Medical
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Towards Precision Therapy in Hepatocellular Carcinoma: A Clinical-Reasoning LLM for Risk Stratification and Treatment Guidance
2026-07-09 15:33:08Peng Cui, Jitao Wang, Siyan Xue, Yao Huang, Haoming Xia, Dong Li, Dengxiang Liu, Weilin Wang, Liping Liu, Leida Zhang, Yunfu Cui, Tao Peng, Daolin Ji, Haitao Zhao, Wei Zhang, Xiaojuan Wang, Weijie Ma, Zongren Ding, Jinlong Li, Yuan Ding, Jiajing Zhao, Zhiyu Chen, Chengkun Yang, Ziyue Huang, Jiaqi Liu, Fusheng Liu, Yang Zhou, Xiaojuan Wang, Zhongquan Sun, Shiyun Bao, Xiaojun Wang, Ming Yang, Guangxin Li, Bin Shu, Yong Liao, Hongxuan Li, Yao Tang, Shizhong Yang, Yongyi Zeng, Yufeng Yuan, Yinpeng Dong, Jihui Hao, Jun Zhu, Jiahong DongAbstract
Hepatocellular carcinoma (HCC) is a common malignancy and a leading cause of cancer-related mortality. Current guidelines and staging systems provide coarse categories, but often miss within-stage heterogeneity and the clinical context in electronic medical records (EMRs). We present HCC-STAR (Hepatocellular Carcinoma Staging, Treatment And pRognosis), a clinically aligned large language model that reads routine EMR narratives and jointly outputs risk score-based staging, ranked guideline-consistent treatments with evidence-based rationales, and individualized survival estimates. We curated about 30,000 HCC cases from SEER and expanded them into EMR-style narrative training data using a clinician-validated, prompt-based augmentation workflow. On this corpus, we developed a knowledge-aligned reasoning framework optimized with a step-verifiable composite reward, moving beyond text-level memorization of clinical guidelines. In a multi-center cohort of 6,668 patients from 12 hospitals in China, HCC-STAR achieved state-of-the-art performance in treatment recommendation and risk stratification compared with clinical guidelines and competitive models, including GPT-5 and Gemini-2.5 Pro. Hypothetical overall-survival analysis showed a median survival of 51 months under adherence to HCC-STAR recommendations, compared with 29 and 32 months under BCLC and CNLC. In clinician-centric evaluations, blinded hepatobiliary specialists rated HCC-STAR's reasoning and evidence-based justifications as trustworthy. The model surpassed resident and attending physicians in treatment accuracy and helped physicians make more accurate decisions faster when used as an assistant. These findings support HCC-STAR as a reliable and verifiable decision-support system for risk stratification and precision therapy in HCC.
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URL
https://arxiv.org/abs/2607.08602
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Drift-Aware Temporal Graph Rewiring for Adaptive Semantic Modeling in Biomedical Text
2026-07-09 13:49:34Bharathwaj Vijayakumar, Sahana K. VaradarajuAbstract
Biomedical language evolves rapidly as new discoveries emerge, causing traditional text models to lose semantic fidelity over time. Static embeddings and co-occurrence graphs cannot capture such evolution, leading to performance degradation in retrieval and knowledge discovery tasks. This paper introduces a Drift-Aware Temporal Graph Rewiring (DATGR) framework that models concept evolution by dynamically updating co-occurrence edges based on estimated semantic drift. Instead of retraining embeddings for each time slice, DATGR performs lightweight, feedback-driven rewiring using a logistic update rule applied to edge weights. Evaluated on the Biomedical Multi-Relation Corpus (BIOMRC), the method achieved a mean Area Under the Receiver Operating Characteristic (AUROC) improvement of approximately 0.066 absolute difference (0.699 vs. 0.633) over a static baseline. Area Under the Precision-Recall Curve (AUPRC) remained comparable (0.738 vs. 0.744), showing that drift-aware adaptation enhances link-prediction recall without a loss in precision. These results demonstrate that edge-level adaptation effectively captures temporal semantic change in evolving biomedical text while remaining computationally efficient and interpretable.
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URL
https://arxiv.org/abs/2607.08490
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OmniFood-Bench: Evaluating VLMs for Nutrient Reasoning and Personalized Health Advice
2026-07-09 12:46:00Qian Jiang, Zhecheng Shi, Jingpu Yang, Zirui Song, Miao FangAbstract
The rapid integration of Large Vision-Language Models (VLMs) into critical infrastructure promises to revolutionize personalized healthcare and dietary management. However, in the domain of food systems, autonomous agents face a unique and persistent challenge: the "Systemic Information Asymmetry" between visual appearance and intrinsic nutritional composition. Existing benchmarks primarily focus on coarse-grained classification tasks, such as food category recognition, which fail to evaluate the intricate reasoning chain required for real-world dietary management -- specifically, the ability to traverse from identifying hidden ingredients to estimating physical mass, and finally synthesizing safety-critical medical advice. In this paper, we introduce OmniFood-Bench, a comprehensive benchmark constructed from the MM-Food-100K dataset. Unlike previous works, OmniFood-Bench evaluates VLMs across three progressive capabilities: Basic Perception (Ingredients & Cooking Methods), Quantitative Reasoning (Portion Size & Nutritional Profiling), and Safety-Critical Advisory (Disease-Specific Recommendations). We evaluate six state-of-the-art VLMs, including gpt-5.1, gemini-3-flash, and qwen3-vl-8B. Our extensive experiments reveal a startling "Semantic-Physical Gap": while models achieve near-human accuracy in naming dishes, they exhibit catastrophic failure in mass estimation and frequently hallucinate benign advice for high-risk diabetic profiles. This work establishes a rigorous standard for trustworthiness in autonomous agents deployed for public health. The code and datasets are available in: this https URL
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URL
https://arxiv.org/abs/2607.08423
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Classical versus Deep Mirror-Symmetry Scoring: A Benchmark of Thirteen Methods
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Quantifying how mirror-symmetric an image is about a given axis (symmetry scoring) underpins applications from visual aesthetics to medical imaging, yet proposed scoring methods have never been compared on a common, statistically grounded protocol. We benchmark 13 scoring methods (nine collected from literature, four introduced here) spanning from classical features to frozen deep features, across four single-axis and five multi-axis datasets under a reflection-exact protocol with a chance-anchored, significance-tested discrimination skill. Deep backbones perform best on single-axis and harder multi-axis protocols. However, a classical histogram-of-oriented-gradients (HOG) descriptor trails the best frozen-network readout by a small (but significant) margin, is not statistically separable from the runner-up (a CNN-filter measure), and runs ~300x faster on CPU. Our results show that discrimination concentrates in mid-scale oriented features, where deep backbones peak at a low or mid stage, and HOG peaks at a mid cell size. Among existing methods, frozen deep features thus offer little over a tuned classical descriptor for measuring symmetry; whether task-trained deep scorers can do better remains open. We release the scorers and harness in imgsym, an open toolkit for image symmetry detection and measurement.
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https://arxiv.org/abs/2607.08379
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LUMI: Tokenizer-Agnostic LLM-Based Lossless Image Compression
2026-07-09 08:16:14Chris Xing Tian, Chengkai Wu, Ziyu Wang, Rongqun Lin, Kecheng Chen, Xiandong Meng, Haoliang Li, Shiqi Wang, Siwei MaAbstract
Large language model (LLM)-based lossless image compression methods typically represent pixel data through the native text interface of a pretrained model, converting pixel values into token sequences that the LLM processes through its vocabulary head. This design shows that pretrained language models can provide probability estimates for image coding, but it also couples compression to tokenizer behavior, vocabulary-specific numeric tokens, and model-family-specific adaptation. In this paper, we present LUMI (LLM-based Unified Model-agnostic lossless Image compression), a tokenizer-agnostic framework for lossless RGB image compression with frozen LLM backbones. LUMI replaces pixel-as-text tokenization with a pixel embedding module that maps raw intensity and channel information into the continuous embedding space of the LLM. It further introduces intra-patch position encoding to retain two-dimensional spatial structure after flattening, and uses a 256-way prediction head to produce probabilities over the native pixel alphabet. Only the pixel embedding, position encoding, soft-prefix parameters, and prediction head are trained, while the LLM backbone remains fixed. Experiments on natural, medical, and remote-sensing image benchmarks with LLaMA, Qwen, and Gemma backbones show that LUMI provides a unified interface across tokenizer families, achieves competitive compression rates, and improves cross-domain robustness over tokenizer-based LLM compression baselines. These results formulate LLM-based lossless image compression as pixel-space adaptation of frozen foundation models rather than tokenizer-specific language-symbol modeling.
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URL
https://arxiv.org/abs/2607.08221
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Benchmark Evaluation of Feredated Learning on Multi-organ Images
2026-07-09 08:14:15Junbin Mao, Xu Tian, Jianchun Zhu, Ludi Li, Jin LiuAbstract
The privacy requirements of medical data and its substantial variations across organs and modalities hinder the clinical implementation of medical AI. Federated learning (FL) is a feasible approach to overcome these challenges. Due to the continuous emergence of FL algorithms and the highly heterogeneous nature of medical data, objectively evaluating their performance in real-world clinical settings remains difficult. Therefore, a comprehensive federated medical imaging benchmark, serving as a unified evaluation standard, is crucial for advancing the technology toward reliable clinical application. Existing federated medical imaging benchmarks have not yet adequately incorporated state-of-the-art algorithms, are limited to data from single organs or modalities, and overly emphasize model accuracy, making it difficult to comprehensively assess the overall efficacy of FL in real-world medical environments. To address these challenges, we developed the MobenFL benchmark. This benchmark integrates 20 cutting-edge FL algorithms and 22 medical imaging datasets, covering 12 critical organs across the human body, surpassing existing benchmark in breadth. In terms of evaluation dimensions, MobenFL not only assesses performance but also systematically incorporates key metrics such as algorithmic efficiency and privacy protection capabilities. Additionally, it conducts specialized evaluations for complex real-world clinical scenarios involving different diseases, devices, and imaging modalities, thereby providing a comprehensive and in-depth evaluation framework for the clinical application of FL in the medical field.
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URL
https://arxiv.org/abs/2607.08219
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ConRad: Efficient Conformal Prediction for Radiomics
2026-07-09 03:32:58Matt Y. Cheung, Ashok Veeraraghavan, Guha BalakrishnanAbstract
Radiomic features derived from medical images and segmentation masks are used to support decision making in clinical imaging pipelines. In practice, these features are often computed from predicted masks, but segmentation models can be overconfident or poorly calibrated, making derived measurements appear more reliable than they are. Conformal prediction (CP) provides distribution-free prediction intervals with finite-sample marginal coverage guarantees, but black-box intervals for segmentation-derived radiomics can be inefficient because they ignore test-time information about image appearance, mask geometry, and segmentation uncertainty. We propose ConRad, a conformal framework for scalar radiomic targets that uses covariates derived from the predicted mask, input image, predicted radiomics, and boundary uncertainty to construct adaptive intervals while maintaining coverage. Across five 2D medical imaging datasets and 171 retained radiomic targets, we show that ConRad improves feature-level efficiency compared to baselines while maintaining near-nominal empirical coverage. Ablation results further indicate that segmentation boundary uncertainty features are the largest contributors to interval efficiency.
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URL
https://arxiv.org/abs/2607.08084
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A safety-oriented hypothetico-deductive framework for AI-assisted differential diagnosis
2026-07-09 01:30:24Fan Ma, Mauro Giuffr\`e, Donald Wright, Kent McCann, Mark Iscoe, Lingfei Qian, Mingyang Jiang, Chi Wing Ng, Na Hong, Huan He, Cathy Shyr, Qingyu Chen, Lee Schwamm, Lucila Ohno-Machado, Hua XuAbstract
Diagnostic error is a major threat to patient safety, yet current large language model (LLM) systems often treat diagnosis as a one-shot prediction task, lacking safeguards against missed high-risk alternatives or rigorous verification of their reasoning. Here, we present AegisDx, a safety-oriented framework for hypothetico-deductive clinical reasoning. AegisDx coordinates specialized LLM components through role-specific contracts, structured intermediate outputs, evidence-retrieval interfaces, and verification gates to generate broad differential diagnoses, enforce explicit screening for dangerous "must-not-miss" conditions, verify reasoning against grounded medical evidence, and structure actionable next steps. We evaluated AegisDx across three layers. On literature-derived case reports from NEJM and JAMA, with GPT-oss-120B as the shared backbone, Top-3 diagnostic accuracy was 59.9% versus 52.1% for the standalone LLM on JAMA cases and 62.7% versus 51.4% on NEJM cases. On cases from Annals of Emergency Medicine, Top-3 accuracy was 85.7% versus 68.6%; against physician-consensus must-not-miss diagnosis sets, AegisDx captured at least one such condition among its top three diagnoses in 78.0% of cases versus 52.0%. In a blinded physician evaluation of 43 real-world emergency department notes from the Yale New Haven Health System compared against GPT-5, AegisDx improved the physician-rated composite safety score from 4.31 to 4.55 on a 5-point scale (adjusted p = 2.1x10^-4), with qualitative gains in must-not-miss identification and reasoning safety. Our findings suggest that engineering diagnostic AI as a safety-oriented reasoning framework, rather than optimizing raw predictive accuracy alone, can provide a safer, more transparent, and clinically meaningful layer of bedside decision support for acute care workflows.
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URL
https://arxiv.org/abs/2607.08038
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Concretized Proposition Prompting Resolves Composition-Knowledge Dichotomy in Large Language Models
2026-07-09 00:49:28Changhun Lee, Minguk Jeon, Jongkyung Shin, Chiehyeon LimAbstract
LLMs often struggle to balance compositionality with knowledgeability, a challenge we define as Composition-Knowledge Dichotomy. To address this, we propose Concretized Proposition Prompting (CPP), a framework that explicitly concretizes propositions relevant to questions. The results demonstrate that CPP significantly enhances reasoning performance, particularly in medical benchmarks where precise knowledge is paramount, while being competitive on math benchmarks where deductive reasoning is prioritized. Additional experiments reveal that CPP is scalable to various foundation models and parameter sizes, being a fundamental paradigm that bridges the gap between composition- and knowledge-based approaches. Consequently, CPP resolves the composition-knowledge dichotomy by providing a solid foundation for logically organized and factually grounded reasoning.
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URL
https://arxiv.org/abs/2607.08018
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MedPMC: A Systematic Framework for Scaling High-Fidelity Medical Multimodal Data for Foundation Models
2026-07-08 17:26:49Hyunjae Kim, Dain Kim, Pan Xiao, Serina S. Applebaum, Younjoon Chung, Xuguang Ai, Yu Yin, Roy Jiang, Yuexi Du, Yawen Wei, Yiming Kong, Tuo Guo, Zhiyuan Cao, Mengmeng Du, Yuelei Fu, Yan Hu, Rui Shi, Gui Yang, Kevin W. Jin, Yuntian Liu, Yuxuan Tian, Jonathan Marquez, Zhen Chen, Sheng Zhang, Hoifung Poon, Hua Xu, Jaewoo Kang, Qingyu ChenAbstract
Medicine is inherently multimodal, requiring clinicians to synthesize information across diverse data streams. Yet the development of multimodal foundation models is constrained by limited access to large-scale, high-quality clinical data. Although PubMed Central (PMC) offers a complementary source of expert-authored image-text data, existing PMC-derived resources remain limited in fidelity, reproducibility, and clinical validation. We introduce MedPMC, an automated, continuously updatable framework that transforms permissively licensed literature into high-fidelity infrastructure for medical multimodal models. Applied to 6.1 million PMC articles, MedPMC curated 11 million medical image-text pairs. Component evaluations showed strong performance for initial screening (F1 = 93.2), multi-panel figure detection (F1 = 96.5), figure separation (mAP = 89.8), caption separation and alignment (F1 = 81.4; ROUGE-L = 85.3), and medical figure classification (F1 = 96.5). Manual review by five annotators, three with medical training, found 95.3% of MedPMC images medically relevant, versus 19.7% in a prior PMC-derived dataset. Across 26 benchmarks spanning 11 specialties, a MedPMC-trained CLIP-style model improved average zero-shot AUC by 7.1 percentage points over the strongest architecture-matched biomedical CLIP baseline despite using fewer than half as many image-text pairs. As the vision encoder in a multimodal large language model, it improved medical visual question-answering by 1.9 and 16.9 percentage points across two benchmarks. In 10,524 Yale New Haven Health System dermatology photographs, it improved morphology-to-image retrieval Recall@5 by 11.7 percentage points. These findings show that high-fidelity literature curation strengthens medical multimodal foundation models across benchmark and clinical settings. We publicly release the framework, corpus, benchmarks, and pretrained models.
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URL
https://arxiv.org/abs/2607.07673
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Aligning Clinical Needs and AI Capabilities: A Survey on LLMs for Medical Reasoning
2026-07-08 15:19:37Qi Peng, Jiatong Li, Sirui Huang, Yiyang Jiang, Kaisong Gong, Ronger Ding, Shijie Ye, Changmeng Zheng, Yi Cai, Xiaobo Yang, Jin Huang, Xiao-Yong Wei, Qing LiAbstract
Large language models (LLMs) have emerged as important tools in healthcare, showing growing potential for clinical reasoning and patient care. This survey examines recent progress in medical LLMs, focusing on reasoning applications and requirements. We present a dual-view approach that connects clinical practice with computational methods. On the clinical side, we establish a five-level competency scheme following Miller's Pyramid, progressing from knowledge recall to dynamic case management. On the computational side, we link deductive, inductive, and abductive reasoning patterns to common medical goals and tasks. We also introduce a benchmark dataset spanning five levels of medical reasoning capability and report results on 18 state-of-the-art models, revealing that medical specialist models excel in diagnosis-centric tasks while general models lead in decision support and dialogue. We conclude by discussing current progress and open challenges, including data limitations, hallucination, and grounding issues, and outline directions toward safer, more reliable, and workflow-ready systems.
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URL
https://arxiv.org/abs/2607.07761
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VCDP: Variation-Conditioned Distributional Proxy Learning for Semi-Supervised Medical Image Segmentation
2026-07-08 13:46:53Zimu Zhang, Yiheng Zhong, Zhuoru Zhang, Yingzhen Hu, Yanan He, Fanliang Meng, Xiaofeng LiuAbstract
Semi-supervised 3D medical image segmentation reduces the need for dense voxel-level annotations by exploiting unlabeled volumes. Although existing methods such as consistency regularization, pseudo-labeling, and co-training improve prediction-level robustness, they often provide insufficient feature-space organization for anatomically complex structures, especially small organs and ambiguous boundary regions with large intra-class variations. To address this issue, we propose Variation-Conditioned Distributional Proxy Learning (VCDP), a plug-and-play training-only regularization module for semi-supervised 3D medical image segmentation. VCDP represents each class with a learnable Gaussian distribution for shared class semantics and multiple variation prototypes for fine-grained intra-class patterns. A unified variation-conditioned compatibility score is further formulated to fuse distributional similarity and soft variation aggregation, guiding voxel embeddings to align with both global organ identity and local anatomical variations. VCDP is attached to decoder features during training and removed during inference, introducing no additional inference cost. Experiments on multi-organ segmentation benchmarks show that VCDP improves most evaluated baselines, particularly for small, ambiguous, and highly variable organs. Our anonymous code is released at this https URL.
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URL
https://arxiv.org/abs/2607.07416
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Heterogeneity-Adaptive Diffusion Schrodinger Bridge for PET-Guided Whole-Body MRI Translation
2026-07-08 13:35:22Chengbo Wang, Jiacheng Yu, Linjie Bian, Ming Qi, Xiaosheng Liu, Tongtong Che, Jichang Zhang, Shuyu Li, Shaoli Song, Xiuying WangAbstract
While whole-body multimodal medical imaging scanners have been increasingly recognized for more effective medical applications, the excessive long acquisition time in PET-MR scanning is a major obstacle in more efficient clinical practice. Deep learning-based MRI translation provides a potential solution to reduce scan duration. However, current models often focus on specific anatomical regions and face challenges for whole-body scans that consists of highly heterogeneous feature distributions mainly due to (1) different anatomical regions across whole-body, and (2) lesions or pathological tissues. This paper tackles the challenges through a novel Heterogeneity-Adaptive Diffusion Schrodinger Bridge (HA-DSB) framework. By explicitly modeling translation as stochastic transport between source and target distributions, HA-DSB incorporates region context embeddings derived from a vision-language model (VLM) to enable region-specific modeling. To enhance fidelity of the pathological tissue, lesion-aware metabolic prior from PET is integrated directly into the bridge dynamics through a dual-stage guidance mechanism. Specifically, a PET-guided noise modulation module adaptively scales spatial diffusion perturbations during the forward process, while PET features are leveraged during the reverse process to selectively amplify lesion-relevant structures via an attention mechanism. Experiments demonstrate the superiority of our method across different body regions in whole-body MRI translation and show improved translation quality in lesion areas under PET guidance. Our code is available at Github.
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URL
https://arxiv.org/abs/2607.07401
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Naming the Concepts Classifiers Rely On: Language-Anchored Decomposition for Faithful Explanation
2026-07-08 10:50:04Ahsan Habib Akash, Dipkamal Bhusal, Stacey Jones, Donald A. Adjeroh, Binod Bhattarai, Prashnna Kumar GyawaliAbstract
Deep neural networks are widely deployed in high-stakes visual applications where interpretability is critical, yet existing explanations face a trade-off: post-hoc concept methods recover factors that are faithful to a model's behavior but unnamed, while naming and by-design methods attach human-readable concepts only by retraining or altering the classifier. We propose Language-Anchored Decomposition (LAD), a post-hoc framework that delivers concepts which are simultaneously named, faithful, and obtained without modifying the model. For each class, a large language model proposes a concept vocabulary that CLIP-based similarity maps localize across image regions. Inverting standard non-negative matrix factorization, LAD fixes these language-grounded maps as the coefficient matrix and learns only a concept basis that reconstructs the frozen encoder's activations, so naming becomes a structural constraint and the model's own feature geometry determines which concepts are retained. Removing this anchor preserves accuracy but collapses attribution faithfulness. Across natural-image, scene, and medical-imaging benchmarks, LAD produces spatially precise explanations that are decision-relevant under both concept insertion and deletion, while uniquely providing stable, human-interpretable concept names.
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URL
https://arxiv.org/abs/2607.07264
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From Text to Parameters: Predicting Item Parameters from Embedding Regularization with Reliability and Design Ceilings
2026-07-08 08:34:46Shi-Ting Chen, Jinsong ChenAbstract
Newly developed items must ordinarily be field tested before their psychometric properties are known, creating a cold start problem for item calibration. Predicting item parameters from features is a long standing measurement problem dating back to the Linear Logistic Test Model; modern text embeddings now automate the design matrices traditionally specified by hand. We propose an evaluation framework combining regularized regression on item text embeddings, repeated cross validated R squared reported with its resampling standard deviation, and two performance upper bounds: a reliability ceiling derived from parameter standard errors, and a design ceiling derived from simulation based power calibration. Applying this framework to a mathematics item bank (EEDI) and a medical licensure benchmark (BEA 2024), we find that item difficulty is highly predictable from text (repeated cross validated R squared = 0.53, or about 57% of its reliability ceiling), whereas discrimination and pseudo guessing appear less predictable. However, evaluating these results against our ceilings reveals that this apparent hierarchy stems from target reliability rather than text signal strength: text uniformly recovers 57 to 63% of the reliable variance across difficulty targets, whereas the 3PL pseudo guessing parameter has a reliability ceiling near zero, making it an unviable target at current precision. On BEA, embedding based regression matches leaderboard RMSE despite explaining almost no variance, highlighting the critical need for scale free metrics and explicit ceilings in benchmarking. Finally, we show that a single train and test split can inflate apparent accuracy by 0.1 to 0.15 in R squared, underscoring the necessity of repeated cross validation for calibration support applications and future benchmark construction.
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URL
https://arxiv.org/abs/2607.07141
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TRACE-Seg3D: Counterfactual Context Auditing For Robust 3D Glioma Segmentation Under Institutional Shift
2026-07-08 06:15:14Nguyen Linh Dan Le, Nguyen Pham Hoang Le, Tran Dang KhoiAbstract
Medical image segmentation models can achieve strong benchmark performance while remaining sensitive to scanner, protocol, and institutional variation. These context shifts alter image appearance without changing the underlying lesion, allowing models to exploit nuisance cues that Dice and HD95 fail to expose. We present TRACE-Seg3D, a counterfactual context auditing framework for robust 3D medical image segmentation. TRACE-Seg3D preserves lesion-relevant evidence and systematically varies imaging context to quantify prediction stability under controlled context shifts. The framework pairs each segmentation with audit evidence for context sensitivity and anatomical plausibility, enabling case-level reliability assessment beyond overlap-based evaluation. Experiments on BraTS and UTSW glioma segmentation benchmarks demonstrate competitive in-distribution and cross-domain performance. TRACE-Seg3D also exposes context-sensitive failure modes missed by conventional metrics. These results establish counterfactual context auditing as a practical route toward transparent and reliable 3D medical image segmentation under distribution shift. Our code is available at this https URL.
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URL
https://arxiv.org/abs/2607.07038
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SHTA: Semantic Hard Token Correction and Center Alignment for Semi-Supervised Medical Image Segmentation
2026-07-08 05:30:24Zhuoru Zhang, Yiheng Zhong, Zimu Zhang, Xiaofeng LiuAbstract
Recent advances in semi-supervised medical image segmentation have achieved remarkable performance through prediction consistency, pseudo-label supervision, and hard-region supervision. However, these methods primarily improve supervision quality rather than explicitly enforcing semantic consistency in the learned representations of hard regions. Consequently, even under increasingly stronger prediction-level supervision, difficult regions exhibiting unstable semantic assignment often fail to establish semantically consistent representations during training, thereby limiting further segmentation improvement. To address this issue, we propose SHTA (Semantic Hard Token Correction and Center Alignment), a lightweight training-time semantic representation branch. Instead of introducing additional prediction supervision, SHTA refines intermediate semantic representations through Semantic Assignment, Hard Token Refinement, and Semantic Center Alignment, thereby improving semantic consistency in hard regions while preserving the original prediction pathway and introducing no additional inference cost. We integrate SHTA into representative semi-supervised segmentation frameworks, including GA-CPS, CPS, URPC, and MagicNet, and conduct evaluations on the Synapse and AMOS datasets. Experimental results demonstrate that SHTA delivers consistent paired improvements across frameworks, with especially clear gains in segmentation accuracy, weak-organ recovery, and semantic ambiguity reduction, while incurring only training-time overhead. The code is available at this https URL.
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URL
https://arxiv.org/abs/2607.07019
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HPR-SAM: Hierarchical Probabilistic Representation Learning for Prompt-free SAM-based Medical Image Segmentation
2026-07-08 03:49:08Yingzhen Hu, Yiheng Zhong, Keying Zhu, Zimu Zhang, Zihan Ye, Sifan Song, Jionglong Su, Xiaofeng LiuAbstract
Prompt-free adaptation of the Segment Anything Model (SAM) has emerged as a promising paradigm for automatic medical image segmentation. Existing methods mainly focus on prompt generation, while overlooking that prompt quality is fundamentally constrained by the expressiveness of anatomical representations. However, deterministic prototypes or semantic tokens are insufficient to jointly capture global anatomical priors, intra-structure diversity, and local structural reliability. To address this limitation, we propose the Hierarchical Probabilistic Representation (HPR) framework, which learns complementary anatomical representations through Distributional Anatomical Representation (DAR), Multi-component Anatomical Representation (MAR), and Local Reliability Representation (LRR), and integrates their predictions via Hierarchical Prediction Fusion (HPF) while remaining compatible with the original SAM decoder. Experiments on the Synapse, LA, and PROMISE12 datasets demonstrate that HPR-SAM achieves state-of-the-art performance on Synapse and the best performance under few-shot settings on LA and PROMISE12, validating the effectiveness of the proposed hierarchical probabilistic representation learning framework for prompt-free medical image segmentation. Code is available at this https URL.
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URL
https://arxiv.org/abs/2607.06972
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A Continual Learning Framework for Adaptive Control of Modular Soft Robots
2026-07-07 19:11:07Nilay Kushawaha, Muhammad Sunny Nazeer, Baljinder Singh Bal, Cecilia Laschi, Egidio FaloticoAbstract
Soft robots have attracted significant attention in applications such as medical intervention, rehabilitation, and robotic manipulation due to their inherent compliance, flexibility, and high degrees of freedom. Modular soft robots (MSRs), composed of multiple interconnected segments, represent an emerging class of robotic systems with highly deformable and reconfigurable structures capable of performing complex tasks. However, designing controllers for MSRs remains challenging due to their nonlinear dynamics, modeling complexity, and hyper-redundant nature. Existing approaches typically require controllers to be retrained from scratch whenever the robot morphology changes. In this work, we address these challenges through a continual learning inspired control framework capable of incrementally adapting to changes in robot morphology while preserving previously acquired knowledge. Specifically, the proposed framework enables the controller to sequentially learn new MSR configurations without forgetting previously learned ones. In addition, for MSRs with fixed configurations, the same framework can be employed in a distributed manner to learn module-specific dynamics, enabling localized control and improved precision. The proposed approach is validated through closed-loop trajectory tracking experiments in simulation using a tendon-driven soft robot, as well as on a real-world three-module pneumatic soft robotic arm. Furthermore, we demonstrate the adaptive capabilities of the framework through a reaching experiment in which the controller selectively activates only the necessary modules to reach a virtual target position, thereby reducing computational overhead.
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URL
https://arxiv.org/abs/2607.06740
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The Large Cancer Assistant : A Model-Agnostic Orchestration Framework for Scalable Clinical Decision Support in Oncology
2026-07-07 17:38:47Ghassen Marrakchi, Basarab MateiAbstract
- Objective: Multimodal deep learning models in oncology are currently limited by monolithic designs that rigidly couple data ingestion, clinical routing, and artificial intelligence (AI) inference. To address this inflexibility, we propose the Large Cancer Assistant (LCA), a model-agnostic, post-hoc orchestration framework designed for scalable clinical decision support. - Methods: The LCA is mathematically formalized as a 7-tuple architecture grounded in the principle of Algorithmic Impermeability, ensuring the orchestration logic remains strictly independent of underlying black-box AI models. We introduce the Entry Theory, leveraging Geometric Deep Learning (GDL) to standardize multimodal patient data along distinct structural and medical axes. The system dynamically orchestrates data via a Cancer Switching Module and intentionally isolates the core AI execution from volatile hospital IT infrastructures by outputting a Standardized Intermediate Payload (SIP). - Results: A Proof of Concept (PoC) validated the orchestration logic across four technical scenarios. The framework executed a nominal flow with negligible orchestration overhead. It empirically demonstrated algorithmic impermeability by maintaining an invariant routing projection during AI model swaps, and it validated strict failure-safety by achieving a 100\% recall rate in generating targeted Supplementary Data Requests (SDR) under injected data anomalies. Multi-protocol execution capability was also successfully verified. - Conclusion: By structurally decoupling multimodal ingestion from feature inference, the LCA provides a highly adaptable and modular orchestration foundation. The SIP establishes a clear architectural boundary, natively setting the stage for downstream Electronic Medical Record (EMR) interoperability as an independent future paradigm.
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URL
https://arxiv.org/abs/2607.06531
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