Daily Papers

Radiology report generation (RRG) has attracted significant attention due to its potential to reduce the workload of radiologists. Current RRG approaches are still unsatisfactory against clinical standards. This paper introduces a novel RRG method, LM-RRG, that integrates large models (LMs) with clinical quality reinforcement learning to generate accurate and comprehensive chest X-ray radiology reports. Our method first designs a large language model driven feature extractor to analyze and interpret different regions of the chest X-ray image, emphasizing specific regions with medical significance. Next, based on the large model's decoder, we develop a multimodal report generator that leverages multimodal prompts from visual features and textual instruction to produce the radiology report in an auto-regressive way. Finally, to better reflect the clinical significant and insignificant errors that radiologists would normally assign in the report, we introduce a novel clinical quality reinforcement learning strategy. It utilizes the radiology report clinical quality (RadCliQ) metric as a reward function in the learning process. Extensive experiments on the MIMIC-CXR and IU-Xray datasets demonstrate the superiority of our method over the state of the art.

Visualizations play a crucial part in effective communication of concepts and information. Recent advances in reasoning and retrieval augmented generation have enabled Large Language Models (LLMs) to perform deep research and generate comprehensive reports. Despite its progress, existing deep research frameworks primarily focus on generating text-only content, leaving the automated generation of interleaved texts and visualizations underexplored. This novel task poses key challenges in designing informative visualizations and effectively integrating them with text reports. To address these challenges, we propose Formal Description of Visualization (FDV), a structured textual representation of charts that enables LLMs to learn from and generate diverse, high-quality visualizations. Building on this representation, we introduce Multimodal DeepResearcher, an agentic framework that decomposes the task into four stages: (1) researching, (2) exemplar report textualization, (3) planning, and (4) multimodal report generation. For the evaluation of generated multimodal reports, we develop MultimodalReportBench, which contains 100 diverse topics served as inputs along with 5 dedicated metrics. Extensive experiments across models and evaluation methods demonstrate the effectiveness of Multimodal DeepResearcher. Notably, utilizing the same Claude 3.7 Sonnet model, Multimodal DeepResearcher achieves an 82\% overall win rate over the baseline method.

Radiology report generation (RRG) is commonly formulated as a single-path generation task, where a multimodal large language model (MLLM) produces one decoded report as the final output. While recent progress has largely been driven by scaling training data, model capacity, and retrieval mechanisms, improving report quality at inference time remains underexplored. In this work, we observe that fixed radiology MLLMs often generate clinically stronger reports elsewhere in their candidate pool than the one selected by default decoding, suggesting that inference-time decision making remains an overlooked bottleneck. To address this, we propose Clinical Consensus Selection (CCS), a decoder-agnostic inference-time selection framework that samples multiple candidate reports and selects the one with the highest clinical consensus across the rollout pool. CCS unifies text-based utilities with a radiology-adapted utility computed by an image--report-trained multimodal embedder, which measures candidate agreement beyond surface-level textual similarity. Across three datasets and multiple radiology MLLMs, CCS consistently improves inference-time performance over single-path decoding and generic Best-of-N baselines, with particularly clear gains on clinical metrics. Further analysis shows that image-grounded utility forms a selection axis distinct from textual consensus and that substantial headroom remains for improving RRG at inference time.

The autonomous synthesis of deep research reports represents a critical frontier for Large Language Models (LLMs), demanding sophisticated information orchestration and non-linear narrative logic. Current approaches rely on rigid predefined linear workflows, which cause error accumulation, preclude global restructuring from subsequent insights, and ultimately limit in-depth multimodal fusion and report quality. We propose CogGen, a Cognitively inspired recursive framework for deep research report Generation. Leveraging a Hierarchical Recursive Architecture to simulate cognitive writing, CogGen enables flexible planning and global restructuring. To extend this recursivity to multimodal content, we introduce Abstract Visual Representation (AVR): a concise intent-driven language that iteratively refines visual-text layouts without pixel-level regeneration overhead. We further present CLEF, a Cognitive Load Evaluation Framework, and curate a new benchmark from Our World in Data (OWID). Extensive experiments show CogGen achieves state-of-the-art results among open-source systems, generating reports comparable to professional analysts' outputs and surpassing Gemini Deep Research. Our code and dataset are available at https://github.com/NJUNLP/CogGen.

Many clinical tasks require an understanding of specialized data, such as medical images and genomics, which is not typically found in general-purpose large multimodal models. Building upon Gemini's multimodal models, we develop several models within the new Med-Gemini family that inherit core capabilities of Gemini and are optimized for medical use via fine-tuning with 2D and 3D radiology, histopathology, ophthalmology, dermatology and genomic data. Med-Gemini-2D sets a new standard for AI-based chest X-ray (CXR) report generation based on expert evaluation, exceeding previous best results across two separate datasets by an absolute margin of 1% and 12%, where 57% and 96% of AI reports on normal cases, and 43% and 65% on abnormal cases, are evaluated as "equivalent or better" than the original radiologists' reports. We demonstrate the first ever large multimodal model-based report generation for 3D computed tomography (CT) volumes using Med-Gemini-3D, with 53% of AI reports considered clinically acceptable, although additional research is needed to meet expert radiologist reporting quality. Beyond report generation, Med-Gemini-2D surpasses the previous best performance in CXR visual question answering (VQA) and performs well in CXR classification and radiology VQA, exceeding SoTA or baselines on 17 of 20 tasks. In histopathology, ophthalmology, and dermatology image classification, Med-Gemini-2D surpasses baselines across 18 out of 20 tasks and approaches task-specific model performance. Beyond imaging, Med-Gemini-Polygenic outperforms the standard linear polygenic risk score-based approach for disease risk prediction and generalizes to genetically correlated diseases for which it has never been trained. Although further development and evaluation are necessary in the safety-critical medical domain, our results highlight the potential of Med-Gemini across a wide range of medical tasks.

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.

Frontier models have demonstrated remarkable capabilities in understanding and reasoning with natural-language text, but they still exhibit major competency gaps in multimodal understanding and reasoning especially in high-value verticals such as biomedicine. Medical imaging report generation is a prominent example. Supervised fine-tuning can substantially improve performance, but they are prone to overfitting to superficial boilerplate patterns. In this paper, we introduce Universal Report Generation (UniRG) as a general framework for medical imaging report generation. By leveraging reinforcement learning as a unifying mechanism to directly optimize for evaluation metrics designed for end applications, UniRG can significantly improve upon supervised fine-tuning and attain durable generalization across diverse institutions and clinical practices. We trained UniRG-CXR on publicly available chest X-ray (CXR) data and conducted a thorough evaluation in CXR report generation with rigorous evaluation scenarios. On the authoritative ReXrank benchmark, UniRG-CXR sets new overall SOTA, outperforming prior state of the art by a wide margin.

Automating medical report generation from histopathology images is a critical challenge requiring effective visual representations and domain-specific knowledge. Inspired by the common practices of human experts, we propose an in-context learning framework called PathGenIC that integrates context derived from the training set with a multimodal in-context learning (ICL) mechanism. Our method dynamically retrieves semantically similar whole slide image (WSI)-report pairs and incorporates adaptive feedback to enhance contextual relevance and generation quality. Evaluated on the HistGen benchmark, the framework achieves state-of-the-art results, with significant improvements across BLEU, METEOR, and ROUGE-L metrics, and demonstrates robustness across diverse report lengths and disease categories. By maximizing training data utility and bridging vision and language with ICL, our work offers a solution for AI-driven histopathology reporting, setting a strong foundation for future advancements in multimodal clinical applications.

We present a radiology-specific multimodal model for the task for generating radiological reports from chest X-rays (CXRs). Our work builds on the idea that large language model(s) can be equipped with multimodal capabilities through alignment with pre-trained vision encoders. On natural images, this has been shown to allow multimodal models to gain image understanding and description capabilities. Our proposed model (MAIRA-1) leverages a CXR-specific image encoder in conjunction with a fine-tuned large language model based on Vicuna-7B, and text-based data augmentation, to produce reports with state-of-the-art quality. In particular, MAIRA-1 significantly improves on the radiologist-aligned RadCliQ metric and across all lexical metrics considered. Manual review of model outputs demonstrates promising fluency and accuracy of generated reports while uncovering failure modes not captured by existing evaluation practices. More information and resources can be found on the project website: https://aka.ms/maira.

Large Language Models (LLMs) have advanced autonomous agents from deep search, which retrieves concise factual answers, to deep research, which synthesizes scattered evidence into long-form reports. However, verifiable multimodal deep research remains challenging due to open-ended synthesis without deterministic ground truth and the need to interleave textual arguments with visual evidence. We propose Ptah, a multi-agent harness for interleaved report generation. Ptah orchestrates the lifecycle from user query to rendered web report through planning, research, and writing stages, where specialized agents construct visual-aware plans, collect claim-grounded evidence, maintain source-aligned images in a Visual Working Memory, and compose reports through declarative multimodal tool use. A verifier agent serves as the harness's acceptance function, enforcing factual grounding, citation fidelity, and cross-modal consistency throughout the workflow. We further introduce PtahEval, an evaluation protocol that augments existing benchmarks with image-level and presentation-level assessments. Experiments on deep research benchmarks show that Ptah produces more reliable, visually informative, and usable human-facing multimodal reports than strong baselines.

The recent release of RadGenome-Chest CT has significantly advanced CT-based report generation. However, existing methods primarily focus on global features, making it challenging to capture region-specific details, which may cause certain abnormalities to go unnoticed. To address this, we propose MedRegion-CT, a region-focused Multi-Modal Large Language Model (MLLM) framework, featuring three key innovations. First, we introduce Region Representative (R^2) Token Pooling, which utilizes a 2D-wise pretrained vision model to efficiently extract 3D CT features. This approach generates global tokens representing overall slice features and region tokens highlighting target areas, enabling the MLLM to process comprehensive information effectively. Second, a universal segmentation model generates pseudo-masks, which are then processed by a mask encoder to extract region-centric features. This allows the MLLM to focus on clinically relevant regions, using six predefined region masks. Third, we leverage segmentation results to extract patient-specific attributions, including organ size, diameter, and locations. These are converted into text prompts, enriching the MLLM's understanding of patient-specific contexts. To ensure rigorous evaluation, we conducted benchmark experiments on report generation using the RadGenome-Chest CT. MedRegion-CT achieved state-of-the-art performance, outperforming existing methods in natural language generation quality and clinical relevance while maintaining interpretability. The code for our framework is publicly available.

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.

Vision-Language Foundation Models (VLMs), trained on large-scale multimodal datasets, have driven significant advances in Artificial Intelligence (AI) by enabling rich cross-modal reasoning. Despite their success in general domains, applying these models to medical imaging remains challenging due to the limited availability of diverse imaging modalities and multilingual clinical data. Most existing medical VLMs are trained on a subset of imaging modalities and focus primarily on high-resource languages, thus limiting their generalizability and clinical utility. To address these limitations, we introduce a novel Vietnamese-language multimodal medical dataset consisting of 2,757 whole-body PET/CT volumes from independent patients and their corresponding full-length clinical reports. This dataset is designed to fill two pressing gaps in medical AI development: (1) the lack of PET/CT imaging data in existing VLMs training corpora, which hinders the development of models capable of handling functional imaging tasks; and (2) the underrepresentation of low-resource languages, particularly the Vietnamese language, in medical vision-language research. To the best of our knowledge, this is the first dataset to provide comprehensive PET/CT-report pairs in Vietnamese. We further introduce a training framework to enhance VLMs' learning, including data augmentation and expert-validated test sets. We conduct comprehensive experiments benchmarking state-of-the-art VLMs on downstream tasks. The experimental results show that incorporating our dataset significantly improves the performance of existing VLMs. We believe this dataset and benchmark will serve as a pivotal step in advancing the development of more robust VLMs for medical imaging, especially for low-resource languages and clinical use in Vietnamese healthcare. The source code is available at https://github.com/AIoT-Lab-BKAI/ViPET-ReportGen.

Automatic radiology report generation is a promising application of multimodal deep learning, aiming to reduce reporting workload and improve consistency. However, current state-of-the-art (SOTA) systems - such as Multimodal AI for Radiology Applications (MAIRA-2) and Medical Pathways Language Model-Multimodal (MedPaLM-M) - depend on large-scale multimodal training, clinical metadata, and multiple imaging views, making them resource-intensive and inaccessible for most settings. We introduce a compact image-to-text architecture that generates the Findings section of chest X-ray reports from a single frontal image. The model combines a frozen Self-Distillation with No Labels v3 (DINOv3) Vision Transformer (ViT) encoder with a Generative Pre-trained Transformer 2 (GPT-2) decoder enhanced by layer-wise anatomical attention. This mechanism integrates lung and heart segmentation masks through hierarchical Gaussian smoothing, biasing attention toward clinically relevant regions without adding trainable parameters. Evaluated on the official Medical Information Mart for Intensive Care-Chest X-ray (MIMIC-CXR) dataset using Chest Radiograph Expert (CheXpert) and Radiology Graph (RadGraph) metrics, our approach achieved substantial gains: CheXpert Macro-F1 for five key pathologies increased by 168% (0.083 -> 0.238) and Micro-F1 by 146% (0.137 -> 0.337), while broader performance across 14 observations improved by 86% (0.170 -> 0.316). Structural coherence also improved, with RadGraph F1 rising by 9.7%. Despite its small size and purely image-conditioned design, the model demonstrates that decoder-level anatomical guidance improves spatial grounding and enhances coherence in clinically relevant regions. The source code is publicly available at: https://github.com/devMuniz02/UDEM-CXR-Reporting-Thesis-2025.

Radiology reporting is a complex task that requires detailed image understanding, integration of multiple inputs, including comparison with prior imaging, and precise language generation. This makes it ideal for the development and use of generative multimodal models. Here, we extend report generation to include the localisation of individual findings on the image - a task we call grounded report generation. Prior work indicates that grounding is important for clarifying image understanding and interpreting AI-generated text. Therefore, grounded reporting stands to improve the utility and transparency of automated report drafting. To enable evaluation of grounded reporting, we propose a novel evaluation framework - RadFact - leveraging the reasoning capabilities of large language models (LLMs). RadFact assesses the factuality of individual generated sentences, as well as correctness of generated spatial localisations when present. We introduce MAIRA-2, a large multimodal model combining a radiology-specific image encoder with a LLM, and trained for the new task of grounded report generation on chest X-rays. MAIRA-2 uses more comprehensive inputs than explored previously: the current frontal image, the current lateral image, the prior frontal image and prior report, as well as the Indication, Technique and Comparison sections of the current report. We demonstrate that these additions significantly improve report quality and reduce hallucinations, establishing a new state of the art on findings generation (without grounding) on MIMIC-CXR while demonstrating the feasibility of grounded reporting as a novel and richer task.

Large language models (LLMs) have demonstrated remarkable capabilities in various domains, including radiology report generation. Previous approaches have attempted to utilize multimodal LLMs for this task, enhancing their performance through the integration of domain-specific knowledge retrieval. However, these approaches often overlook the knowledge already embedded within the LLMs, leading to redundant information integration and inefficient utilization of learned representations. To address this limitation, we propose RADAR, a framework for enhancing radiology report generation with supplementary knowledge injection. RADAR improves report generation by systematically leveraging both the internal knowledge of an LLM and externally retrieved information. Specifically, it first extracts the model's acquired knowledge that aligns with expert image-based classification outputs. It then retrieves relevant supplementary knowledge to further enrich this information. Finally, by aggregating both sources, RADAR generates more accurate and informative radiology reports. Extensive experiments on MIMIC-CXR, CheXpert-Plus, and IU X-ray demonstrate that our model outperforms state-of-the-art LLMs in both language quality and clinical accuracy

Automated structured radiology report generation (SRRG) from chest X-ray images offers significant potential to reduce workload of radiologists by generating reports in structured formats that ensure clarity, consistency, and adherence to clinical reporting standards. While radiologists effectively utilize available clinical contexts in their diagnostic reasoning, existing SRRG systems overlook these essential elements. This fundamental gap leads to critical problems including temporal hallucinations when referencing non-existent clinical contexts. To address these limitations, we propose contextualized SRRG (C-SRRG) that comprehensively incorporates rich clinical context for SRRG. We curate C-SRRG dataset by integrating comprehensive clinical context encompassing 1) multi-view X-ray images, 2) clinical indication, 3) imaging techniques, and 4) prior studies with corresponding comparisons based on patient histories. Through extensive benchmarking with state-of-the-art multimodal large language models, we demonstrate that incorporating clinical context with the proposed C-SRRG significantly improves report generation quality. We publicly release dataset, code, and checkpoints to facilitate future research for clinically-aligned automated RRG at https://github.com/vuno/contextualized-srrg.

Electrocardiogram (ECG) serves as the primary non-invasive diagnostic tool for cardiac conditions monitoring, are crucial in assisting clinicians. Recent studies have concentrated on classifying cardiac conditions using ECG data but have overlooked ECG report generation, which is not only time-consuming but also requires clinical expertise. To automate ECG report generation and ensure its versatility, we propose the Multimodal ECG Instruction Tuning (MEIT) framework, the first attempt to tackle ECG report generation with LLMs and multimodal instructions. To facilitate future research, we establish a benchmark to evaluate MEIT with various LLMs backbones across two large-scale ECG datasets. Our approach uniquely aligns the representations of the ECG signal and the report, and we conduct extensive experiments to benchmark MEIT with nine open source LLMs, using more than 800,000 ECG reports. MEIT's results underscore the superior performance of instruction-tuned LLMs, showcasing their proficiency in quality report generation, zero-shot capabilities, and resilience to signal perturbation. These findings emphasize the efficacy of our MEIT framework and its potential for real-world clinical application.

Deep Research Agents have shown strong capability in multi-step information retrieval, reasoning, and long-form report generation, but existing benchmarks and systems remain predominantly text-centric, with limited evaluation of whether visual elements are factually reliable and well aligned with the surrounding analysis. To address this gap, we introduce TVIR (Text--Visual Interleaved Report Generation), which includes TVIR-Bench, a benchmark of 100 expert-curated multimodal deep research tasks that require visual elements to serve specific analytical sub-goals, and TVIR-Agent, a hierarchical multi-agent framework that serves as a strong baseline for constructing outlines, retrieving images, generating charts with traceable sources, and composing reports through context-aware sequential writing. We further develop a dual-path evaluation framework that combines Textual Assessment and Visual Assessment. Experiments across nine deep research systems show that TVIR-Agent achieves strong overall performance, underscoring the importance of explicit multimodal design and evaluation for evidence-driven report generation.

Automated radiology report generation (RRG) aims to produce detailed textual reports from clinical imaging, such as computed tomography (CT) scans, to improve the accuracy and efficiency of diagnosis and provision of management advice. RRG is complicated by two key challenges: (1) inherent complexity in extracting relevant information from imaging data under resource constraints, and (2) difficulty in objectively evaluating discrepancies between model-generated and expert-written reports. To address these challenges, we propose mu^2LLM, a textbf{mu}ltiscale textbf{mu}ltimodal large language models for RRG tasks. The novel {mu}^2Tokenizer, as an intermediate layer, integrates multi-modal features from the multiscale visual tokenizer and the text tokenizer, then enhances report generation quality through direct preference optimization (DPO), guided by GREEN-RedLlama. Experimental results on four large CT image-report medical datasetdemonstrate that our method outperforms existing approaches, highlighting the potential of our fine-tuned mu^2LLMs on limited data for RRG tasks.

Automated radiology report generation holds immense potential to alleviate the heavy workload of radiologists. Despite the formidable vision-language capabilities of recent Multimodal Large Language Models (MLLMs), their clinical deployment is severely constrained by inherent limitations: their "black-box" decision-making renders the generated reports untraceable due to the lack of explicit visual evidence to support the diagnosis, and they struggle to access external domain knowledge. To address these challenges, we propose the Evidence-driven Radiology Report Generation Agent (EviAgent). Unlike opaque end-to-end paradigms, EviAgent coordinates a transparent reasoning trajectory by breaking down the complex generation process into granular operational units. We integrate multi-dimensional visual experts and retrieval mechanisms as external support modules, endowing the system with explicit visual evidence and high-quality clinical priors. Extensive experiments on MIMIC-CXR, CheXpert Plus, and IU-Xray datasets demonstrate that EviAgent outperforms both large-scale generalist models and specialized medical models, providing a robust and trustworthy solution for automated radiology report generation.

Medical vision-language models can automate the generation of radiology reports but struggle with accurate visual grounding and factual consistency. Existing models often misalign textual findings with visual evidence, leading to unreliable or weakly grounded predictions. We present CURE, an error-aware curriculum learning framework that improves grounding and report quality without any additional data. CURE fine-tunes a multimodal instructional model on phrase grounding, grounded report generation, and anatomy-grounded report generation using public datasets. The method dynamically adjusts sampling based on model performance, emphasizing harder samples to improve spatial and textual alignment. CURE improves grounding accuracy by +0.37 IoU, boosts report quality by +0.188 CXRFEScore, and reduces hallucinations by 18.6%. CURE is a data-efficient framework that enhances both grounding accuracy and report reliability. Code is available at https://github.com/PabloMessina/CURE and model weights at https://huggingface.co/pamessina/medgemma-4b-it-cure

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

This study investigates the integration of diverse patient data sources into multimodal language models for automated chest X-ray (CXR) report generation. Traditionally, CXR report generation relies solely on CXR images and limited radiology data, overlooking valuable information from patient health records, particularly from emergency departments. Utilising the MIMIC-CXR and MIMIC-IV-ED datasets, we incorporate detailed patient information such as aperiodic vital signs, medications, and clinical history to enhance diagnostic accuracy. We introduce a novel approach to transform these heterogeneous data sources into embeddings that prompt a multimodal language model, significantly enhancing the diagnostic accuracy of generated radiology reports. Our comprehensive evaluation demonstrates the benefits of using a broader set of patient data, underscoring the potential for enhanced diagnostic capabilities and better patient outcomes through the integration of multimodal data in CXR report generation.

Recent advances in generative medical models are constrained by modality-specific scenarios that hinder the integration of complementary evidence from imaging, pathology, and clinical notes. This fragmentation limits their evolution into foundation models that can learn and reason across the full spectrum of biomedical data. We propose MeDiM, the first medical discrete diffusion model that learns shared distributions across modalities without modality-specific components. MeDiM unifies multiple generative tasks: translating between images and text, and jointly producing image-report pairs across domains in response to prompts. Built on a discrete diffusion framework, MeDiM bridges vision and language representations through a shared probabilistic space. To enable unified and flexible medical generation, we employ a multimodal large language model (MLLM) as the diffusion backbone, leveraging its prior knowledge and cross-modal reasoning. Two key designs are introduced: (1) removing the causal attention mask for bidirectional context, and (2) injecting continuous timestep embeddings for diffusion awareness. Experiments demonstrate high-fidelity medical generation (FID 16.60 on MIMIC-CXR and FID 24.19 on PathGen) and accurate report generation (METEOR 0.2650 and 0.2580). Jointly generated image-report pairs further enhance downstream performance (plus6.43 percent BLEU-1, plus18.57 percent BLEU-2, plus31.58 percent BLEU-3, plus4.80 percent METEOR), showing that MeDiM supports coherent and clinically grounded multimodal outputs.

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.

Chest X-ray (CXR) radiology report generation (RRG) models have shown rapid progress, yet their clinical utility remains uncertain due to limited evaluation by radiologists. We present CXRMate-2, a state-of-the-art CXR RRG model that integrates structured multimodal conditioning and reinforcement learning with a composite reward for semantic alignment with radiologist reports. Across the MIMIC-CXR, CheXpert Plus, and ReXgradient datasets, CXRMate-2 achieves statistically significant improvements over strong benchmarks, including gains of 11.2% and 24.4% in GREEN and RadGraph-XL, respectively, on MIMIC-CXR relative to MedGemma 1.5 (4B). To directly compare CXRMate-2 against radiologist reporting, we conduct a blinded, randomised qualitative retrospective evaluation. Three consultant radiologists compare generated and radiologist reports across 120 studies from the MIMIC-CXR test set. Generated reports were deemed acceptable (defined as preferred or rated equally to radiologist reports) in 45% of ratings, with no statistically significant difference in preference rates between radiologist reports and acceptable generated reports for seven of the eight analysed findings. Preference for radiologist reports was driven primarily by higher recall, while generated reports were often preferred for readability. Together, these results suggest a credible pathway to clinically acceptable CXR RRG. Improvements in recall, alongside better detection of subtle findings (e.g., pulmonary congestion), are likely sufficient to achieve non-inferiority to radiologist reporting. With these targeted advances, CXR RRG systems may be ready for prospective evaluation in assistive roles within radiologist-led workflows.

Medical imaging plays a pivotal role in modern healthcare, with computed tomography pulmonary angiography (CTPA) being a critical tool for diagnosing pulmonary embolism and other thoracic conditions. However, the complexity of interpreting CTPA scans and generating accurate radiology reports remains a significant challenge. This paper introduces Abn-BLIP (Abnormality-aligned Bootstrapping Language-Image Pretraining), an advanced diagnosis model designed to align abnormal findings to generate the accuracy and comprehensiveness of radiology reports. By leveraging learnable queries and cross-modal attention mechanisms, our model demonstrates superior performance in detecting abnormalities, reducing missed findings, and generating structured reports compared to existing methods. Our experiments show that Abn-BLIP outperforms state-of-the-art medical vision-language models and 3D report generation methods in both accuracy and clinical relevance. These results highlight the potential of integrating multimodal learning strategies for improving radiology reporting. The source code is available at https://github.com/zzs95/abn-blip.

Radiology report generation requires advanced medical image analysis, effective temporal reasoning, and accurate text generation. Although recent innovations, particularly multimodal large language models (MLLMs), have shown improved performance, their supervised fine-tuning (SFT) objective is not explicitly aligned with clinical efficacy. In this work, we introduce EditGRPO, a mixed-policy reinforcement learning (RL) algorithm designed specifically to optimize the generation through clinically motivated rewards. EditGRPO integrates on-policy exploration with off-policy guidance by injecting sentence-level detailed corrections during training rollouts. This mixed-policy approach addresses the exploration dilemma and sampling efficiency issues typically encountered in RL. Applied to a Qwen2.5-VL-3B MLLM initialized with supervised fine-tuning (SFT), EditGRPO outperforms both SFT and vanilla GRPO baselines, achieving an average improvement of 3.4% in CheXbert, GREEN, Radgraph, and RATEScore metrics across four major chest X-ray report generation datasets. Notably, EditGRPO also demonstrates superior out-of-domain generalization, with an average performance gain of 5.9% on unseen datasets.

Automatic radiology report generation has attracted enormous research interest due to its practical value in reducing the workload of radiologists. However, simultaneously establishing global correspondences between the image (e.g., Chest X-ray) and its related report and local alignments between image patches and keywords remains challenging. To this end, we propose an Unify, Align and then Refine (UAR) approach to learn multi-level cross-modal alignments and introduce three novel modules: Latent Space Unifier (LSU), Cross-modal Representation Aligner (CRA) and Text-to-Image Refiner (TIR). Specifically, LSU unifies multimodal data into discrete tokens, making it flexible to learn common knowledge among modalities with a shared network. The modality-agnostic CRA learns discriminative features via a set of orthonormal basis and a dual-gate mechanism first and then globally aligns visual and textual representations under a triplet contrastive loss. TIR boosts token-level local alignment via calibrating text-to-image attention with a learnable mask. Additionally, we design a two-stage training procedure to make UAR gradually grasp cross-modal alignments at different levels, which imitates radiologists' workflow: writing sentence by sentence first and then checking word by word. Extensive experiments and analyses on IU-Xray and MIMIC-CXR benchmark datasets demonstrate the superiority of our UAR against varied state-of-the-art methods.

Multimodal large language models (MLLMs) have rapidly advanced, yet their adoption in medicine remains limited by gaps in domain coverage, modality alignment, and grounded reasoning. In this work, we introduce MedMO, a medical foundation model built upon a generalized MLLM architecture and trained exclusively on large-scale, domain-specific data. MedMO follows a multi-stage training recipe: (i) cross-modal pretraining to align heterogeneous visual encoders with a medical language backbone; (ii) instruction tuning on multi-task supervision that spans captioning, VQA, report generation, retrieval, and grounded disease localization with bounding boxes; and (iii) reinforcement learning with verifiable rewards that combine factuality checks with a box-level GIoU reward to strengthen spatial grounding and step-by-step reasoning in complex clinical scenarios. MedMO consistently outperforms strong open-source medical MLLMs across multiple modalities and tasks. On VQA benchmarks, MedMO achieves an average accuracy improvement of +13.7% over the baseline and performs within 1.9% of the SOTA Fleming-VL. For text-based QA, it attains +6.9% over the baseline and +14.5% over Fleming-VL. In medical report generation, MedMO delivers significant gains in both semantic and clinical accuracy. Moreover, it exhibits strong grounding capability, achieving an IoU improvement of +40.4 over the baseline and +37.0% over Fleming-VL, underscoring its robust spatial reasoning and localization performance. Evaluations across radiology, ophthalmology, and pathology-microscopy confirm MedMO's broad cross-modality generalization. We release two versions of MedMO: 4B and 8B. Project is available at https://genmilab.github.io/MedMO-Page

Deep Research Agents (DRAs) generate citation-rich reports via multi-step search and synthesis, yet existing benchmarks mainly target text-only settings or short-form multimodal QA, missing end-to-end multimodal evidence use. We introduce MMDeepResearch-Bench (MMDR-Bench), a benchmark of 140 expert-crafted tasks across 21 domains, where each task provides an image-text bundle to evaluate multimodal understanding and citation-grounded report generation. Compared to prior setups, MMDR-Bench emphasizes report-style synthesis with explicit evidence use, where models must connect visual artifacts to sourced claims and maintain consistency across narrative, citations, and visual references. We further propose a unified, interpretable evaluation pipeline: Formula-LLM Adaptive Evaluation (FLAE) for report quality, Trustworthy Retrieval-Aligned Citation Evaluation (TRACE) for citation-grounded evidence alignment, and Multimodal Support-Aligned Integrity Check (MOSAIC) for text-visual integrity, each producing fine-grained signals that support error diagnosis beyond a single overall score. Experiments across 25 state-of-the-art models reveal systematic trade-offs between generation quality, citation discipline, and multimodal grounding, highlighting that strong prose alone does not guarantee faithful evidence use and that multimodal integrity remains a key bottleneck for deep research agents.

Medical images and radiology reports are crucial for diagnosing medical conditions, highlighting the importance of quantitative analysis for clinical decision-making. However, the diversity and cross-source heterogeneity of these data challenge the generalizability of current data-mining methods. Multimodal large language models (MLLMs) have recently transformed many domains, significantly affecting the medical field. Notably, Gemini-Vision-series (Gemini) and GPT-4-series (GPT-4) models have epitomized a paradigm shift in Artificial General Intelligence (AGI) for computer vision, showcasing their potential in the biomedical domain. In this study, we evaluated the performance of the Gemini, GPT-4, and 4 popular large models for an exhaustive evaluation across 14 medical imaging datasets, including 5 medical imaging categories (dermatology, radiology, dentistry, ophthalmology, and endoscopy), and 3 radiology report datasets. The investigated tasks encompass disease classification, lesion segmentation, anatomical localization, disease diagnosis, report generation, and lesion detection. Our experimental results demonstrated that Gemini-series models excelled in report generation and lesion detection but faces challenges in disease classification and anatomical localization. Conversely, GPT-series models exhibited proficiency in lesion segmentation and anatomical localization but encountered difficulties in disease diagnosis and lesion detection. Additionally, both the Gemini series and GPT series contain models that have demonstrated commendable generation efficiency. While both models hold promise in reducing physician workload, alleviating pressure on limited healthcare resources, and fostering collaboration between clinical practitioners and artificial intelligence technologies, substantial enhancements and comprehensive validations remain imperative before clinical deployment.

This paper presents a comprehensive evaluation of GPT-4V's capabilities across diverse medical imaging tasks, including Radiology Report Generation, Medical Visual Question Answering (VQA), and Visual Grounding. While prior efforts have explored GPT-4V's performance in medical image analysis, to the best of our knowledge, our study represents the first quantitative evaluation on publicly available benchmarks. Our findings highlight GPT-4V's potential in generating descriptive reports for chest X-ray images, particularly when guided by well-structured prompts. Meanwhile, its performance on the MIMIC-CXR dataset benchmark reveals areas for improvement in certain evaluation metrics, such as CIDEr. In the domain of Medical VQA, GPT-4V demonstrates proficiency in distinguishing between question types but falls short of the VQA-RAD benchmark in terms of accuracy. Furthermore, our analysis finds the limitations of conventional evaluation metrics like the BLEU scores, advocating for the development of more semantically robust assessment methods. In the field of Visual Grounding, GPT-4V exhibits preliminary promise in recognizing bounding boxes, but its precision is lacking, especially in identifying specific medical organs and signs. Our evaluation underscores the significant potential of GPT-4V in the medical imaging domain, while also emphasizing the need for targeted refinements to fully unlock its capabilities.

Despite the success of Large Language Models (LLMs) in general image tasks, a gap persists in the medical field for a multimodal large model adept at handling the nuanced diversity of medical images. Addressing this, we propose MedXChat, a unified multimodal large model designed for seamless interactions between medical assistants and users. MedXChat encompasses three key functionalities: CXR(Chest X-ray)-to-Report generation, CXR-based visual question-answering (VQA), and Text-to-CXR synthesis. Our contributions are as follows. Firstly, our model showcases exceptional cross-task adaptability, displaying adeptness across all three defined tasks and outperforming the benchmark models on the MIMIC dataset in medical multimodal applications. Secondly, we introduce an innovative Text-to-CXR synthesis approach that utilizes instruction-following capabilities within the Stable Diffusion (SD) architecture. This technique integrates smoothly with the existing model framework, requiring no extra parameters, thereby maintaining the SD's generative strength while also bestowing upon it the capacity to render fine-grained medical images with high fidelity. Comprehensive experiments validate MedXChat's synergistic enhancement across all tasks. Our instruction data and model will be open-sourced.

Recent progress in medical vision-language models (VLMs) has achieved strong performance on image-level text-centric tasks such as report generation and visual question answering (VQA). However, achieving fine-grained visual grounding and volumetric spatial reasoning in 3D medical VLMs remains challenging, particularly when aiming to unify these capabilities within a single, generalizable framework. To address this challenge, we proposed MedVL-SAM2, a unified 3D medical multimodal model that concurrently supports report generation, VQA, and multi-paradigm segmentation, including semantic, referring, and interactive segmentation. MedVL-SAM2 integrates image-level reasoning and pixel-level perception through a cohesive architecture tailored for 3D medical imaging, and incorporates a SAM2-based volumetric segmentation module to enable precise multi-granular spatial reasoning. The model is trained in a multi-stage pipeline: it is first pre-trained on a large-scale corpus of 3D CT image-text pairs to align volumetric visual features with radiology-language embeddings. It is then jointly optimized with both language-understanding and segmentation objectives using a comprehensive 3D CT segmentation dataset. This joint training enables flexible interaction via language, point, or box prompts, thereby unifying high-level visual reasoning with spatially precise localization. Our unified architecture delivers state-of-the-art performance across report generation, VQA, and multiple 3D segmentation tasks. Extensive analyses further show that the model provides reliable 3D visual grounding, controllable interactive segmentation, and robust cross-modal reasoning, demonstrating that high-level semantic reasoning and precise 3D localization can be jointly achieved within a unified 3D medical VLM.

Retrieval-augmented generation (RAG) has emerged as a pivotal technique in artificial intelligence (AI), particularly in enhancing the capabilities of large language models (LLMs) by enabling access to external, reliable, and up-to-date knowledge sources. In the context of AI-Generated Content (AIGC), RAG has proven invaluable by augmenting model outputs with supplementary, relevant information, thus improving their quality. Recently, the potential of RAG has extended beyond natural language processing, with emerging methods integrating retrieval-augmented strategies into the computer vision (CV) domain. These approaches aim to address the limitations of relying solely on internal model knowledge by incorporating authoritative external knowledge bases, thereby improving both the understanding and generation capabilities of vision models. This survey provides a comprehensive review of the current state of retrieval-augmented techniques in CV, focusing on two main areas: (I) visual understanding and (II) visual generation. In the realm of visual understanding, we systematically review tasks ranging from basic image recognition to complex applications such as medical report generation and multimodal question answering. For visual content generation, we examine the application of RAG in tasks related to image, video, and 3D generation. Furthermore, we explore recent advancements in RAG for embodied AI, with a particular focus on applications in planning, task execution, multimodal perception, interaction, and specialized domains. Given that the integration of retrieval-augmented techniques in CV is still in its early stages, we also highlight the key limitations of current approaches and propose future research directions to drive the development of this promising area.

The field of computational pathology has been transformed with recent advances in foundation models that encode histopathology region-of-interests (ROIs) into versatile and transferable feature representations via self-supervised learning (SSL). However, translating these advancements to address complex clinical challenges at the patient and slide level remains constrained by limited clinical data in disease-specific cohorts, especially for rare clinical conditions. We propose TITAN, a multimodal whole slide foundation model pretrained using 335,645 WSIs via visual self-supervised learning and vision-language alignment with corresponding pathology reports and 423,122 synthetic captions generated from a multimodal generative AI copilot for pathology. Without any finetuning or requiring clinical labels, TITAN can extract general-purpose slide representations and generate pathology reports that generalize to resource-limited clinical scenarios such as rare disease retrieval and cancer prognosis. We evaluate TITAN on diverse clinical tasks and find that TITAN outperforms both ROI and slide foundation models across machine learning settings such as linear probing, few-shot and zero-shot classification, rare cancer retrieval and cross-modal retrieval, and pathology report generation.

Left-behind children (LBCs), numbering over 66 million in China, face severe mental health challenges due to parental migration for work. Early screening and identification of at-risk LBCs is crucial, yet challenging due to the severe shortage of mental health professionals, especially in rural areas. While the House-Tree-Person (HTP) test shows higher child participation rates, its requirement for expert interpretation limits its application in resource-scarce regions. To address this challenge, we propose PsyDraw, a multi-agent system based on Multimodal Large Language Models that assists mental health professionals in analyzing HTP drawings. The system employs specialized agents for feature extraction and psychological interpretation, operating in two stages: comprehensive feature analysis and professional report generation. Evaluation of HTP drawings from 290 primary school students reveals that 71.03% of the analyzes achieved High Consistency with professional evaluations, 26.21% Moderate Consistency and only 2.41% Low Consistency. The system identified 31.03% of cases requiring professional attention, demonstrating its effectiveness as a preliminary screening tool. Currently deployed in pilot schools, \method shows promise in supporting mental health professionals, particularly in resource-limited areas, while maintaining high professional standards in psychological assessment.

Large multimodal models (LMMs) have demonstrated significant potential in providing innovative solutions for various biomedical tasks, including pathology analysis, radiology report generation, and biomedical assistance. However, the existing multimodal biomedical AI is typically based on foundation LLMs, thus hindering the understanding of intricate medical concepts with limited medical training data. Moreover, recent LLaVA-induced medical LMMs struggle to effectively capture the intricate relationship between the texts and the images. Therefore, we introduce Doctor Sun, a large multimodal generative model specialized in medicine, developed to encode, integrate, and interpret diverse biomedical data modalities such as text and images. In particular, Doctor Sun integrates a pre-trained vision encoder with a medical LLM and conducts two-stage training on various medical datasets, focusing on feature alignment and instruction tuning. Moreover, we release SunMed-VL, a wide-range bilingual medical multimodal dataset, along with all associated models, code, and resources, to freely support the advancement of biomedical multimodal research.

Pretrained Multimodal Large Language Models (MLLMs) are increasingly deployed in medical AI systems for clinical reasoning, diagnosis support, and report generation. However, their training on sensitive patient data raises critical privacy and compliance challenges under regulations such as HIPAA and GDPR, which enforce the "right to be forgotten". Unlearning, the process of tuning models to selectively remove the influence of specific training data points, offers a potential solution, yet its effectiveness in complex medical settings remains underexplored. To systematically study this, we introduce MedForget, a Hierarchy-Aware Multimodal Unlearning Testbed with explicit retain and forget splits and evaluation sets containing rephrased variants. MedForget models hospital data as a nested hierarchy (Institution -> Patient -> Study -> Section), enabling fine-grained assessment across eight organizational levels. The benchmark contains 3840 multimodal (image, question, answer) instances, each hierarchy level having a dedicated unlearning target, reflecting distinct unlearning challenges. Experiments with four SOTA unlearning methods on three tasks (generation, classification, cloze) show that existing methods struggle to achieve complete, hierarchy-aware forgetting without reducing diagnostic performance. To test whether unlearning truly deletes hierarchical pathways, we introduce a reconstruction attack that progressively adds hierarchical level context to prompts. Models unlearned at a coarse granularity show strong resistance, while fine-grained unlearning leaves models vulnerable to such reconstruction. MedForget provides a practical, HIPAA-aligned testbed for building compliant medical AI systems.

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

Multimodal large language models (MLLMs) hold immense potential to revolutionize clinical practice, yet deploying them in the medical domain is fundamentally a vision-centric challenge: models must absorb knowledge from heterogeneous 2D and 3D medical images, and evaluation protocols must align with radiologists' clinical practice and provide an accurate, fine-grained and factualness-driven assessment. In this paper, we introduce ClinFusion, a vision-centric MLLM designed for holistic medical understanding that systematically addresses these limitations. We propose a compositional and cascaded vision encoder architecture featuring a Cascade Spatial-Aware Locality Fusion operator that unifies diverse 2D and native 3D medical image understanding within a fused encoder. We further introduce a vision-grounded evaluation framework, including MedIF-Bench for instruction-following assessment and a region-of-interest-grounded method for clinically aligned and factualness-driven report generation evaluation. We show that ClinFusion sets a new state-of-the-art across a comprehensive suite of 2D and 3D multimodal medical benchmarks---spanning visual question answering, report generation, and instruction following---as well as textual medical tasks, outperforming leading open-source medical MLLMs (e.g., Hulu-Med, Lingshu) on 20 out of 24 benchmarks and demonstrating multimodal capabilities better than powerful proprietary models such as GPT-5.2 and Gemini-3-Flash on 13 out of 16 benchmarks, and can be further augmented with agentic tool use for retrieval-augmented and tool-assisted clinical workflows. A blinded evaluation by board-certified radiologists confirms that ClinFusion produces the highest-ranked reports, and validates our RoI-grounded metric as achieving the strongest correlation with expert judgment among all automatic evaluation metrics examined.

The advancement of artificial intelligence in oral healthcare relies on the availability of large-scale multimodal datasets that capture the complexity of clinical practice. In this paper, we present a comprehensive multimodal dataset, comprising 8775 dental checkups from 4800 patients collected over eight years (2018-2025), with patients ranging from 10 to 90 years of age. The dataset includes 50000 intraoral images, 8056 radiographs, and detailed textual records, including diagnoses, treatment plans, and follow-up notes. The data were collected under standard ethical guidelines and annotated for benchmarking. To demonstrate its utility, we fine-tuned state-of-the-art large vision-language models, Qwen-VL 3B and 7B, and evaluated them on two tasks: classification of six oro-dental anomalies and generation of complete diagnostic reports from multimodal inputs. We compared the fine-tuned models with their base counterparts and GPT-4o. The fine-tuned models achieved substantial gains over these baselines, validating the dataset and underscoring its effectiveness in advancing AI-driven oro-dental healthcare solutions. The dataset is publicly available, providing an essential resource for future research in AI dentistry.

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

Several medical Multimodal Large Languange Models (MLLMs) have been developed to address tasks involving visual images with textual instructions across various medical modalities, achieving impressive results. Most current medical generalist models are region-agnostic, treating the entire image as a holistic representation. However, they struggle to identify which specific regions they are focusing on when generating a sentence. To mimic the behavior of doctors, who typically begin by reviewing the entire image before concentrating on specific regions for a thorough evaluation, we aim to enhance the capability of medical MLLMs in understanding anatomical regions within entire medical scans. To achieve it, we first formulate Region-Centric tasks and construct a large-scale dataset, MedRegInstruct, to incorporate regional information into training. Combining our collected dataset with other medical multimodal corpora for training, we propose a Region-Aware medical MLLM, MedRegA, which is the first bilingual generalist medical AI system to simultaneously handle image-level and region-level medical vision-language tasks across a broad range of modalities. Our MedRegA not only enables three region-centric tasks, but also achieves the best performance for visual question answering, report generation and medical image classification over 8 modalities, showcasing significant versatility. Experiments demonstrate that our model can not only accomplish powerful performance across various medical vision-language tasks in bilingual settings, but also recognize and detect structures in multimodal medical scans, boosting the interpretability and user interactivity of medical MLLMs. Our project page is https://medrega.github.io.

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

Recent advances in large vision-language models (LVLMs) have demonstrated strong performance on general-purpose medical tasks. However, their effectiveness in specialized domains such as dentistry remains underexplored. In particular, panoramic X-rays, a widely used imaging modality in oral radiology, pose interpretative challenges due to dense anatomical structures and subtle pathological cues, which are not captured by existing medical benchmarks or instruction datasets. To this end, we introduce MMOral, the first large-scale multimodal instruction dataset and benchmark tailored for panoramic X-ray interpretation. MMOral consists of 20,563 annotated images paired with 1.3 million instruction-following instances across diverse task types, including attribute extraction, report generation, visual question answering, and image-grounded dialogue. In addition, we present MMOral-Bench, a comprehensive evaluation suite covering five key diagnostic dimensions in dentistry. We evaluate 64 LVLMs on MMOral-Bench and find that even the best-performing model, i.e., GPT-4o, only achieves 41.45% accuracy, revealing significant limitations of current models in this domain. To promote the progress of this specific domain, we also propose OralGPT, which conducts supervised fine-tuning (SFT) upon Qwen2.5-VL-7B with our meticulously curated MMOral instruction dataset. Remarkably, a single epoch of SFT yields substantial performance enhancements for LVLMs, e.g., OralGPT demonstrates a 24.73% improvement. Both MMOral and OralGPT hold significant potential as a critical foundation for intelligent dentistry and enable more clinically impactful multimodal AI systems in the dental field. The dataset, model, benchmark, and evaluation suite are available at https://github.com/isbrycee/OralGPT.

Medical image segmentation has achieved remarkable success through the continuous advancement of UNet-based and Transformer-based foundation backbones. However, clinical diagnosis in the real world often requires integrating domain knowledge, especially textual information. Conducting multimodal learning involves visual and text modalities shown as a solution, but collecting paired vision-language datasets is expensive and time-consuming, posing significant challenges. Inspired by the superior ability in numerous cross-modal tasks for Large Language Models (LLMs), we proposed a novel Vision-LLM union framework to address the issues. Specifically, we introduce frozen LLMs for zero-shot instruction generation based on corresponding medical images, imitating the radiology scanning and report generation process. {To better approximate real-world diagnostic processes}, we generate more precise text instruction from multimodal radiology images (e.g., T1-w or T2-w MRI and CT). Based on the impressive ability of semantic understanding and rich knowledge of LLMs. This process emphasizes extracting special features from different modalities and reunion the information for the ultimate clinical diagnostic. With generated text instruction, our proposed union segmentation framework can handle multimodal segmentation without prior collected vision-language datasets. To evaluate our proposed method, we conduct comprehensive experiments with influential baselines, the statistical results and the visualized case study demonstrate the superiority of our novel method.}

The analysis of 3D medical images is crucial for modern healthcare, yet traditional task-specific models are becoming increasingly inadequate due to limited generalizability across diverse clinical scenarios. Multimodal large language models (MLLMs) offer a promising solution to these challenges. However, existing MLLMs have limitations in fully leveraging the rich, hierarchical information embedded in 3D medical images. Inspired by clinical practice, where radiologists focus on both 3D spatial structure and 2D planar content, we propose Med-2E3, a novel MLLM for 3D medical image analysis that integrates 3D and 2D encoders. To aggregate 2D features more effectively, we design a Text-Guided Inter-Slice (TG-IS) scoring module, which scores the attention of each 2D slice based on slice contents and task instructions. To the best of our knowledge, Med-2E3 is the first MLLM to integrate both 3D and 2D features for 3D medical image analysis. Experiments on a large-scale, open-source 3D medical multimodal benchmark demonstrate that Med-2E3 exhibits task-specific attention distribution and significantly outperforms current state-of-the-art models, with a 14% improvement in report generation and a 5% gain in medical visual question answering (VQA), highlighting the model's potential in addressing complex multimodal clinical tasks. The code will be released upon acceptance.

Multimodal Large Language Models (MLLMs) have demonstrated impressive capabilities in understanding common visual elements, largely due to their large-scale datasets and advanced training strategies. However, their effectiveness in medical applications remains limited due to the inherent discrepancies between data and tasks in medical scenarios and those in the general domain. Concretely, existing medical MLLMs face the following critical limitations: (1) limited coverage of medical knowledge beyond imaging, (2) heightened susceptibility to hallucinations due to suboptimal data curation processes, (3) lack of reasoning capabilities tailored for complex medical scenarios. To address these challenges, we first propose a comprehensive data curation procedure that (1) efficiently acquires rich medical knowledge data not only from medical imaging but also from extensive medical texts and general-domain data; and (2) synthesizes accurate medical captions, visual question answering (VQA), and reasoning samples. As a result, we build a multimodal dataset enriched with extensive medical knowledge. Building on the curated data, we introduce our medical-specialized MLLM: Lingshu. Lingshu undergoes multi-stage training to embed medical expertise and enhance its task-solving capabilities progressively. Besides, we preliminarily explore the potential of applying reinforcement learning with verifiable rewards paradigm to enhance Lingshu's medical reasoning ability. Additionally, we develop MedEvalKit, a unified evaluation framework that consolidates leading multimodal and textual medical benchmarks for standardized, fair, and efficient model assessment. We evaluate the performance of Lingshu on three fundamental medical tasks, multimodal QA, text-based QA, and medical report generation. The results show that Lingshu consistently outperforms the existing open-source multimodal models on most tasks ...

The proliferation of disinformation demands reliable and scalable fact-checking solutions. We present Dynamic Evidence-based FAct-checking with Multimodal Experts (DEFAME), a modular, zero-shot MLLM pipeline for open-domain, text-image claim verification. DEFAME operates in a six-stage process, dynamically selecting the tools and search depth to extract and evaluate textual and visual evidence. Unlike prior approaches that are text-only, lack explainability, or rely solely on parametric knowledge, DEFAME performs end-to-end verification, accounting for images in claims and evidence while generating structured, multimodal reports. Evaluation on the popular benchmarks VERITE, AVerITeC, and MOCHEG shows that DEFAME surpasses all previous methods, establishing itself as the new state-of-the-art fact-checking system for uni- and multimodal fact-checking. Moreover, we introduce a new multimodal benchmark, ClaimReview2024+, featuring claims after the knowledge cutoff of GPT-4o, avoiding data leakage. Here, DEFAME drastically outperforms the GPT-4o baselines, showing temporal generalizability and the potential for real-time fact-checking.

Medical multimodal large language models (MLLMs) are increasingly expected to perform complex image understanding tasks, yet their reliability is often compromised by frequent errors in visual interpretation. To systematically trace these failures, we traverse the hierarchy from high-level clinical tasks down to fundamental visual perception. We therefore introduce Perception-Bench, a large-scale benchmark comprising 1.13 million samples that assesses medical MLLMs across six dimensions: attribute judgment, spatial grounding, spatial understanding, disease prediction, anomaly detection, and report generation, spanning both 2D and 3D radiology images. Our analysis on Perception-Bench reveals that existing MLLMs lack the ability to capture even the most basic lesion attributes, such as location, size, and density. This inability to ground clinical outputs in primary visual evidence reveals that the models' diagnostic unreliability is rooted in a critical but overlooked bottleneck in low-level visual perception. Motivated by this, we propose RadSight, a perception-driven MLLM built upon a dual 2D/3D encoder architecture that preserves native imaging spatial structures. RadSight formulates medical image understanding as a four-stage progressive process: visual-language alignment, fine-grained visual perception, clinical diagnosis, and diagnostic interpretation. The model is trained on an 8.37 million perception-oriented corpus using progressive curriculum learning. On Perception-Bench, RadSight consistently outperforms existing MLLMs across all six evaluation dimensions, with particularly strong gains in spatial grounding and clinical diagnosis. It also achieves consistent improvements on public 2D and 3D medical benchmarks, further demonstrating that robust low-level visual perception is a critical foundation for reliable clinical understanding. Code and model will be publicly available.

Uterine diseases represent an important category of gynecologic pathology and require accurate histopathological assessment for diagnosis and treatment planning. Whole-slide images (WSI) have enabled the digital transformation of pathology workflows and provided new opportunities for artificial intelligence (AI) in computational pathology. In particular, multimodal models that jointly analyze histopathology images and pathology reports have shown promising potential for automated pathology report generation and AI-assisted diagnosis. However, the development of such systems remains limited by the scarcity of datasets that pair whole-slide images with clinically meaningful pathology reports. Instead, existing pathology datasets focus on patch- or slide-level annotations of a single endpoint (e.g., disease class), which do not fully capture the rich information in full clinical diagnostic workflow reports. Here, we introduce TUM-Uteria, a uterine pathology dataset comprising WSIs paired with diagnostic pathology reports at both the case and slide levels, collected from a tertiary medical center. The dataset contains 216 clinical cases, comprising 455 slide-level WSI-report pairs. The dataset underwent a structured multi-stage validation procedure involving board-certified pathologists to ensure reliable annotations. TUM-Uteria supports research in computational pathology, including whole-slide image analysis, multimodal learning, and automated pathology report generation.

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

While Multimodal Large Language Models (MLLMs) have demonstrated remarkable proficiency in tasks such as abnormality detection and report generation for anatomical modalities, their capability in functional imaging remains largely unexplored. In this work, we identify and quantify a fundamental functional perception gap: the inability of current vision encoders to decode functional tracer biodistribution independent of morphological priors. Identifying Positron Emission Tomography (PET) as the quintessential modality to investigate this disconnect, we introduce PET-Bench, the first large-scale functional imaging benchmark comprising 52,308 hierarchical QA pairs from 9,732 multi-site, multi-tracer PET studies. Extensive evaluation of 19 state-of-the-art MLLMs reveals a critical safety hazard termed the Chain-of-Thought (CoT) hallucination trap. We observe that standard CoT prompting, widely considered to enhance reasoning, paradoxically decouples linguistic generation from visual evidence in PET, producing clinically fluent but factually ungrounded diagnoses. To resolve this, we propose Atomic Visual Alignment (AVA), a simple fine-tuning strategy that enforces the mastery of low-level functional perception prior to high-level diagnostic reasoning. Our results demonstrate that AVA effectively bridges the perception gap, transforming CoT from a source of hallucination into a robust inference tool and improving diagnostic accuracy by up to 14.83%. Code and data are available at https://github.com/yezanting/PET-Bench.

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.

Most medical multimodal benchmarks focus on static tasks such as image question answering, report generation, and plain-language rewriting. Patient education is more demanding: systems must identify relevant evidence across images, show patients where to look, explain findings in accessible language, and handle confusion or distress. Yet most patient education work remains text-only, even though combined image-and-text explanations may better support understanding. We introduce MedImageEdu, a benchmark for multi-turn, evidence-grounded radiology patient education. Each case provides a radiology report with report text and case images. A DoctorAgent interacts with a PatientAgent, conditioned on a hidden profile that captures factors such as education level, health literacy, and personality. When a patient question would benefit from visual support, the DoctorAgent can issue drawing instructions grounded in the report, case images, and the current question to a benchmark-provided drawing tool. The tool returns image(s), after which the DoctorAgent produces a final multimodal response consisting of the image(s) and a grounded plain-language explanation. MedImageEdu contains 150 cases from three sources and evaluates both the consultation process and the final multimodal response along five dimensions: Consultation, Safety and Scope, Language Quality, Drawing Quality, and Image-Text Response Quality. Across representative open- and closed-source vision-language model agents, we find three consistent gaps: fluent language often outpaces faithful visual grounding, safety is the weakest dimension across disease categories, and emotionally tense interactions are harder than low education or low health literacy. MedImageEdu provides a controlled testbed for assessing whether multimodal agents can teach from evidence rather than merely answer from text.

Deep Research Agents (DRAs) aim to solve complex, long-horizon research tasks involving planning, retrieval, multimodal understanding, and report generation, yet their evaluation remains challenging due to dynamic web environments and ambiguous task definitions. We propose DR^{3}-Eval, a realistic and reproducible benchmark for evaluating deep research agents on multimodal, multi-file report generation. DR^{3}-Eval is constructed from authentic user-provided materials and paired with a per-task static research sandbox corpus that simulates open-web complexity while remaining fully verifiable, containing supportive documents, distractors, and noise. Moreover, we introduce a multi-dimensional evaluation framework measuring Information Recall, Factual Accuracy, Citation Coverage, Instruction Following, and Depth Quality, and validate its alignment with human judgments. Experiments with our developed multi-agent system DR^{3}-Agent based on multiple state-of-the-art language models demonstrate that DR^{3}-Eval is highly challenging and reveals critical failure modes in retrieval robustness and hallucination control. Our code and data are publicly available.

Radiology report generation (RRG) is a challenging task, as it requires a thorough understanding of medical images, integration of multiple temporal inputs, and accurate report generation. Effective interpretation of medical images, such as chest X-rays (CXRs), demands sophisticated visual-language reasoning to map visual findings to structured reports. Recent studies have shown that multimodal large language models (MLLMs) can acquire multimodal capabilities by aligning with pre-trained vision encoders. However, current approaches predominantly focus on single-image analysis or utilise rule-based symbolic processing to handle multiple images, thereby overlooking the essential temporal information derived from comparing current images with prior ones. To overcome this critical limitation, we introduce Libra, a temporal-aware MLLM tailored for CXR report generation using temporal images. Libra integrates a radiology-specific image encoder with a MLLM and utilises a novel Temporal Alignment Connector to capture and synthesise temporal information of images across different time points with unprecedented precision. Extensive experiments show that Libra achieves new state-of-the-art performance among the same parameter scale MLLMs for RRG tasks on the MIMIC-CXR. Specifically, Libra improves the RadCliQ metric by 12.9% and makes substantial gains across all lexical metrics compared to previous models.

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

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

Multimodal Foundation Models (MMFMs) have shown remarkable performance on various computer vision and natural language processing tasks. However, their performance on particular tasks such as document understanding is still limited. They also require more compute, time, and engineering resources to finetune and deploy compared to traditional, unimodal models. In this report, we present Multimodal Structured Generation, a general framework which constrains the output logits of frozen MMFMs to force them to reason before responding with structured outputs that downstream APIs can parse and use. We provide a detailed account of our approach, including the technical details, theoretical discussions, and final evaluation results in the 2nd Multimodal Foundation Models Challenge hosted by the Computer Vision and Pattern Recognition (CVPR) conference. Our approach achieved the second highest score in the hidden test set for Phase 2 and third highest overall. This shows the method's ability to generalize to unseen tasks. And that simple engineering can beat expensive & complicated modelling steps as we first discussed in our paper, Retrieval Augmented Structured Generation: Business Document Information Extraction as Tool Use. All of our scripts, deployment steps, and evaluation results can be accessed in https://github.com/leloykun/MMFM-Challenge

We present a node-based storytelling system for multimodal content generation. The system represents stories as graphs of nodes that can be expanded, edited, and iteratively refined through direct user edits and natural-language prompts. Each node can integrate text, images, audio, and video, allowing creators to compose multimodal narratives. A task selection agent routes between specialized generative tasks that handle story generation, node structure reasoning, node diagram formatting, and context generation. The interface supports targeted editing of individual nodes, automatic branching for parallel storylines, and node-based iterative refinement. Our results demonstrate that node-based editing supports control over narrative structure and iterative generation of text, images, audio, and video. We report quantitative outcomes on automatic story outline generation and qualitative observations of editing workflows. Finally, we discuss current limitations such as scalability to longer narratives and consistency across multiple nodes, and outline future work toward human-in-the-loop and user-centered creative AI tools.

This report presents PixelBytes, an approach for unified multimodal representation learning. Drawing inspiration from sequence models like Image Transformers, PixelCNN, and Mamba-Bytes, we explore integrating text, audio, action-state, and pixelated images (sprites) into a cohesive representation. We conducted experiments on a PixelBytes Pokemon dataset and an Optimal-Control dataset. Our investigation covered various model architectures, including Recurrent Neural Networks (RNNs), State Space Models (SSMs), and Attention-based models, with a focus on bidirectional processing and our PxBy embedding technique. We evaluated models based on data reduction strategies and autoregressive learning, specifically examining Long Short-Term Memory (LSTM) networks in predictive and autoregressive modes. Our results indicate that autoregressive models perform better than predictive models in this context. Additionally, we found that diffusion models can be applied to control problems and parallelized generation. PixelBytes aims to contribute to the development of foundation models for multimodal data processing and generation. The project's code, models, and datasets are available online.

This report introduces PixelBytes Embedding, a novel approach for unified multimodal representation learning. Our method captures diverse inputs in a single, cohesive representation, enabling emergent properties for multimodal sequence generation, particularly for text and pixelated images. Inspired by state-of-the-art sequence models such as Image Transformers, PixelCNN, and Mamba-Bytes, PixelBytes aims to address the challenges of integrating different data types. We explore various model architectures, including Recurrent Neural Networks (RNNs), State Space Models (SSMs), and Attention-based models, focusing on bidirectional processing and our innovative PxBy embedding technique. Our experiments, conducted on a specialized PixelBytes Pok{\'e}mon dataset, demonstrate that bidirectional sequence models with PxBy embedding and convolutional layers can generate coherent multimodal sequences. This work contributes to the advancement of integrated AI models capable of understanding and generating multimodal data in a unified manner.

Unified multimodal models (UMMs) that integrate understanding, reasoning, generation, and editing face inherent trade-offs between maintaining strong semantic comprehension and acquiring powerful generation capabilities. In this report, we present InternVL-U, a lightweight 4B-parameter UMM that democratizes these capabilities within a unified framework. Guided by the principles of unified contextual modeling and modality-specific modular design with decoupled visual representations, InternVL-U integrates a state-of-the-art Multimodal Large Language Model (MLLM) with a specialized MMDiT-based visual generation head. To further bridge the gap between aesthetic generation and high-level intelligence, we construct a comprehensive data synthesis pipeline targeting high-semantic-density tasks, such as text rendering and scientific reasoning, under a reasoning-centric paradigm that leverages Chain-of-Thought (CoT) to better align abstract user intent with fine-grained visual generation details. Extensive experiments demonstrate that InternVL-U achieves a superior performance - efficiency balance. Despite using only 4B parameters, it consistently outperforms unified baseline models with over 3x larger scales such as BAGEL (14B) on various generation and editing tasks, while retaining strong multimodal understanding and reasoning capabilities.

Multimodal representation learning is a cornerstone of modern AI. By encoding multimodal queries and targets into vectors, it powers industrial search and recommendation and underpins modern agents. Real-world platforms with complex modalities and massive-scale content, such as Douyin, Xiaohongshu, and YouTube, demand both efficiency under billion-scale indexing and fine-grained discrimination for hard matching. Existing MLLM embedding models rarely satisfy both. Contrastive models are efficient but rely on pair-level supervision too coarse for fine-grained distinctions, while CoT-based models improve discrimination through explicit generation impractical to serve online. We present Douyin Multimodal Embedding (DME), a model trained in two stages to combine both strengths. Stage 1 performs large-scale contrastive pre-training that establishes a unified multimodal embedding space with broad modality and task coverage. Stage 2 supplements semantic sufficiency, the property that an embedding is grounded in retrieval-relevant evidence and preserves fine-grained counterpart-side semantics, via two mechanisms. Evidence-Grounded Typed Latent Reasoning organizes retrieval evidence through hidden-space latent reasoning, and Cross-Conditional Reconstruction enforces counterpart-side semantics through cross-directional autoregressive reconstruction. Both act only during training and add only marginal query-side overhead, so DME serves as efficiently as a standard contrastive encoder. On MMEB-v2, DME reaches state-of-the-art results at comparable scales for its 2B and 9B variants (74.8 and 78.4), with especially strong video and visual-document tasks. In production, DME delivers a 2.92% relative gain on Douyin's in-house offline evaluation set, is deployed across Douyin scenarios such as generative, image, and AI search, and yields a 0.1% Lifetime (LT) gain in online A/B testing on Douyin search.

Inspired by the development of OpenClaw, there is a growing demand for mobile-based personal agents capable of handling complex and intuitive interactions. In this technical report, we introduce X-OmniClaw, a unified mobile agent designed for multimodal understanding and interaction in the Android ecosystem. This unified architecture of perception, memory, and action enables the agent to handle complex mobile tasks with high contextual awareness. Specifically, Omni Perception provides a unified multimodal ingress pipeline that integrates UI states, real-world visual contexts, and speech inputs, leveraging a temporal alignment module to decompose raw data into structured multimodal intent representations. Omni Memory leverages multimodal memory optimization to enhance personalized intelligence by integrating runtime working memory for task continuity with long-term personal memory distilled from local data, enabling highly context-aware and personalized interactions. Finally, Omni Action employs a hybrid grounding strategy that combines structural XML metadata with visual perception for robust interaction. Through Behavior Cloning and Trajectory Replay, the system captures user navigation as reusable skills, enabling precise direct-access execution. Demonstrations across diverse scenarios show that X-OmniClaw effectively enhances interaction efficiency and task reliability, providing a practical architectural blueprint for the next generation of mobile-native personal assistants.

We introduce Phi-4-Mini and Phi-4-Multimodal, compact yet highly capable language and multimodal models. Phi-4-Mini is a 3.8-billion-parameter language model trained on high-quality web and synthetic data, significantly outperforming recent open-source models of similar size and matching the performance of models twice its size on math and coding tasks requiring complex reasoning. This achievement is driven by a carefully curated synthetic data recipe emphasizing high-quality math and coding datasets. Compared to its predecessor, Phi-3.5-Mini, Phi-4-Mini features an expanded vocabulary size of 200K tokens to better support multilingual applications, as well as group query attention for more efficient long-sequence generation. Phi-4-Multimodal is a multimodal model that integrates text, vision, and speech/audio input modalities into a single model. Its novel modality extension approach leverages LoRA adapters and modality-specific routers to allow multiple inference modes combining various modalities without interference. For example, it now ranks first in the OpenASR leaderboard to date, although the LoRA component of the speech/audio modality has just 460 million parameters. Phi-4-Multimodal supports scenarios involving (vision + language), (vision + speech), and (speech/audio) inputs, outperforming larger vision-language and speech-language models on a wide range of tasks. Additionally, we experiment to further train Phi-4-Mini to enhance its reasoning capabilities. Despite its compact 3.8-billion-parameter size, this experimental version achieves reasoning performance on par with or surpassing significantly larger models, including DeepSeek-R1-Distill-Qwen-7B and DeepSeek-R1-Distill-Llama-8B.

We present Qwen-Image-2.0, an omni-capable image generation foundation model that unifies high-fidelity generation and precise image editing within a single framework. Despite recent progress, existing models still struggle with ultra-long text rendering, multilingual typography, high-resolution photorealism, robust instruction following, and efficient deployment, especially in text-rich and compositionally complex scenarios. Qwen-Image-2.0 addresses these challenges by coupling Qwen3-VL as the condition encoder with a Multimodal Diffusion Transformer for joint condition-target modeling, supported by large-scale data curation and a customized multi-stage training pipeline. This enables strong multimodal understanding while preserving flexible generation and editing capabilities. The model supports instructions of up to 1K tokens for generating text-rich content such as slides, posters, infographics, and comics, while significantly improving multilingual text fidelity and typography. It also enhances photorealistic generation with richer details, more realistic textures, and coherent lighting, and follows complex prompts more reliably across diverse styles. Extensive human evaluations show that Qwen-Image-2.0 substantially outperforms previous Qwen-Image models in both generation and editing, marking a step toward more general, reliable, and practical image generation foundation models.

Video generation serves as a cornerstone for building world models, where multimodal contextual inference stands as the defining test of capability. In this end, we present SkyReels-V3, a conditional video generation model, built upon a unified multimodal in-context learning framework with diffusion Transformers. SkyReels-V3 model supports three core generative paradigms within a single architecture: reference images-to-video synthesis, video-to-video extension and audio-guided video generation. (i) reference images-to-video model is designed to produce high-fidelity videos with strong subject identity preservation, temporal coherence, and narrative consistency. To enhance reference adherence and compositional stability, we design a comprehensive data processing pipeline that leverages cross frame pairing, image editing, and semantic rewriting, effectively mitigating copy paste artifacts. During training, an image video hybrid strategy combined with multi-resolution joint optimization is employed to improve generalization and robustness across diverse scenarios. (ii) video extension model integrates spatio-temporal consistency modeling with large-scale video understanding, enabling both seamless single-shot continuation and intelligent multi-shot switching with professional cinematographic patterns. (iii) Talking avatar model supports minute-level audio-conditioned video generation by training first-and-last frame insertion patterns and reconstructing key-frame inference paradigms. On the basis of ensuring visual quality, synchronization of audio and videos has been optimized. Extensive evaluations demonstrate that SkyReels-V3 achieves state-of-the-art or near state-of-the-art performance on key metrics including visual quality, instruction following, and specific aspect metrics, approaching leading closed-source systems. Github: https://github.com/SkyworkAI/SkyReels-V3.

We present HunyuanImage 3.0, a native multimodal model that unifies multimodal understanding and generation within an autoregressive framework, with its image generation module publicly available. The achievement of HunyuanImage 3.0 relies on several key components, including meticulous data curation, advanced architecture design, a native Chain-of-Thoughts schema, progressive model pre-training, aggressive model post-training, and an efficient infrastructure that enables large-scale training and inference. With these advancements, we successfully trained a Mixture-of-Experts (MoE) model comprising over 80 billion parameters in total, with 13 billion parameters activated per token during inference, making it the largest and most powerful open-source image generative model to date. We conducted extensive experiments and the results of automatic and human evaluation of text-image alignment and visual quality demonstrate that HunyuanImage 3.0 rivals previous state-of-the-art models. By releasing the code and weights of HunyuanImage 3.0, we aim to enable the community to explore new ideas with a state-of-the-art foundation model, fostering a dynamic and vibrant multimodal ecosystem. All open source assets are publicly available at https://github.com/Tencent-Hunyuan/HunyuanImage-3.0

Latent diffusion modeling (LDM), a prominent paradigm, utilizes tokenizers to map input signal to compressed representation. This dependency positions tokenizer as an integral part of generation process itself, since it affects learning speed, quality of synthesized samples and lay foundation for later applications. This report presents series of KVAE tokenizers for audio, image and video, all designed for subsequent text-conditioned generation: KVAE-Audio, a continuous full-band 48 kHz tokenizer with a 50 Hz latent of 64 channels; KVAE-3D -- two causal video tokenizers for 4x16x16 and 4x8x8 compression; KVAE-2D, an image model, compressing input by factor of 8 with 32 channels. We demonstrate that reconstruction (PSNR, LPIPS, PESQ, etc.) and generation results on objective (Frechet Distance, CLIP score, CLAP score, etc.) and subjective (side-by-side evaluation) metrics matches or surpasses frontier opensource tokenizers, such as VAEs from Wan-2.2, HunyuanVideo-1.5, FLUX.2, MovieGen, StableAudio and MMAudio. Considering difficulty of development, we share with community training details, model selection method and ablation on design choices. The code is publicly available at https://github.com/kandinskylab/kvae and https://github.com/kandinskylab/kvae-audio.

World models aim to endow AI systems with the ability to represent, generate, and interact with dynamic environments in a coherent and temporally consistent manner. While recent video generation models have demonstrated impressive visual quality, they remain limited in real-time interaction, long-horizon consistency, and persistent memory of dynamic scenes, hindering their evolution into practical world models. In this report, we present TeleWorld, a real-time multimodal 4D world modeling framework that unifies video generation, dynamic scene reconstruction, and long-term world memory within a closed-loop system. TeleWorld introduces a novel generation-reconstruction-guidance paradigm, where generated video streams are continuously reconstructed into a dynamic 4D spatio-temporal representation, which in turn guides subsequent generation to maintain spatial, temporal, and physical consistency. To support long-horizon generation with low latency, we employ an autoregressive diffusion-based video model enhanced with Macro-from-Micro Planning (MMPL)--a hierarchical planning method that reduces error accumulation from frame-level to segment-level-alongside efficient Distribution Matching Distillation (DMD), enabling real-time synthesis under practical computational budgets. Our approach achieves seamless integration of dynamic object modeling and static scene representation within a unified 4D framework, advancing world models toward practical, interactive, and computationally accessible systems. Extensive experiments demonstrate that TeleWorld achieves strong performance in both static and dynamic world understanding, long-term consistency, and real-time generation efficiency, positioning it as a practical step toward interactive, memory-enabled world models for multimodal generation and embodied intelligence.

In this technical report, we introduce SEED-Data-Edit: a unique hybrid dataset for instruction-guided image editing, which aims to facilitate image manipulation using open-form language. SEED-Data-Edit is composed of three distinct types of data: (1) High-quality editing data produced by an automated pipeline, ensuring a substantial volume of diverse image editing pairs. (2) Real-world scenario data collected from the internet, which captures the intricacies of user intentions for promoting the practical application of image editing in the real world. (3) High-precision multi-turn editing data annotated by humans, which involves multiple rounds of edits for simulating iterative editing processes. The combination of these diverse data sources makes SEED-Data-Edit a comprehensive and versatile dataset for training language-guided image editing model. We fine-tune a pretrained Multimodal Large Language Model (MLLM) that unifies comprehension and generation with SEED-Data-Edit. The instruction tuned model demonstrates promising results, indicating the potential and effectiveness of SEED-Data-Edit in advancing the field of instructional image editing. The datasets are released in https://huggingface.co/datasets/AILab-CVC/SEED-Data-Edit.

In this work, we present Qwen3.5-Omni, the latest advancement in the Qwen-Omni model family. Representing a significant evolution over its predecessor, Qwen3.5-Omni scales to hundreds of billions of parameters and supports a 256k context length. By leveraging a massive dataset comprising heterogeneous text-vision pairs and over 100 million hours of audio-visual content, the model demonstrates robust omni-modality capabilities. Qwen3.5-Omni-plus achieves SOTA results across 215 audio and audio-visual understanding, reasoning, and interaction subtasks and benchmarks, surpassing Gemini-3.1 Pro in key audio tasks and matching it in comprehensive audio-visual understanding. Architecturally, Qwen3.5-Omni employs a Hybrid Attention Mixture-of-Experts (MoE) framework for both Thinker and Talker, enabling efficient long-sequence inference. The model facilitates sophisticated interaction, supporting over 10 hours of audio understanding and 400 seconds of 720P video (at 1 FPS). To address the inherent instability and unnaturalness in streaming speech synthesis, often caused by encoding efficiency discrepancies between text and speech tokenizers, we introduce ARIA. ARIA dynamically aligns text and speech units, significantly enhancing the stability and prosody of conversational speech with minimal latency impact. Furthermore, Qwen3.5-Omni expands linguistic boundaries, supporting multilingual understanding and speech generation across 10 languages with human-like emotional nuance. Finally, Qwen3.5-Omni exhibits superior audio-visual grounding capabilities, generating script-level structured captions with precise temporal synchronization and automated scene segmentation. Remarkably, we observed the emergence of a new capability in omnimodal models: directly performing coding based on audio-visual instructions, which we call Audio-Visual Vibe Coding.

In this report, we introduce ERNIE 5.0, a natively autoregressive foundation model desinged for unified multimodal understanding and generation across text, image, video, and audio. All modalities are trained from scratch under a unified next-group-of-tokens prediction objective, based on an ultra-sparse mixture-of-experts (MoE) architecture with modality-agnostic expert routing. To address practical challenges in large-scale deployment under diverse resource constraints, ERNIE 5.0 adopts a novel elastic training paradigm. Within a single pre-training run, the model learns a family of sub-models with varying depths, expert capacities, and routing sparsity, enabling flexible trade-offs among performance, model size, and inference latency in memory- or time-constrained scenarios. Moreover, we systematically address the challenges of scaling reinforcement learning to unified foundation models, thereby guaranteeing efficient and stable post-training under ultra-sparse MoE architectures and diverse multimodal settings. Extensive experiments demonstrate that ERNIE 5.0 achieves strong and balanced performance across multiple modalities. To the best of our knowledge, among publicly disclosed models, ERNIE 5.0 represents the first production-scale realization of a trillion-parameter unified autoregressive model that supports both multimodal understanding and generation. To facilitate further research, we present detailed visualizations of modality-agnostic expert routing in the unified model, alongside comprehensive empirical analysis of elastic training, aiming to offer profound insights to the community.

Autoregressive large language models (LLMs) scale well by expressing diverse tasks as sequences of discrete natural-language tokens and training with next-token prediction, which unifies comprehension and generation under self-supervision. Extending this paradigm to multimodal data requires a shared, discrete representation across modalities. However, most vision-language models (VLMs) still rely on a hybrid interface: discrete text tokens paired with continuous Vision Transformer (ViT) features. Because supervision is largely text-driven, these models are often biased toward understanding and cannot fully leverage large-scale self-supervised learning on non-text data. Recent work has explored discrete visual tokenization to enable fully autoregressive multimodal modeling, showing promising progress toward unified understanding and generation. Yet existing discrete vision tokens frequently lose information due to limited code capacity, resulting in noticeably weaker understanding than continuous-feature VLMs. We present Kelix, a fully discrete autoregressive unified model that closes the understanding gap between discrete and continuous visual representations.

We present Kling-Omni, a generalist generative framework designed to synthesize high-fidelity videos directly from multimodal visual language inputs. Adopting an end-to-end perspective, Kling-Omni bridges the functional separation among diverse video generation, editing, and intelligent reasoning tasks, integrating them into a holistic system. Unlike disjointed pipeline approaches, Kling-Omni supports a diverse range of user inputs, including text instructions, reference images, and video contexts, processing them into a unified multimodal representation to deliver cinematic-quality and highly-intelligent video content creation. To support these capabilities, we constructed a comprehensive data system that serves as the foundation for multimodal video creation. The framework is further empowered by efficient large-scale pre-training strategies and infrastructure optimizations for inference. Comprehensive evaluations reveal that Kling-Omni demonstrates exceptional capabilities in in-context generation, reasoning-based editing, and multimodal instruction following. Moving beyond a content creation tool, we believe Kling-Omni is a pivotal advancement toward multimodal world simulators capable of perceiving, reasoning, generating and interacting with the dynamic and complex worlds.

We introduce Gemma 4, a new generation of open-weight, natively multimodal language models in the Gemma model family. Designed to advance compute efficiency and reasoning, the Gemma 4 model suite features dense and Mixture-of-Experts architectures, ranging from 2.3B to 31B parameters. Alongside improved vision and audio encoders for all model sizes, we propose a unified, encoder-free architecture for our 12B model, which ingests raw audio and image patches. Furthermore, we integrate a thinking mode, enabling Gemma models to generate reasoning traces prior to responding. We improve inference speed, memory, and compute efficiency, as well as long-context abilities through critical design choices. Gemma 4 establishes a leap in performance across STEM, multimodal, and long-context benchmarks, and rivals larger, frontier open models in human-rated tasks.

We introduce Baichuan-Omni-1.5, an omni-modal model that not only has omni-modal understanding capabilities but also provides end-to-end audio generation capabilities. To achieve fluent and high-quality interaction across modalities without compromising the capabilities of any modality, we prioritized optimizing three key aspects. First, we establish a comprehensive data cleaning and synthesis pipeline for multimodal data, obtaining about 500B high-quality data (text, audio, and vision). Second, an audio-tokenizer (Baichuan-Audio-Tokenizer) has been designed to capture both semantic and acoustic information from audio, enabling seamless integration and enhanced compatibility with MLLM. Lastly, we designed a multi-stage training strategy that progressively integrates multimodal alignment and multitask fine-tuning, ensuring effective synergy across all modalities. Baichuan-Omni-1.5 leads contemporary models (including GPT4o-mini and MiniCPM-o 2.6) in terms of comprehensive omni-modal capabilities. Notably, it achieves results comparable to leading models such as Qwen2-VL-72B across various multimodal medical benchmarks.

In this report, we introduce Ovis-U1, a 3-billion-parameter unified model that integrates multimodal understanding, text-to-image generation, and image editing capabilities. Building on the foundation of the Ovis series, Ovis-U1 incorporates a diffusion-based visual decoder paired with a bidirectional token refiner, enabling image generation tasks comparable to leading models like GPT-4o. Unlike some previous models that use a frozen MLLM for generation tasks, Ovis-U1 utilizes a new unified training approach starting from a language model. Compared to training solely on understanding or generation tasks, unified training yields better performance, demonstrating the enhancement achieved by integrating these two tasks. Ovis-U1 achieves a score of 69.6 on the OpenCompass Multi-modal Academic Benchmark, surpassing recent state-of-the-art models such as Ristretto-3B and SAIL-VL-1.5-2B. In text-to-image generation, it excels with scores of 83.72 and 0.89 on the DPG-Bench and GenEval benchmarks, respectively. For image editing, it achieves 4.00 and 6.42 on the ImgEdit-Bench and GEdit-Bench-EN, respectively. As the initial version of the Ovis unified model series, Ovis-U1 pushes the boundaries of multimodal understanding, generation, and editing.

We present Amazon Nova, a new generation of state-of-the-art foundation models that deliver frontier intelligence and industry-leading price performance. Amazon Nova Pro is a highly-capable multimodal model with the best combination of accuracy, speed, and cost for a wide range of tasks. Amazon Nova Lite is a low-cost multimodal model that is lightning fast for processing images, video, documents and text. Amazon Nova Micro is a text-only model that delivers our lowest-latency responses at very low cost. Amazon Nova Canvas is an image generation model that creates professional grade images with rich customization controls. Amazon Nova Reel is a video generation model offering high-quality outputs, customization, and motion control. Our models were built responsibly and with a commitment to customer trust, security, and reliability. We report benchmarking results for core capabilities, agentic performance, long context, functional adaptation, runtime performance, and human evaluation.

Whole Slide Images (WSIs) exhibit hierarchical structure, where diagnostic information emerges from cellular morphology, regional tissue organization, and global context. Existing Computational Pathology (CPath) Multimodal Large Language Models (MLLMs) typically compress an entire WSI into a single embedding, which hinders fine-grained grounding and ignores how pathologists synthesize evidence across different scales. We introduce MLLM-HWSI, a Hierarchical WSI-level MLLM that aligns visual features with pathology language at four distinct scales, cell as word, patch as phrase, region as sentence, and WSI as paragraph to support interpretable evidence-grounded reasoning. MLLM-HWSI decomposes each WSI into multi-scale embeddings with scale-specific projectors and jointly enforces (i) a hierarchical contrastive objective and (ii) a cross-scale consistency loss, preserving semantic coherence from cells to the WSI. We compute diagnostically relevant patches and aggregate segmented cell embeddings into a compact cellular token per-patch using a lightweight Cell-Cell Attention Fusion (CCAF) transformer. The projected multi-scale tokens are fused with text tokens and fed to an instruction-tuned LLM for open-ended reasoning, VQA, report, and caption generation tasks. Trained in three stages, MLLM-HWSI achieves new SOTA results on 13 WSI-level benchmarks across six CPath tasks. By aligning language with multi-scale visual evidence, MLLM-HWSI provides accurate, interpretable outputs that mirror diagnostic workflows and advance holistic WSI understanding. Code is available at: https://github.com/BasitAlawode/HWSI-MLLM{GitHub}.

Avatar video generation models have achieved remarkable progress in recent years. However, prior work exhibits limited efficiency in generating long-duration high-resolution videos, suffering from temporal drifting, quality degradation, and weak prompt following as video length increases. To address these challenges, we propose KlingAvatar 2.0, a spatio-temporal cascade framework that performs upscaling in both spatial resolution and temporal dimension. The framework first generates low-resolution blueprint video keyframes that capture global semantics and motion, and then refines them into high-resolution, temporally coherent sub-clips using a first-last frame strategy, while retaining smooth temporal transitions in long-form videos. To enhance cross-modal instruction fusion and alignment in extended videos, we introduce a Co-Reasoning Director composed of three modality-specific large language model (LLM) experts. These experts reason about modality priorities and infer underlying user intent, converting inputs into detailed storylines through multi-turn dialogue. A Negative Director further refines negative prompts to improve instruction alignment. Building on these components, we extend the framework to support ID-specific multi-character control. Extensive experiments demonstrate that our model effectively addresses the challenges of efficient, multimodally aligned long-form high-resolution video generation, delivering enhanced visual clarity, realistic lip-teeth rendering with accurate lip synchronization, strong identity preservation, and coherent multimodal instruction following.

Ensuring the safety, quality, and timely completion of construction projects is paramount, with construction inspections serving as a vital instrument towards these goals. Nevertheless, the predominantly manual approach of present-day inspections frequently results in inefficiencies and inadequate information management. Such methods often fall short of providing holistic, exhaustive assessments, consequently engendering regulatory oversights and potential safety hazards. To address this issue, this paper presents a novel framework named AutoRepo for automated generation of construction inspection reports. The unmanned vehicles efficiently perform construction inspections and collect scene information, while the multimodal large language models (LLMs) are leveraged to automatically generate the inspection reports. The framework was applied and tested on a real-world construction site, demonstrating its potential to expedite the inspection process, significantly reduce resource allocation, and produce high-quality, regulatory standard-compliant inspection reports. This research thus underscores the immense potential of multimodal large language models in revolutionizing construction inspection practices, signaling a significant leap forward towards a more efficient and safer construction management paradigm.

Recent advancements in mixed-modal generative models have enabled flexible integration of information across image-text content. These models have opened new avenues for developing unified biomedical assistants capable of analyzing biomedical images, answering complex questions about them, and predicting the impact of medical procedures on a patient's health. However, existing resources face challenges such as limited data availability, narrow domain coverage, and restricted sources (e.g., medical papers). To address these gaps, we present MedMax, the first large-scale multimodal biomedical instruction-tuning dataset for mixed-modal foundation models. With 1.47 million instances, MedMax encompasses a diverse range of tasks, including multimodal content generation (interleaved image-text data), biomedical image captioning and generation, visual chatting, and report understanding. These tasks span diverse medical domains such as radiology and histopathology. Subsequently, we fine-tune a mixed-modal foundation model on the MedMax dataset, achieving significant performance improvements: a 26% gain over the Chameleon model and an 18.3% improvement over GPT-4o across 12 downstream biomedical visual question-answering tasks. Additionally, we introduce a unified evaluation suite for biomedical tasks, providing a robust framework to guide the development of next-generation mixed-modal biomedical AI assistants.

Medical report generation from X-ray images is a challenging task, particularly in an unpaired setting where paired image-report data is unavailable for training. To address this challenge, we propose a novel model that leverages the available information in two distinct datasets, one comprising reports and the other consisting of images. The core idea of our model revolves around the notion that combining auto-encoding report generation with multi-modal (report-image) alignment can offer a solution. However, the challenge persists regarding how to achieve this alignment when pair correspondence is absent. Our proposed solution involves the use of auxiliary tasks, particularly contrastive learning and classification, to position related images and reports in close proximity to each other. This approach differs from previous methods that rely on pre-processing steps, such as using external information stored in a knowledge graph. Our model, named MedRAT, surpasses previous state-of-the-art methods, demonstrating the feasibility of generating comprehensive medical reports without the need for paired data or external tools.

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

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.

Reliable end-to-end clinical report generation has been a longstanding goal of medical ML research. The end goal for this process is to alleviate radiologists' workloads and provide second opinions to clinicians or patients. Thus, a necessary prerequisite for report generation models is a strong general performance and some type of innate grounding capability, to convince clinicians or patients of the veracity of the generated reports. In this paper, we present ASaRG (Automatic Segmentation-assisted Report Generation), an extension of the popular LLaVA architecture that aims to tackle both of these problems. ASaRG proposes to fuse intermediate features and fine-grained segmentation maps created by specialist radiological models into LLaVA's multi-modal projection layer via simple concatenation. With a small number of added parameters, our approach achieves a +0.89\% performance gain (p=0.012) in CE F1 score compared to the LLaVA baseline when using only intermediate features, and +2.77\% performance gain (p<0.001) when adding a combination of intermediate features and fine-grained segmentation maps. Compared with COMG and ORID, two other report generation methods that utilize segmentations, the performance gain amounts to 6.98\% and 6.28\% in F1 score, respectively. ASaRG is not mutually exclusive with other changes made to the LLaVA architecture, potentially allowing our method to be combined with other advances in the field. Finally, the use of an arbitrary number of segmentations as part of the input demonstrably allows tracing elements of the report to the corresponding segmentation maps and verifying the groundedness of assessments. Our code will be made publicly available at a later date.

Interpreting chest X-rays is inherently challenging due to the overlap between anatomical structures and the subtle presentation of many clinically significant pathologies, making accurate diagnosis time-consuming even for experienced radiologists. Recent radiology-focused foundation models, such as LLaVA-Rad and Maira-2, have positioned multi-modal large language models (MLLMs) at the forefront of automated radiology report generation (RRG). However, despite these advances, current foundation models generate reports in a single forward pass. This decoding strategy diminishes attention to visual tokens and increases reliance on language priors as generation proceeds, which in turn introduces spurious pathology co-occurrences in the generated reports. To mitigate these limitations, we propose Category-Wise Contrastive Decoding (CWCD), a novel and modular framework designed to enhance structured radiology report generation (SRRG). Our approach introduces category-specific parameterization and generates category-wise reports by contrasting normal X-rays with masked X-rays using category-specific visual prompts. Experimental results demonstrate that CWCD consistently outperforms baseline methods across both clinical efficacy and natural language generation metrics. An ablation study further elucidates the contribution of each architectural component to overall performance.

The objective of Radiology Report Generation (RRG) is to automatically generate coherent textual analyses of diseases based on radiological images, thereby alleviating the workload of radiologists. Current AI-based methods for RRG primarily focus on modifications to the encoder-decoder model architecture. To advance these approaches, this paper introduces an Organ-Regional Information Driven (ORID) framework which can effectively integrate multi-modal information and reduce the influence of noise from unrelated organs. Specifically, based on the LLaVA-Med, we first construct an RRG-related instruction dataset to improve organ-regional diagnosis description ability and get the LLaVA-Med-RRG. After that, we propose an organ-based cross-modal fusion module to effectively combine the information from the organ-regional diagnosis description and radiology image. To further reduce the influence of noise from unrelated organs on the radiology report generation, we introduce an organ importance coefficient analysis module, which leverages Graph Neural Network (GNN) to examine the interconnections of the cross-modal information of each organ region. Extensive experiments an1d comparisons with state-of-the-art methods across various evaluation metrics demonstrate the superior performance of our proposed method.

The rapid evolution of artificial intelligence, especially in large language models (LLMs), has significantly impacted various domains, including healthcare. In chest X-ray (CXR) analysis, previous studies have employed LLMs, but with limitations: either underutilizing the multi-tasking capabilities of LLMs or lacking clinical accuracy. This paper presents M4CXR, a multi-modal LLM designed to enhance CXR interpretation. The model is trained on a visual instruction-following dataset that integrates various task-specific datasets in a conversational format. As a result, the model supports multiple tasks such as medical report generation (MRG), visual grounding, and visual question answering (VQA). M4CXR achieves state-of-the-art clinical accuracy in MRG by employing a chain-of-thought prompting strategy, in which it identifies findings in CXR images and subsequently generates corresponding reports. The model is adaptable to various MRG scenarios depending on the available inputs, such as single-image, multi-image, and multi-study contexts. In addition to MRG, M4CXR performs visual grounding at a level comparable to specialized models and also demonstrates outstanding performance in VQA. Both quantitative and qualitative assessments reveal M4CXR's versatility in MRG, visual grounding, and VQA, while consistently maintaining clinical accuracy.

Medical image analysis is essential to clinical diagnosis and treatment, which is increasingly supported by multi-modal large language models (MLLMs). However, previous research has primarily focused on 2D medical images, leaving 3D images under-explored, despite their richer spatial information. This paper aims to advance 3D medical image analysis with MLLMs. To this end, we present a large-scale 3D multi-modal medical dataset, M3D-Data, comprising 120K image-text pairs and 662K instruction-response pairs specifically tailored for various 3D medical tasks, such as image-text retrieval, report generation, visual question answering, positioning, and segmentation. Additionally, we propose M3D-LaMed, a versatile multi-modal large language model for 3D medical image analysis. Furthermore, we introduce a new 3D multi-modal medical benchmark, M3D-Bench, which facilitates automatic evaluation across eight tasks. Through comprehensive evaluation, our method proves to be a robust model for 3D medical image analysis, outperforming existing solutions. All code, data, and models are publicly available at: https://github.com/BAAI-DCAI/M3D.

With the advancement of telemedicine, both researchers and medical practitioners are working hand-in-hand to develop various techniques to automate various medical operations, such as diagnosis report generation. In this paper, we first present a multi-modal clinical conversation summary generation task that takes a clinician-patient interaction (both textual and visual information) and generates a succinct synopsis of the conversation. We propose a knowledge-infused, multi-modal, multi-tasking medical domain identification and clinical conversation summary generation (MM-CliConSummation) framework. It leverages an adapter to infuse knowledge and visual features and unify the fused feature vector using a gated mechanism. Furthermore, we developed a multi-modal, multi-intent clinical conversation summarization corpus annotated with intent, symptom, and summary. The extensive set of experiments, both quantitatively and qualitatively, led to the following findings: (a) critical significance of visuals, (b) more precise and medical entity preserving summary with additional knowledge infusion, and (c) a correlation between medical department identification and clinical synopsis generation. Furthermore, the dataset and source code are available at https://github.com/NLP-RL/MM-CliConSummation.

Recent advances in Large Vision-Language Models (LVLMs) have shown strong potential for multi-modal radiological reasoning, particularly in tasks like diagnostic visual question answering (VQA) and radiology report generation. However, most existing approaches for 3D CT analysis largely rely on static, single-pass inference. In practice, clinical interpretation is a dynamic, tool-mediated workflow where radiologists iteratively review slices and use measurement, radiomics, and segmentation tools to refine findings. To bridge this gap, we propose CT-Flow, an agentic framework designed for interoperable volumetric interpretation. By leveraging the Model Context Protocol (MCP), CT-Flow shifts from closed-box inference to an open, tool-aware paradigm. We curate CT-FlowBench, the first large-scale instruction-tuning benchmark tailored for 3D CT tool-use and multi-step reasoning. Built upon this, CT-Flow functions as a clinical orchestrator capable of decomposing complex natural language queries into automated tool-use sequences. Experimental evaluations on CT-FlowBench and standard 3D VQA datasets demonstrate that CT-Flow achieves state-of-the-art performance, surpassing baseline models by 41% in diagnostic accuracy and achieving a 95% success rate in autonomous tool invocation. This work provides a scalable foundation for integrating autonomous, agentic intelligence into real-world clinical radiology.

Medical image analysis is crucial in modern radiological diagnostics, especially given the exponential growth in medical imaging data. The demand for automated report generation systems has become increasingly urgent. While prior research has mainly focused on using machine learning and multimodal language models for 2D medical images, the generation of reports for 3D medical images has been less explored due to data scarcity and computational complexities. This paper introduces 3D-CT-GPT, a Visual Question Answering (VQA)-based medical visual language model specifically designed for generating radiology reports from 3D CT scans, particularly chest CTs. Extensive experiments on both public and private datasets demonstrate that 3D-CT-GPT significantly outperforms existing methods in terms of report accuracy and quality. Although current methods are few, including the partially open-source CT2Rep and the open-source M3D, we ensured fair comparison through appropriate data conversion and evaluation methodologies. Experimental results indicate that 3D-CT-GPT enhances diagnostic accuracy and report coherence, establishing itself as a robust solution for clinical radiology report generation. Future work will focus on expanding the dataset and further optimizing the model to enhance its performance and applicability.

Pathological diagnosis remains the definitive standard for identifying tumors. The rise of multimodal large models has simplified the process of integrating image analysis with textual descriptions. Despite this advancement, the substantial costs associated with training and deploying these complex multimodal models, together with a scarcity of high-quality training datasets, create a significant divide between cutting-edge technology and its application in the clinical setting. We had meticulously compiled a dataset of approximately 45,000 cases, covering over 6 different tasks, including the classification of organ tissues, generating pathology report descriptions, and addressing pathology-related questions and answers. We have fine-tuned multimodal large models, specifically LLaVA, Qwen-VL, InternLM, with this dataset to enhance instruction-based performance. We conducted a qualitative assessment of the capabilities of the base model and the fine-tuned model in performing image captioning and classification tasks on the specific dataset. The evaluation results demonstrate that the fine-tuned model exhibits proficiency in addressing typical pathological questions. We hope that by making both our models and datasets publicly available, they can be valuable to the medical and research communities.

Multimodal Large Language Models (MLLMs) have advanced in integrating diverse modalities but frequently suffer from hallucination. A promising solution to mitigate this issue is to generate text with citations, providing a transparent chain for verification. However, existing work primarily focuses on generating citations for text-only content, overlooking the challenges and opportunities of multimodal contexts. To address this gap, we introduce MCiteBench, the first benchmark designed to evaluate and analyze the multimodal citation text generation ability of MLLMs. Our benchmark comprises data derived from academic papers and review-rebuttal interactions, featuring diverse information sources and multimodal content. We comprehensively evaluate models from multiple dimensions, including citation quality, source reliability, and answer accuracy. Through extensive experiments, we observe that MLLMs struggle with multimodal citation text generation. We also conduct deep analyses of models' performance, revealing that the bottleneck lies in attributing the correct sources rather than understanding the multimodal content.

This paper proposes a practical multimodal video summarization task setting and a dataset to train and evaluate the task. The target task involves summarizing a given video into a predefined number of keyframe-caption pairs and displaying them in a listable format to grasp the video content quickly. This task aims to extract crucial scenes from the video in the form of images (keyframes) and generate corresponding captions explaining each keyframe's situation. This task is useful as a practical application and presents a highly challenging problem worthy of study. Specifically, achieving simultaneous optimization of the keyframe selection performance and caption quality necessitates careful consideration of the mutual dependence on both preceding and subsequent keyframes and captions. To facilitate subsequent research in this field, we also construct a dataset by expanding upon existing datasets and propose an evaluation framework. Furthermore, we develop two baseline systems and report their respective performance.

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.

Creating new documents by synthesizing information from existing sources is an important part of knowledge work in many domains. This process often involves gathering content from multiple documents, organizing it, and then transforming it into new forms such as reports, slides, or spreadsheets. While recent advances in Generative AI have shown potential in automating parts of this process, they often provide limited user control over the handling of multimodal inputs and outputs. In this work, we introduce the notion of "infomorphs" which are modular, user-steerable, AI-augmented transformations that support controlled synthesis, and restructuring of information across formats and modalities. We propose a design space that leverage infomorph-driven workflows to enable flexible, interactive, and multimodal document creation by combining Generative AI techniques with user intent and desired information context. As a concrete instantiation of this design space, we present DocuCraft, a canvas-based interface to visually compose infomorph workflows. DocuCraft allows users to chain together infomorphs that perform operations such as page extraction, content summarization, reformatting, and generation, leveraging Generative AI at each stage to support rich, cross-document and cross-modal transformations. We demonstrate the capabilities of DocuCraft through an example-driven usage scenario that spans across different facets of common knowledge work tasks illustrating its support for fluid, human-in-the-loop document synthesis and highlights opportunities for more transparent and modular interaction for Generative AI-assisted information work.

Multimodal large language models (MLLMs) have achieved significant success in the general field of image processing. Their emerging task generalization and freeform conversational capabilities can greatly facilitate medical diagnostic assistance, helping patients better understand their conditions and enhancing doctor-patient trust. Computed Tomography (CT) is a non-invasive imaging technique used to capture the internal mechanisms of a patient's condition and is widely utilized. However, in past research, the complex textural features of this imaging data have made accurate interpretation by algorithms challenging, impeding the performance of general LLMs in diagnostic assistance. To address this, we developed OrthoDoc, a MLLM designed for CT diagnostics. OrthoDoc is trained on 120,000 CT images and diagnostic reports and includes a Retrieval-Augmented Generation (RAG) module capable of effectively mitigating model hallucinations. This module is informed by extensive medical literature, textbooks, and explanatory data. Thus, OrthoDoc not only processes complex CT images but also stores, understands, and reasons over medical knowledge and language. In extensive experiments, OrthoDoc outperforms commercial models led by GPT-4, demonstrating superior diagnostic capabilities and accuracy. Specifically, OrthoDoc significantly surpasses existing models in the diagnosis of common orthopedic conditions such as fractures, arthritis, and tumors. Additionally, OrthoDoc exhibits robust generalization and stability when handling rare and complex cases.

In order to better simulate the real human conversation process, models need to generate dialogue utterances based on not only preceding textual contexts but also visual contexts. However, with the development of multi-modal dialogue learning, the dataset scale gradually becomes a bottleneck. In this report, we release OpenViDial 2.0, a larger-scale open-domain multi-modal dialogue dataset compared to the previous version OpenViDial 1.0. OpenViDial 2.0 contains a total number of 5.6 million dialogue turns extracted from either movies or TV series from different resources, and each dialogue turn is paired with its corresponding visual context. We hope this large-scale dataset can help facilitate future researches on open-domain multi-modal dialog generation, e.g., multi-modal pretraining for dialogue generation.

This paper presents Step-Audio~2, an end-to-end multi-modal large language model designed for industry-strength audio understanding and speech conversation. By integrating a latent audio encoder and reasoning-centric reinforcement learning (RL), Step-Audio 2 achieves promising performance in automatic speech recognition (ASR) and audio understanding. To facilitate genuine end-to-end speech conversation, Step-Audio 2 incorporates the generation of discrete audio tokens into language modeling, significantly enhancing its responsiveness to paralinguistic information such as speaking styles and emotions. To effectively leverage the rich textual and acoustic knowledge in real-world data, Step-Audio 2 integrates retrieval-augmented generation (RAG) and is able to call external tools such as web search to mitigate hallucination and audio search to switch timbres. Trained on millions of hours of speech and audio data, Step-Audio 2 delivers intelligence and expressiveness across diverse conversational scenarios. Evaluation results demonstrate that Step-Audio 2 achieves state-of-the-art performance on various audio understanding and conversational benchmarks compared to other open-source and commercial solutions. Please visit https://github.com/stepfun-ai/Step-Audio2 for more information.

In this report, we present Qwen2.5-Omni, an end-to-end multimodal model designed to perceive diverse modalities, including text, images, audio, and video, while simultaneously generating text and natural speech responses in a streaming manner. To enable the streaming of multimodal information inputs, both audio and visual encoders utilize a block-wise processing approach. To synchronize the timestamps of video inputs with audio, we organize the audio and video sequentially in an interleaved manner and propose a novel position embedding approach, named TMRoPE(Time-aligned Multimodal RoPE). To concurrently generate text and speech while avoiding interference between the two modalities, we propose Thinker-Talker architecture. In this framework, Thinker functions as a large language model tasked with text generation, while Talker is a dual-track autoregressive model that directly utilizes the hidden representations from the Thinker to produce audio tokens as output. Both the Thinker and Talker models are designed to be trained and inferred in an end-to-end manner. For decoding audio tokens in a streaming manner, we introduce a sliding-window DiT that restricts the receptive field, aiming to reduce the initial package delay. Qwen2.5-Omni is comparable with the similarly sized Qwen2.5-VL and outperforms Qwen2-Audio. Furthermore, Qwen2.5-Omni achieves state-of-the-art performance on multimodal benchmarks like Omni-Bench. Notably, Qwen2.5-Omni's performance in end-to-end speech instruction following is comparable to its capabilities with text inputs, as evidenced by benchmarks such as MMLU and GSM8K. As for speech generation, Qwen2.5-Omni's streaming Talker outperforms most existing streaming and non-streaming alternatives in robustness and naturalness.

This paper explores the use of Large Language Models (LLMs) in the generation and evaluation of analytical reports derived from Earnings Calls (ECs). Addressing a current gap in research, we explore the generation of analytical reports with LLMs in a multi-agent framework, designing specialized agents that introduce diverse viewpoints and desirable topics of analysis into the report generation process. Through multiple analyses, we examine the alignment between generated and human-written reports and the impact of both individual and collective agents. Our findings suggest that the introduction of additional agents results in more insightful reports, although reports generated by human experts remain preferred in the majority of cases. Finally, we address the challenging issue of report evaluation, we examine the limitations and strengths of LLMs in assessing the quality of generated reports in different settings, revealing a significant correlation with human experts across multiple dimensions.

Large Language Models (LLMs) struggle with hallucinations and outdated knowledge due to their reliance on static training data. Retrieval-Augmented Generation (RAG) mitigates these issues by integrating external dynamic information enhancing factual and updated grounding. Recent advances in multimodal learning have led to the development of Multimodal RAG, incorporating multiple modalities such as text, images, audio, and video to enhance the generated outputs. However, cross-modal alignment and reasoning introduce unique challenges to Multimodal RAG, distinguishing it from traditional unimodal RAG. This survey offers a structured and comprehensive analysis of Multimodal RAG systems, covering datasets, metrics, benchmarks, evaluation, methodologies, and innovations in retrieval, fusion, augmentation, and generation. We precisely review training strategies, robustness enhancements, and loss functions, while also exploring the diverse Multimodal RAG scenarios. Furthermore, we discuss open challenges and future research directions to support advancements in this evolving field. This survey lays the foundation for developing more capable and reliable AI systems that effectively leverage multimodal dynamic external knowledge bases. Resources are available at https://github.com/llm-lab-org/Multimodal-RAG-Survey.

We present EasyGen, an efficient model designed to enhance multimodal understanding and generation by harnessing the capabilities of diffusion models and large language models (LLMs). Unlike existing multimodal models that predominately depend on encoders like CLIP or ImageBind and need ample amounts of training data to bridge the gap between modalities, EasyGen is built upon a bidirectional conditional diffusion model named BiDiffuser, which promotes more efficient interactions between modalities. EasyGen handles image-to-text generation by integrating BiDiffuser and an LLM via a simple projection layer. Unlike most existing multimodal models that are limited to generating text responses, EasyGen can also facilitate text-to-image generation by leveraging the LLM to create textual descriptions, which can be interpreted by BiDiffuser to generate appropriate visual responses. Extensive quantitative and qualitative experiments demonstrate the effectiveness of EasyGen, whose training can be easily achieved in a lab setting. The source code is available at https://github.com/zxy556677/EasyGen.

We propose a method to fuse frozen text-only large language models (LLMs) with pre-trained image encoder and decoder models, by mapping between their embedding spaces. Our model demonstrates a wide suite of multimodal capabilities: image retrieval, novel image generation, and multimodal dialogue. Ours is the first approach capable of conditioning on arbitrarily interleaved image and text inputs to generate coherent image (and text) outputs. To achieve strong performance on image generation, we propose an efficient mapping network to ground the LLM to an off-the-shelf text-to-image generation model. This mapping network translates hidden representations of text into the embedding space of the visual models, enabling us to leverage the strong text representations of the LLM for visual outputs. Our approach outperforms baseline generation models on tasks with longer and more complex language. In addition to novel image generation, our model is also capable of image retrieval from a prespecified dataset, and decides whether to retrieve or generate at inference time. This is done with a learnt decision module which conditions on the hidden representations of the LLM. Our model exhibits a wider range of capabilities compared to prior multimodal language models. It can process image-and-text inputs, and produce retrieved images, generated images, and generated text -- outperforming non-LLM based generation models across several text-to-image tasks that measure context dependence.

Large Language Models (LLMs) have demonstrated impressive capabilities in answering questions, but they lack domain-specific knowledge and are prone to hallucinations. Retrieval Augmented Generation (RAG) is one approach to address these challenges, while multimodal models are emerging as promising AI assistants for processing both text and images. In this paper we describe a series of experiments aimed at determining how to best integrate multimodal models into RAG systems for the industrial domain. The purpose of the experiments is to determine whether including images alongside text from documents within the industrial domain increases RAG performance and to find the optimal configuration for such a multimodal RAG system. Our experiments include two approaches for image processing and retrieval, as well as two LLMs (GPT4-Vision and LLaVA) for answer synthesis. These image processing strategies involve the use of multimodal embeddings and the generation of textual summaries from images. We evaluate our experiments with an LLM-as-a-Judge approach. Our results reveal that multimodal RAG can outperform single-modality RAG settings, although image retrieval poses a greater challenge than text retrieval. Additionally, leveraging textual summaries from images presents a more promising approach compared to the use of multimodal embeddings, providing more opportunities for future advancements.

Rapid advances in Multimodal Large Language Models (MLLMs) have expanded information retrieval beyond purely textual inputs, enabling retrieval from complex real world documents that combine text and visuals. However, most documents are private either owned by individuals or confined within corporate silos and current retrievers struggle when faced with unseen domains or languages. To address this gap, we introduce PREMIR, a simple yet effective framework that leverages the broad knowledge of an MLLM to generate cross modal pre questions (preQs) before retrieval. Unlike earlier multimodal retrievers that compare embeddings in a single vector space, PREMIR leverages preQs from multiple complementary modalities to expand the scope of matching to the token level. Experiments show that PREMIR achieves state of the art performance on out of distribution benchmarks, including closed domain and multilingual settings, outperforming strong baselines across all retrieval metrics. We confirm the contribution of each component through in depth ablation studies, and qualitative analyses of the generated preQs further highlight the model's robustness in real world settings.

Large Language Models (LLMs) have demonstrated exceptional text understanding. Existing works explore their application in text embedding tasks. However, there are few works utilizing LLMs to assist multimodal representation tasks. In this work, we investigate the potential of LLMs to enhance multimodal representation in multimodal item-to-item (I2I) recommendations. One feasible method is the transfer of Multimodal Large Language Models (MLLMs) for representation tasks. However, pre-training MLLMs usually requires collecting high-quality, web-scale multimodal data, resulting in complex training procedures and high costs. This leads the community to rely heavily on open-source MLLMs, hindering customized training for representation scenarios. Therefore, we aim to design an end-to-end training method that customizes the integration of any existing LLMs and vision encoders to construct efficient multimodal representation models. Preliminary experiments show that fine-tuned LLMs in this end-to-end method tend to overlook image content. To overcome this challenge, we propose a novel training framework, NoteLLM-2, specifically designed for multimodal representation. We propose two ways to enhance the focus on visual information. The first method is based on the prompt viewpoint, which separates multimodal content into visual content and textual content. NoteLLM-2 adopts the multimodal In-Content Learning method to teach LLMs to focus on both modalities and aggregate key information. The second method is from the model architecture, utilizing a late fusion mechanism to directly fuse visual information into textual information. Extensive experiments have been conducted to validate the effectiveness of our method.

Multimodal AI has the potential to significantly enhance document-understanding tasks, such as processing receipts, understanding workflows, extracting data from documents, and summarizing reports. Code generation tasks that require long-structured outputs can also be enhanced by multimodality. Despite this, their use in commercial applications is often limited due to limited access to training data and restrictive licensing, which hinders open access. To address these limitations, we introduce BigDocs-7.5M, a high-quality, open-access dataset comprising 7.5 million multimodal documents across 30 tasks. We use an efficient data curation process to ensure our data is high-quality and license-permissive. Our process emphasizes accountability, responsibility, and transparency through filtering rules, traceable metadata, and careful content analysis. Additionally, we introduce BigDocs-Bench, a benchmark suite with 10 novel tasks where we create datasets that reflect real-world use cases involving reasoning over Graphical User Interfaces (GUI) and code generation from images. Our experiments show that training with BigDocs-Bench improves average performance up to 25.8% over closed-source GPT-4o in document reasoning and structured output tasks such as Screenshot2HTML or Image2Latex generation. Finally, human evaluations showed a preference for outputs from models trained on BigDocs over GPT-4o. This suggests that BigDocs can help both academics and the open-source community utilize and improve AI tools to enhance multimodal capabilities and document reasoning. The project is hosted at https://bigdocs.github.io .

Large models have recently played a dominant role in natural language processing and multimodal vision-language learning. It remains less explored about their efficacy in text-related visual tasks. We conducted a comprehensive study of existing publicly available multimodal models, evaluating their performance in text recognition (document text, artistic text, handwritten text, scene text), text-based visual question answering (document text, scene text, and bilingual text), key information extraction (receipts, documents, and nutrition facts) and handwritten mathematical expression recognition. Our findings reveal strengths and weaknesses in these models, which primarily rely on semantic understanding for word recognition and exhibit inferior perception of individual character shapes. They also display indifference towards text length and have limited capabilities in detecting finegrained features in images. Consequently, these results demonstrate that even the current most powerful large multimodal models cannot match domain-specific methods in traditional text tasks and face greater challenges in more complex tasks. Most importantly, the baseline results showcased in this study could provide a foundational framework for the conception and assessment of innovative strategies targeted at enhancing zero-shot multimodal techniques. Evaluation pipeline is available at https://github.com/Yuliang-Liu/MultimodalOCR.

With the popularity of multimodal techniques, it receives growing interests to acquire useful information in visual forms. In this work, we formally define an emerging IR paradigm called Visualized Information Retrieval, or Vis-IR, where multimodal information, such as texts, images, tables and charts, is jointly represented by a unified visual format called Screenshots, for various retrieval applications. We further make three key contributions for Vis-IR. First, we create VIRA (Vis-IR Aggregation), a large-scale dataset comprising a vast collection of screenshots from diverse sources, carefully curated into captioned and question-answer formats. Second, we develop UniSE (Universal Screenshot Embeddings), a family of retrieval models that enable screenshots to query or be queried across arbitrary data modalities. Finally, we construct MVRB (Massive Visualized IR Benchmark), a comprehensive benchmark covering a variety of task forms and application scenarios. Through extensive evaluations on MVRB, we highlight the deficiency from existing multimodal retrievers and the substantial improvements made by UniSE. Our work will be shared with the community, laying a solid foundation for this emerging field.

The rapid development of Artificial Intelligence (AI) has revolutionized numerous fields, with large language models (LLMs) and computer vision (CV) systems driving advancements in natural language understanding and visual processing, respectively. The convergence of these technologies has catalyzed the rise of multimodal AI, enabling richer, cross-modal understanding that spans text, vision, audio, and video modalities. Multimodal large language models (MLLMs), in particular, have emerged as a powerful framework, demonstrating impressive capabilities in tasks like image-text generation, visual question answering, and cross-modal retrieval. Despite these advancements, the complexity and scale of MLLMs introduce significant challenges in interpretability and explainability, essential for establishing transparency, trustworthiness, and reliability in high-stakes applications. This paper provides a comprehensive survey on the interpretability and explainability of MLLMs, proposing a novel framework that categorizes existing research across three perspectives: (I) Data, (II) Model, (III) Training \& Inference. We systematically analyze interpretability from token-level to embedding-level representations, assess approaches related to both architecture analysis and design, and explore training and inference strategies that enhance transparency. By comparing various methodologies, we identify their strengths and limitations and propose future research directions to address unresolved challenges in multimodal explainability. This survey offers a foundational resource for advancing interpretability and transparency in MLLMs, guiding researchers and practitioners toward developing more accountable and robust multimodal AI systems.

Existing benchmarks for multimodal agentic search evaluate multimodal search and visual browsing, but visual evidence is either confined to the input or treated as an answer endpoint rather than part of an interleaved search trajectory. We introduce InterLV-Search, a benchmark for Interleaved Language-Vision Agentic Search, in which textual and visual evidence is repeatedly used to condition later search. It contains 2,061 examples across three levels: active visual evidence seeking, controlled offline interleaved multimodal search, and open-web interleaved multimodal search. Beyond existing benchmarks, it also includes multimodal multi-branch samples that involve comparison between multiple entities during the evidence search. We construct Level 1 and Level 2 with automated pipelines and Level 3 with a machine-led, human-supervised open-web pipeline. We further provide InterLV-Agent for standardized tool use, trajectory logging, and evaluation. Experiments on proprietary and open-source multimodal agents show that current systems remain far from solving interleaved multimodal search, with the best model below 50% overall accuracy, highlighting challenges in visual evidence seeking, search control, and multimodal evidence integration. We release the benchmark data and evaluation code at https://github.com/hbhalpha/InterLV-Search-Bench