes: https://github.com/HITsz-TMG/Cognitive-Visual-Language-Mapper
Pathology Report Generation and Multimodal Representation Learning for Cutaneous Melanocytic Lesions
Millions of melanocytic skin lesions are examined by pathologists each year, the majority of which concern common nevi (i.e., ordinary moles). While most of these lesions can be diagnosed in seconds, writing the corresponding pathology report is much more time-consuming. Automating part of the report writing could, therefore, alleviate the increasing workload of pathologists. In this work, we develop a vision-language model specifically for the pathology domain of cutaneous melanocytic lesions. The model follows the Contrastive Captioner framework and was trained and evaluated using a melanocytic lesion dataset of 42,512 H&E-stained whole slide images and 19,645 corresponding pathology reports. Our results show that the quality scores of model-generated reports were on par with pathologist-written reports for common nevi, assessed by an expert pathologist in a reader study. While report generation revealed to be more difficult for rare melanocytic lesion subtypes, the cross-modal retrieval performance for these cases was considerably better.
Transfer Visual Prompt Generator across LLMs
While developing a new vision-language LLM (VL-LLM) by pre-training on tremendous image-text pairs from scratch can be exceedingly resource-consuming, connecting an existing LLM with a comparatively lightweight visual prompt generator (VPG) becomes a feasible paradigm. However, further tuning the VPG part of the VL-LLM still suffers from indispensable computational costs, i.e., requiring thousands of GPU hours and millions of training data. One alternative solution is to transfer an existing VPG from any existing VL-LLMs for the target VL-LLM. In this work, we for the first time investigate the VPG transferability across LLMs, and explore a solution to reduce the cost of VPG transfer. We first study the VPG transfer across different LLM sizes (e.g., small-to-large), and across different LLM types, through which we diagnose the key factors to maximize the transfer efficiency. Based on our observation, we design a two-stage transfer framework named VPGTrans, which is simple yet highly effective. Through extensive experiments, we demonstrate that VPGTrans helps significantly speed up the transfer learning process without compromising performance. Remarkably, it helps achieve the VPG transfer from BLIP-2 OPT_2.7B to BLIP-2 OPT_6.7B with over 10 times speed-up and 10.7% training data compared with connecting a VPG to OPT_6.7B from scratch. Further, a series of intriguing findings and potential rationales behind them are provided and discussed. Finally, we showcase the practical value of our VPGTrans approach, by customizing two novel VL-LLMs, including VL-LLaMA and VL-Vicuna, with recently released LLaMA and Vicuna LLMs.
Vision-Driven Prompt Optimization for Large Language Models in Multimodal Generative Tasks
Vision generation remains a challenging frontier in artificial intelligence, requiring seamless integration of visual understanding and generative capabilities. In this paper, we propose a novel framework, Vision-Driven Prompt Optimization (VDPO), that leverages Large Language Models (LLMs) to dynamically generate textual prompts from visual inputs, guiding high-fidelity image synthesis. VDPO combines a visual embedding prompt tuner, a textual instruction generator, and a vision generation module to achieve state-of-the-art performance in diverse vision generation tasks. Extensive experiments on benchmarks such as COCO and Sketchy demonstrate that VDPO consistently outperforms existing methods, achieving significant improvements in FID, LPIPS, and BLEU/CIDEr scores. Additional analyses reveal the scalability, robustness, and generalization capabilities of VDPO, making it a versatile solution for in-domain and out-of-domain tasks. Human evaluations further validate the practical superiority of VDPO in generating visually appealing and semantically coherent outputs.
Generate, but Verify: Reducing Hallucination in Vision-Language Models with Retrospective Resampling
Vision-Language Models (VLMs) excel at visual understanding but often suffer from visual hallucinations, where they generate descriptions of nonexistent objects, actions, or concepts, posing significant risks in safety-critical applications. Existing hallucination mitigation methods typically follow one of two paradigms: generation adjustment, which modifies decoding behavior to align text with visual inputs, and post-hoc verification, where external models assess and correct outputs. While effective, generation adjustment methods often rely on heuristics and lack correction mechanisms, while post-hoc verification is complicated, typically requiring multiple models and tending to reject outputs rather than refine them. In this work, we introduce REVERSE, a unified framework that integrates hallucination-aware training with on-the-fly self-verification. By leveraging a new hallucination-verification dataset containing over 1.3M semi-synthetic samples, along with a novel inference-time retrospective resampling technique, our approach enables VLMs to both detect hallucinations during generation and dynamically revise those hallucinations. Our evaluations show that REVERSE achieves state-of-the-art hallucination reduction, outperforming the best existing methods by up to 12% on CHAIR-MSCOCO and 28% on HaloQuest. Our dataset, model, and code are available at: https://reverse-vlm.github.io.
Repurposing the scientific literature with vision-language models
Leading vision-language models (VLMs) are trained on general Internet content, overlooking scientific journals' rich, domain-specific knowledge. Training on specialty-specific literature could yield high-performance, task-specific tools, enabling generative AI to match generalist models in specialty publishing, educational, and clinical tasks. We created NeuroPubs, a multimodal dataset of 23,000 Neurosurgery Publications articles (134M words, 78K image-caption pairs). Using NeuroPubs, VLMs generated publication-ready graphical abstracts (70% of 100 abstracts) and board-style questions indistinguishable from human-written ones (54% of 89,587 questions). We used these questions to train CNS-Obsidian, a 34B-parameter VLM. In a blinded, randomized controlled trial, our model demonstrated non-inferiority to then state-of-the-art GPT-4o in neurosurgical differential diagnosis (clinical utility, 40.62% upvotes vs. 57.89%, p=0.1150; accuracy, 59.38% vs. 65.79%, p=0.3797). Our pilot study demonstrates how training generative AI models on specialty-specific journal content - without large-scale internet data - results in high-performance academic and clinical tools, enabling domain-tailored AI across diverse fields.
Cognitive Mirage: A Review of Hallucinations in Large Language Models
As large language models continue to develop in the field of AI, text generation systems are susceptible to a worrisome phenomenon known as hallucination. In this study, we summarize recent compelling insights into hallucinations in LLMs. We present a novel taxonomy of hallucinations from various text generation tasks, thus provide theoretical insights, detection methods and improvement approaches. Based on this, future research directions are proposed. Our contribution are threefold: (1) We provide a detailed and complete taxonomy for hallucinations appearing in text generation tasks; (2) We provide theoretical analyses of hallucinations in LLMs and provide existing detection and improvement methods; (3) We propose several research directions that can be developed in the future. As hallucinations garner significant attention from the community, we will maintain updates on relevant research progress.
PMC-VQA: Visual Instruction Tuning for Medical Visual Question Answering
In this paper, we focus on the problem of Medical Visual Question Answering (MedVQA), which is crucial in efficiently interpreting medical images with vital clinic-relevant information. Firstly, we reframe the problem of MedVQA as a generation task that naturally follows the human-machine interaction, we propose a generative-based model for medical visual understanding by aligning visual information from a pre-trained vision encoder with a large language model. Secondly, we establish a scalable pipeline to construct a large-scale medical visual question-answering dataset, named PMC-VQA, which contains 227k VQA pairs of 149k images that cover various modalities or diseases. Thirdly, we pre-train our proposed model on PMC-VQA and then fine-tune it on multiple public benchmarks, e.g., VQA-RAD and SLAKE, outperforming existing work by a large margin. Additionally, we propose a test set that has undergone manual verification, which is significantly more challenging, even the best models struggle to solve.
Comprehensive language-image pre-training for 3D medical image understanding
Vision-language pre-training, i.e., aligning images with paired text, is a powerful paradigm to create encoders that can be directly used for tasks such as classification and retrieval, and for downstream tasks such as segmentation and report generation. In the 3D medical image domain, these capabilities allow vision-language encoders (VLEs) to support radiologists by retrieving patients with similar abnormalities or predicting likelihoods of abnormality. While the methodology holds promise, data availability limits the capabilities of current 3D VLEs. In this paper, we alleviate the lack of data by injecting additional inductive biases: introducing a report generation objective and pairing vision-language pre-training with vision-only pre-training. This allows us to leverage both image-only and paired image-text 3D datasets, increasing the total amount of data to which our model is exposed. Through these additional inductive biases, paired with best practices of the 3D medical imaging domain, we develop the Comprehensive Language-image Pre-training (COLIPRI) encoder family. Our COLIPRI encoders achieve state-of-the-art performance in report generation, classification probing, and zero-shot classification, and remain competitive for semantic segmentation.
Towards Unifying Medical Vision-and-Language Pre-training via Soft Prompts
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.
Patho-AgenticRAG: Towards Multimodal Agentic Retrieval-Augmented Generation for Pathology VLMs via Reinforcement Learning
Although Vision Language Models (VLMs) have shown strong generalization in medical imaging, pathology presents unique challenges due to ultra-high resolution, complex tissue structures, and nuanced clinical semantics. These factors make pathology VLMs prone to hallucinations, i.e., generating outputs inconsistent with visual evidence, which undermines clinical trust. Existing RAG approaches in this domain largely depend on text-based knowledge bases, limiting their ability to leverage diagnostic visual cues. To address this, we propose Patho-AgenticRAG, a multimodal RAG framework with a database built on page-level embeddings from authoritative pathology textbooks. Unlike traditional text-only retrieval systems, it supports joint text-image search, enabling direct retrieval of textbook pages that contain both the queried text and relevant visual cues, thus avoiding the loss of critical image-based information. Patho-AgenticRAG also supports reasoning, task decomposition, and multi-turn search interactions, improving accuracy in complex diagnostic scenarios. Experiments show that Patho-AgenticRAG significantly outperforms existing multimodal models in complex pathology tasks like multiple-choice diagnosis and visual question answering. Our project is available at the Patho-AgenticRAG repository: https://github.com/Wenchuan-Zhang/Patho-AgenticRAG.
Token Coordinated Prompt Attention is Needed for Visual Prompting
Visual prompting techniques are widely used to efficiently fine-tune pretrained Vision Transformers (ViT) by learning a small set of shared prompts for all tokens. However, existing methods overlook the unique roles of different tokens in conveying discriminative information and interact with all tokens using the same prompts, thereby limiting the representational capacity of ViT. This often leads to indistinguishable and biased prompt-extracted features, hindering performance. To address this issue, we propose a plug-and-play Token Coordinated Prompt Attention (TCPA) module, which assigns specific coordinated prompts to different tokens for attention-based interactions. Firstly, recognizing the distinct functions of CLS and image tokens-global information aggregation and local feature extraction, we disentangle the prompts into CLS Prompts and Image Prompts, which interact exclusively with CLS tokens and image tokens through attention mechanisms. This enhances their respective discriminative abilities. Furthermore, as different image tokens correspond to distinct image patches and contain diverse information, we employ a matching function to automatically assign coordinated prompts to individual tokens. This enables more precise attention interactions, improving the diversity and representational capacity of the extracted features. Extensive experiments across various benchmarks demonstrate that TCPA significantly enhances the diversity and discriminative power of the extracted features. The code is available at https://github.com/zhoujiahuan1991/ICML2025-TCPA.
Constructing Ophthalmic MLLM for Positioning-diagnosis Collaboration Through Clinical Cognitive Chain Reasoning
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.
ReDSM5: A Reddit Dataset for DSM-5 Depression Detection
Depression is a pervasive mental health condition that affects hundreds of millions of individuals worldwide, yet many cases remain undiagnosed due to barriers in traditional clinical access and pervasive stigma. Social media platforms, and Reddit in particular, offer rich, user-generated narratives that can reveal early signs of depressive symptomatology. However, existing computational approaches often label entire posts simply as depressed or not depressed, without linking language to specific criteria from the DSM-5, the standard clinical framework for diagnosing depression. This limits both clinical relevance and interpretability. To address this gap, we introduce ReDSM5, a novel Reddit corpus comprising 1484 long-form posts, each exhaustively annotated at the sentence level by a licensed psychologist for the nine DSM-5 depression symptoms. For each label, the annotator also provides a concise clinical rationale grounded in DSM-5 methodology. We conduct an exploratory analysis of the collection, examining lexical, syntactic, and emotional patterns that characterize symptom expression in social media narratives. Compared to prior resources, ReDSM5 uniquely combines symptom-specific supervision with expert explanations, facilitating the development of models that not only detect depression but also generate human-interpretable reasoning. We establish baseline benchmarks for both multi-label symptom classification and explanation generation, providing reference results for future research on detection and interpretability.
Unimedvl: Unifying Medical Multimodal Understanding And Generation Through Observation-Knowledge-Analysis
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.
A Multimodal Framework for the Assessment of the Schizophrenia Spectrum
This paper presents a novel multimodal framework to distinguish between different symptom classes of subjects in the schizophrenia spectrum and healthy controls using audio, video, and text modalities. We implemented Convolution Neural Network and Long Short Term Memory based unimodal models and experimented on various multimodal fusion approaches to come up with the proposed framework. We utilized a minimal Gated multimodal unit (mGMU) to obtain a bi-modal intermediate fusion of the features extracted from the input modalities before finally fusing the outputs of the bimodal fusions to perform subject-wise classifications. The use of mGMU units in the multimodal framework improved the performance in both weighted f1-score and weighted AUC-ROC scores.
Do Multimodal Large Language Models Understand Welding?
This paper examines the performance of Multimodal LLMs (MLLMs) in skilled production work, with a focus on welding. Using a novel data set of real-world and online weld images, annotated by a domain expert, we evaluate the performance of two state-of-the-art MLLMs in assessing weld acceptability across three contexts: RV \& Marine, Aeronautical, and Farming. While both models perform better on online images, likely due to prior exposure or memorization, they also perform relatively well on unseen, real-world weld images. Additionally, we introduce WeldPrompt, a prompting strategy that combines Chain-of-Thought generation with in-context learning to mitigate hallucinations and improve reasoning. WeldPrompt improves model recall in certain contexts but exhibits inconsistent performance across others. These results underscore the limitations and potentials of MLLMs in high-stakes technical domains and highlight the importance of fine-tuning, domain-specific data, and more sophisticated prompting strategies to improve model reliability. The study opens avenues for further research into multimodal learning in industry applications.
VideoDreamer: Customized Multi-Subject Text-to-Video Generation with Disen-Mix Finetuning
Customized text-to-video generation aims to generate text-guided videos with customized user-given subjects, which has gained increasing attention recently. However, existing works are primarily limited to generating videos for a single subject, leaving the more challenging problem of customized multi-subject text-to-video generation largely unexplored. In this paper, we fill this gap and propose a novel VideoDreamer framework. VideoDreamer can generate temporally consistent text-guided videos that faithfully preserve the visual features of the given multiple subjects. Specifically, VideoDreamer leverages the pretrained Stable Diffusion with latent-code motion dynamics and temporal cross-frame attention as the base video generator. The video generator is further customized for the given multiple subjects by the proposed Disen-Mix Finetuning and Human-in-the-Loop Re-finetuning strategy, which can tackle the attribute binding problem of multi-subject generation. We also introduce MultiStudioBench, a benchmark for evaluating customized multi-subject text-to-video generation models. Extensive experiments demonstrate the remarkable ability of VideoDreamer to generate videos with new content such as new events and backgrounds, tailored to the customized multiple subjects. Our project page is available at https://videodreamer23.github.io/.
A Unified Hallucination Mitigation Framework for Large Vision-Language Models
Hallucination is a common problem for Large Vision-Language Models (LVLMs) with long generations which is difficult to eradicate. The generation with hallucinations is partially inconsistent with the image content. To mitigate hallucination, current studies either focus on the process of model inference or the results of model generation, but the solutions they design sometimes do not deal appropriately with various types of queries and the hallucinations of the generations about these queries. To accurately deal with various hallucinations, we present a unified framework, Dentist, for hallucination mitigation. The core step is to first classify the queries, then perform different processes of hallucination mitigation based on the classification result, just like a dentist first observes the teeth and then makes a plan. In a simple deployment, Dentist can classify queries as perception or reasoning and easily mitigate potential hallucinations in answers which has been demonstrated in our experiments. On MMbench, we achieve a 13.44%/10.2%/15.8% improvement in accuracy on Image Quality, a Coarse Perception visual question answering (VQA) task, over the baseline InstructBLIP/LLaVA/VisualGLM.
Vision Language Models in Medicine
With the advent of Vision-Language Models (VLMs), medical artificial intelligence (AI) has experienced significant technological progress and paradigm shifts. This survey provides an extensive review of recent advancements in Medical Vision-Language Models (Med-VLMs), which integrate visual and textual data to enhance healthcare outcomes. We discuss the foundational technology behind Med-VLMs, illustrating how general models are adapted for complex medical tasks, and examine their applications in healthcare. The transformative impact of Med-VLMs on clinical practice, education, and patient care is highlighted, alongside challenges such as data scarcity, narrow task generalization, interpretability issues, and ethical concerns like fairness, accountability, and privacy. These limitations are exacerbated by uneven dataset distribution, computational demands, and regulatory hurdles. Rigorous evaluation methods and robust regulatory frameworks are essential for safe integration into healthcare workflows. Future directions include leveraging large-scale, diverse datasets, improving cross-modal generalization, and enhancing interpretability. Innovations like federated learning, lightweight architectures, and Electronic Health Record (EHR) integration are explored as pathways to democratize access and improve clinical relevance. This review aims to provide a comprehensive understanding of Med-VLMs' strengths and limitations, fostering their ethical and balanced adoption in healthcare.
TemMed-Bench: Evaluating Temporal Medical Image Reasoning in Vision-Language Models
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.
InterMind: A Doctor-Patient-Family Interactive Depression Assessment System Empowered by Large Language Models
Depression poses significant challenges to patients and healthcare organizations, necessitating efficient assessment methods. Existing paradigms typically focus on a patient-doctor way that overlooks multi-role interactions, such as family involvement in the evaluation and caregiving process. Moreover, current automatic depression detection (ADD) methods usually model depression detection as a classification or regression task, lacking interpretability for the decision-making process. To address these issues, we developed InterMind, a doctor-patient-family interactive depression assessment system empowered by large language models (LLMs). Our system enables patients and families to contribute descriptions, generates assistive diagnostic reports for doctors, and provides actionable insights, improving diagnostic precision and efficiency. To enhance LLMs' performance in psychological counseling and diagnostic interpretability, we integrate retrieval-augmented generation (RAG) and chain-of-thoughts (CoT) techniques for data augmentation, which mitigates the hallucination issue of LLMs in specific scenarios after instruction fine-tuning. Quantitative experiments and professional assessments by clinicians validate the effectiveness of our system.
Symmetrical Visual Contrastive Optimization: Aligning Vision-Language Models with Minimal Contrastive Images
Recent studies have shown that Large Vision-Language Models (VLMs) tend to neglect image content and over-rely on language-model priors, resulting in errors in visually grounded tasks and hallucinations. We hypothesize that this issue arises because existing VLMs are not explicitly trained to generate texts that are accurately grounded in fine-grained image details. To enhance visual feedback during VLM training, we propose S-VCO (Symmetrical Visual Contrastive Optimization), a novel finetuning objective that steers the model toward capturing important visual details and aligning them with corresponding text tokens. To further facilitate this detailed alignment, we introduce MVC, a paired image-text dataset built by automatically filtering and augmenting visual counterfactual data to challenge the model with hard contrastive cases involving Minimal Visual Contrasts. Experiments show that our method consistently improves VLM performance across diverse benchmarks covering various abilities and domains, achieving up to a 22% reduction in hallucinations, and significant gains in vision-centric and general tasks. Notably, these improvements become increasingly pronounced in benchmarks with higher visual dependency. In short, S-VCO offers a significant enhancement of VLM's visually-dependent task performance while retaining or even improving the model's general abilities. We opensource our code at https://s-vco.github.io/
Prompt-CAM: Making Vision Transformers Interpretable for Fine-Grained Analysis
We present a simple approach to make pre-trained Vision Transformers (ViTs) interpretable for fine-grained analysis, aiming to identify and localize the traits that distinguish visually similar categories, such as bird species. Pre-trained ViTs, such as DINO, have demonstrated remarkable capabilities in extracting localized, discriminative features. However, saliency maps like Grad-CAM often fail to identify these traits, producing blurred, coarse heatmaps that highlight entire objects instead. We propose a novel approach, Prompt Class Attention Map (Prompt-CAM), to address this limitation. Prompt-CAM learns class-specific prompts for a pre-trained ViT and uses the corresponding outputs for classification. To correctly classify an image, the true-class prompt must attend to unique image patches not present in other classes' images (i.e., traits). As a result, the true class's multi-head attention maps reveal traits and their locations. Implementation-wise, Prompt-CAM is almost a ``free lunch,'' requiring only a modification to the prediction head of Visual Prompt Tuning (VPT). This makes Prompt-CAM easy to train and apply, in stark contrast to other interpretable methods that require designing specific models and training processes. Extensive empirical studies on a dozen datasets from various domains (e.g., birds, fishes, insects, fungi, flowers, food, and cars) validate the superior interpretation capability of Prompt-CAM. The source code and demo are available at https://github.com/Imageomics/Prompt_CAM.
ORES: Open-vocabulary Responsible Visual Synthesis
Avoiding synthesizing specific visual concepts is an essential challenge in responsible visual synthesis. However, the visual concept that needs to be avoided for responsible visual synthesis tends to be diverse, depending on the region, context, and usage scenarios. In this work, we formalize a new task, Open-vocabulary Responsible Visual Synthesis (ORES), where the synthesis model is able to avoid forbidden visual concepts while allowing users to input any desired content. To address this problem, we present a Two-stage Intervention (TIN) framework. By introducing 1) rewriting with learnable instruction through a large-scale language model (LLM) and 2) synthesizing with prompt intervention on a diffusion synthesis model, it can effectively synthesize images avoiding any concepts but following the user's query as much as possible. To evaluate on ORES, we provide a publicly available dataset, baseline models, and benchmark. Experimental results demonstrate the effectiveness of our method in reducing risks of image generation. Our work highlights the potential of LLMs in responsible visual synthesis. Our code and dataset is public available.
IPDreamer: Appearance-Controllable 3D Object Generation with Image Prompts
Recent advances in text-to-3D generation have been remarkable, with methods such as DreamFusion leveraging large-scale text-to-image diffusion-based models to supervise 3D generation. These methods, including the variational score distillation proposed by ProlificDreamer, enable the synthesis of detailed and photorealistic textured meshes. However, the appearance of 3D objects generated by these methods is often random and uncontrollable, posing a challenge in achieving appearance-controllable 3D objects. To address this challenge, we introduce IPDreamer, a novel approach that incorporates image prompts to provide specific and comprehensive appearance information for 3D object generation. Our results demonstrate that IPDreamer effectively generates high-quality 3D objects that are consistent with both the provided text and image prompts, demonstrating its promising capability in appearance-controllable 3D object generation.
Leveraging Hallucinations to Reduce Manual Prompt Dependency in Promptable Segmentation
Promptable segmentation typically requires instance-specific manual prompts to guide the segmentation of each desired object. To minimize such a need, task-generic promptable segmentation has been introduced, which employs a single task-generic prompt to segment various images of different objects in the same task. Current methods use Multimodal Large Language Models (MLLMs) to reason detailed instance-specific prompts from a task-generic prompt for improving segmentation accuracy. The effectiveness of this segmentation heavily depends on the precision of these derived prompts. However, MLLMs often suffer hallucinations during reasoning, resulting in inaccurate prompting. While existing methods focus on eliminating hallucinations to improve a model, we argue that MLLM hallucinations can reveal valuable contextual insights when leveraged correctly, as they represent pre-trained large-scale knowledge beyond individual images. In this paper, we utilize hallucinations to mine task-related information from images and verify its accuracy for enhancing precision of the generated prompts. Specifically, we introduce an iterative Prompt-Mask Cycle generation framework (ProMaC) with a prompt generator and a mask generator.The prompt generator uses a multi-scale chain of thought prompting, initially exploring hallucinations for extracting extended contextual knowledge on a test image.These hallucinations are then reduced to formulate precise instance-specific prompts, directing the mask generator to produce masks that are consistent with task semantics by mask semantic alignment. The generated masks iteratively induce the prompt generator to focus more on task-relevant image areas and reduce irrelevant hallucinations, resulting jointly in better prompts and masks. Experiments on 5 benchmarks demonstrate the effectiveness of ProMaC. Code given in https://lwpyh.github.io/ProMaC/.
Introducing Visual Perception Token into Multimodal Large Language Model
To utilize visual information, Multimodal Large Language Model (MLLM) relies on the perception process of its vision encoder. The completeness and accuracy of visual perception significantly influence the precision of spatial reasoning, fine-grained understanding, and other tasks. However, MLLM still lacks the autonomous capability to control its own visual perception processes, for example, selectively reviewing specific regions of an image or focusing on information related to specific object categories. In this work, we propose the concept of Visual Perception Token, aiming to empower MLLM with a mechanism to control its visual perception processes. We design two types of Visual Perception Tokens, termed the Region Selection Token and the Vision Re-Encoding Token. MLLMs autonomously generate these tokens, just as they generate text, and use them to trigger additional visual perception actions. The Region Selection Token explicitly identifies specific regions in an image that require further perception, while the Vision Re-Encoding Token uses its hidden states as control signals to guide additional visual perception processes. Extensive experiments demonstrate the advantages of these tokens in handling spatial reasoning, improving fine-grained understanding, and other tasks. On average, the introduction of Visual Perception Tokens improves the performance of a 2B model by 23.6\%, increasing its score from 0.572 to 0.708, and even outperforms a 7B parameter model by 13.4\% (from 0.624). Please check out our repo https://github.com/yu-rp/VisualPerceptionToken
GENOME: GenerativE Neuro-symbOlic visual reasoning by growing and reusing ModulEs
Recent works have shown that Large Language Models (LLMs) could empower traditional neuro-symbolic models via programming capabilities to translate language into module descriptions, thus achieving strong visual reasoning results while maintaining the model's transparency and efficiency. However, these models usually exhaustively generate the entire code snippet given each new instance of a task, which is extremely ineffective. We propose generative neuro-symbolic visual reasoning by growing and reusing modules. Specifically, our model consists of three unique stages, module initialization, module generation, and module execution. First, given a vision-language task, we adopt LLMs to examine whether we could reuse and grow over established modules to handle this new task. If not, we initialize a new module needed by the task and specify the inputs and outputs of this new module. After that, the new module is created by querying LLMs to generate corresponding code snippets that match the requirements. In order to get a better sense of the new module's ability, we treat few-shot training examples as test cases to see if our new module could pass these cases. If yes, the new module is added to the module library for future reuse. Finally, we evaluate the performance of our model on the testing set by executing the parsed programs with the newly made visual modules to get the results. We find the proposed model possesses several advantages. First, it performs competitively on standard tasks like visual question answering and referring expression comprehension; Second, the modules learned from one task can be seamlessly transferred to new tasks; Last but not least, it is able to adapt to new visual reasoning tasks by observing a few training examples and reusing modules.
List Items One by One: A New Data Source and Learning Paradigm for Multimodal LLMs
Set-of-Mark (SoM) Prompting unleashes the visual grounding capability of GPT-4V, by enabling the model to associate visual objects with tags inserted on the image. These tags, marked with alphanumerics, can be indexed via text tokens for easy reference. Despite the extraordinary performance from GPT-4V, we observe that other Multimodal Large Language Models (MLLMs) struggle to understand these visual tags. To promote the learning of SoM prompting for open-source models, we propose a new learning paradigm: "list items one by one," which asks the model to enumerate and describe all visual tags placed on the image following the alphanumeric orders of tags. By integrating our curated dataset with other visual instruction tuning datasets, we are able to equip existing MLLMs with the SoM prompting ability. Furthermore, we evaluate our finetuned SoM models on five MLLM benchmarks. We find that this new dataset, even in a relatively small size (10k-30k images with tags), significantly enhances visual reasoning capabilities and reduces hallucinations for MLLMs. Perhaps surprisingly, these improvements persist even when the visual tags are omitted from input images during inference. This suggests the potential of "list items one by one" as a new paradigm for training MLLMs, which strengthens the object-text alignment through the use of visual tags in the training stage. Finally, we conduct analyses by probing trained models to understand the working mechanism of SoM. Our code and data are available at https://github.com/zzxslp/SoM-LLaVA.
Generative Multiplane Neural Radiance for 3D-Aware Image Generation
We present a method to efficiently generate 3D-aware high-resolution images that are view-consistent across multiple target views. The proposed multiplane neural radiance model, named GMNR, consists of a novel {\alpha}-guided view-dependent representation ({\alpha}-VdR) module for learning view-dependent information. The {\alpha}-VdR module, faciliated by an {\alpha}-guided pixel sampling technique, computes the view-dependent representation efficiently by learning viewing direction and position coefficients. Moreover, we propose a view-consistency loss to enforce photometric similarity across multiple views. The GMNR model can generate 3D-aware high-resolution images that are viewconsistent across multiple camera poses, while maintaining the computational efficiency in terms of both training and inference time. Experiments on three datasets demonstrate the effectiveness of the proposed modules, leading to favorable results in terms of both generation quality and inference time, compared to existing approaches. Our GMNR model generates 3D-aware images of 1024 X 1024 pixels with 17.6 FPS on a single V100. Code : https://github.com/VIROBO-15/GMNR
Hidden in plain sight: VLMs overlook their visual representations
Language provides a natural interface to specify and evaluate performance on visual tasks. To realize this possibility, vision language models (VLMs) must successfully integrate visual and linguistic information. Our work compares VLMs to a direct readout of their visual encoders to understand their ability to integrate across these modalities. Across a series of vision-centric benchmarks (e.g., depth estimation, correspondence), we find that VLMs perform substantially worse than their visual encoders, dropping to near-chance performance. We investigate these results through a series of analyses across the entire VLM: namely 1) the degradation of vision representations, 2) brittleness to task prompt, and 3) the language model's role in solving the task. We find that the bottleneck in performing these vision-centric tasks lies in this third category; VLMs are not effectively using visual information easily accessible throughout the entire model, and they inherit the language priors present in the LLM. Our work helps diagnose the failure modes of open-source VLMs, and presents a series of evaluations useful for future investigations into visual understanding within VLMs.
Visual Programming for Text-to-Image Generation and Evaluation
As large language models have demonstrated impressive performance in many domains, recent works have adopted language models (LMs) as controllers of visual modules for vision-and-language tasks. While existing work focuses on equipping LMs with visual understanding, we propose two novel interpretable/explainable visual programming frameworks for text-to-image (T2I) generation and evaluation. First, we introduce VPGen, an interpretable step-by-step T2I generation framework that decomposes T2I generation into three steps: object/count generation, layout generation, and image generation. We employ an LM to handle the first two steps (object/count generation and layout generation), by finetuning it on text-layout pairs. Our step-by-step T2I generation framework provides stronger spatial control than end-to-end models, the dominant approach for this task. Furthermore, we leverage the world knowledge of pretrained LMs, overcoming the limitation of previous layout-guided T2I works that can only handle predefined object classes. We demonstrate that our VPGen has improved control in counts/spatial relations/scales of objects than state-of-the-art T2I generation models. Second, we introduce VPEval, an interpretable and explainable evaluation framework for T2I generation based on visual programming. Unlike previous T2I evaluations with a single scoring model that is accurate in some skills but unreliable in others, VPEval produces evaluation programs that invoke a set of visual modules that are experts in different skills, and also provides visual+textual explanations of the evaluation results. Our analysis shows VPEval provides a more human-correlated evaluation for skill-specific and open-ended prompts than widely used single model-based evaluation. We hope our work encourages future progress on interpretable/explainable generation and evaluation for T2I models. Website: https://vp-t2i.github.io
ProAPO: Progressively Automatic Prompt Optimization for Visual Classification
Vision-language models (VLMs) have made significant progress in image classification by training with large-scale paired image-text data. Their performances largely depend on the prompt quality. While recent methods show that visual descriptions generated by large language models (LLMs) enhance the generalization of VLMs, class-specific prompts may be inaccurate or lack discrimination due to the hallucination in LLMs. In this paper, we aim to find visually discriminative prompts for fine-grained categories with minimal supervision and no human-in-the-loop. An evolution-based algorithm is proposed to progressively optimize language prompts from task-specific templates to class-specific descriptions. Unlike optimizing templates, the search space shows an explosion in class-specific candidate prompts. This increases prompt generation costs, iterative times, and the overfitting problem. To this end, we first introduce several simple yet effective edit-based and evolution-based operations to generate diverse candidate prompts by one-time query of LLMs. Then, two sampling strategies are proposed to find a better initial search point and reduce traversed categories, saving iteration costs. Moreover, we apply a novel fitness score with entropy constraints to mitigate overfitting. In a challenging one-shot image classification setting, our method outperforms existing textual prompt-based methods and improves LLM-generated description methods across 13 datasets. Meanwhile, we demonstrate that our optimal prompts improve adapter-based methods and transfer effectively across different backbones.
MMXU: A Multi-Modal and Multi-X-ray Understanding Dataset for Disease Progression
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}.
Visual Style Prompting with Swapping Self-Attention
In the evolving domain of text-to-image generation, diffusion models have emerged as powerful tools in content creation. Despite their remarkable capability, existing models still face challenges in achieving controlled generation with a consistent style, requiring costly fine-tuning or often inadequately transferring the visual elements due to content leakage. To address these challenges, we propose a novel approach, \ours, to produce a diverse range of images while maintaining specific style elements and nuances. During the denoising process, we keep the query from original features while swapping the key and value with those from reference features in the late self-attention layers. This approach allows for the visual style prompting without any fine-tuning, ensuring that generated images maintain a faithful style. Through extensive evaluation across various styles and text prompts, our method demonstrates superiority over existing approaches, best reflecting the style of the references and ensuring that resulting images match the text prompts most accurately. Our project page is available https://curryjung.github.io/VisualStylePrompt/.
Vi(E)va LLM! A Conceptual Stack for Evaluating and Interpreting Generative AI-based Visualizations
The automatic generation of visualizations is an old task that, through the years, has shown more and more interest from the research and practitioner communities. Recently, large language models (LLM) have become an interesting option for supporting generative tasks related to visualization, demonstrating initial promising results. At the same time, several pitfalls, like the multiple ways of instructing an LLM to generate the desired result, the different perspectives leading the generation (code-based, image-based, grammar-based), and the presence of hallucinations even for the visualization generation task, make their usage less affordable than expected. Following similar initiatives for benchmarking LLMs, this paper copes with the problem of modeling the evaluation of a generated visualization through an LLM. We propose a theoretical evaluation stack, EvaLLM, that decomposes the evaluation effort in its atomic components, characterizes their nature, and provides an overview of how to implement and interpret them. We also designed and implemented an evaluation platform that provides a benchmarking resource for the visualization generation task. The platform supports automatic and manual scoring conducted by multiple assessors to support a fine-grained and semantic evaluation based on the EvaLLM stack. Two case studies on GPT3.5-turbo with Code Interpreter and Llama2-70-b models show the benefits of EvaLLM and illustrate interesting results on the current state-of-the-art LLM-generated visualizations.
Self-Imagine: Effective Unimodal Reasoning with Multimodal Models using Self-Imagination
The potential of Vision-Language Models (VLMs) often remains underutilized in handling complex text-based problems, particularly when these problems could benefit from visual representation. Resonating with humans' ability to solve complex text-based problems by (1) creating a visual diagram from the problem and (2) deducing what steps they need to take to solve it, we propose Self-Imagine. We leverage a single Vision-Language Model (VLM) to generate a structured representation of the question using HTML, then render the HTML as an image, and finally use the same VLM to answer the question using both the question and the image. Our approach does not require any additional training data or training. We evaluate our approach on three mathematics tasks and nine general-purpose reasoning tasks using state-of-the-art (LLAVA-1.5 and GEMINI PRO) VLMs. Our approach boosts the performance of LLAVA-1.5 and GEMINI PRO on all math tasks (on average GSM8K: +3.1%; ASDIV: +3.2%; SVAMP: +6.9%) and the majority of the general-purpose reasoning tasks by 3.2% to 6.0% on average.
Parameter-Efficient Fine-Tuning Medical Multimodal Large Language Models for Medical Visual Grounding
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.
MMFactory: A Universal Solution Search Engine for Vision-Language Tasks
With advances in foundational and vision-language models, and effective fine-tuning techniques, a large number of both general and special-purpose models have been developed for a variety of visual tasks. Despite the flexibility and accessibility of these models, no single model is able to handle all tasks and/or applications that may be envisioned by potential users. Recent approaches, such as visual programming and multimodal LLMs with integrated tools aim to tackle complex visual tasks, by way of program synthesis. However, such approaches overlook user constraints (e.g., performance / computational needs), produce test-time sample-specific solutions that are difficult to deploy, and, sometimes, require low-level instructions that maybe beyond the abilities of a naive user. To address these limitations, we introduce MMFactory, a universal framework that includes model and metrics routing components, acting like a solution search engine across various available models. Based on a task description and few sample input-output pairs and (optionally) resource and/or performance constraints, MMFactory can suggest a diverse pool of programmatic solutions by instantiating and combining visio-lingual tools from its model repository. In addition to synthesizing these solutions, MMFactory also proposes metrics and benchmarks performance / resource characteristics, allowing users to pick a solution that meets their unique design constraints. From the technical perspective, we also introduced a committee-based solution proposer that leverages multi-agent LLM conversation to generate executable, diverse, universal, and robust solutions for the user. Experimental results show that MMFactory outperforms existing methods by delivering state-of-the-art solutions tailored to user problem specifications. Project page is available at https://davidhalladay.github.io/mmfactory_demo.
Multimodal ChatGPT for Medical Applications: an Experimental Study of GPT-4V
In this paper, we critically evaluate the capabilities of the state-of-the-art multimodal large language model, i.e., GPT-4 with Vision (GPT-4V), on Visual Question Answering (VQA) task. Our experiments thoroughly assess GPT-4V's proficiency in answering questions paired with images using both pathology and radiology datasets from 11 modalities (e.g. Microscopy, Dermoscopy, X-ray, CT, etc.) and fifteen objects of interests (brain, liver, lung, etc.). Our datasets encompass a comprehensive range of medical inquiries, including sixteen distinct question types. Throughout our evaluations, we devised textual prompts for GPT-4V, directing it to synergize visual and textual information. The experiments with accuracy score conclude that the current version of GPT-4V is not recommended for real-world diagnostics due to its unreliable and suboptimal accuracy in responding to diagnostic medical questions. In addition, we delineate seven unique facets of GPT-4V's behavior in medical VQA, highlighting its constraints within this complex arena. The complete details of our evaluation cases are accessible at https://github.com/ZhilingYan/GPT4V-Medical-Report.
On the Automatic Generation of Medical Imaging Reports
Medical imaging is widely used in clinical practice for diagnosis and treatment. Report-writing can be error-prone for unexperienced physicians, and time- consuming and tedious for experienced physicians. To address these issues, we study the automatic generation of medical imaging reports. This task presents several challenges. First, a complete report contains multiple heterogeneous forms of information, including findings and tags. Second, abnormal regions in medical images are difficult to identify. Third, the re- ports are typically long, containing multiple sentences. To cope with these challenges, we (1) build a multi-task learning framework which jointly performs the pre- diction of tags and the generation of para- graphs, (2) propose a co-attention mechanism to localize regions containing abnormalities and generate narrations for them, (3) develop a hierarchical LSTM model to generate long paragraphs. We demonstrate the effectiveness of the proposed methods on two publicly available datasets.
VisuCraft: Enhancing Large Vision-Language Models for Complex Visual-Guided Creative Content Generation via Structured Information Extraction
This paper introduces VisuCraft, a novel framework designed to significantly enhance the capabilities of Large Vision-Language Models (LVLMs) in complex visual-guided creative content generation. Existing LVLMs often exhibit limitations in maintaining high visual fidelity, genuine creativity, and precise adherence to nuanced user instructions when generating long-form texts. VisuCraft addresses these challenges by integrating a multimodal structured information extractor (E) and a dynamic prompt generation module (G). The extractor distills fine-grained visual attributes from input images into a rich, structured representation, which the dynamic prompt module then combines with user instructions to create highly optimized prompts for underlying LVLMs (e.g., LLaVA, InstructBLIP). Evaluated on the self-constructed ImageStoryGen-500K dataset using VisuGen Metrics (Visual Grounding, Creativity, and Instruction Adherence), VisuCraft consistently outperforms baseline LVLMs across tasks like story generation and poetry composition. Our results demonstrate remarkable improvements, particularly in creativity and instruction adherence, validating VisuCraft's effectiveness in producing imaginative, visually grounded, and user-aligned long-form creative text. This work unlocks new potential for LVLMs in sophisticated creative AI applications.
Eagle: Exploring The Design Space for Multimodal LLMs with Mixture of Encoders
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
DermaSynth: Rich Synthetic Image-Text Pairs Using Open Access Dermatology Datasets
A major barrier to developing vision large language models (LLMs) in dermatology is the lack of large image--text pairs dataset. We introduce DermaSynth, a dataset comprising of 92,020 synthetic image--text pairs curated from 45,205 images (13,568 clinical and 35,561 dermatoscopic) for dermatology-related clinical tasks. Leveraging state-of-the-art LLMs, using Gemini 2.0, we used clinically related prompts and self-instruct method to generate diverse and rich synthetic texts. Metadata of the datasets were incorporated into the input prompts by targeting to reduce potential hallucinations. The resulting dataset builds upon open access dermatological image repositories (DERM12345, BCN20000, PAD-UFES-20, SCIN, and HIBA) that have permissive CC-BY-4.0 licenses. We also fine-tuned a preliminary Llama-3.2-11B-Vision-Instruct model, DermatoLlama 1.0, on 5,000 samples. We anticipate this dataset to support and accelerate AI research in dermatology. Data and code underlying this work are accessible at https://github.com/abdurrahimyilmaz/DermaSynth.
VLM-Guided Adaptive Negative Prompting for Creative Generation
Creative generation is the synthesis of new, surprising, and valuable samples that reflect user intent yet cannot be envisioned in advance. This task aims to extend human imagination, enabling the discovery of visual concepts that exist in the unexplored spaces between familiar domains. While text-to-image diffusion models excel at rendering photorealistic scenes that faithfully match user prompts, they still struggle to generate genuinely novel content. Existing approaches to enhance generative creativity either rely on interpolation of image features, which restricts exploration to predefined categories, or require time-intensive procedures such as embedding optimization or model fine-tuning. We propose VLM-Guided Adaptive Negative-Prompting, a training-free, inference-time method that promotes creative image generation while preserving the validity of the generated object. Our approach utilizes a vision-language model (VLM) that analyzes intermediate outputs of the generation process and adaptively steers it away from conventional visual concepts, encouraging the emergence of novel and surprising outputs. We evaluate creativity through both novelty and validity, using statistical metrics in the CLIP embedding space. Through extensive experiments, we show consistent gains in creative novelty with negligible computational overhead. Moreover, unlike existing methods that primarily generate single objects, our approach extends to complex scenarios, such as generating coherent sets of creative objects and preserving creativity within elaborate compositional prompts. Our method integrates seamlessly into existing diffusion pipelines, offering a practical route to producing creative outputs that venture beyond the constraints of textual descriptions.
Right this way: Can VLMs Guide Us to See More to Answer Questions?
In question-answering scenarios, humans can assess whether the available information is sufficient and seek additional information if necessary, rather than providing a forced answer. In contrast, Vision Language Models (VLMs) typically generate direct, one-shot responses without evaluating the sufficiency of the information. To investigate this gap, we identify a critical and challenging task in the Visual Question Answering (VQA) scenario: can VLMs indicate how to adjust an image when the visual information is insufficient to answer a question? This capability is especially valuable for assisting visually impaired individuals who often need guidance to capture images correctly. To evaluate this capability of current VLMs, we introduce a human-labeled dataset as a benchmark for this task. Additionally, we present an automated framework that generates synthetic training data by simulating ``where to know'' scenarios. Our empirical results show significant performance improvements in mainstream VLMs when fine-tuned with this synthetic data. This study demonstrates the potential to narrow the gap between information assessment and acquisition in VLMs, bringing their performance closer to humans.
HalluciDoctor: Mitigating Hallucinatory Toxicity in Visual Instruction Data
Multi-modal Large Language Models (MLLMs) tuned on machine-generated instruction-following data have demonstrated remarkable performance in various multi-modal understanding and generation tasks. However, the hallucinations inherent in machine-generated data, which could lead to hallucinatory outputs in MLLMs, remain under-explored. This work aims to investigate various hallucinations (i.e., object, relation, attribute hallucinations) and mitigate those hallucinatory toxicities in large-scale machine-generated visual instruction datasets. Drawing on the human ability to identify factual errors, we present a novel hallucination detection and elimination framework, HalluciDoctor, based on the cross-checking paradigm. We use our framework to identify and eliminate hallucinations in the training data automatically. Interestingly, HalluciDoctor also indicates that spurious correlations arising from long-tail object co-occurrences contribute to hallucinations. Based on that, we execute counterfactual visual instruction expansion to balance data distribution, thereby enhancing MLLMs' resistance to hallucinations. Comprehensive experiments on hallucination evaluation benchmarks show that our method successfully mitigates 44.6% hallucinations relatively and maintains competitive performance compared to LLaVA.The source code will be released at https://github.com/Yuqifan1117/HalluciDoctor.
Design2Code: How Far Are We From Automating Front-End Engineering?
Generative AI has made rapid advancements in recent years, achieving unprecedented capabilities in multimodal understanding and code generation. This can enable a new paradigm of front-end development, in which multimodal LLMs might directly convert visual designs into code implementations. In this work, we formalize this as a Design2Code task and conduct comprehensive benchmarking. Specifically, we manually curate a benchmark of 484 diverse real-world webpages as test cases and develop a set of automatic evaluation metrics to assess how well current multimodal LLMs can generate the code implementations that directly render into the given reference webpages, given the screenshots as input. We also complement automatic metrics with comprehensive human evaluations. We develop a suite of multimodal prompting methods and show their effectiveness on GPT-4V and Gemini Pro Vision. We further finetune an open-source Design2Code-18B model that successfully matches the performance of Gemini Pro Vision. Both human evaluation and automatic metrics show that GPT-4V performs the best on this task compared to other models. Moreover, annotators think GPT-4V generated webpages can replace the original reference webpages in 49% of cases in terms of visual appearance and content; and perhaps surprisingly, in 64% of cases GPT-4V generated webpages are considered better than the original reference webpages. Our fine-grained break-down metrics indicate that open-source models mostly lag in recalling visual elements from the input webpages and in generating correct layout designs, while aspects like text content and coloring can be drastically improved with proper finetuning.
ViR: Vision Retention Networks
Vision Transformers (ViTs) have attracted a lot of popularity in recent years, due to their exceptional capabilities in modeling long-range spatial dependencies and scalability for large scale training. Although the training parallelism of self-attention mechanism plays an important role in retaining great performance, its quadratic complexity baffles the application of ViTs in many scenarios which demand fast inference. This effect is even more pronounced in applications in which autoregressive modeling of input features is required. In Natural Language Processing (NLP), a new stream of efforts have proposed parallelizable models with recurrent formulation that allows for efficient inference in generative applications. Inspired by this trend, we propose a new class of computer vision models, dubbed Vision Retention Networks (ViR), with dual parallel and recurrent formulations, which strike an optimal balance between fast inference and parallel training with competitive performance. In particular, ViR scales favorably for image throughput and memory consumption in tasks that require higher-resolution images due to its flexible formulation in processing large sequence lengths. The ViR is the first attempt to realize dual parallel and recurrent equivalency in a general vision backbone for recognition tasks. We have validated the effectiveness of ViR through extensive experiments with different dataset sizes and various image resolutions and achieved competitive performance. Our code and pretrained models will be made publicly available.
Survey of Hallucination in Natural Language Generation
Natural Language Generation (NLG) has improved exponentially in recent years thanks to the development of sequence-to-sequence deep learning technologies such as Transformer-based language models. This advancement has led to more fluent and coherent NLG, leading to improved development in downstream tasks such as abstractive summarization, dialogue generation and data-to-text generation. However, it is also apparent that deep learning based generation is prone to hallucinate unintended text, which degrades the system performance and fails to meet user expectations in many real-world scenarios. To address this issue, many studies have been presented in measuring and mitigating hallucinated texts, but these have never been reviewed in a comprehensive manner before. In this survey, we thus provide a broad overview of the research progress and challenges in the hallucination problem in NLG. The survey is organized into two parts: (1) a general overview of metrics, mitigation methods, and future directions; and (2) an overview of task-specific research progress on hallucinations in the following downstream tasks, namely abstractive summarization, dialogue generation, generative question answering, data-to-text generation, machine translation, and visual-language generation. This survey serves to facilitate collaborative efforts among researchers in tackling the challenge of hallucinated texts in NLG.
Hulu-Med: A Transparent Generalist Model towards Holistic Medical Vision-Language Understanding
Real-world clinical decision-making grapples with integrating information from diverse data modalities, including medical text, 2D/3D images, and video, leading to inefficiencies and potential diagnostic oversights. While generalist vision-language models (VLMs) offer promise, their medical development faces challenges of opaque pipelines, data scarcity, and architectural inflexibility. Here we present Hulu-Med, a transparent medical VLM that unifies understanding across all these modalities. Built upon a unified patch-based vision encoder and an LLM decoder, Hulu-Med was progressively trained on 16.7 million (M) samples to scale from 2D to 3D and video comprehension. The medical-aware token reduction enables efficient training, requiring only 4,000 to 40,000 GPU hours for 7B to 32B parameter variants. Extensive evaluation across 30 benchmarks exhibits state-of-the-art performance, surpassing leading open-source models and competing with proprietary systems in tasks spanning visual question-answering, medical report generation, and complex reasoning in multilingual and rare disease scenarios. By open-sourcing our complete pipeline, we establish that high-performance medical VLM can be achieved transparently, providing a foundational tool for accessible and impactful clinical AI. Code is released on https://github.com/ZJUI-AI4H/Hulu-Med{https://github.com/ZJUI-AI4H/Hulu-Med}.
RadDiagSeg-M: A Vision Language Model for Joint Diagnosis and Multi-Target Segmentation in Radiology
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.
Less is More: Mitigating Multimodal Hallucination from an EOS Decision Perspective
Large Multimodal Models (LMMs) often suffer from multimodal hallucinations, wherein they may create content that is not present in the visual inputs. In this paper, we explore a new angle of this issue: overly detailed training data hinders the model's ability to timely terminate generation, leading to continued outputs beyond visual perception limits. By investigating how the model decides to terminate generation with EOS, the special end-of-sentence token, we find that the model assesses the completeness of the entire sequence by comparing the generated text with the image. This observation suggests that the model possesses an inherent potential of making proper EOS decisions based on its visual perception to avoid overly lengthy outputs. To take advantage of such potential, we explore two methods to mitigate multimodal hallucinations: a training objective that enables the model to reduce hallucinations by learning from regular instruction data, and a data filtering strategy to prevent harmful training data from exacerbating model hallucinations. Both methods significantly improve the hallucination performance of LMMs, without requiring any additional data or knowledge.
The Mind's Eye: A Multi-Faceted Reward Framework for Guiding Visual Metaphor Generation
Visual metaphor generation is a challenging task that aims to generate an image given an input text metaphor. Inherently, it needs language understanding to bind a source concept with a target concept, in a way that preserves meaning while ensuring visual coherence. We propose a self-evaluating visual metaphor generation framework that focuses on metaphor alignment. Our self-evaluation approach combines existing metrics with our newly proposed metaphor decomposition score and a meaning alignment (MA) metric. Within this setup, we explore two novel approaches: a training-free pipeline that explicitly decomposes prompts into source-target-meaning (S-T-M) mapping for image synthesis, and a complementary training-based pipeline that improves alignment using our proposed self-evaluation reward schema, without any large-scale retraining. On the held-out test set, the training-free approach surpasses strong closed baselines (GPT-4o, Imagen) on decomposition, CLIP, and MA scores, with the training-based approach close behind. We evaluate our framework output using a user-facing study, and observed that participants preferred GPT-4o overall, while our training-free pipeline led open-source methods and edged Imagen on abstract metaphors. Our analyses show S-T-M prompting helps longer or more abstract metaphors, with closed models excelling on short, concrete cases; we also observe sensitivity to sampler settings. Overall, structured prompting and lightweight RL perform metaphor alignment well under modest compute, and remaining gaps to human preference appear driven by aesthetics and sampling.
Time Series Representations for Classification Lie Hidden in Pretrained Vision Transformers
Time series classification is a fundamental task in healthcare and industry, yet the development of time series foundation models (TSFMs) remains limited by the scarcity of publicly available time series datasets. In this work, we propose Time Vision Transformer (TiViT), a framework that converts time series into images to leverage the representational power of frozen Vision Transformers (ViTs) pretrained on large-scale image datasets. First, we theoretically motivate our approach by analyzing the 2D patching of ViTs for time series, showing that it can increase the number of label-relevant tokens and reduce the sample complexity. Second, we empirically demonstrate that TiViT achieves state-of-the-art performance on standard time series classification benchmarks by utilizing the hidden representations of large OpenCLIP models. We explore the structure of TiViT representations and find that intermediate layers with high intrinsic dimension are the most effective for time series classification. Finally, we assess the alignment between TiViT and TSFM representation spaces and identify a strong complementarity, with further performance gains achieved by combining their features. Our findings reveal a new direction for reusing vision representations in a non-visual domain. Code is available at https://github.com/ExplainableML/TiViT.
Unlocking Aha Moments via Reinforcement Learning: Advancing Collaborative Visual Comprehension and Generation
Recent endeavors in Multimodal Large Language Models (MLLMs) aim to unify visual comprehension and generation. However, these two capabilities remain largely independent, as if they are two separate functions encapsulated within the same model. Consequently, visual comprehension does not enhance visual generation, and the reasoning mechanisms of LLMs have not been fully integrated to revolutionize image generation. In this paper, we propose to enable the collaborative co-evolution of visual comprehension and generation, advancing image generation into an iterative introspective process. We introduce a two-stage training approach: supervised fine-tuning teaches the MLLM with the foundational ability to generate genuine CoT for visual generation, while reinforcement learning activates its full potential via an exploration-exploitation trade-off. Ultimately, we unlock the Aha moment in visual generation, advancing MLLMs from text-to-image tasks to unified image generation. Extensive experiments demonstrate that our model not only excels in text-to-image generation and image editing, but also functions as a superior image semantic evaluator with enhanced visual comprehension capabilities. Project Page: https://janus-pro-r1.github.io.
mRAG: Elucidating the Design Space of Multi-modal Retrieval-Augmented Generation
Large Vision-Language Models (LVLMs) have made remarkable strides in multimodal tasks such as visual question answering, visual grounding, and complex reasoning. However, they remain limited by static training data, susceptibility to hallucinations, and inability to verify claims against up-to-date, external evidence, compromising their performance in dynamic real-world applications. Retrieval-Augmented Generation (RAG) offers a practical solution to mitigate these challenges by allowing the LVLMs to access large-scale knowledge databases via retrieval mechanisms, thereby grounding model outputs in factual, contextually relevant information. Here in this paper, we conduct the first systematic dissection of the multimodal RAG pipeline for LVLMs, explicitly investigating (1) the retrieval phase: on the modality configurations and retrieval strategies, (2) the re-ranking stage: on strategies to mitigate positional biases and improve the relevance of retrieved evidence, and (3) the generation phase: we further investigate how to best integrate retrieved candidates into the final generation process. Finally, we extend to explore a unified agentic framework that integrates re-ranking and generation through self-reflection, enabling LVLMs to select relevant evidence and suppress irrelevant context dynamically. Our full-stack exploration of RAG for LVLMs yields substantial insights, resulting in an average performance boost of 5% without any fine-tuning.
Gla-AI4BioMed at RRG24: Visual Instruction-tuned Adaptation for Radiology Report Generation
We introduce a radiology-focused visual language model designed to generate radiology reports from chest X-rays. Building on previous findings that large language models (LLMs) can acquire multimodal capabilities when aligned with pretrained vision encoders, we demonstrate similar potential with chest X-ray images. This integration enhances the ability of model to understand and describe chest X-ray images. Our model combines an image encoder with a fine-tuned LLM based on the Vicuna-7B architecture, enabling it to generate different sections of a radiology report with notable accuracy. The training process involves a two-stage approach: (i) initial alignment of chest X-ray features with the LLM (ii) followed by fine-tuning for radiology report generation.
Depression Detection and Analysis using Large Language Models on Textual and Audio-Visual Modalities
Depression has proven to be a significant public health issue, profoundly affecting the psychological well-being of individuals. If it remains undiagnosed, depression can lead to severe health issues, which can manifest physically and even lead to suicide. Generally, Diagnosing depression or any other mental disorder involves conducting semi-structured interviews alongside supplementary questionnaires, including variants of the Patient Health Questionnaire (PHQ) by Clinicians and mental health professionals. This approach places significant reliance on the experience and judgment of trained physicians, making the diagnosis susceptible to personal biases. Given that the underlying mechanisms causing depression are still being actively researched, physicians often face challenges in diagnosing and treating the condition, particularly in its early stages of clinical presentation. Recently, significant strides have been made in Artificial neural computing to solve problems involving text, image, and speech in various domains. Our analysis has aimed to leverage these state-of-the-art (SOTA) models in our experiments to achieve optimal outcomes leveraging multiple modalities. The experiments were performed on the Extended Distress Analysis Interview Corpus Wizard of Oz dataset (E-DAIC) corpus presented in the Audio/Visual Emotion Challenge (AVEC) 2019 Challenge. The proposed solutions demonstrate better results achieved by Proprietary and Open-source Large Language Models (LLMs), which achieved a Root Mean Square Error (RMSE) score of 3.98 on Textual Modality, beating the AVEC 2019 challenge baseline results and current SOTA regression analysis architectures. Additionally, the proposed solution achieved an accuracy of 71.43% in the classification task. The paper also includes a novel audio-visual multi-modal network that predicts PHQ-8 scores with an RMSE of 6.51.
Structural Entities Extraction and Patient Indications Incorporation for Chest X-ray Report Generation
The automated generation of imaging reports proves invaluable in alleviating the workload of radiologists. A clinically applicable reports generation algorithm should demonstrate its effectiveness in producing reports that accurately describe radiology findings and attend to patient-specific indications. In this paper, we introduce a novel method, Structural Entities extraction and patient indications Incorporation (SEI) for chest X-ray report generation. Specifically, we employ a structural entities extraction (SEE) approach to eliminate presentation-style vocabulary in reports and improve the quality of factual entity sequences. This reduces the noise in the following cross-modal alignment module by aligning X-ray images with factual entity sequences in reports, thereby enhancing the precision of cross-modal alignment and further aiding the model in gradient-free retrieval of similar historical cases. Subsequently, we propose a cross-modal fusion network to integrate information from X-ray images, similar historical cases, and patient-specific indications. This process allows the text decoder to attend to discriminative features of X-ray images, assimilate historical diagnostic information from similar cases, and understand the examination intention of patients. This, in turn, assists in triggering the text decoder to produce high-quality reports. Experiments conducted on MIMIC-CXR validate the superiority of SEI over state-of-the-art approaches on both natural language generation and clinical efficacy metrics.
Thinking with Generated Images
We present Thinking with Generated Images, a novel paradigm that fundamentally transforms how large multimodal models (LMMs) engage with visual reasoning by enabling them to natively think across text and vision modalities through spontaneous generation of intermediate visual thinking steps. Current visual reasoning with LMMs is constrained to either processing fixed user-provided images or reasoning solely through text-based chain-of-thought (CoT). Thinking with Generated Images unlocks a new dimension of cognitive capability where models can actively construct intermediate visual thoughts, critique their own visual hypotheses, and refine them as integral components of their reasoning process. We demonstrate the effectiveness of our approach through two complementary mechanisms: (1) vision generation with intermediate visual subgoals, where models decompose complex visual tasks into manageable components that are generated and integrated progressively, and (2) vision generation with self-critique, where models generate an initial visual hypothesis, analyze its shortcomings through textual reasoning, and produce refined outputs based on their own critiques. Our experiments on vision generation benchmarks show substantial improvements over baseline approaches, with our models achieving up to 50% (from 38% to 57%) relative improvement in handling complex multi-object scenarios. From biochemists exploring novel protein structures, and architects iterating on spatial designs, to forensic analysts reconstructing crime scenes, and basketball players envisioning strategic plays, our approach enables AI models to engage in the kind of visual imagination and iterative refinement that characterizes human creative, analytical, and strategic thinking. We release our open-source suite at https://github.com/GAIR-NLP/thinking-with-generated-images.
Vision-Flan: Scaling Human-Labeled Tasks in Visual Instruction Tuning
Despite vision-language models' (VLMs) remarkable capabilities as versatile visual assistants, two substantial challenges persist within the existing VLM frameworks: (1) lacking task diversity in pretraining and visual instruction tuning, and (2) annotation error and bias in GPT-4 synthesized instruction tuning data. Both challenges lead to issues such as poor generalizability, hallucination, and catastrophic forgetting. To address these challenges, we construct Vision-Flan, the most diverse publicly available visual instruction tuning dataset to date, comprising 187 diverse tasks and 1,664,261 instances sourced from academic datasets, and each task is accompanied by an expert-written instruction. In addition, we propose a two-stage instruction tuning framework, in which VLMs are firstly finetuned on Vision-Flan and further tuned on GPT-4 synthesized data. We find this two-stage tuning framework significantly outperforms the traditional single-stage visual instruction tuning framework and achieves the state-of-the-art performance across a wide range of multi-modal evaluation benchmarks. Finally, we conduct in-depth analyses to understand visual instruction tuning and our findings reveal that: (1) GPT-4 synthesized data does not substantially enhance VLMs' capabilities but rather modulates the model's responses to human-preferred formats; (2) A minimal quantity (e.g., 1,000) of GPT-4 synthesized data can effectively align VLM responses with human-preference; (3) Visual instruction tuning mainly helps large-language models (LLMs) to understand visual features.
