Daily Papers

Multi-task learning (MTL) compresses the information from multiple tasks into a unified backbone to improve computational efficiency and generalization. Recent work directly merges multiple independently trained models to perform MTL instead of collecting their raw data for joint training, greatly expanding the application scenarios of MTL. However, by visualizing the representation distribution of existing model merging schemes, we find that the merged model often suffers from the dilemma of representation bias. That is, there is a significant discrepancy in the representation distribution between the merged and individual models, resulting in poor performance of merged MTL. In this paper, we propose a representation surgery solution called "Surgery" to reduce representation bias in the merged model. Specifically, Surgery is a lightweight task-specific module that takes the representation of the merged model as input and attempts to output the biases contained in the representation from the merged model. We then designed an unsupervised optimization objective that updates the Surgery module by minimizing the distance between the merged model's representation and the individual model's representation. Extensive experiments demonstrate significant MTL performance improvements when our Surgery module is applied to state-of-the-art (SOTA) model merging schemes.

Language models often exhibit undesirable behavior, e.g., generating toxic or gender-biased text. In the case of neural language models, an encoding of the undesirable behavior is often present in the model's representations. Thus, one natural (and common) approach to prevent the model from exhibiting undesirable behavior is to steer the model's representations in a manner that reduces the probability of it generating undesirable text. This paper investigates the formal and empirical properties of steering functions, i.e., transformation of the neural language model's representations that alter its behavior. First, we derive two optimal, in the least-squares sense, affine steering functions under different constraints. Our theory provides justification for existing approaches and offers a novel, improved steering approach. Second, we offer a series of experiments that demonstrate the empirical effectiveness of the methods in mitigating bias and reducing toxic generation.

Interventions targeting the representation space of language models (LMs) have emerged as an effective means to influence model behavior. Such methods are employed, for example, to eliminate or alter the encoding of demographic information such as gender within the model's representations and, in so doing, create a counterfactual representation. However, because the intervention operates within the representation space, understanding precisely what aspects of the text it modifies poses a challenge. In this paper, we give a method to convert representation counterfactuals into string counterfactuals. We demonstrate that this approach enables us to analyze the linguistic alterations corresponding to a given representation space intervention and to interpret the features utilized to encode a specific concept. Moreover, the resulting counterfactuals can be used to mitigate bias in classification through data augmentation.

Understanding and manipulating the causal generation mechanisms in language models is essential for controlling their behavior. Previous work has primarily relied on techniques such as representation surgery -- e.g., model ablations or manipulation of linear subspaces tied to specific concepts -- to intervene on these models. To understand the impact of interventions precisely, it is useful to examine counterfactuals -- e.g., how a given sentence would have appeared had it been generated by the model following a specific intervention. We highlight that counterfactual reasoning is conceptually distinct from interventions, as articulated in Pearl's causal hierarchy. Based on this observation, we propose a framework for generating true string counterfactuals by reformulating language models as Generalized Structural-equation. Models using the Gumbel-max trick. This allows us to model the joint distribution over original strings and their counterfactuals resulting from the same instantiation of the sampling noise. We develop an algorithm based on hindsight Gumbel sampling that allows us to infer the latent noise variables and generate counterfactuals of observed strings. Our experiments demonstrate that the approach produces meaningful counterfactuals while at the same time showing that commonly used intervention techniques have considerable undesired side effects.

Large Language Models (LLMs) have demonstrated remarkable generalization capabilities across tasks and languages, revolutionizing natural language processing. This paper investigates the naturally emerging representation alignment in LLMs, particularly in the middle layers, and its implications for disentangling language-specific and language-agnostic information. We empirically confirm the existence of this alignment, analyze its behavior in comparison to explicitly designed alignment models, and demonstrate its potential for language-specific manipulation without semantic degradation. Building on these findings, we propose Inference-Time Language Control (ITLC), a novel method that leverages latent injection to enable precise cross-lingual language control and mitigate language confusion in LLMs. Our experiments highlight ITLC's strong cross-lingual control capabilities while preserving semantic integrity in target languages. Furthermore, we demonstrate its effectiveness in alleviating the cross-lingual language confusion problem, which persists even in current large-scale LLMs, leading to inconsistent language generation. This work advances our understanding of representation alignment in LLMs and introduces a practical solution for enhancing their cross-lingual performance.

Vision-language pre-training (VLP) offers unique advantages for surgery by aligning language with surgical videos, enabling workflow understanding and transfer across tasks without relying on expert-labeled datasets. However, progress in surgical VLP remains constrained by the limited scale, procedural diversity, semantic quality, and hierarchical structure of existing datasets. In this work, we present SurgLaVi, the largest and most diverse surgical vision-language dataset to date, comprising nearly 240k clip-caption pairs from more than 200 procedures, and comprising hierarchical levels at phase-, step-, and task-level. At the core of SurgLaVi lies a fully automated pipeline that systematically generates fine-grained transcriptions of surgical videos and segments them into coherent procedural units. To ensure high-quality annotations, it applies dual-modality filtering to remove irrelevant and noisy samples. Within this framework, the resulting captions are enriched with contextual detail, producing annotations that are both semantically rich and easy to interpret. To ensure accessibility, we release SurgLaVi-eta, an open-source derivative of 113k clip-caption pairs constructed entirely from public data, which is over four times larger than existing surgical VLP datasets. To demonstrate the value of SurgLaVi datasets, we introduce SurgCLIP, a CLIP-style video-text contrastive framework with dual encoders, as a representative base model. SurgCLIP achieves consistent improvements across phase, step, action, and tool recognition, surpassing prior state-of-the-art methods, often by large margins. These results validate that large-scale, semantically rich, and hierarchically structured datasets directly translate into stronger and more generalizable representations, establishing SurgLaVi as a key resource for developing surgical foundation models.

Self-supervised learning (SSL) has potential for effective representation learning in medical imaging, but the choice of data augmentation is critical and domain-specific. It remains uncertain if general augmentation policies suit surgical applications. In this work, we automate the search for suitable augmentation policies through a new method called Dimensionality Driven Augmentation Search (DDA). DDA leverages the local dimensionality of deep representations as a proxy target, and differentiably searches for suitable data augmentation policies in contrastive learning. We demonstrate the effectiveness and efficiency of DDA in navigating a large search space and successfully identifying an appropriate data augmentation policy for laparoscopic surgery. We systematically evaluate DDA across three laparoscopic image classification and segmentation tasks, where it significantly improves over existing baselines. Furthermore, DDA's optimised set of augmentations provides insight into domain-specific dependencies when applying contrastive learning in medical applications. For example, while hue is an effective augmentation for natural images, it is not advantageous for laparoscopic images.

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

Understanding the workflow of surgical procedures in complex operating rooms requires a deep understanding of the interactions between clinicians and their environment. Surgical activity recognition (SAR) is a key computer vision task that detects activities or phases from multi-view camera recordings. Existing SAR models often fail to account for fine-grained clinician movements and multi-view knowledge, or they require calibrated multi-view camera setups and advanced point-cloud processing to obtain better results. In this work, we propose a novel calibration-free multi-view multi-modal pretraining framework called Multiview Pretraining for Video-Pose Surgical Activity Recognition PreViPS, which aligns 2D pose and vision embeddings across camera views. Our model follows CLIP-style dual-encoder architecture: one encoder processes visual features, while the other encodes human pose embeddings. To handle the continuous 2D human pose coordinates, we introduce a tokenized discrete representation to convert the continuous 2D pose coordinates into discrete pose embeddings, thereby enabling efficient integration within the dual-encoder framework. To bridge the gap between these two modalities, we propose several pretraining objectives using cross- and in-modality geometric constraints within the embedding space and incorporating masked pose token prediction strategy to enhance representation learning. Extensive experiments and ablation studies demonstrate improvements over the strong baselines, while data-efficiency experiments on two distinct operating room datasets further highlight the effectiveness of our approach. We highlight the benefits of our approach for surgical activity recognition in both multi-view and single-view settings, showcasing its practical applicability in complex surgical environments. Code will be made available at: https://github.com/CAMMA-public/PreViPS.

Dynamic reconstruction of deformable tissues in endoscopic video is a key technology for robot-assisted surgery. Recent reconstruction methods based on neural radiance fields (NeRFs) have achieved remarkable results in the reconstruction of surgical scenes. However, based on implicit representation, NeRFs struggle to capture the intricate details of objects in the scene and cannot achieve real-time rendering. In addition, restricted single view perception and occluded instruments also propose special challenges in surgical scene reconstruction. To address these issues, we develop SurgicalGaussian, a deformable 3D Gaussian Splatting method to model dynamic surgical scenes. Our approach models the spatio-temporal features of soft tissues at each time stamp via a forward-mapping deformation MLP and regularization to constrain local 3D Gaussians to comply with consistent movement. With the depth initialization strategy and tool mask-guided training, our method can remove surgical instruments and reconstruct high-fidelity surgical scenes. Through experiments on various surgical videos, our network outperforms existing method on many aspects, including rendering quality, rendering speed and GPU usage. The project page can be found at https://surgicalgaussian.github.io.

In this paper, we propose a novel text promptable surgical instrument segmentation approach to overcome challenges associated with diversity and differentiation of surgical instruments in minimally invasive surgeries. We redefine the task as text promptable, thereby enabling a more nuanced comprehension of surgical instruments and adaptability to new instrument types. Inspired by recent advancements in vision-language models, we leverage pretrained image and text encoders as our model backbone and design a text promptable mask decoder consisting of attention- and convolution-based prompting schemes for surgical instrument segmentation prediction. Our model leverages multiple text prompts for each surgical instrument through a new mixture of prompts mechanism, resulting in enhanced segmentation performance. Additionally, we introduce a hard instrument area reinforcement module to improve image feature comprehension and segmentation precision. Extensive experiments on EndoVis2017 and EndoVis2018 datasets demonstrate our model's superior performance and promising generalization capability. To our knowledge, this is the first implementation of a promptable approach to surgical instrument segmentation, offering significant potential for practical application in the field of robotic-assisted surgery.

Natural language could play an important role in developing generalist surgical models by providing a broad source of supervision from raw texts. This flexible form of supervision can enable the model's transferability across datasets and tasks as natural language can be used to reference learned visual concepts or describe new ones. In this work, we present HecVL, a novel hierarchical video-language pretraining approach for building a generalist surgical model. Specifically, we construct a hierarchical video-text paired dataset by pairing the surgical lecture video with three hierarchical levels of texts: at clip-level, atomic actions using transcribed audio texts; at phase-level, conceptual text summaries; and at video-level, overall abstract text of the surgical procedure. Then, we propose a novel fine-to-coarse contrastive learning framework that learns separate embedding spaces for the three video-text hierarchies using a single model. By disentangling embedding spaces of different hierarchical levels, the learned multi-modal representations encode short-term and long-term surgical concepts in the same model. Thanks to the injected textual semantics, we demonstrate that the HecVL approach can enable zero-shot surgical phase recognition without any human annotation. Furthermore, we show that the same HecVL model for surgical phase recognition can be transferred across different surgical procedures and medical centers. The code is available at https://github.com/CAMMA-public/SurgVLP

We investigate how both the adaptation of a generic foundation model via transfer learning and the integration of complementary modalities from the operating room (OR) can support surgical data science. To this end, we use V-JEPA as the single-modality foundation of a multimodal model for minimally invasive surgery support. We analyze how the model's downstream performance can benefit (a) from finetuning on unlabeled surgical video data and (b) from providing additional time-resolved data streams from the OR in a multimodal setup. In an in-house dataset of liver surgery videos, we analyze the tasks of predicting hospital length of stay and postoperative complications. In videos of the public HeiCo dataset, we analyze the task of surgical phase recognition. As a baseline, we apply pretrained V-JEPA to all tasks. We then finetune it on unlabeled, held-out videos to investigate its change in performance after domain adaptation. Following the idea of modular decision support networks, we integrate additional data streams from the OR by training a separate encoder to form a shared representation space with V-JEPA's embeddings. Our experiments show that finetuning on domain-specific data increases model performance. On the in-house data, integrating additional time-resolved data likewise benefits the model. On the HeiCo data, accuracy of the pretrained video-only, single-modality baseline setup is on par with the top-performing submissions of the EndoVis2017 challenge, while finetuning on domain-specific data increases accuracy further. Our results thus demonstrate how surgical data science can leverage public, generic foundation models. Likewise, they indicate the potential of domain adaptation and of integrating suitable complementary data streams from the OR. To support further research, we release our code and model weights at https://github.com/DigitalSurgeryLab-Basel/ML-CDS-2025.

Current volumetric biomedical foundation models struggle to generalize as public 3D datasets are small and do not cover the broad diversity of medical procedures, conditions, anatomical regions, and imaging protocols. We address this by creating a representation learning method that instead anticipates strong domain shifts at training time itself. We first propose a data engine that synthesizes highly variable training samples that would enable generalization to new biomedical contexts. To then train a single 3D network for any voxel-level task, we develop a contrastive learning method that pretrains the network to be stable against nuisance imaging variation simulated by the data engine, a key inductive bias for generalization. This network's features can be used as robust representations of input images for downstream tasks and its weights provide a strong, dataset-agnostic initialization for finetuning on new datasets. As a result, we set new standards across both multimodality registration and few-shot segmentation, a first for any 3D biomedical vision model, all without (pre-)training on any existing dataset of real images.

Contrastive learning based vision-language joint pre-training has emerged as a successful representation learning strategy. In this paper, we present a prototype representation learning framework incorporating both global and local alignment between medical images and reports. In contrast to standard global multi-modality alignment methods, we employ a local alignment module for fine-grained representation. Furthermore, a cross-modality conditional reconstruction module is designed to interchange information across modalities in the training phase by reconstructing masked images and reports. For reconstructing long reports, a sentence-wise prototype memory bank is constructed, enabling the network to focus on low-level localized visual and high-level clinical linguistic features. Additionally, a non-auto-regressive generation paradigm is proposed for reconstructing non-sequential reports. Experimental results on five downstream tasks, including supervised classification, zero-shot classification, image-to-text retrieval, semantic segmentation, and object detection, show the proposed method outperforms other state-of-the-art methods across multiple datasets and under different dataset size settings. The code is available at https://github.com/QtacierP/PRIOR.

The lack of labeled datasets in 3D vision for surgical scenes inhibits the development of robust 3D reconstruction algorithms in the medical domain. Despite the popularity of Neural Radiance Fields and 3D Gaussian Splatting in the general computer vision community, these systems have yet to find consistent success in surgical scenes due to challenges such as non-stationary lighting and non-Lambertian surfaces. As a result, the need for labeled surgical datasets continues to grow. In this work, we introduce a differentiable rendering framework for material and lighting estimation from endoscopic images and known geometry. Compared to previous approaches that model lighting and material jointly as radiance, we explicitly disentangle these scene properties for robust and photorealistic novel view synthesis. To disambiguate the training process, we formulate domain-specific properties inherent in surgical scenes. Specifically, we model the scene lighting as a simple spotlight and material properties as a bidirectional reflectance distribution function, parameterized by a neural network. By grounding color predictions in the rendering equation, we can generate photorealistic images at arbitrary camera poses. We evaluate our method with various sequences from the Colonoscopy 3D Video Dataset and show that our method produces competitive novel view synthesis results compared with other approaches. Furthermore, we demonstrate that synthetic data can be used to develop 3D vision algorithms by finetuning a depth estimation model with our rendered outputs. Overall, we see that the depth estimation performance is on par with fine-tuning with the original real images.

Purpose: Surgical video is an important data stream for gesture recognition. Thus, robust visual encoders for those data-streams is similarly important. Methods: Leveraging the Bridge-Prompt framework, we fine-tune a pre-trained vision-text model (CLIP) for gesture recognition in surgical videos. This can utilize extensive outside video data such as text, but also make use of label meta-data and weakly supervised contrastive losses. Results: Our experiments show that prompt-based video encoder outperforms standard encoders in surgical gesture recognition tasks. Notably, it displays strong performance in zero-shot scenarios, where gestures/tasks that were not provided during the encoder training phase are included in the prediction phase. Additionally, we measure the benefit of inclusion text descriptions in the feature extractor training schema. Conclusion: Bridge-Prompt and similar pre-trained+fine-tuned video encoder models present significant visual representation for surgical robotics, especially in gesture recognition tasks. Given the diverse range of surgical tasks (gestures), the ability of these models to zero-shot transfer without the need for any task (gesture) specific retraining makes them invaluable.

Learned representations are a central component in modern ML systems, serving a multitude of downstream tasks. When training such representations, it is often the case that computational and statistical constraints for each downstream task are unknown. In this context rigid, fixed capacity representations can be either over or under-accommodating to the task at hand. This leads us to ask: can we design a flexible representation that can adapt to multiple downstream tasks with varying computational resources? Our main contribution is Matryoshka Representation Learning (MRL) which encodes information at different granularities and allows a single embedding to adapt to the computational constraints of downstream tasks. MRL minimally modifies existing representation learning pipelines and imposes no additional cost during inference and deployment. MRL learns coarse-to-fine representations that are at least as accurate and rich as independently trained low-dimensional representations. The flexibility within the learned Matryoshka Representations offer: (a) up to 14x smaller embedding size for ImageNet-1K classification at the same level of accuracy; (b) up to 14x real-world speed-ups for large-scale retrieval on ImageNet-1K and 4K; and (c) up to 2% accuracy improvements for long-tail few-shot classification, all while being as robust as the original representations. Finally, we show that MRL extends seamlessly to web-scale datasets (ImageNet, JFT) across various modalities -- vision (ViT, ResNet), vision + language (ALIGN) and language (BERT). MRL code and pretrained models are open-sourced at https://github.com/RAIVNLab/MRL.

The field of computer vision applied to videos of minimally invasive surgery is ever-growing. Workflow recognition pertains to the automated recognition of various aspects of a surgery: including which surgical steps are performed; and which surgical instruments are used. This information can later be used to assist clinicians when learning the surgery; during live surgery; and when writing operation notes. The Pituitary Vision (PitVis) 2023 Challenge tasks the community to step and instrument recognition in videos of endoscopic pituitary surgery. This is a unique task when compared to other minimally invasive surgeries due to the smaller working space, which limits and distorts vision; and higher frequency of instrument and step switching, which requires more precise model predictions. Participants were provided with 25-videos, with results presented at the MICCAI-2023 conference as part of the Endoscopic Vision 2023 Challenge in Vancouver, Canada, on 08-Oct-2023. There were 18-submissions from 9-teams across 6-countries, using a variety of deep learning models. A commonality between the top performing models was incorporating spatio-temporal and multi-task methods, with greater than 50% and 10% macro-F1-score improvement over purely spacial single-task models in step and instrument recognition respectively. The PitVis-2023 Challenge therefore demonstrates state-of-the-art computer vision models in minimally invasive surgery are transferable to a new dataset, with surgery specific techniques used to enhance performance, progressing the field further. Benchmark results are provided in the paper, and the dataset is publicly available at: https://doi.org/10.5522/04/26531686.

Every day, countless surgeries are performed worldwide, each within the distinct settings of operating rooms (ORs) that vary not only in their setups but also in the personnel, tools, and equipment used. This inherent diversity poses a substantial challenge for achieving a holistic understanding of the OR, as it requires models to generalize beyond their initial training datasets. To reduce this gap, we introduce ORacle, an advanced vision-language model designed for holistic OR domain modeling, which incorporates multi-view and temporal capabilities and can leverage external knowledge during inference, enabling it to adapt to previously unseen surgical scenarios. This capability is further enhanced by our novel data augmentation framework, which significantly diversifies the training dataset, ensuring ORacle's proficiency in applying the provided knowledge effectively. In rigorous testing, in scene graph generation, and downstream tasks on the 4D-OR dataset, ORacle not only demonstrates state-of-the-art performance but does so requiring less data than existing models. Furthermore, its adaptability is displayed through its ability to interpret unseen views, actions, and appearances of tools and equipment. This demonstrates ORacle's potential to significantly enhance the scalability and affordability of OR domain modeling and opens a pathway for future advancements in surgical data science. We will release our code and data upon acceptance.

Representation learning promises to unlock deep learning for the long tail of vision tasks without expensive labelled datasets. Yet, the absence of a unified evaluation for general visual representations hinders progress. Popular protocols are often too constrained (linear classification), limited in diversity (ImageNet, CIFAR, Pascal-VOC), or only weakly related to representation quality (ELBO, reconstruction error). We present the Visual Task Adaptation Benchmark (VTAB), which defines good representations as those that adapt to diverse, unseen tasks with few examples. With VTAB, we conduct a large-scale study of many popular publicly-available representation learning algorithms. We carefully control confounders such as architecture and tuning budget. We address questions like: How effective are ImageNet representations beyond standard natural datasets? How do representations trained via generative and discriminative models compare? To what extent can self-supervision replace labels? And, how close are we to general visual representations?

The rising importance of 3D representation learning, pivotal in computer vision, autonomous driving, and robotics, is evident. However, a prevailing trend, which straightforwardly resorted to transferring 2D alignment strategies to the 3D domain, encounters three distinct challenges: (1) Information Degradation: This arises from the alignment of 3D data with mere single-view 2D images and generic texts, neglecting the need for multi-view images and detailed subcategory texts. (2) Insufficient Synergy: These strategies align 3D representations to image and text features individually, hampering the overall optimization for 3D models. (3) Underutilization: The fine-grained information inherent in the learned representations is often not fully exploited, indicating a potential loss in detail. To address these issues, we introduce JM3D, a comprehensive approach integrating point cloud, text, and image. Key contributions include the Structured Multimodal Organizer (SMO), enriching vision-language representation with multiple views and hierarchical text, and the Joint Multi-modal Alignment (JMA), combining language understanding with visual representation. Our advanced model, JM3D-LLM, marries 3D representation with large language models via efficient fine-tuning. Evaluations on ModelNet40 and ScanObjectNN establish JM3D's superiority. The superior performance of JM3D-LLM further underscores the effectiveness of our representation transfer approach. Our code and models are available at https://github.com/Mr-Neko/JM3D.

Semi-supervised learning relaxes the need of large pixel-wise labeled datasets for image segmentation by leveraging unlabeled data. A prominent way to exploit unlabeled data is to regularize model predictions. Since the predictions of unlabeled data can be unreliable, uncertainty-aware schemes are typically employed to gradually learn from meaningful and reliable predictions. Uncertainty estimation methods, however, rely on multiple inferences from the model predictions that must be computed for each training step, which is computationally expensive. Moreover, these uncertainty maps capture pixel-wise disparities and do not consider global information. This work proposes a novel method to estimate segmentation uncertainty by leveraging global information from the segmentation masks. More precisely, an anatomically-aware representation is first learnt to model the available segmentation masks. The learnt representation thereupon maps the prediction of a new segmentation into an anatomically-plausible segmentation. The deviation from the plausible segmentation aids in estimating the underlying pixel-level uncertainty in order to further guide the segmentation network. The proposed method consequently estimates the uncertainty using a single inference from our representation, thereby reducing the total computation. We evaluate our method on two publicly available segmentation datasets of left atria in cardiac MRIs and of multiple organs in abdominal CTs. Our anatomically-aware method improves the segmentation accuracy over the state-of-the-art semi-supervised methods in terms of two commonly used evaluation metrics.

Purpose: General consensus amongst researchers and industry points to a lack of large, representative annotated datasets as the biggest obstacle to progress in the field of surgical data science. Self-supervised learning represents a solution to part of this problem, removing the reliance on annotations. However, the robustness of current self-supervised learning methods to domain shifts remains unclear, limiting our understanding of its utility for leveraging diverse sources of surgical data. Methods: In this work, we employ self-supervised learning to flexibly leverage diverse surgical datasets, thereby learning taskagnostic representations that can be used for various surgical downstream tasks. Based on this approach, to elucidate the impact of pre-training on downstream task performance, we explore 22 different pre-training dataset combinations by modulating three variables: source hospital, type of surgical procedure, and pre-training scale (number of videos). We then finetune the resulting model initializations on three diverse downstream tasks: namely, phase recognition and critical view of safety in laparoscopic cholecystectomy and phase recognition in laparoscopic hysterectomy. Results: Controlled experimentation highlights sizable boosts in performance across various tasks, datasets, and labeling budgets. However, this performance is intricately linked to the composition of the pre-training dataset, robustly proven through several study stages. Conclusion: The composition of pre-training datasets can severely affect the effectiveness of SSL methods for various downstream tasks and should critically inform future data collection efforts to scale the application of SSL methodologies. Keywords: Self-Supervised Learning, Transfer Learning, Surgical Computer Vision, Endoscopic Videos, Critical View of Safety, Phase Recognition

Well structured visual representations can make robot learning faster and can improve generalization. In this paper, we study how we can acquire effective object-centric representations for robotic manipulation tasks without human labeling by using autonomous robot interaction with the environment. Such representation learning methods can benefit from continuous refinement of the representation as the robot collects more experience, allowing them to scale effectively without human intervention. Our representation learning approach is based on object persistence: when a robot removes an object from a scene, the representation of that scene should change according to the features of the object that was removed. We formulate an arithmetic relationship between feature vectors from this observation, and use it to learn a representation of scenes and objects that can then be used to identify object instances, localize them in the scene, and perform goal-directed grasping tasks where the robot must retrieve commanded objects from a bin. The same grasping procedure can also be used to automatically collect training data for our method, by recording images of scenes, grasping and removing an object, and recording the outcome. Our experiments demonstrate that this self-supervised approach for tasked grasping substantially outperforms direct reinforcement learning from images and prior representation learning methods.

Surgical scene segmentation is critical in computer-assisted surgery and is vital for enhancing surgical quality and patient outcomes. Recently, referring surgical segmentation is emerging, given its advantage of providing surgeons with an interactive experience to segment the target object. However, existing methods are limited by low efficiency and short-term tracking, hindering their applicability in complex real-world surgical scenarios. In this paper, we introduce ReSurgSAM2, a two-stage surgical referring segmentation framework that leverages Segment Anything Model 2 to perform text-referred target detection, followed by tracking with reliable initial frame identification and diversity-driven long-term memory. For the detection stage, we propose a cross-modal spatial-temporal Mamba to generate precise detection and segmentation results. Based on these results, our credible initial frame selection strategy identifies the reliable frame for the subsequent tracking. Upon selecting the initial frame, our method transitions to the tracking stage, where it incorporates a diversity-driven memory mechanism that maintains a credible and diverse memory bank, ensuring consistent long-term tracking. Extensive experiments demonstrate that ReSurgSAM2 achieves substantial improvements in accuracy and efficiency compared to existing methods, operating in real-time at 61.2 FPS. Our code and datasets will be available at https://github.com/jinlab-imvr/ReSurgSAM2.

Sequence modeling plays a vital role across various domains, with recurrent neural networks being historically the predominant method of performing these tasks. However, the emergence of transformers has altered this paradigm due to their superior performance. Built upon these advances, transformers have conjoined CNNs as two leading foundational models for learning visual representations. However, transformers are hindered by the O(N^2) complexity of their attention mechanisms, while CNNs lack global receptive fields and dynamic weight allocation. State Space Models (SSMs), specifically the \textbf{Mamba} model with selection mechanisms and hardware-aware architecture, have garnered immense interest lately in sequential modeling and visual representation learning, challenging the dominance of transformers by providing infinite context lengths and offering substantial efficiency maintaining linear complexity in the input sequence. Capitalizing on the advances in computer vision, medical imaging has heralded a new epoch with Mamba models. Intending to help researchers navigate the surge, this survey seeks to offer an encyclopedic review of Mamba models in medical imaging. Specifically, we start with a comprehensive theoretical review forming the basis of SSMs, including Mamba architecture and its alternatives for sequence modeling paradigms in this context. Next, we offer a structured classification of Mamba models in the medical field and introduce a diverse categorization scheme based on their application, imaging modalities, and targeted organs. Finally, we summarize key challenges, discuss different future research directions of the SSMs in the medical domain, and propose several directions to fulfill the demands of this field. In addition, we have compiled the studies discussed in this paper along with their open-source implementations on our GitHub repository.

Representation learning, and interpreting learned representations, are key areas of focus in machine learning and neuroscience. Both fields generally use representations as a means to understand or improve a system's computations. In this work, however, we explore surprising dissociations between representation and computation that may pose challenges for such efforts. We create datasets in which we attempt to match the computational role that different features play, while manipulating other properties of the features or the data. We train various deep learning architectures to compute these multiple abstract features about their inputs. We find that their learned feature representations are systematically biased towards representing some features more strongly than others, depending upon extraneous properties such as feature complexity, the order in which features are learned, and the distribution of features over the inputs. For example, features that are simpler to compute or learned first tend to be represented more strongly and densely than features that are more complex or learned later, even if all features are learned equally well. We also explore how these biases are affected by architectures, optimizers, and training regimes (e.g., in transformers, features decoded earlier in the output sequence also tend to be represented more strongly). Our results help to characterize the inductive biases of gradient-based representation learning. These results also highlight a key challenge for interpretability - or for comparing the representations of models and brains - disentangling extraneous biases from the computationally important aspects of a system's internal representations.

Learning representations in the joint domain of vision and touch can improve manipulation dexterity, robustness, and sample-complexity by exploiting mutual information and complementary cues. Here, we present Visuo-Tactile Transformers (VTTs), a novel multimodal representation learning approach suited for model-based reinforcement learning and planning. Our approach extends the Visual Transformer dosovitskiy2021image to handle visuo-tactile feedback. Specifically, VTT uses tactile feedback together with self and cross-modal attention to build latent heatmap representations that focus attention on important task features in the visual domain. We demonstrate the efficacy of VTT for representation learning with a comparative evaluation against baselines on four simulated robot tasks and one real world block pushing task. We conduct an ablation study over the components of VTT to highlight the importance of cross-modality in representation learning.

In this paper, we introduce SPA, a novel representation learning framework that emphasizes the importance of 3D spatial awareness in embodied AI. Our approach leverages differentiable neural rendering on multi-view images to endow a vanilla Vision Transformer (ViT) with intrinsic spatial understanding. We present the most comprehensive evaluation of embodied representation learning to date, covering 268 tasks across 8 simulators with diverse policies in both single-task and language-conditioned multi-task scenarios. The results are compelling: SPA consistently outperforms more than 10 state-of-the-art representation methods, including those specifically designed for embodied AI, vision-centric tasks, and multi-modal applications, while using less training data. Furthermore, we conduct a series of real-world experiments to confirm its effectiveness in practical scenarios. These results highlight the critical role of 3D spatial awareness for embodied representation learning. Our strongest model takes more than 6000 GPU hours to train and we are committed to open-sourcing all code and model weights to foster future research in embodied representation learning. Project Page: https://haoyizhu.github.io/spa/.

Surgical practice involves complex visual interpretation, procedural skills, and advanced medical knowledge, making surgical vision-language pretraining (VLP) particularly challenging due to this complexity and the limited availability of annotated data. To address the gap, we propose OphCLIP, a hierarchical retrieval-augmented vision-language pretraining framework specifically designed for ophthalmic surgical workflow understanding. OphCLIP leverages the OphVL dataset we constructed, a large-scale and comprehensive collection of over 375K hierarchically structured video-text pairs with tens of thousands of different combinations of attributes (surgeries, phases/operations/actions, instruments, medications, as well as more advanced aspects like the causes of eye diseases, surgical objectives, and postoperative recovery recommendations, etc). These hierarchical video-text correspondences enable OphCLIP to learn both fine-grained and long-term visual representations by aligning short video clips with detailed narrative descriptions and full videos with structured titles, capturing intricate surgical details and high-level procedural insights, respectively. Our OphCLIP also designs a retrieval-augmented pretraining framework to leverage the underexplored large-scale silent surgical procedure videos, automatically retrieving semantically relevant content to enhance the representation learning of narrative videos. Evaluation across 11 datasets for phase recognition and multi-instrument identification shows OphCLIP's robust generalization and superior performance.

Medical image registration is a critical task that estimates the spatial correspondence between pairs of images. However, current traditional and deep-learning-based methods rely on similarity measures to generate a deforming field, which often results in disproportionate volume changes in dissimilar regions, especially in tumor regions. These changes can significantly alter the tumor size and underlying anatomy, which limits the practical use of image registration in clinical diagnosis. To address this issue, we have formulated image registration with tumors as a constraint problem that preserves tumor volumes while maximizing image similarity in other normal regions. Our proposed strategy involves a two-stage process. In the first stage, we use similarity-based registration to identify potential tumor regions by their volume change, generating a soft tumor mask accordingly. In the second stage, we propose a volume-preserving registration with a novel adaptive volume-preserving loss that penalizes the change in size adaptively based on the masks calculated from the previous stage. Our approach balances image similarity and volume preservation in different regions, i.e., normal and tumor regions, by using soft tumor masks to adjust the imposition of volume-preserving loss on each one. This ensures that the tumor volume is preserved during the registration process. We have evaluated our strategy on various datasets and network architectures, demonstrating that our method successfully preserves the tumor volume while achieving comparable registration results with state-of-the-art methods. Our codes is available at: https://dddraxxx.github.io/Volume-Preserving-Registration/.

In this work, we develop an open-source surgical simulation environment that includes a realistic model obtained by MRI-scanning a physical phantom, for the purpose of training and evaluating a Learning from Demonstration (LfD) algorithm for autonomous suturing. The LfD algorithm utilizes Dynamic Movement Primitives (DMP) and Locally Weighted Regression (LWR), but focuses on the needle trajectory, rather than the instruments, to obtain better generality with respect to needle grasps. We conduct a user study to collect multiple suturing demonstrations and perform a comprehensive analysis of the ability of the LfD algorithm to generalize from a demonstration at one location in one phantom to different locations in the same phantom and to a different phantom. Our results indicate good generalization, on the order of 91.5%, when learning from more experienced subjects, indicating the need to integrate skill assessment in the future.

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

Modern studies in radiograph representation learning rely on either self-supervision to encode invariant semantics or associated radiology reports to incorporate medical expertise, while the complementarity between them is barely noticed. To explore this, we formulate the self- and report-completion as two complementary objectives and present a unified framework based on masked record modeling (MRM). In practice, MRM reconstructs masked image patches and masked report tokens following a multi-task scheme to learn knowledge-enhanced semantic representations. With MRM pre-training, we obtain pre-trained models that can be well transferred to various radiography tasks. Specifically, we find that MRM offers superior performance in label-efficient fine-tuning. For instance, MRM achieves 88.5% mean AUC on CheXpert using 1% labeled data, outperforming previous R^2L methods with 100% labels. On NIH ChestX-ray, MRM outperforms the best performing counterpart by about 3% under small labeling ratios. Besides, MRM surpasses self- and report-supervised pre-training in identifying the pneumonia type and the pneumothorax area, sometimes by large margins.

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

We provide a construction for categorical representation learning and introduce the foundations of "categorifier". The central theme in representation learning is the idea of everything to vector. Every object in a dataset S can be represented as a vector in R^n by an encoding map E: Obj(S)toR^n. More importantly, every morphism can be represented as a matrix E: Hom(S)toR^{n}_{n}. The encoding map E is generally modeled by a deep neural network. The goal of representation learning is to design appropriate tasks on the dataset to train the encoding map (assuming that an encoding is optimal if it universally optimizes the performance on various tasks). However, the latter is still a set-theoretic approach. The goal of the current article is to promote the representation learning to a new level via a category-theoretic approach. As a proof of concept, we provide an example of a text translator equipped with our technology, showing that our categorical learning model outperforms the current deep learning models by 17 times. The content of the current article is part of the recent US patent proposal (patent application number: 63110906).

Large-scale pre-trained Vision-Language Models (VLMs) have significantly advanced transfer learning across diverse tasks. However, adapting these models with limited few-shot data often leads to overfitting, undermining their ability to generalize to new tasks. To address this, we propose Multi-Modal Representation Learning (MMRL), which introduces a shared, learnable, modality-agnostic representation space. MMRL generates space tokens projected into both text and image encoders as representation tokens, enabling more effective cross-modal interactions. Unlike prior methods that mainly optimize class token features, MMRL inserts representation tokens into higher encoder layers--where task-specific features are more prominent--while preserving general knowledge in the lower layers. During training, both class and representation features are jointly optimized: a trainable projection layer is applied to representation tokens for task adaptation, while the projection layer for class token remains frozen to retain pre-trained knowledge. To further promote generalization, we introduce a regularization term aligning class and text features with the frozen VLM's zero-shot features. At inference, a decoupling strategy uses both class and representation features for base tasks, but only class features for novel tasks due to their stronger generalization. Building upon this, we propose MMRL++, a parameter-efficient and interaction-aware extension that significantly reduces trainable parameters and enhances intra-modal interactions--particularly across the layers of representation tokens--allowing gradient sharing and instance-specific information to propagate more effectively through the network. Extensive experiments on 15 datasets demonstrate that MMRL and MMRL++ consistently outperform state-of-the-art methods, achieving a strong balance between task-specific adaptation and generalization.

Surgery video segmentation is an important topic in the surgical AI field. It allows the AI model to understand the spatial information of a surgical scene. Meanwhile, due to the lack of annotated surgical data, surgery segmentation models suffer from limited performance. With the emergence of SAM2 model, a large foundation model for video segmentation trained on natural videos, zero-shot surgical video segmentation became more realistic but meanwhile remains to be explored. In this paper, we systematically evaluate the performance of SAM2 model in zero-shot surgery video segmentation task. We conducted experiments under different configurations, including different prompting strategies, robustness, etc. Moreover, we conducted an empirical evaluation over the performance, including 9 datasets with 17 different types of surgeries.

In this paper, we contend that the objective of representation learning is to compress and transform the distribution of the data, say sets of tokens, towards a mixture of low-dimensional Gaussian distributions supported on incoherent subspaces. The quality of the final representation can be measured by a unified objective function called sparse rate reduction. From this perspective, popular deep networks such as transformers can be naturally viewed as realizing iterative schemes to optimize this objective incrementally. Particularly, we show that the standard transformer block can be derived from alternating optimization on complementary parts of this objective: the multi-head self-attention operator can be viewed as a gradient descent step to compress the token sets by minimizing their lossy coding rate, and the subsequent multi-layer perceptron can be viewed as attempting to sparsify the representation of the tokens. This leads to a family of white-box transformer-like deep network architectures which are mathematically fully interpretable. Despite their simplicity, experiments show that these networks indeed learn to optimize the designed objective: they compress and sparsify representations of large-scale real-world vision datasets such as ImageNet, and achieve performance very close to thoroughly engineered transformers such as ViT. Code is at https://github.com/Ma-Lab-Berkeley/CRATE.

Vision encoders are increasingly used in modern applications, from vision-only models to multimodal systems such as vision-language models. Despite their remarkable success, it remains unclear how these architectures represent features internally. Here, we propose a novel approach for interpreting vision features via image reconstruction. We compare two related model families, SigLIP and SigLIP2, which differ only in their training objective, and show that encoders pre-trained on image-based tasks retain significantly more image information than those trained on non-image tasks such as contrastive learning. We further apply our method to a range of vision encoders, ranking them by the informativeness of their feature representations. Finally, we demonstrate that manipulating the feature space yields predictable changes in reconstructed images, revealing that orthogonal rotations (rather than spatial transformations) control color encoding. Our approach can be applied to any vision encoder, shedding light on the inner structure of its feature space. The code and model weights to reproduce the experiments are available in GitHub.

Over the past decade, computer vision applications in minimally invasive surgery have rapidly increased. Despite this growth, the impact of surgical computer vision remains limited compared to other medical fields like pathology and radiology, primarily due to the scarcity of representative annotated data. Whereas transfer learning from large annotated datasets such as ImageNet has been conventionally the norm to achieve high-performing models, recent advancements in self-supervised learning (SSL) have demonstrated superior performance. In medical image analysis, in-domain SSL pretraining has already been shown to outperform ImageNet-based initialization. Although unlabeled data in the field of surgical computer vision is abundant, the diversity within this data is limited. This study investigates the role of dataset diversity in SSL for surgical computer vision, comparing procedure-specific datasets against a more heterogeneous general surgical dataset across three different downstream surgical applications. The obtained results show that using solely procedure-specific data can lead to substantial improvements of 13.8%, 9.5%, and 36.8% compared to ImageNet pretraining. However, extending this data with more heterogeneous surgical data further increases performance by an additional 5.0%, 5.2%, and 2.5%, suggesting that increasing diversity within SSL data is beneficial for model performance. The code and pretrained model weights are made publicly available at https://github.com/TimJaspers0801/SurgeNet.

Building AI models with trustworthiness is important especially in regulated areas such as healthcare. In tackling COVID-19, previous work uses convolutional neural networks as the backbone architecture, which has shown to be prone to over-caution and overconfidence in making decisions, rendering them less trustworthy -- a crucial flaw in the context of medical imaging. In this study, we propose a feature learning approach using Vision Transformers, which use an attention-based mechanism, and examine the representation learning capability of Transformers as a new backbone architecture for medical imaging. Through the task of classifying COVID-19 chest radiographs, we investigate into whether generalization capabilities benefit solely from Vision Transformers' architectural advances. Quantitative and qualitative evaluations are conducted on the trustworthiness of the models, through the use of "trust score" computation and a visual explainability technique. We conclude that the attention-based feature learning approach is promising in building trustworthy deep learning models for healthcare.

Foundation models have revolutionized computer vision by achieving vastly superior performance across diverse tasks through large-scale pretraining on extensive datasets. However, their application in surgical computer vision has been limited. This study addresses this gap by introducing SurgeNetXL, a novel surgical foundation model that sets a new benchmark in surgical computer vision. Trained on the largest reported surgical dataset to date, comprising over 4.7 million video frames, SurgeNetXL achieves consistent top-tier performance across six datasets spanning four surgical procedures and three tasks, including semantic segmentation, phase recognition, and critical view of safety (CVS) classification. Compared with the best-performing surgical foundation models, SurgeNetXL shows mean improvements of 2.4, 9.0, and 12.6 percent for semantic segmentation, phase recognition, and CVS classification, respectively. Additionally, SurgeNetXL outperforms the best-performing ImageNet-based variants by 14.4, 4.0, and 1.6 percent in the respective tasks. In addition to advancing model performance, this study provides key insights into scaling pretraining datasets, extending training durations, and optimizing model architectures specifically for surgical computer vision. These findings pave the way for improved generalizability and robustness in data-scarce scenarios, offering a comprehensive framework for future research in this domain. All models and a subset of the SurgeNetXL dataset, including over 2 million video frames, are publicly available at: https://github.com/TimJaspers0801/SurgeNet.

The field of surgical computer vision has undergone considerable breakthroughs in recent years with the rising popularity of deep neural network-based methods. However, standard fully-supervised approaches for training such models require vast amounts of annotated data, imposing a prohibitively high cost; especially in the clinical domain. Self-Supervised Learning (SSL) methods, which have begun to gain traction in the general computer vision community, represent a potential solution to these annotation costs, allowing to learn useful representations from only unlabeled data. Still, the effectiveness of SSL methods in more complex and impactful domains, such as medicine and surgery, remains limited and unexplored. In this work, we address this critical need by investigating four state-of-the-art SSL methods (MoCo v2, SimCLR, DINO, SwAV) in the context of surgical computer vision. We present an extensive analysis of the performance of these methods on the Cholec80 dataset for two fundamental and popular tasks in surgical context understanding, phase recognition and tool presence detection. We examine their parameterization, then their behavior with respect to training data quantities in semi-supervised settings. Correct transfer of these methods to surgery, as described and conducted in this work, leads to substantial performance gains over generic uses of SSL - up to 7.4% on phase recognition and 20% on tool presence detection - as well as state-of-the-art semi-supervised phase recognition approaches by up to 14%. Further results obtained on a highly diverse selection of surgical datasets exhibit strong generalization properties. The code is available at https://github.com/CAMMA-public/SelfSupSurg.

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

Representation learning seeks to expose certain aspects of observed data in a learned representation that's amenable to downstream tasks like classification. For instance, a good representation for 2D images might be one that describes only global structure and discards information about detailed texture. In this paper, we present a simple but principled method to learn such global representations by combining Variational Autoencoder (VAE) with neural autoregressive models such as RNN, MADE and PixelRNN/CNN. Our proposed VAE model allows us to have control over what the global latent code can learn and , by designing the architecture accordingly, we can force the global latent code to discard irrelevant information such as texture in 2D images, and hence the VAE only "autoencodes" data in a lossy fashion. In addition, by leveraging autoregressive models as both prior distribution p(z) and decoding distribution p(x|z), we can greatly improve generative modeling performance of VAEs, achieving new state-of-the-art results on MNIST, OMNIGLOT and Caltech-101 Silhouettes density estimation tasks.

Implicit Neural Representation (INR), leveraging a neural network to transform coordinate input into corresponding attributes, has recently driven significant advances in several vision-related domains. However, the performance of INR is heavily influenced by the choice of the nonlinear activation function used in its multilayer perceptron (MLP) architecture. Multiple nonlinearities have been investigated; yet, current INRs face limitations in capturing high-frequency components, diverse signal types, and handling inverse problems. We have identified that these problems can be greatly alleviated by introducing a paradigm shift in INRs. We find that an architecture with learnable activations in initial layers can represent fine details in the underlying signals. Specifically, we propose SL^{2}A-INR, a hybrid network for INR with a single-layer learnable activation function, prompting the effectiveness of traditional ReLU-based MLPs. Our method performs superior across diverse tasks, including image representation, 3D shape reconstructions, inpainting, single image super-resolution, CT reconstruction, and novel view synthesis. Through comprehensive experiments, SL^{2}A-INR sets new benchmarks in accuracy, quality, and convergence rates for INR.

In this study, we focus on the problem of 3D human mesh recovery from a single image under obscured conditions. Most state-of-the-art methods aim to improve 2D alignment technologies, such as spatial averaging and 2D joint sampling. However, they tend to neglect the crucial aspect of 3D alignment by improving 3D representations. Furthermore, recent methods struggle to separate the target human from occlusion or background in crowded scenes as they optimize the 3D space of target human with 3D joint coordinates as local supervision. To address these issues, a desirable method would involve a framework for fusing 2D and 3D features and a strategy for optimizing the 3D space globally. Therefore, this paper presents 3D JOint contrastive learning with TRansformers (JOTR) framework for handling occluded 3D human mesh recovery. Our method includes an encoder-decoder transformer architecture to fuse 2D and 3D representations for achieving 2D&3D aligned results in a coarse-to-fine manner and a novel 3D joint contrastive learning approach for adding explicitly global supervision for the 3D feature space. The contrastive learning approach includes two contrastive losses: joint-to-joint contrast for enhancing the similarity of semantically similar voxels (i.e., human joints), and joint-to-non-joint contrast for ensuring discrimination from others (e.g., occlusions and background). Qualitative and quantitative analyses demonstrate that our method outperforms state-of-the-art competitors on both occlusion-specific and standard benchmarks, significantly improving the reconstruction of occluded humans.

In this paper, we introduce a set of simple yet effective TOken REduction (TORE) strategies for Transformer-based Human Mesh Recovery from monocular images. Current SOTA performance is achieved by Transformer-based structures. However, they suffer from high model complexity and computation cost caused by redundant tokens. We propose token reduction strategies based on two important aspects, i.e., the 3D geometry structure and 2D image feature, where we hierarchically recover the mesh geometry with priors from body structure and conduct token clustering to pass fewer but more discriminative image feature tokens to the Transformer. Our method massively reduces the number of tokens involved in high-complexity interactions in the Transformer. This leads to a significantly reduced computational cost while still achieving competitive or even higher accuracy in shape recovery. Extensive experiments across a wide range of benchmarks validate the superior effectiveness of the proposed method. We further demonstrate the generalizability of our method on hand mesh recovery. Visit our project page at https://frank-zy-dou.github.io/projects/Tore/index.html.

Representation learning has been evolving from traditional supervised training to Contrastive Learning (CL) and Masked Image Modeling (MIM). Previous works have demonstrated their pros and cons in specific scenarios, i.e., CL and supervised pre-training excel at capturing longer-range global patterns and enabling better feature discrimination, while MIM can introduce more local and diverse attention across all transformer layers. In this paper, we explore how to obtain a model that combines their strengths. We start by examining previous feature distillation and mask feature reconstruction methods and identify their limitations. We find that their increasing diversity mainly derives from the asymmetric designs, but these designs may in turn compromise the discrimination ability. In order to better obtain both discrimination and diversity, we propose a simple but effective Hybrid Distillation strategy, which utilizes both the supervised/CL teacher and the MIM teacher to jointly guide the student model. Hybrid Distill imitates the token relations of the MIM teacher to alleviate attention collapse, as well as distills the feature maps of the supervised/CL teacher to enable discrimination. Furthermore, a progressive redundant token masking strategy is also utilized to reduce the distilling costs and avoid falling into local optima. Experiment results prove that Hybrid Distill can achieve superior performance on different benchmarks.

Surgical robotics holds much promise for improving patient safety and clinician experience in the Operating Room (OR). However, it also comes with new challenges, requiring strong team coordination and effective OR management. Automatic detection of surgical activities is a key requirement for developing AI-based intelligent tools to tackle these challenges. The current state-of-the-art surgical activity recognition methods however operate on image-based representations and depend on large-scale labeled datasets whose collection is time-consuming and resource-expensive. This work proposes a new sample-efficient and object-based approach for surgical activity recognition in the OR. Our method focuses on the geometric arrangements between clinicians and surgical devices, thus utilizing the significant object interaction dynamics in the OR. We conduct experiments in a low-data regime study for long video activity recognition. We also benchmark our method againstother object-centric approaches on clip-level action classification and show superior performance.

Self-supervised learning (SSL) has recently achieved promising performance for 3D medical image analysis tasks. Most current methods follow existing SSL paradigm originally designed for photographic or natural images, which cannot explicitly and thoroughly exploit the intrinsic similar anatomical structures across varying medical images. This may in fact degrade the quality of learned deep representations by maximizing the similarity among features containing spatial misalignment information and different anatomical semantics. In this work, we propose a new self-supervised learning framework, namely Alice, that explicitly fulfills Anatomical invariance modeling and semantic alignment via elaborately combining discriminative and generative objectives. Alice introduces a new contrastive learning strategy which encourages the similarity between views that are diversely mined but with consistent high-level semantics, in order to learn invariant anatomical features. Moreover, we design a conditional anatomical feature alignment module to complement corrupted embeddings with globally matched semantics and inter-patch topology information, conditioned by the distribution of local image content, which permits to create better contrastive pairs. Our extensive quantitative experiments on three 3D medical image analysis tasks demonstrate and validate the performance superiority of Alice, surpassing the previous best SSL counterpart methods and showing promising ability for united representation learning. Codes are available at https://github.com/alibaba-damo-academy/alice.

Transformer-based methods have demonstrated impressive results in medical image restoration, attributed to the multi-head self-attention (MSA) mechanism in the spatial dimension. However, the majority of existing Transformers conduct attention within fixed and coarsely partitioned regions (e.g. the entire image or fixed patches), resulting in interference from irrelevant regions and fragmentation of continuous image content. To overcome these challenges, we introduce a novel Region Attention Transformer (RAT) that utilizes a region-based multi-head self-attention mechanism (R-MSA). The R-MSA dynamically partitions the input image into non-overlapping semantic regions using the robust Segment Anything Model (SAM) and then performs self-attention within these regions. This region partitioning is more flexible and interpretable, ensuring that only pixels from similar semantic regions complement each other, thereby eliminating interference from irrelevant regions. Moreover, we introduce a focal region loss to guide our model to adaptively focus on recovering high-difficulty regions. Extensive experiments demonstrate the effectiveness of RAT in various medical image restoration tasks, including PET image synthesis, CT image denoising, and pathological image super-resolution. Code is available at https://github.com/Yaziwel/Region-Attention-Transformer-for-Medical-Image-Restoration.git{https://github.com/RAT}.

Convolutional neural networks (CNNs) have been the consensus for medical image segmentation tasks. However, they suffer from the limitation in modeling long-range dependencies and spatial correlations due to the nature of convolution operation. Although transformers were first developed to address this issue, they fail to capture low-level features. In contrast, it is demonstrated that both local and global features are crucial for dense prediction, such as segmenting in challenging contexts. In this paper, we propose HiFormer, a novel method that efficiently bridges a CNN and a transformer for medical image segmentation. Specifically, we design two multi-scale feature representations using the seminal Swin Transformer module and a CNN-based encoder. To secure a fine fusion of global and local features obtained from the two aforementioned representations, we propose a Double-Level Fusion (DLF) module in the skip connection of the encoder-decoder structure. Extensive experiments on various medical image segmentation datasets demonstrate the effectiveness of HiFormer over other CNN-based, transformer-based, and hybrid methods in terms of computational complexity, and quantitative and qualitative results. Our code is publicly available at: https://github.com/amirhossein-kz/HiFormer

Multimodal magnetic resonance imaging (MRI) constitutes the first line of investigation for clinicians in the care of brain tumors, providing crucial insights for surgery planning, treatment monitoring, and biomarker identification. Pre-training on large datasets have been shown to help models learn transferable representations and adapt with minimal labeled data. This behavior is especially valuable in medical imaging, where annotations are often scarce. However, applying this paradigm to multimodal medical data introduces a challenge: most existing approaches assume that all imaging modalities are available during both pre-training and fine-tuning. In practice, missing modalities often occur due to acquisition issues, specialist unavailability, or specific experimental designs on small in-house datasets. Consequently, a common approach involves training a separate model for each desired modality combination, making the process both resource-intensive and impractical for clinical use. Therefore, we introduce BM-MAE, a masked image modeling pre-training strategy tailored for multimodal MRI data. The same pre-trained model seamlessly adapts to any combination of available modalities, extracting rich representations that capture both intra- and inter-modal information. This allows fine-tuning on any subset of modalities without requiring architectural changes, while still benefiting from a model pre-trained on the full set of modalities. Extensive experiments show that the proposed pre-training strategy outperforms or remains competitive with baselines that require separate pre-training for each modality subset, while substantially surpassing training from scratch on several downstream tasks. Additionally, it can quickly and efficiently reconstruct missing modalities, highlighting its practical value. Code and trained models are available at: https://github.com/Lucas-rbnt/BM-MAE

Advancements in computer-assisted surgical procedures heavily rely on accurate visual data interpretation from camera systems used during surgeries. Traditional open-access datasets focusing on surgical procedures are often limited by their small size, typically consisting of fewer than 100 videos with less than 100K images. To address these constraints, a new dataset called Surg-3M has been compiled using a novel aggregation pipeline that collects high-resolution videos from online sources. Featuring an extensive collection of over 4K surgical videos and more than 3 million high-quality images from multiple procedure types, Surg-3M offers a comprehensive resource surpassing existing alternatives in size and scope, including two novel tasks. To demonstrate the effectiveness of this dataset, we present SurgFM, a self-supervised foundation model pretrained on Surg-3M that achieves impressive results in downstream tasks such as surgical phase recognition, action recognition, and tool presence detection. Combining key components from ConvNeXt, DINO, and an innovative augmented distillation method, SurgFM exhibits exceptional performance compared to specialist architectures across various benchmarks. Our experimental results show that SurgFM outperforms state-of-the-art models in multiple downstream tasks, including significant gains in surgical phase recognition (+8.9pp, +4.7pp, and +3.9pp of Jaccard in AutoLaparo, M2CAI16, and Cholec80), action recognition (+3.1pp of mAP in CholecT50) and tool presence detection (+4.6pp of mAP in Cholec80). Moreover, even when using only half of the data, SurgFM outperforms state-of-the-art models in AutoLaparo and achieves state-of-the-art performance in Cholec80. Both Surg-3M and SurgFM have significant potential to accelerate progress towards developing autonomous robotic surgery systems.

Mainstream 3D representation learning approaches are built upon contrastive or generative modeling pretext tasks, where great improvements in performance on various downstream tasks have been achieved. However, we find these two paradigms have different characteristics: (i) contrastive models are data-hungry that suffer from a representation over-fitting issue; (ii) generative models have a data filling issue that shows inferior data scaling capacity compared to contrastive models. This motivates us to learn 3D representations by sharing the merits of both paradigms, which is non-trivial due to the pattern difference between the two paradigms. In this paper, we propose Contrast with Reconstruct (ReCon) that unifies these two paradigms. ReCon is trained to learn from both generative modeling teachers and single/cross-modal contrastive teachers through ensemble distillation, where the generative student guides the contrastive student. An encoder-decoder style ReCon-block is proposed that transfers knowledge through cross attention with stop-gradient, which avoids pretraining over-fitting and pattern difference issues. ReCon achieves a new state-of-the-art in 3D representation learning, e.g., 91.26% accuracy on ScanObjectNN. Codes have been released at https://github.com/qizekun/ReCon.

Vision Transformers (ViT)s have shown great performance in self-supervised learning of global and local representations that can be transferred to downstream applications. Inspired by these results, we introduce a novel self-supervised learning framework with tailored proxy tasks for medical image analysis. Specifically, we propose: (i) a new 3D transformer-based model, dubbed Swin UNEt TRansformers (Swin UNETR), with a hierarchical encoder for self-supervised pre-training; (ii) tailored proxy tasks for learning the underlying pattern of human anatomy. We demonstrate successful pre-training of the proposed model on 5,050 publicly available computed tomography (CT) images from various body organs. The effectiveness of our approach is validated by fine-tuning the pre-trained models on the Beyond the Cranial Vault (BTCV) Segmentation Challenge with 13 abdominal organs and segmentation tasks from the Medical Segmentation Decathlon (MSD) dataset. Our model is currently the state-of-the-art (i.e. ranked 1st) on the public test leaderboards of both MSD and BTCV datasets. Code: https://monai.io/research/swin-unetr

The detailed images produced by Magnetic Resonance Imaging (MRI) provide life-critical information for the diagnosis and treatment of prostate cancer. To provide standardized acquisition, interpretation and usage of the complex MRI images, the PI-RADS v2 guideline was proposed. An automated segmentation following the guideline facilitates consistent and precise lesion detection, staging and treatment. The guideline recommends a division of the prostate into four zones, PZ (peripheral zone), TZ (transition zone), DPU (distal prostatic urethra) and AFS (anterior fibromuscular stroma). Not every zone shares a boundary with the others and is present in every slice. Further, the representations captured by a single model might not suffice for all zones. This motivated us to design a dual-branch convolutional neural network (CNN), where each branch captures the representations of the connected zones separately. Further, the representations from different branches act complementary to each other at the second stage of training, where they are fine-tuned through an unsupervised loss. The loss penalises the difference in predictions from the two branches for the same class. We also incorporate multi-task learning in our framework to further improve the segmentation accuracy. The proposed approach improves the segmentation accuracy of the baseline (mean absolute symmetric distance) by 7.56%, 11.00%, 58.43% and 19.67% for PZ, TZ, DPU and AFS zones respectively.

Despite the widespread adoption of transformers in medical applications, the exploration of multi-scale learning through transformers remains limited, while hierarchical representations are considered advantageous for computer-aided medical diagnosis. We propose a novel hierarchical transformer model that adeptly integrates the feature extraction capabilities of Convolutional Neural Networks (CNNs) with the advanced representational potential of Vision Transformers (ViTs). Addressing the lack of inductive biases and dependence on extensive training datasets in ViTs, our model employs a CNN backbone to generate hierarchical visual representations. These representations are adapted for transformer input through an innovative patch tokenization process, preserving the inherited multi-scale inductive biases. We also introduce a scale-wise attention mechanism that directly captures intra-scale and inter-scale associations. This mechanism complements patch-wise attention by enhancing spatial understanding and preserving global perception, which we refer to as local and global attention, respectively. Our model significantly outperforms baseline models in terms of classification accuracy, demonstrating its efficiency in bridging the gap between Convolutional Neural Networks (CNNs) and Vision Transformers (ViTs). The components are designed as plug-and-play for different CNN architectures and can be adapted for multiple applications. The code is available at https://github.com/xiaoyatang/DuoFormer.git.

The surgical usage of Mixed Reality (MR) has received growing attention in areas such as surgical navigation systems, skill assessment, and robot-assisted surgeries. For such applications, pose estimation for hand and surgical instruments from an egocentric perspective is a fundamental task and has been studied extensively in the computer vision field in recent years. However, the development of this field has been impeded by a lack of datasets, especially in the surgical field, where bloody gloves and reflective metallic tools make it hard to obtain 3D pose annotations for hands and objects using conventional methods. To address this issue, we propose POV-Surgery, a large-scale, synthetic, egocentric dataset focusing on pose estimation for hands with different surgical gloves and three orthopedic surgical instruments, namely scalpel, friem, and diskplacer. Our dataset consists of 53 sequences and 88,329 frames, featuring high-resolution RGB-D video streams with activity annotations, accurate 3D and 2D annotations for hand-object pose, and 2D hand-object segmentation masks. We fine-tune the current SOTA methods on POV-Surgery and further show the generalizability when applying to real-life cases with surgical gloves and tools by extensive evaluations. The code and the dataset are publicly available at batfacewayne.github.io/POV_Surgery_io/.

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

Data diversity and volume are crucial to the success of training deep learning models, while in the medical imaging field, the difficulty and cost of data collection and annotation are especially huge. Specifically in robotic surgery, data scarcity and imbalance have heavily affected the model accuracy and limited the design and deployment of deep learning-based surgical applications such as surgical instrument segmentation. Considering this, we rethink the surgical instrument segmentation task and propose a one-to-many data generation solution that gets rid of the complicated and expensive process of data collection and annotation from robotic surgery. In our method, we only utilize a single surgical background tissue image and a few open-source instrument images as the seed images and apply multiple augmentations and blending techniques to synthesize amounts of image variations. In addition, we also introduce the chained augmentation mixing during training to further enhance the data diversities. The proposed approach is evaluated on the real datasets of the EndoVis-2018 and EndoVis-2017 surgical scene segmentation. Our empirical analysis suggests that without the high cost of data collection and annotation, we can achieve decent surgical instrument segmentation performance. Moreover, we also observe that our method can deal with novel instrument prediction in the deployment domain. We hope our inspiring results will encourage researchers to emphasize data-centric methods to overcome demanding deep learning limitations besides data shortage, such as class imbalance, domain adaptation, and incremental learning. Our code is available at https://github.com/lofrienger/Single_SurgicalScene_For_Segmentation.

Large Language Models (LLMs), known for their versatility in textual data, are increasingly being explored for their potential to enhance medical image segmentation, a crucial task for accurate diagnostic imaging. This study explores enhancing Vision Transformers (ViTs) for medical image segmentation by integrating pre-trained LLM transformer blocks. Our approach, which incorporates a frozen LLM transformer block into the encoder of a ViT-based model, leads to substantial improvements in segmentation performance across various medical imaging modalities. We propose a Hybrid Attention Mechanism that combines global and local feature learning with a Multi-Scale Fusion Block for aggregating features across different scales. The enhanced model shows significant performance gains, including an average Dice score increase from 0.74 to 0.79 and improvements in accuracy, precision, and the Jaccard Index. These results demonstrate the effectiveness of LLM-based transformers in refining medical image segmentation, highlighting their potential to significantly boost model accuracy and robustness. The source code and our implementation are available at: https://bit.ly/3zf2CVs

Advanced autoregressive models have reshaped multimodal AI. However, their transformative potential in medical imaging remains largely untapped due to the absence of a unified visual tokenizer -- one capable of capturing fine-grained visual structures for faithful image reconstruction and realistic image synthesis, as well as rich semantics for accurate diagnosis and image interpretation. To this end, we present MedITok, the first unified tokenizer tailored for medical images, encoding both low-level structural details and high-level clinical semantics within a unified latent space. To balance these competing objectives, we introduce a novel two-stage training framework: a visual representation alignment stage that cold-starts the tokenizer reconstruction learning with a visual semantic constraint, followed by a textual semantic representation alignment stage that infuses detailed clinical semantics into the latent space. Trained on the meticulously collected large-scale dataset with over 30 million medical images and 2 million image-caption pairs, MedITok achieves state-of-the-art performance on more than 30 datasets across 9 imaging modalities and 4 different tasks. By providing a unified token space for autoregressive modeling, MedITok supports a wide range of tasks in clinical diagnostics and generative healthcare applications. Model and code will be made publicly available at: https://github.com/Masaaki-75/meditok.

Generating accurate 3D reconstructions from endoscopic video is a promising avenue for longitudinal radiation-free analysis of sinus anatomy and surgical outcomes. Several methods for monocular reconstruction have been proposed, yielding visually pleasant 3D anatomical structures by retrieving relative camera poses with structure-from-motion-type algorithms and fusion of monocular depth estimates. However, due to the complex properties of the underlying algorithms and endoscopic scenes, the reconstruction pipeline may perform poorly or fail unexpectedly. Further, acquiring medical data conveys additional challenges, presenting difficulties in quantitatively benchmarking these models, understanding failure cases, and identifying critical components that contribute to their precision. In this work, we perform a quantitative analysis of a self-supervised approach for sinus reconstruction using endoscopic sequences paired with optical tracking and high-resolution computed tomography acquired from nine ex-vivo specimens. Our results show that the generated reconstructions are in high agreement with the anatomy, yielding an average point-to-mesh error of 0.91 mm between reconstructions and CT segmentations. However, in a point-to-point matching scenario, relevant for endoscope tracking and navigation, we found average target registration errors of 6.58 mm. We identified that pose and depth estimation inaccuracies contribute equally to this error and that locally consistent sequences with shorter trajectories generate more accurate reconstructions. These results suggest that achieving global consistency between relative camera poses and estimated depths with the anatomy is essential. In doing so, we can ensure proper synergy between all components of the pipeline for improved reconstructions that will facilitate clinical application of this innovative technology.

Anatomical segmentation is a fundamental task in medical image computing, generally tackled with fully convolutional neural networks which produce dense segmentation masks. These models are often trained with loss functions such as cross-entropy or Dice, which assume pixels to be independent of each other, thus ignoring topological errors and anatomical inconsistencies. We address this limitation by moving from pixel-level to graph representations, which allow to naturally incorporate anatomical constraints by construction. To this end, we introduce HybridGNet, an encoder-decoder neural architecture that leverages standard convolutions for image feature encoding and graph convolutional neural networks (GCNNs) to decode plausible representations of anatomical structures. We also propose a novel image-to-graph skip connection layer which allows localized features to flow from standard convolutional blocks to GCNN blocks, and show that it improves segmentation accuracy. The proposed architecture is extensively evaluated in a variety of domain shift and image occlusion scenarios, and audited considering different types of demographic domain shift. Our comprehensive experimental setup compares HybridGNet with other landmark and pixel-based models for anatomical segmentation in chest x-ray images, and shows that it produces anatomically plausible results in challenging scenarios where other models tend to fail.

Purpose: Foundation models, trained on multitudes of public datasets, often require additional fine-tuning or re-prompting mechanisms to be applied to visually distinct target domains such as surgical videos. Further, without domain knowledge, they cannot model the specific semantics of the target domain. Hence, when applied to surgical video segmentation, they fail to generalise to sections where previously tracked objects leave the scene or new objects enter. Methods: We propose SASVi, a novel re-prompting mechanism based on a frame-wise Mask R-CNN Overseer model, which is trained on a minimal amount of scarcely available annotations for the target domain. This model automatically re-prompts the foundation model SAM2 when the scene constellation changes, allowing for temporally smooth and complete segmentation of full surgical videos. Results: Re-prompting based on our Overseer model significantly improves the temporal consistency of surgical video segmentation compared to similar prompting techniques and especially frame-wise segmentation, which neglects temporal information, by at least 1.5%. Our proposed approach allows us to successfully deploy SAM2 to surgical videos, which we quantitatively and qualitatively demonstrate for three different cholecystectomy and cataract surgery datasets. Conclusion: SASVi can serve as a new baseline for smooth and temporally consistent segmentation of surgical videos with scarcely available annotation data. Our method allows us to leverage scarce annotations and obtain complete annotations for full videos of the large-scale counterpart datasets. We make those annotations publicly available, providing extensive annotation data for the future development of surgical data science models.

Clinical routine and retrospective cohorts commonly include multi-parametric Magnetic Resonance Imaging; however, they are mostly acquired in different anisotropic 2D views due to signal-to-noise-ratio and scan-time constraints. Thus acquired views suffer from poor out-of-plane resolution and affect downstream volumetric image analysis that typically requires isotropic 3D scans. Combining different views of multi-contrast scans into high-resolution isotropic 3D scans is challenging due to the lack of a large training cohort, which calls for a subject-specific framework. This work proposes a novel solution to this problem leveraging Implicit Neural Representations (INR). Our proposed INR jointly learns two different contrasts of complementary views in a continuous spatial function and benefits from exchanging anatomical information between them. Trained within minutes on a single commodity GPU, our model provides realistic super-resolution across different pairs of contrasts in our experiments with three datasets. Using Mutual Information (MI) as a metric, we find that our model converges to an optimum MI amongst sequences, achieving anatomically faithful reconstruction. Code is available at: https://github.com/jqmcginnis/multi_contrast_inr/

Automated segmentation of brain tumors from 3D magnetic resonance images (MRIs) is necessary for the diagnosis, monitoring, and treatment planning of the disease. Manual delineation practices require anatomical knowledge, are expensive, time consuming and can be inaccurate due to human error. Here, we describe a semantic segmentation network for tumor subregion segmentation from 3D MRIs based on encoder-decoder architecture. Due to a limited training dataset size, a variational auto-encoder branch is added to reconstruct the input image itself in order to regularize the shared decoder and impose additional constraints on its layers. The current approach won 1st place in the BraTS 2018 challenge.

Surgical scene perception via videos are critical for advancing robotic surgery, telesurgery, and AI-assisted surgery, particularly in ophthalmology. However, the scarcity of diverse and richly annotated video datasets has hindered the development of intelligent systems for surgical workflow analysis. Existing datasets for surgical workflow analysis, which typically face challenges such as small scale, a lack of diversity in surgery and phase categories, and the absence of time-localized annotations, limit the requirements for action understanding and model generalization validation in complex and diverse real-world surgical scenarios. To address this gap, we introduce OphNet, a large-scale, expert-annotated video benchmark for ophthalmic surgical workflow understanding. OphNet features: 1) A diverse collection of 2,278 surgical videos spanning 66 types of cataract, glaucoma, and corneal surgeries, with detailed annotations for 102 unique surgical phases and 150 granular operations; 2) It offers sequential and hierarchical annotations for each surgery, phase, and operation, enabling comprehensive understanding and improved interpretability; 3) Moreover, OphNet provides time-localized annotations, facilitating temporal localization and prediction tasks within surgical workflows. With approximately 205 hours of surgical videos, OphNet is about 20 times larger than the largest existing surgical workflow analysis benchmark. Our dataset and code have been made available at: https://github.com/minghu0830/OphNet-benchmark.

Visual scenes are composed of visual concepts and have the property of combinatorial explosion. An important reason for humans to efficiently learn from diverse visual scenes is the ability of compositional perception, and it is desirable for artificial intelligence to have similar abilities. Compositional scene representation learning is a task that enables such abilities. In recent years, various methods have been proposed to apply deep neural networks, which have been proven to be advantageous in representation learning, to learn compositional scene representations via reconstruction, advancing this research direction into the deep learning era. Learning via reconstruction is advantageous because it may utilize massive unlabeled data and avoid costly and laborious data annotation. In this survey, we first outline the current progress on reconstruction-based compositional scene representation learning with deep neural networks, including development history and categorizations of existing methods from the perspectives of the modeling of visual scenes and the inference of scene representations; then provide benchmarks, including an open source toolbox to reproduce the benchmark experiments, of representative methods that consider the most extensively studied problem setting and form the foundation for other methods; and finally discuss the limitations of existing methods and future directions of this research topic.

Training visual embeddings with labeled data supervision has been the de facto setup for representation learning in computer vision. Inspired by recent success of adopting masked image modeling (MIM) in self-supervised representation learning, we propose a simple yet effective setup that can easily integrate MIM into existing supervised training paradigms. In our design, in addition to the original classification task applied to a vision transformer image encoder, we add a shallow transformer-based decoder on top of the encoder and introduce an MIM task which tries to reconstruct image tokens based on masked image inputs. We show with minimal change in architecture and no overhead in inference that this setup is able to improve the quality of the learned representations for downstream tasks such as classification, image retrieval, and semantic segmentation. We conduct a comprehensive study and evaluation of our setup on public benchmarks. On ImageNet-1k, our ViT-B/14 model achieves 81.72% validation accuracy, 2.01% higher than the baseline model. On K-Nearest-Neighbor image retrieval evaluation with ImageNet-1k, the same model outperforms the baseline by 1.32%. We also show that this setup can be easily scaled to larger models and datasets. Code and checkpoints will be released.

During surgical training, real-time feedback from trainers to trainees is important for preventing errors and enhancing long-term skill acquisition. Accurately predicting the effectiveness of this feedback, specifically whether it leads to a change in trainee behavior, is crucial for developing methods for improving surgical training and education. However, relying on human annotations to assess feedback effectiveness is laborious and prone to biases, underscoring the need for an automated, scalable, and objective method. Creating such an automated system poses challenges, as it requires an understanding of both the verbal feedback delivered by the trainer and the visual context of the real-time surgical scene. To address this, we propose a method that integrates information from transcribed verbal feedback and corresponding surgical video to predict feedback effectiveness. Our findings show that both transcribed feedback and surgical video are individually predictive of trainee behavior changes, and their combination achieves an AUROC of 0.70+/-0.02, improving prediction accuracy by up to 6.6%. Additionally, we introduce self-supervised fine-tuning as a strategy for enhancing surgical video representation learning, which is scalable and further enhances prediction performance. Our results demonstrate the potential of multi-modal learning to advance the automated assessment of surgical feedback.

We propose a new representation for encoding 3D shapes as neural fields. The representation is designed to be compatible with the transformer architecture and to benefit both shape reconstruction and shape generation. Existing works on neural fields are grid-based representations with latents defined on a regular grid. In contrast, we define latents on irregular grids, enabling our representation to be sparse and adaptive. In the context of shape reconstruction from point clouds, our shape representation built on irregular grids improves upon grid-based methods in terms of reconstruction accuracy. For shape generation, our representation promotes high-quality shape generation using auto-regressive probabilistic models. We show different applications that improve over the current state of the art. First, we show results for probabilistic shape reconstruction from a single higher resolution image. Second, we train a probabilistic model conditioned on very low resolution images. Third, we apply our model to category-conditioned generation. All probabilistic experiments confirm that we are able to generate detailed and high quality shapes to yield the new state of the art in generative 3D shape modeling.

Representation learning has been a critical topic in machine learning. In Click-through Rate Prediction, most features are represented as embedding vectors and learned simultaneously with other parameters in the model. With the development of CTR models, feature representation learning has become a trending topic and has been extensively studied by both industrial and academic researchers in recent years. This survey aims at summarizing the feature representation learning in a broader picture and pave the way for future research. To achieve such a goal, we first present a taxonomy of current research methods on feature representation learning following two main issues: (i) which feature to represent and (ii) how to represent these features. Then we give a detailed description of each method regarding these two issues. Finally, the review concludes with a discussion on the future directions of this field.

Shape assembly aims to reassemble parts (or fragments) into a complete object, which is a common task in our daily life. Different from the semantic part assembly (e.g., assembling a chair's semantic parts like legs into a whole chair), geometric part assembly (e.g., assembling bowl fragments into a complete bowl) is an emerging task in computer vision and robotics. Instead of semantic information, this task focuses on geometric information of parts. As the both geometric and pose space of fractured parts are exceptionally large, shape pose disentanglement of part representations is beneficial to geometric shape assembly. In our paper, we propose to leverage SE(3) equivariance for such shape pose disentanglement. Moreover, while previous works in vision and robotics only consider SE(3) equivariance for the representations of single objects, we move a step forward and propose leveraging SE(3) equivariance for representations considering multi-part correlations, which further boosts the performance of the multi-part assembly. Experiments demonstrate the significance of SE(3) equivariance and our proposed method for geometric shape assembly. Project page: https://crtie.github.io/SE-3-part-assembly/

Learning effective visual representations for robotic manipulation remains a fundamental challenge due to the complex body dynamics involved in action execution. In this paper, we study how visual representations that carry body-relevant cues can enable efficient policy learning for downstream robotic manipulation tasks. We present Inter-token Contrast (ICon), a contrastive learning method applied to the token-level representations of Vision Transformers (ViTs). ICon enforces a separation in the feature space between agent-specific and environment-specific tokens, resulting in agent-centric visual representations that embed body-specific inductive biases. This framework can be seamlessly integrated into end-to-end policy learning by incorporating the contrastive loss as an auxiliary objective. Our experiments show that ICon not only improves policy performance across various manipulation tasks but also facilitates policy transfer across different robots. The project website: https://github.com/HenryWJL/icon

In recent years, the landscape of computer-assisted interventions and post-operative surgical video analysis has been dramatically reshaped by deep-learning techniques, resulting in significant advancements in surgeons' skills, operation room management, and overall surgical outcomes. However, the progression of deep-learning-powered surgical technologies is profoundly reliant on large-scale datasets and annotations. Particularly, surgical scene understanding and phase recognition stand as pivotal pillars within the realm of computer-assisted surgery and post-operative assessment of cataract surgery videos. In this context, we present the largest cataract surgery video dataset that addresses diverse requisites for constructing computerized surgical workflow analysis and detecting post-operative irregularities in cataract surgery. We validate the quality of annotations by benchmarking the performance of several state-of-the-art neural network architectures for phase recognition and surgical scene segmentation. Besides, we initiate the research on domain adaptation for instrument segmentation in cataract surgery by evaluating cross-domain instrument segmentation performance in cataract surgery videos. The dataset and annotations will be publicly available upon acceptance of the paper.

Human readers or radiologists routinely perform full-body multi-organ multi-disease detection and diagnosis in clinical practice, while most medical AI systems are built to focus on single organs with a narrow list of a few diseases. This might severely limit AI's clinical adoption. A certain number of AI models need to be assembled non-trivially to match the diagnostic process of a human reading a CT scan. In this paper, we construct a Unified Tumor Transformer (UniT) model to detect (tumor existence and location) and diagnose (tumor characteristics) eight major cancer-prevalent organs in CT scans. UniT is a query-based Mask Transformer model with the output of multi-organ and multi-tumor semantic segmentation. We decouple the object queries into organ queries, detection queries and diagnosis queries, and further establish hierarchical relationships among the three groups. This clinically-inspired architecture effectively assists inter- and intra-organ representation learning of tumors and facilitates the resolution of these complex, anatomically related multi-organ cancer image reading tasks. UniT is trained end-to-end using a curated large-scale CT images of 10,042 patients including eight major types of cancers and occurring non-cancer tumors (all are pathology-confirmed with 3D tumor masks annotated by radiologists). On the test set of 631 patients, UniT has demonstrated strong performance under a set of clinically relevant evaluation metrics, substantially outperforming both multi-organ segmentation methods and an assembly of eight single-organ expert models in tumor detection, segmentation, and diagnosis. Such a unified multi-cancer image reading model (UniT) can significantly reduce the number of false positives produced by combined multi-system models. This moves one step closer towards a universal high-performance cancer screening tool.

For 3D object manipulation, methods that build an explicit 3D representation perform better than those relying only on camera images. But using explicit 3D representations like voxels comes at large computing cost, adversely affecting scalability. In this work, we propose RVT, a multi-view transformer for 3D manipulation that is both scalable and accurate. Some key features of RVT are an attention mechanism to aggregate information across views and re-rendering of the camera input from virtual views around the robot workspace. In simulations, we find that a single RVT model works well across 18 RLBench tasks with 249 task variations, achieving 26% higher relative success than the existing state-of-the-art method (PerAct). It also trains 36X faster than PerAct for achieving the same performance and achieves 2.3X the inference speed of PerAct. Further, RVT can perform a variety of manipulation tasks in the real world with just a few (sim10) demonstrations per task. Visual results, code, and trained model are provided at https://robotic-view-transformer.github.io/.

Masked Image Modeling (MIM) achieves outstanding success in self-supervised representation learning. Unfortunately, MIM models typically have huge computational burden and slow learning process, which is an inevitable obstacle for their industrial applications. Although the lower layers play the key role in MIM, existing MIM models conduct reconstruction task only at the top layer of encoder. The lower layers are not explicitly guided and the interaction among their patches is only used for calculating new activations. Considering the reconstruction task requires non-trivial inter-patch interactions to reason target signals, we apply it to multiple local layers including lower and upper layers. Further, since the multiple layers expect to learn the information of different scales, we design local multi-scale reconstruction, where the lower and upper layers reconstruct fine-scale and coarse-scale supervision signals respectively. This design not only accelerates the representation learning process by explicitly guiding multiple layers, but also facilitates multi-scale semantical understanding to the input. Extensive experiments show that with significantly less pre-training burden, our model achieves comparable or better performance on classification, detection and segmentation tasks than existing MIM models.

In this work, we take aim towards increasing the effectiveness of surgical assistant robots. We intended to make assistant robots safer by making them aware about the actions of surgeon, so it can take appropriate assisting actions. In other words, we aim to solve the problem of surgeon action detection in endoscopic videos. To this, we introduce a challenging dataset for surgeon action detection in real-world endoscopic videos. Action classes are picked based on the feedback of surgeons and annotated by medical professional. Given a video frame, we draw bounding box around surgical tool which is performing action and label it with action label. Finally, we presenta frame-level action detection baseline model based on recent advances in ob-ject detection. Results on our new dataset show that our presented dataset provides enough interesting challenges for future method and it can serveas strong benchmark corresponding research in surgeon action detection in endoscopic videos.

The integration of artificial intelligence in image-guided interventions holds transformative potential, promising to extract 3D geometric and quantitative information from conventional 2D imaging modalities during complex procedures. Achieving this requires the rapid and precise alignment of 2D intraoperative images (e.g., X-ray) with 3D preoperative volumes (e.g., CT, MRI). However, current 2D/3D registration methods fail across the broad spectrum of procedures dependent on X-ray guidance: traditional optimization techniques require custom parameter tuning for each subject, whereas neural networks trained on small datasets do not generalize to new patients or require labor-intensive manual annotations, increasing clinical burden and precluding application to new anatomical targets. To address these challenges, we present xvr, a fully automated framework for training patient-specific neural networks for 2D/3D registration. xvr uses physics-based simulation to generate abundant high-quality training data from a patient's own preoperative volumetric imaging, thereby overcoming the inherently limited ability of supervised models to generalize to new patients and procedures. Furthermore, xvr requires only 5 minutes of training per patient, making it suitable for emergency interventions as well as planned procedures. We perform the largest evaluation of a 2D/3D registration algorithm on real X-ray data to date and find that xvr robustly generalizes across a diverse dataset comprising multiple anatomical structures, imaging modalities, and hospitals. Across surgical tasks, xvr achieves submillimeter-accurate registration at intraoperative speeds, improving upon existing methods by an order of magnitude. xvr is released as open-source software freely available at https://github.com/eigenvivek/xvr.

We propose Panoptic Lifting, a novel approach for learning panoptic 3D volumetric representations from images of in-the-wild scenes. Once trained, our model can render color images together with 3D-consistent panoptic segmentation from novel viewpoints. Unlike existing approaches which use 3D input directly or indirectly, our method requires only machine-generated 2D panoptic segmentation masks inferred from a pre-trained network. Our core contribution is a panoptic lifting scheme based on a neural field representation that generates a unified and multi-view consistent, 3D panoptic representation of the scene. To account for inconsistencies of 2D instance identifiers across views, we solve a linear assignment with a cost based on the model's current predictions and the machine-generated segmentation masks, thus enabling us to lift 2D instances to 3D in a consistent way. We further propose and ablate contributions that make our method more robust to noisy, machine-generated labels, including test-time augmentations for confidence estimates, segment consistency loss, bounded segmentation fields, and gradient stopping. Experimental results validate our approach on the challenging Hypersim, Replica, and ScanNet datasets, improving by 8.4, 13.8, and 10.6% in scene-level PQ over state of the art.

Precise spatial modeling in the operating room (OR) is foundational to many clinical tasks, supporting intraoperative awareness, hazard avoidance, and surgical decision-making. While existing approaches leverage large-scale multimodal datasets for latent-space alignment to implicitly learn spatial relationships, they overlook the 3D capabilities of MLLMs. However, this approach raises two issues: (1) Operating rooms typically lack multiple video and audio sensors, making multimodal 3D data difficult to obtain; (2) Training solely on readily available 2D data fails to capture fine-grained details in complex scenes. To address this gap, we introduce Spatial-ORMLLM, the first large vision-language model for 3D spatial reasoning in operating rooms using only RGB modality to infer volumetric and semantic cues, enabling downstream medical tasks with detailed and holistic spatial context. Spatial-ORMLLM incorporates a Spatial-Enhanced Feature Fusion Block, which integrates 2D modality inputs with rich 3D spatial knowledge extracted by the estimation algorithm and then feeds the combined features into the visual tower. By employing a unified end-to-end MLLM framework, it combines powerful spatial features with textual features to deliver robust 3D scene reasoning without any additional expert annotations or sensor inputs. Experiments on multiple benchmark clinical datasets demonstrate that Spatial-ORMLLM achieves state-of-the-art performance and generalizes robustly to previously unseen surgical scenarios and downstream tasks.

Recent advances in robot-assisted surgery have resulted in progressively more precise, efficient, and minimally invasive procedures, sparking a new era of robotic surgical intervention. This enables doctors, in collaborative interaction with robots, to perform traditional or minimally invasive surgeries with improved outcomes through smaller incisions. Recent efforts are working toward making robotic surgery more autonomous which has the potential to reduce variability of surgical outcomes and reduce complication rates. Deep reinforcement learning methodologies offer scalable solutions for surgical automation, but their effectiveness relies on extensive data acquisition due to the absence of prior knowledge in successfully accomplishing tasks. Due to the intensive nature of simulated data collection, previous works have focused on making existing algorithms more efficient. In this work, we focus on making the simulator more efficient, making training data much more accessible than previously possible. We introduce Surgical Gym, an open-source high performance platform for surgical robot learning where both the physics simulation and reinforcement learning occur directly on the GPU. We demonstrate between 100-5000x faster training times compared with previous surgical learning platforms. The code is available at: https://github.com/SamuelSchmidgall/SurgicalGym.

Visual robotic manipulation research and applications often use multiple cameras, or views, to better perceive the world. How else can we utilize the richness of multi-view data? In this paper, we investigate how to learn good representations with multi-view data and utilize them for visual robotic manipulation. Specifically, we train a multi-view masked autoencoder which reconstructs pixels of randomly masked viewpoints and then learn a world model operating on the representations from the autoencoder. We demonstrate the effectiveness of our method in a range of scenarios, including multi-view control and single-view control with auxiliary cameras for representation learning. We also show that the multi-view masked autoencoder trained with multiple randomized viewpoints enables training a policy with strong viewpoint randomization and transferring the policy to solve real-robot tasks without camera calibration and an adaptation procedure. Video demonstrations are available at: https://sites.google.com/view/mv-mwm.

Purpose: This study aims to explore training strategies to improve convolutional neural network-based image-to-image deformable registration for abdominal imaging. Methods: Different training strategies, loss functions, and transfer learning schemes were considered. Furthermore, an augmentation layer which generates artificial training image pairs on-the-fly was proposed, in addition to a loss layer that enables dynamic loss weighting. Results: Guiding registration using segmentations in the training step proved beneficial for deep-learning-based image registration. Finetuning the pretrained model from the brain MRI dataset to the abdominal CT dataset further improved performance on the latter application, removing the need for a large dataset to yield satisfactory performance. Dynamic loss weighting also marginally improved performance, all without impacting inference runtime. Conclusion: Using simple concepts, we improved the performance of a commonly used deep image registration architecture, VoxelMorph. In future work, our framework, DDMR, should be validated on different datasets to further assess its value.

This paper presents the Holistic and Multi-Granular Surgical Scene Understanding of Prostatectomies (GraSP) dataset, a curated benchmark that models surgical scene understanding as a hierarchy of complementary tasks with varying levels of granularity. Our approach encompasses long-term tasks, such as surgical phase and step recognition, and short-term tasks, including surgical instrument segmentation and atomic visual actions detection. To exploit our proposed benchmark, we introduce the Transformers for Actions, Phases, Steps, and Instrument Segmentation (TAPIS) model, a general architecture that combines a global video feature extractor with localized region proposals from an instrument segmentation model to tackle the multi-granularity of our benchmark. Through extensive experimentation in ours and alternative benchmarks, we demonstrate TAPIS's versatility and state-of-the-art performance across different tasks. This work represents a foundational step forward in Endoscopic Vision, offering a novel framework for future research towards holistic surgical scene understanding.

The success of machine learning algorithms generally depends on data representation, and we hypothesize that this is because different representations can entangle and hide more or less the different explanatory factors of variation behind the data. Although specific domain knowledge can be used to help design representations, learning with generic priors can also be used, and the quest for AI is motivating the design of more powerful representation-learning algorithms implementing such priors. This paper reviews recent work in the area of unsupervised feature learning and deep learning, covering advances in probabilistic models, auto-encoders, manifold learning, and deep networks. This motivates longer-term unanswered questions about the appropriate objectives for learning good representations, for computing representations (i.e., inference), and the geometrical connections between representation learning, density estimation and manifold learning.

The field of visual representation learning has seen explosive growth in the past years, but its benefits in robotics have been surprisingly limited so far. Prior work uses generic visual representations as a basis to learn (task-specific) robot action policies (e.g., via behavior cloning). While the visual representations do accelerate learning, they are primarily used to encode visual observations. Thus, action information has to be derived purely from robot data, which is expensive to collect! In this work, we present a scalable alternative where the visual representations can help directly infer robot actions. We observe that vision encoders express relationships between image observations as distances (e.g., via embedding dot product) that could be used to efficiently plan robot behavior. We operationalize this insight and develop a simple algorithm for acquiring a distance function and dynamics predictor, by fine-tuning a pre-trained representation on human collected video sequences. The final method is able to substantially outperform traditional robot learning baselines (e.g., 70% success v.s. 50% for behavior cloning on pick-place) on a suite of diverse real-world manipulation tasks. It can also generalize to novel objects, without using any robot demonstrations during train time. For visualizations of the learned policies please check: https://agi-labs.github.io/manipulate-by-seeing/.

We present a novel masked image modeling (MIM) approach, context autoencoder (CAE), for self-supervised representation pretraining. We pretrain an encoder by making predictions in the encoded representation space. The pretraining tasks include two tasks: masked representation prediction - predict the representations for the masked patches, and masked patch reconstruction - reconstruct the masked patches. The network is an encoder-regressor-decoder architecture: the encoder takes the visible patches as input; the regressor predicts the representations of the masked patches, which are expected to be aligned with the representations computed from the encoder, using the representations of visible patches and the positions of visible and masked patches; the decoder reconstructs the masked patches from the predicted encoded representations. The CAE design encourages the separation of learning the encoder (representation) from completing the pertaining tasks: masked representation prediction and masked patch reconstruction tasks, and making predictions in the encoded representation space empirically shows the benefit to representation learning. We demonstrate the effectiveness of our CAE through superior transfer performance in downstream tasks: semantic segmentation, object detection and instance segmentation, and classification. The code will be available at https://github.com/Atten4Vis/CAE.

In this paper, we explore methods of complicating self-supervised tasks for representation learning. That is, we do severe damage to data and encourage a network to recover them. First, we complicate each of three powerful self-supervised task candidates: jigsaw puzzle, inpainting, and colorization. In addition, we introduce a novel complicated self-supervised task called "Completing damaged jigsaw puzzles" which is puzzles with one piece missing and the other pieces without color. We train a convolutional neural network not only to solve the puzzles, but also generate the missing content and colorize the puzzles. The recovery of the aforementioned damage pushes the network to obtain robust and general-purpose representations. We demonstrate that complicating the self-supervised tasks improves their original versions and that our final task learns more robust and transferable representations compared to the previous methods, as well as the simple combination of our candidate tasks. Our approach achieves state-of-the-art performance in transfer learning on PASCAL classification and semantic segmentation.

Machine learning systems often experience a distribution shift between training and testing. In this paper, we introduce a simple variational objective whose optima are exactly the set of all representations on which risk minimizers are guaranteed to be robust to any distribution shift that preserves the Bayes predictor, e.g., covariate shifts. Our objective has two components. First, a representation must remain discriminative for the task, i.e., some predictor must be able to simultaneously minimize the source and target risk. Second, the representation's marginal support needs to be the same across source and target. We make this practical by designing self-supervised objectives that only use unlabelled data and augmentations to train robust representations. Our objectives give insights into the robustness of CLIP, and further improve CLIP's representations to achieve SOTA results on DomainBed.

Limited by the nature of the low-dimensional representational capacity of 3DMM, most of the 3DMM-based face reconstruction (FR) methods fail to recover high-frequency facial details, such as wrinkles, dimples, etc. Some attempt to solve the problem by introducing detail maps or non-linear operations, however, the results are still not vivid. To this end, we in this paper present a novel hierarchical representation network (HRN) to achieve accurate and detailed face reconstruction from a single image. Specifically, we implement the geometry disentanglement and introduce the hierarchical representation to fulfill detailed face modeling. Meanwhile, 3D priors of facial details are incorporated to enhance the accuracy and authenticity of the reconstruction results. We also propose a de-retouching module to achieve better decoupling of the geometry and appearance. It is noteworthy that our framework can be extended to a multi-view fashion by considering detail consistency of different views. Extensive experiments on two single-view and two multi-view FR benchmarks demonstrate that our method outperforms the existing methods in both reconstruction accuracy and visual effects. Finally, we introduce a high-quality 3D face dataset FaceHD-100 to boost the research of high-fidelity face reconstruction. The project homepage is at https://younglbw.github.io/HRN-homepage/.

Semi-Supervised Semantic Segmentation (S4) aims to train a segmentation model with limited labeled images and a substantial volume of unlabeled images. To improve the robustness of representations, powerful methods introduce a pixel-wise contrastive learning approach in latent space (i.e., representation space) that aggregates the representations to their prototypes in a fully supervised manner. However, previous contrastive-based S4 methods merely rely on the supervision from the model's output (logits) in logit space during unlabeled training. In contrast, we utilize the outputs in both logit space and representation space to obtain supervision in a collaborative way. The supervision from two spaces plays two roles: 1) reduces the risk of over-fitting to incorrect semantic information in logits with the help of representations; 2) enhances the knowledge exchange between the two spaces. Furthermore, unlike previous approaches, we use the similarity between representations and prototypes as a new indicator to tilt training those under-performing representations and achieve a more efficient contrastive learning process. Results on two public benchmarks demonstrate the competitive performance of our method compared with state-of-the-art methods.

Breast cancer survival prediction in computational pathology presents a remarkable challenge due to tumor heterogeneity. For instance, different regions of the same tumor in the pathology image can show distinct morphological and molecular characteristics. This makes it difficult to extract representative features from whole slide images (WSIs) that truly reflect the tumor's aggressive potential and likely survival outcomes. In this paper, we present PathoHR, a novel pipeline for accurate breast cancer survival prediction that enhances any size of pathological images to enable more effective feature learning. Our approach entails (1) the incorporation of a plug-and-play high-resolution Vision Transformer (ViT) to enhance patch-wise WSI representation, enabling more detailed and comprehensive feature extraction, (2) the systematic evaluation of multiple advanced similarity metrics for comparing WSI-extracted features, optimizing the representation learning process to better capture tumor characteristics, (3) the demonstration that smaller image patches enhanced follow the proposed pipeline can achieve equivalent or superior prediction accuracy compared to raw larger patches, while significantly reducing computational overhead. Experimental findings valid that PathoHR provides the potential way of integrating enhanced image resolution with optimized feature learning to advance computational pathology, offering a promising direction for more accurate and efficient breast cancer survival prediction. Code will be available at https://github.com/AIGeeksGroup/PathoHR.

This paper introduces a network for volumetric segmentation that learns from sparsely annotated volumetric images. We outline two attractive use cases of this method: (1) In a semi-automated setup, the user annotates some slices in the volume to be segmented. The network learns from these sparse annotations and provides a dense 3D segmentation. (2) In a fully-automated setup, we assume that a representative, sparsely annotated training set exists. Trained on this data set, the network densely segments new volumetric images. The proposed network extends the previous u-net architecture from Ronneberger et al. by replacing all 2D operations with their 3D counterparts. The implementation performs on-the-fly elastic deformations for efficient data augmentation during training. It is trained end-to-end from scratch, i.e., no pre-trained network is required. We test the performance of the proposed method on a complex, highly variable 3D structure, the Xenopus kidney, and achieve good results for both use cases.

Purpose: Surgical workflow analysis is crucial for improving surgical efficiency and safety. However, previous studies rely heavily on large-scale annotated datasets, posing challenges in cost, scalability, and reliance on expert annotations. To address this, we propose Surg-FTDA (Few-shot Text-driven Adaptation), designed to handle various surgical workflow analysis tasks with minimal paired image-label data. Methods: Our approach has two key components. First, Few-shot selection-based modality alignment selects a small subset of images and aligns their embeddings with text embeddings from the downstream task, bridging the modality gap. Second, Text-driven adaptation leverages only text data to train a decoder, eliminating the need for paired image-text data. This decoder is then applied to aligned image embeddings, enabling image-related tasks without explicit image-text pairs. Results: We evaluate our approach to generative tasks (image captioning) and discriminative tasks (triplet recognition and phase recognition). Results show that Surg-FTDA outperforms baselines and generalizes well across downstream tasks. Conclusion: We propose a text-driven adaptation approach that mitigates the modality gap and handles multiple downstream tasks in surgical workflow analysis, with minimal reliance on large annotated datasets. The code and dataset will be released in https://github.com/CAMMA-public/Surg-FTDA

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

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

Multimodal MRI provides critical complementary information for accurate brain tumor segmentation. However, conventional methods struggle when certain modalities are missing due to issues such as image quality, protocol inconsistencies, patient allergies, or financial constraints. To address this, we propose a robust single-modality parallel processing framework that achieves high segmentation accuracy even with incomplete modalities. Leveraging Holder divergence and mutual information, our model maintains modality-specific features while dynamically adjusting network parameters based on the available inputs. By using these divergence- and information-based loss functions, the framework effectively quantifies discrepancies between predictions and ground-truth labels, resulting in consistently accurate segmentation. Extensive evaluations on the BraTS 2018 and BraTS 2020 datasets demonstrate superior performance over existing methods in handling missing modalities.

We introduce a novel method for representation learning that uses an artificial supervision signal based on counting visual primitives. This supervision signal is obtained from an equivariance relation, which does not require any manual annotation. We relate transformations of images to transformations of the representations. More specifically, we look for the representation that satisfies such relation rather than the transformations that match a given representation. In this paper, we use two image transformations in the context of counting: scaling and tiling. The first transformation exploits the fact that the number of visual primitives should be invariant to scale. The second transformation allows us to equate the total number of visual primitives in each tile to that in the whole image. These two transformations are combined in one constraint and used to train a neural network with a contrastive loss. The proposed task produces representations that perform on par or exceed the state of the art in transfer learning benchmarks.

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

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

Representation learning has significantly driven the field to develop pretrained models that can act as a valuable starting point when transferring to new datasets. With the rising demand for reliable machine learning and uncertainty quantification, there is a need for pretrained models that not only provide embeddings but also transferable uncertainty estimates. To guide the development of such models, we propose the Uncertainty-aware Representation Learning (URL) benchmark. Besides the transferability of the representations, it also measures the zero-shot transferability of the uncertainty estimate using a novel metric. We apply URL to evaluate eleven uncertainty quantifiers that are pretrained on ImageNet and transferred to eight downstream datasets. We find that approaches that focus on the uncertainty of the representation itself or estimate the prediction risk directly outperform those that are based on the probabilities of upstream classes. Yet, achieving transferable uncertainty quantification remains an open challenge. Our findings indicate that it is not necessarily in conflict with traditional representation learning goals. Code is provided under https://github.com/mkirchhof/url .

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

3D generation guided by text-to-image diffusion models enables the creation of visually compelling assets. However previous methods explore generation based on image or text. The boundaries of creativity are limited by what can be expressed through words or the images that can be sourced. We present YouDream, a method to generate high-quality anatomically controllable animals. YouDream is guided using a text-to-image diffusion model controlled by 2D views of a 3D pose prior. Our method generates 3D animals that are not possible to create using previous text-to-3D generative methods. Additionally, our method is capable of preserving anatomic consistency in the generated animals, an area where prior text-to-3D approaches often struggle. Moreover, we design a fully automated pipeline for generating commonly found animals. To circumvent the need for human intervention to create a 3D pose, we propose a multi-agent LLM that adapts poses from a limited library of animal 3D poses to represent the desired animal. A user study conducted on the outcomes of YouDream demonstrates the preference of the animal models generated by our method over others. Turntable results and code are released at https://youdream3d.github.io/

Surgical future prediction, driven by real-time AI analysis of surgical video, is critical for operating room safety and efficiency. It provides actionable insights into upcoming events, their timing, and risks-enabling better resource allocation, timely instrument readiness, and early warnings for complications (e.g., bleeding, bile duct injury). Despite this need, current surgical AI research focuses on understanding what is happening rather than predicting future events. Existing methods target specific tasks in isolation, lacking unified approaches that span both short-term (action triplets, events) and long-term horizons (remaining surgery duration, phase transitions). These methods rely on coarse-grained supervision while fine-grained surgical action triplets and steps remain underexplored. Furthermore, methods based only on future feature prediction struggle to generalize across different surgical contexts and procedures. We address these limits by reframing surgical future prediction as state-change learning. Rather than forecasting raw observations, our approach classifies state transitions between current and future timesteps. We introduce SurgFUTR, implementing this through a teacher-student architecture. Video clips are compressed into state representations via Sinkhorn-Knopp clustering; the teacher network learns from both current and future clips, while the student network predicts future states from current videos alone, guided by our Action Dynamics (ActDyn) module. We establish SFPBench with five prediction tasks spanning short-term (triplets, events) and long-term (remaining surgery duration, phase and step transitions) horizons. Experiments across four datasets and three procedures show consistent improvements. Cross-procedure transfer validates generalizability.

Robust and accurate detection and segmentation of heterogenous tumors appearing in different anatomical organs with supervised methods require large-scale labeled datasets covering all possible types of diseases. Due to the unavailability of such rich datasets and the high cost of annotations, unsupervised anomaly detection (UAD) methods have been developed aiming to detect the pathologies as deviation from the normality by utilizing the unlabeled healthy image data. However, developed UAD models are often trained with an incomplete distribution of healthy anatomies and have difficulties in preserving anatomical constraints. This work intends to, first, propose a robust inpainting model to learn the details of healthy anatomies and reconstruct high-resolution images by preserving anatomical constraints. Second, we propose an autoinpainting pipeline to automatically detect tumors, replace their appearance with the learned healthy anatomies, and based on that segment the tumoral volumes in a purely unsupervised fashion. Three imaging datasets, including PET, CT, and PET-CT scans of lung tumors and head and neck tumors, are studied as benchmarks for evaluation. Experimental results demonstrate the significant superiority of the proposed method over a wide range of state-of-the-art UAD methods. Moreover, the unsupervised method we propose produces comparable results to a robust supervised segmentation method when applied to multimodal images.

In recent years, the application of machine learning to minimally invasive surgery (MIS) has attracted considerable interest. Datasets are critical to the use of such techniques. This paper presents a unique dataset recorded during ex vivo pseudo-cholecystectomy procedures on pig livers using the da Vinci Research Kit (dVRK). Unlike existing datasets, it addresses a critical gap by providing comprehensive kinematic data, recordings of all pedal inputs, and offers a time-stamped record of the endoscope's movements. This expanded version also includes segmentation and keypoint annotations of images, enhancing its utility for computer vision applications. Contributed by seven surgeons with varied backgrounds and experience levels that are provided as a part of this expanded version, the dataset is an important new resource for surgical robotics research. It enables the development of advanced methods for evaluating surgeon skills, tools for providing better context awareness, and automation of surgical tasks. Our work overcomes the limitations of incomplete recordings and imprecise kinematic data found in other datasets. To demonstrate the potential of the dataset for advancing automation in surgical robotics, we introduce two models that predict clutch usage and camera activation, a 3D scene reconstruction example, and the results from our keypoint and segmentation models.

Transformers have revolutionized medical image restoration, but the quadratic complexity still poses limitations for their application to high-resolution medical images. The recent advent of the Receptance Weighted Key Value (RWKV) model in the natural language processing field has attracted much attention due to its ability to process long sequences efficiently. To leverage its advanced design, we propose Restore-RWKV, the first RWKV-based model for medical image restoration. Since the original RWKV model is designed for 1D sequences, we make two necessary modifications for modeling spatial relations in 2D medical images. First, we present a recurrent WKV (Re-WKV) attention mechanism that captures global dependencies with linear computational complexity. Re-WKV incorporates bidirectional attention as basic for a global receptive field and recurrent attention to effectively model 2D dependencies from various scan directions. Second, we develop an omnidirectional token shift (Omni-Shift) layer that enhances local dependencies by shifting tokens from all directions and across a wide context range. These adaptations make the proposed Restore-RWKV an efficient and effective model for medical image restoration. Even a lightweight variant of Restore-RWKV, with only 1.16 million parameters, achieves comparable or even superior results compared to existing state-of-the-art (SOTA) methods. Extensive experiments demonstrate that the resulting Restore-RWKV achieves SOTA performance across a range of medical image restoration tasks, including PET image synthesis, CT image denoising, MRI image super-resolution, and all-in-one medical image restoration. Code is available at: https://github.com/Yaziwel/Restore-RWKV.

Mamba, a special case of the State Space Model, is gaining popularity as an alternative to template-based deep learning approaches in medical image analysis. While transformers are powerful architectures, they have drawbacks, including quadratic computational complexity and an inability to address long-range dependencies efficiently. This limitation affects the analysis of large and complex datasets in medical imaging, where there are many spatial and temporal relationships. In contrast, Mamba offers benefits that make it well-suited for medical image analysis. It has linear time complexity, which is a significant improvement over transformers. Mamba processes longer sequences without attention mechanisms, enabling faster inference and requiring less memory. Mamba also demonstrates strong performance in merging multimodal data, improving diagnosis accuracy and patient outcomes. The organization of this paper allows readers to appreciate the capabilities of Mamba in medical imaging step by step. We begin by defining core concepts of SSMs and models, including S4, S5, and S6, followed by an exploration of Mamba architectures such as pure Mamba, U-Net variants, and hybrid models with convolutional neural networks, transformers, and Graph Neural Networks. We also cover Mamba optimizations, techniques and adaptations, scanning, datasets, applications, experimental results, and conclude with its challenges and future directions in medical imaging. This review aims to demonstrate the transformative potential of Mamba in overcoming existing barriers within medical imaging while paving the way for innovative advancements in the field. A comprehensive list of Mamba architectures applied in the medical field, reviewed in this work, is available at Github.

Convolutional Neural Networks (CNNs) and Vision Transformers (ViTs) stand as the two most popular foundation models for visual representation learning. While CNNs exhibit remarkable scalability with linear complexity w.r.t. image resolution, ViTs surpass them in fitting capabilities despite contending with quadratic complexity. A closer inspection reveals that ViTs achieve superior visual modeling performance through the incorporation of global receptive fields and dynamic weights. This observation motivates us to propose a novel architecture that inherits these components while enhancing computational efficiency. To this end, we draw inspiration from the recently introduced state space model and propose the Visual State Space Model (VMamba), which achieves linear complexity without sacrificing global receptive fields. To address the encountered direction-sensitive issue, we introduce the Cross-Scan Module (CSM) to traverse the spatial domain and convert any non-causal visual image into order patch sequences. Extensive experimental results substantiate that VMamba not only demonstrates promising capabilities across various visual perception tasks, but also exhibits more pronounced advantages over established benchmarks as the image resolution increases. Source code has been available at https://github.com/MzeroMiko/VMamba.

Medical imaging is critical for diagnostics, but clinical adoption of advanced AI-driven imaging faces challenges due to patient variability, image artifacts, and limited model generalization. While deep learning has transformed image analysis, 3D medical imaging still suffers from data scarcity and inconsistencies due to acquisition protocols, scanner differences, and patient motion. Traditional augmentation uses a single pipeline for all transformations, disregarding the unique traits of each augmentation and struggling with large data volumes. To address these challenges, we propose a Multi-encoder Augmentation-Aware Learning (MEAL) framework that leverages four distinct augmentation variants processed through dedicated encoders. Three fusion strategies such as concatenation (CC), fusion layer (FL), and adaptive controller block (BD) are integrated to build multi-encoder models that combine augmentation-specific features before decoding. MEAL-BD uniquely preserves augmentation-aware representations, enabling robust, protocol-invariant feature learning. As demonstrated in a Computed Tomography (CT)-to-T1-weighted Magnetic Resonance Imaging (MRI) translation study, MEAL-BD consistently achieved the best performance on both unseen- and predefined-test data. On both geometric transformations (like rotations and flips) and non-augmented inputs, MEAL-BD outperformed other competing methods, achieving higher mean peak signal-to-noise ratio (PSNR) and structural similarity index measure (SSIM) scores. These results establish MEAL as a reliable framework for preserving structural fidelity and generalizing across clinically relevant variability. By reframing augmentation as a source of diverse, generalizable features, MEAL supports robust, protocol-invariant learning, advancing clinically reliable medical imaging solutions.

The task of reconstructing detailed 3D human body models from images is interesting but challenging in computer vision due to the high freedom of human bodies. In order to tackle the problem, we propose a coarse-to-fine method to reconstruct a detailed 3D human body from multi-view images combining voxel super-resolution based on learning the implicit representation. Firstly, the coarse 3D models are estimated by learning an implicit representation based on multi-scale features which are extracted by multi-stage hourglass networks from the multi-view images. Then, taking the low resolution voxel grids which are generated by the coarse 3D models as input, the voxel super-resolution based on an implicit representation is learned through a multi-stage 3D convolutional neural network. Finally, the refined detailed 3D human body models can be produced by the voxel super-resolution which can preserve the details and reduce the false reconstruction of the coarse 3D models. Benefiting from the implicit representation, the training process in our method is memory efficient and the detailed 3D human body produced by our method from multi-view images is the continuous decision boundary with high-resolution geometry. In addition, the coarse-to-fine method based on voxel super-resolution can remove false reconstructions and preserve the appearance details in the final reconstruction, simultaneously. In the experiments, our method quantitatively and qualitatively achieves the competitive 3D human body reconstructions from images with various poses and shapes on both the real and synthetic datasets.

The Segment Anything Model (SAM) has achieved remarkable successes in the realm of natural image segmentation, but its deployment in the medical imaging sphere has encountered challenges. Specifically, the model struggles with medical images that feature low contrast, faint boundaries, intricate morphologies, and small-sized objects. To address these challenges and enhance SAM's performance in the medical domain, we introduce a comprehensive modification. Firstly, we incorporate a frozen Convolutional Neural Network (CNN) branch as an image encoder, which synergizes with SAM's original Vision Transformer (ViT) encoder through a novel variational attention fusion module. This integration bolsters the model's capability to capture local spatial information, which is often paramount in medical imagery. Moreover, to further optimize SAM for medical imaging, we introduce feature and position adapters within the ViT branch, refining the encoder's representations. We see that compared to current prompting strategies to fine-tune SAM for ultrasound medical segmentation, the use of text descriptions that serve as text prompts for SAM helps significantly improve the performance. Leveraging ChatGPT's natural language understanding capabilities, we generate prompts that offer contextual information and guidance to SAM, enabling it to better understand the nuances of ultrasound medical images and improve its segmentation accuracy. Our method, in its entirety, represents a significant stride towards making universal image segmentation models more adaptable and efficient in the medical domain.

Modern retrieval system often requires recomputing the representation of every piece of data in the gallery when updating to a better representation model. This process is known as backfilling and can be especially costly in the real world where the gallery often contains billions of samples. Recently, researchers have proposed the idea of Backward Compatible Training (BCT) where the new representation model can be trained with an auxiliary loss to make it backward compatible with the old representation. In this way, the new representation can be directly compared with the old representation, in principle avoiding the need for any backfilling. However, followup work shows that there is an inherent tradeoff where a backward compatible representation model cannot simultaneously maintain the performance of the new model itself. This paper reports our ``not-so-surprising'' finding that adding extra dimensions to the representation can help here. However, we also found that naively increasing the dimension of the representation did not work. To deal with this, we propose Backward-compatible Training with a novel Basis Transformation (BT^2). A basis transformation (BT) is basically a learnable set of parameters that applies an orthonormal transformation. Such a transformation possesses an important property whereby the original information contained in its input is retained in its output. We show in this paper how a BT can be utilized to add only the necessary amount of additional dimensions. We empirically verify the advantage of BT^2 over other state-of-the-art methods in a wide range of settings. We then further extend BT^2 to other challenging yet more practical settings, including significant change in model architecture (CNN to Transformers), modality change, and even a series of updates in the model architecture mimicking the evolution of deep learning models.

Self-Supervised Contrastive Learning has proven effective in deriving high-quality representations from unlabeled data. However, a major challenge that hinders both unimodal and multimodal contrastive learning is feature suppression, a phenomenon where the trained model captures only a limited portion of the information from the input data while overlooking other potentially valuable content. This issue often leads to indistinguishable representations for visually similar but semantically different inputs, adversely affecting downstream task performance, particularly those requiring rigorous semantic comprehension. To address this challenge, we propose a novel model-agnostic Multistage Contrastive Learning (MCL) framework. Unlike standard contrastive learning which inherently captures one single biased feature distribution, MCL progressively learns previously unlearned features through feature-aware negative sampling at each stage, where the negative samples of an anchor are exclusively selected from the cluster it was assigned to in preceding stages. Meanwhile, MCL preserves the previously well-learned features by cross-stage representation integration, integrating features across all stages to form final representations. Our comprehensive evaluation demonstrates MCL's effectiveness and superiority across both unimodal and multimodal contrastive learning, spanning a range of model architectures from ResNet to Vision Transformers (ViT). Remarkably, in tasks where the original CLIP model has shown limitations, MCL dramatically enhances performance, with improvements up to threefold on specific attributes in the recently proposed MMVP benchmark.

Masked image modelling (MIM) is a powerful self-supervised representation learning paradigm, whose potential has not been widely demonstrated in medical image analysis. In this work, we show the capacity of MIM to capture rich semantic representations of Haemotoxylin & Eosin (H&E)-stained images at the nuclear level. Inspired by Bidirectional Encoder representation from Image Transformers (BEiT), we split the images into smaller patches and generate corresponding discrete visual tokens. In addition to the regular grid-based patches, typically used in visual Transformers, we introduce patches of individual cell nuclei. We propose positional encoding of the irregular distribution of these structures within an image. We pre-train the model in a self-supervised manner on H&E-stained whole-slide images of diffuse large B-cell lymphoma, where cell nuclei have been segmented. The pre-training objective is to recover the original discrete visual tokens of the masked image on the one hand, and to reconstruct the visual tokens of the masked object instances on the other. Coupling these two pre-training tasks allows us to build powerful, context-aware representations of nuclei. Our model generalizes well and can be fine-tuned on downstream classification tasks, achieving improved cell classification accuracy on PanNuke dataset by more than 5% compared to current instance segmentation methods.

UniT is a novel approach to tactile representation learning, using VQVAE to learn a compact latent space and serve as the tactile representation. It uses tactile images obtained from a single simple object to train the representation with transferability and generalizability. This tactile representation can be zero-shot transferred to various downstream tasks, including perception tasks and manipulation policy learning. Our benchmarking on an in-hand 3D pose estimation task shows that UniT outperforms existing visual and tactile representation learning methods. Additionally, UniT's effectiveness in policy learning is demonstrated across three real-world tasks involving diverse manipulated objects and complex robot-object-environment interactions. Through extensive experimentation, UniT is shown to be a simple-to-train, plug-and-play, yet widely effective method for tactile representation learning. For more details, please refer to our open-source repository https://github.com/ZhengtongXu/UniT and the project website https://zhengtongxu.github.io/unifiedtactile.github.io/.

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

Representational analysis explores how input data of a neural system are encoded in high dimensional spaces of its distributed neural activations, and how we can compare different systems, for instance, artificial neural networks and brains, on those grounds. While existing methods offer important insights, they typically do not account for local intrinsic geometrical properties within the high-dimensional representation spaces. To go beyond these limitations, we explore Ollivier-Ricci curvature and Ricci flow as tools to study the alignment of representations between humans and artificial neural systems on a geometric level. As a proof-of-principle study, we compared the representations of face stimuli between VGG-Face, a human-aligned version of VGG-Face, and corresponding human similarity judgments from a large online study. Using this discrete geometric framework, we were able to identify local structural similarities and differences by examining the distributions of node and edge curvature and higher-level properties by detecting and comparing community structure in the representational graphs.

This paper addresses the challenge of novel view synthesis for a human performer from a very sparse set of camera views. Some recent works have shown that learning implicit neural representations of 3D scenes achieves remarkable view synthesis quality given dense input views. However, the representation learning will be ill-posed if the views are highly sparse. To solve this ill-posed problem, our key idea is to integrate observations over video frames. To this end, we propose Neural Body, a new human body representation which assumes that the learned neural representations at different frames share the same set of latent codes anchored to a deformable mesh, so that the observations across frames can be naturally integrated. The deformable mesh also provides geometric guidance for the network to learn 3D representations more efficiently. To evaluate our approach, we create a multi-view dataset named ZJU-MoCap that captures performers with complex motions. Experiments on ZJU-MoCap show that our approach outperforms prior works by a large margin in terms of novel view synthesis quality. We also demonstrate the capability of our approach to reconstruct a moving person from a monocular video on the People-Snapshot dataset. The code and dataset are available at https://zju3dv.github.io/neuralbody/.

End-to-end reinforcement learning on images showed significant progress in the recent years. Data-based approach leverage data augmentation and domain randomization while representation learning methods use auxiliary losses to learn task-relevant features. Yet, reinforcement still struggles in visually diverse environments full of distractions and spurious noise. In this work, we tackle the problem of robust visual control at its core and present VIBR (View-Invariant Bellman Residuals), a method that combines multi-view training and invariant prediction to reduce out-of-distribution (OOD) generalization gap for RL based visuomotor control. Our model-free approach improve baselines performances without the need of additional representation learning objectives and with limited additional computational cost. We show that VIBR outperforms existing methods on complex visuo-motor control environment with high visual perturbation. Our approach achieves state-of the-art results on the Distracting Control Suite benchmark, a challenging benchmark still not solved by current methods, where we evaluate the robustness to a number of visual perturbators, as well as OOD generalization and extrapolation capabilities.

Semantic segmentation of brain tumors is a fundamental medical image analysis task involving multiple MRI imaging modalities that can assist clinicians in diagnosing the patient and successively studying the progression of the malignant entity. In recent years, Fully Convolutional Neural Networks (FCNNs) approaches have become the de facto standard for 3D medical image segmentation. The popular "U-shaped" network architecture has achieved state-of-the-art performance benchmarks on different 2D and 3D semantic segmentation tasks and across various imaging modalities. However, due to the limited kernel size of convolution layers in FCNNs, their performance of modeling long-range information is sub-optimal, and this can lead to deficiencies in the segmentation of tumors with variable sizes. On the other hand, transformer models have demonstrated excellent capabilities in capturing such long-range information in multiple domains, including natural language processing and computer vision. Inspired by the success of vision transformers and their variants, we propose a novel segmentation model termed Swin UNEt TRansformers (Swin UNETR). Specifically, the task of 3D brain tumor semantic segmentation is reformulated as a sequence to sequence prediction problem wherein multi-modal input data is projected into a 1D sequence of embedding and used as an input to a hierarchical Swin transformer as the encoder. The swin transformer encoder extracts features at five different resolutions by utilizing shifted windows for computing self-attention and is connected to an FCNN-based decoder at each resolution via skip connections. We have participated in BraTS 2021 segmentation challenge, and our proposed model ranks among the top-performing approaches in the validation phase. Code: https://monai.io/research/swin-unetr

Existing volumetric medical image segmentation models are typically task-specific, excelling at specific target but struggling to generalize across anatomical structures or modalities. This limitation restricts their broader clinical use. In this paper, we introduce SAM-Med3D for general-purpose segmentation on volumetric medical images. Given only a few 3D prompt points, SAM-Med3D can accurately segment diverse anatomical structures and lesions across various modalities. To achieve this, we gather and process a large-scale 3D medical image dataset, SA-Med3D-140K, from a blend of public sources and licensed private datasets. This dataset includes 22K 3D images and 143K corresponding 3D masks. Then SAM-Med3D, a promptable segmentation model characterized by the fully learnable 3D structure, is trained on this dataset using a two-stage procedure and exhibits impressive performance on both seen and unseen segmentation targets. We comprehensively evaluate SAM-Med3D on 16 datasets covering diverse medical scenarios, including different anatomical structures, modalities, targets, and zero-shot transferability to new/unseen tasks. The evaluation shows the efficiency and efficacy of SAM-Med3D, as well as its promising application to diverse downstream tasks as a pre-trained model. Our approach demonstrates that substantial medical resources can be utilized to develop a general-purpose medical AI for various potential applications. Our dataset, code, and models are available at https://github.com/uni-medical/SAM-Med3D.

Parameter-efficient fine-tuning (PEFT) methods seek to adapt large models via updates to a small number of weights. However, much prior interpretability work has shown that representations encode rich semantic information, suggesting that editing representations might be a more powerful alternative. Here, we pursue this hypothesis by developing a family of Representation Finetuning (ReFT) methods. ReFT methods operate on a frozen base model and learn task-specific interventions on hidden representations. We define a strong instance of the ReFT family, Low-rank Linear Subspace ReFT (LoReFT). LoReFT is a drop-in replacement for existing PEFTs and learns interventions that are 10x-50x more parameter-efficient than prior state-of-the-art PEFTs. We showcase LoReFT on eight commonsense reasoning tasks, four arithmetic reasoning tasks, Alpaca-Eval v1.0, and GLUE. In all these evaluations, LoReFT delivers the best balance of efficiency and performance, and almost always outperforms state-of-the-art PEFTs. We release a generic ReFT training library publicly at https://github.com/stanfordnlp/pyreft.

A central question for neuroscience is how to characterize brain representations of perceptual and cognitive content. An ideal characterization should distinguish different functional regions with robustness to noise and idiosyncrasies of individual brains that do not correspond to computational differences. Previous studies have characterized brain representations by their representational geometry, which is defined by the representational dissimilarity matrix (RDM), a summary statistic that abstracts from the roles of individual neurons (or responses channels) and characterizes the discriminability of stimuli. Here we explore a further step of abstraction: from the geometry to the topology of brain representations. We propose topological representational similarity analysis (tRSA), an extension of representational similarity analysis (RSA) that uses a family of geo-topological summary statistics that generalizes the RDM to characterize the topology while de-emphasizing the geometry. We evaluate this new family of statistics in terms of the sensitivity and specificity for model selection using both simulations and functional MRI (fMRI) data. In the simulations, the ground truth is a data-generating layer representation in a neural network model and the models are the same and other layers in different model instances (trained from different random seeds). In fMRI, the ground truth is a visual area and the models are the same and other areas measured in different subjects. Results show that topology-sensitive characterizations of population codes are robust to noise and interindividual variability and maintain excellent sensitivity to the unique representational signatures of different neural network layers and brain regions.

Learning image representations without human supervision is an important and active research field. Several recent approaches have successfully leveraged the idea of making such a representation invariant under different types of perturbations, especially via contrastive-based instance discrimination training. Although effective visual representations should indeed exhibit such invariances, there are other important characteristics, such as encoding contextual reasoning skills, for which alternative reconstruction-based approaches might be better suited. With this in mind, we propose a teacher-student scheme to learn representations by training a convolutional net to reconstruct a bag-of-visual-words (BoW) representation of an image, given as input a perturbed version of that same image. Our strategy performs an online training of both the teacher network (whose role is to generate the BoW targets) and the student network (whose role is to learn representations), along with an online update of the visual-words vocabulary (used for the BoW targets). This idea effectively enables fully online BoW-guided unsupervised learning. Extensive experiments demonstrate the interest of our BoW-based strategy which surpasses previous state-of-the-art methods (including contrastive-based ones) in several applications. For instance, in downstream tasks such Pascal object detection, Pascal classification and Places205 classification, our method improves over all prior unsupervised approaches, thus establishing new state-of-the-art results that are also significantly better even than those of supervised pre-training. We provide the implementation code at https://github.com/valeoai/obow.

Computed Tomography (CT) is one of the most popular modalities for medical imaging. By far, CT images have contributed to the largest publicly available datasets for volumetric medical segmentation tasks, covering full-body anatomical structures. Large amounts of full-body CT images provide the opportunity to pre-train powerful models, e.g., STU-Net pre-trained in a supervised fashion, to segment numerous anatomical structures. However, it remains unclear in which conditions these pre-trained models can be transferred to various downstream medical segmentation tasks, particularly segmenting the other modalities and diverse targets. To address this problem, a large-scale benchmark for comprehensive evaluation is crucial for finding these conditions. Thus, we collected 87 public datasets varying in modality, target, and sample size to evaluate the transfer ability of full-body CT pre-trained models. We then employed a representative model, STU-Net with multiple model scales, to conduct transfer learning across modalities and targets. Our experimental results show that (1) there may be a bottleneck effect concerning the dataset size in fine-tuning, with more improvement on both small- and large-scale datasets than medium-size ones. (2) Models pre-trained on full-body CT demonstrate effective modality transfer, adapting well to other modalities such as MRI. (3) Pre-training on the full-body CT not only supports strong performance in structure detection but also shows efficacy in lesion detection, showcasing adaptability across target tasks. We hope that this large-scale open evaluation of transfer learning can direct future research in volumetric medical image segmentation.

Intra-operative recognition of surgical phases holds significant potential for enhancing real-time contextual awareness in the operating room. However, we argue that online recognition, while beneficial, primarily lends itself to post-operative video analysis due to its limited direct impact on the actual surgical decisions and actions during ongoing procedures. In contrast, we contend that the prediction and anticipation of surgical phases are inherently more valuable for intra-operative assistance, as they can meaningfully influence a surgeon's immediate and long-term planning by providing foresight into future steps. To address this gap, we propose a dual approach that simultaneously recognises the current surgical phase and predicts upcoming ones, thus offering comprehensive intra-operative assistance and guidance on the expected remaining workflow. Our novel method, Surgical Phase Recognition and Anticipation (SuPRA), leverages past and current information for accurate intra-operative phase recognition while using future segments for phase prediction. This unified approach challenges conventional frameworks that treat these objectives separately. We have validated SuPRA on two reputed datasets, Cholec80 and AutoLaparo21, where it demonstrated state-of-the-art performance with recognition accuracies of 91.8% and 79.3%, respectively. Additionally, we introduce and evaluate our model using new segment-level evaluation metrics, namely Edit and F1 Overlap scores, for a more temporal assessment of segment classification. In conclusion, SuPRA presents a new multi-task approach that paves the way for improved intra-operative assistance through surgical phase recognition and prediction of future events.

Radiology reporting generative AI holds significant potential to alleviate clinical workloads and streamline medical care. However, achieving high clinical accuracy is challenging, as radiological images often feature subtle lesions and intricate structures. Existing systems often fall short, largely due to their reliance on fixed size, patch-level image features and insufficient incorporation of pathological information. This can result in the neglect of such subtle patterns and inconsistent descriptions of crucial pathologies. To address these challenges, we propose an innovative approach that leverages pathology-aware regional prompts to explicitly integrate anatomical and pathological information of various scales, significantly enhancing the precision and clinical relevance of generated reports. We develop an anatomical region detector that extracts features from distinct anatomical areas, coupled with a novel multi-label lesion detector that identifies global pathologies. Our approach emulates the diagnostic process of radiologists, producing clinically accurate reports with comprehensive diagnostic capabilities. Experimental results show that our model outperforms previous state-of-the-art methods on most natural language generation and clinical efficacy metrics, with formal expert evaluations affirming its potential to enhance radiology practice.

We introduce Representation Tokenizer (RepTok), a generative modeling framework that represents an image using a single continuous latent token obtained from self-supervised vision transformers. Building on a pre-trained SSL encoder, we fine-tune only the semantic token embedding and pair it with a generative decoder trained jointly using a standard flow matching objective. This adaptation enriches the token with low-level, reconstruction-relevant details, enabling faithful image reconstruction. To preserve the favorable geometry of the original SSL space, we add a cosine-similarity loss that regularizes the adapted token, ensuring the latent space remains smooth and suitable for generation. Our single-token formulation resolves spatial redundancies of 2D latent spaces and significantly reduces training costs. Despite its simplicity and efficiency, RepTok achieves competitive results on class-conditional ImageNet generation and naturally extends to text-to-image synthesis, reaching competitive zero-shot performance on MS-COCO under extremely limited training budgets. Our findings highlight the potential of fine-tuned SSL representations as compact and effective latent spaces for efficient generative modeling.

With the development of Deep Neural Networks (DNNs), many efforts have been made to handle medical image segmentation. Traditional methods such as nnUNet train specific segmentation models on the individual datasets. Plenty of recent methods have been proposed to adapt the foundational Segment Anything Model (SAM) to medical image segmentation. However, they still focus on discrete representations to generate pixel-wise predictions, which are spatially inflexible and scale poorly to higher resolution. In contrast, implicit methods learn continuous representations for segmentation, which is crucial for medical image segmentation. In this paper, we propose I-MedSAM, which leverages the benefits of both continuous representations and SAM, to obtain better cross-domain ability and accurate boundary delineation. Since medical image segmentation needs to predict detailed segmentation boundaries, we designed a novel adapter to enhance the SAM features with high-frequency information during Parameter-Efficient Fine-Tuning (PEFT). To convert the SAM features and coordinates into continuous segmentation output, we utilize Implicit Neural Representation (INR) to learn an implicit segmentation decoder. We also propose an uncertainty-guided sampling strategy for efficient learning of INR. Extensive evaluations on 2D medical image segmentation tasks have shown that our proposed method with only 1.6M trainable parameters outperforms existing methods including discrete and implicit methods. The code will be available at: https://github.com/ucwxb/I-MedSAM.

Extracting useful visual cues for the downstream tasks is especially challenging under low-light vision. Prior works create enhanced representations by either correlating visual quality with machine perception or designing illumination-degrading transformation methods that require pre-training on synthetic datasets. We argue that optimizing enhanced image representation pertaining to the loss of the downstream task can result in more expressive representations. Therefore, in this work, we propose a novel module, FeatEnHancer, that hierarchically combines multiscale features using multiheaded attention guided by task-related loss function to create suitable representations. Furthermore, our intra-scale enhancement improves the quality of features extracted at each scale or level, as well as combines features from different scales in a way that reflects their relative importance for the task at hand. FeatEnHancer is a general-purpose plug-and-play module and can be incorporated into any low-light vision pipeline. We show with extensive experimentation that the enhanced representation produced with FeatEnHancer significantly and consistently improves results in several low-light vision tasks, including dark object detection (+5.7 mAP on ExDark), face detection (+1.5 mAPon DARK FACE), nighttime semantic segmentation (+5.1 mIoU on ACDC ), and video object detection (+1.8 mAP on DarkVision), highlighting the effectiveness of enhancing hierarchical features under low-light vision.

Endoscopic surgery relies on two-dimensional views, posing challenges for surgeons in depth perception and instrument manipulation. While Monocular Visual Simultaneous Localization and Mapping (MVSLAM) has emerged as a promising solution, its implementation in endoscopic procedures faces significant challenges due to hardware limitations, such as the use of a monocular camera and the absence of odometry sensors. This study presents BodySLAM, a robust deep learning-based MVSLAM approach that addresses these challenges through three key components: CycleVO, a novel unsupervised monocular pose estimation module; the integration of the state-of-the-art Zoe architecture for monocular depth estimation; and a 3D reconstruction module creating a coherent surgical map. The approach is rigorously evaluated using three publicly available datasets (Hamlyn, EndoSLAM, and SCARED) spanning laparoscopy, gastroscopy, and colonoscopy scenarios, and benchmarked against four state-of-the-art methods. Results demonstrate that CycleVO exhibited competitive performance with the lowest inference time among pose estimation methods, while maintaining robust generalization capabilities, whereas Zoe significantly outperformed existing algorithms for depth estimation in endoscopy. BodySLAM's strong performance across diverse endoscopic scenarios demonstrates its potential as a viable MVSLAM solution for endoscopic applications.

Attention mechanism has been widely believed as the key to success of vision transformers (ViTs), since it provides a flexible and powerful way to model spatial relationships. However, is the attention mechanism truly an indispensable part of ViT? Can it be replaced by some other alternatives? To demystify the role of attention mechanism, we simplify it into an extremely simple case: ZERO FLOP and ZERO parameter. Concretely, we revisit the shift operation. It does not contain any parameter or arithmetic calculation. The only operation is to exchange a small portion of the channels between neighboring features. Based on this simple operation, we construct a new backbone network, namely ShiftViT, where the attention layers in ViT are substituted by shift operations. Surprisingly, ShiftViT works quite well in several mainstream tasks, e.g., classification, detection, and segmentation. The performance is on par with or even better than the strong baseline Swin Transformer. These results suggest that the attention mechanism might not be the vital factor that makes ViT successful. It can be even replaced by a zero-parameter operation. We should pay more attentions to the remaining parts of ViT in the future work. Code is available at github.com/microsoft/SPACH.

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

Deep learning has demonstrated remarkable success in medical image segmentation and computer-aided diagnosis. In particular, numerous advanced methods have achieved state-of-the-art performance in brain tumor segmentation from MRI scans. While recent studies in other medical imaging domains have revealed that integrating textual reports with visual data can enhance segmentation accuracy, the field of brain tumor analysis lacks a comprehensive dataset that combines radiological images with corresponding textual annotations. This limitation has hindered the exploration of multimodal approaches that leverage both imaging and textual data. To bridge this critical gap, we introduce the TextBraTS dataset, the first publicly available volume-level multimodal dataset that contains paired MRI volumes and rich textual annotations, derived from the widely adopted BraTS2020 benchmark. Building upon this novel dataset, we propose a novel baseline framework and sequential cross-attention method for text-guided volumetric medical image segmentation. Through extensive experiments with various text-image fusion strategies and templated text formulations, our approach demonstrates significant improvements in brain tumor segmentation accuracy, offering valuable insights into effective multimodal integration techniques. Our dataset, implementation code, and pre-trained models are publicly available at https://github.com/Jupitern52/TextBraTS.

Early tumor detection save lives. Each year, more than 300 million computed tomography (CT) scans are performed worldwide, offering a vast opportunity for effective cancer screening. However, detecting small or early-stage tumors on these CT scans remains challenging, even for experts. Artificial intelligence (AI) models can assist by highlighting suspicious regions, but training such models typically requires extensive tumor masks--detailed, voxel-wise outlines of tumors manually drawn by radiologists. Drawing these masks is costly, requiring years of effort and millions of dollars. In contrast, nearly every CT scan in clinical practice is already accompanied by medical reports describing the tumor's size, number, appearance, and sometimes, pathology results--information that is rich, abundant, and often underutilized for AI training. We introduce R-Super, which trains AI to segment tumors that match their descriptions in medical reports. This approach scales AI training with large collections of readily available medical reports, substantially reducing the need for manually drawn tumor masks. When trained on 101,654 reports, AI models achieved performance comparable to those trained on 723 masks. Combining reports and masks further improved sensitivity by +13% and specificity by +8%, surpassing radiologists in detecting five of the seven tumor types. Notably, R-Super enabled segmentation of tumors in the spleen, gallbladder, prostate, bladder, uterus, and esophagus, for which no public masks or AI models previously existed. This study challenges the long-held belief that large-scale, labor-intensive tumor mask creation is indispensable, establishing a scalable and accessible path toward early detection across diverse tumor types. We plan to release our trained models, code, and dataset at https://github.com/MrGiovanni/R-Super

Recent accelerations in multi-modal applications have been made possible with the plethora of image and text data available online. However, the scarcity of analogous data in the medical field, specifically in histopathology, has halted comparable progress. To enable similar representation learning for histopathology, we turn to YouTube, an untapped resource of videos, offering 1,087 hours of valuable educational histopathology videos from expert clinicians. From YouTube, we curate Quilt: a large-scale vision-language dataset consisting of 768,826 image and text pairs. Quilt was automatically curated using a mixture of models, including large language models, handcrafted algorithms, human knowledge databases, and automatic speech recognition. In comparison, the most comprehensive datasets curated for histopathology amass only around 200K samples. We combine Quilt with datasets from other sources, including Twitter, research papers, and the internet in general, to create an even larger dataset: Quilt-1M, with 1M paired image-text samples, marking it as the largest vision-language histopathology dataset to date. We demonstrate the value of Quilt-1M by fine-tuning a pre-trained CLIP model. Our model outperforms state-of-the-art models on both zero-shot and linear probing tasks for classifying new histopathology images across 13 diverse patch-level datasets of 8 different sub-pathologies and cross-modal retrieval tasks.

Foundation models in video generation are demonstrating remarkable capabilities as potential world models for simulating the physical world. However, their application in high-stakes domains like surgery, which demand deep, specialized causal knowledge rather than general physical rules, remains a critical unexplored gap. To systematically address this challenge, we present SurgVeo, the first expert-curated benchmark for video generation model evaluation in surgery, and the Surgical Plausibility Pyramid (SPP), a novel, four-tiered framework tailored to assess model outputs from basic appearance to complex surgical strategy. On the basis of the SurgVeo benchmark, we task the advanced Veo-3 model with a zero-shot prediction task on surgical clips from laparoscopic and neurosurgical procedures. A panel of four board-certified surgeons evaluates the generated videos according to the SPP. Our results reveal a distinct "plausibility gap": while Veo-3 achieves exceptional Visual Perceptual Plausibility, it fails critically at higher levels of the SPP, including Instrument Operation Plausibility, Environment Feedback Plausibility, and Surgical Intent Plausibility. This work provides the first quantitative evidence of the chasm between visually convincing mimicry and causal understanding in surgical AI. Our findings from SurgVeo and the SPP establish a crucial foundation and roadmap for developing future models capable of navigating the complexities of specialized, real-world healthcare domains.

Operating rooms (ORs) are complex, high-stakes environments requiring precise understanding of interactions among medical staff, tools, and equipment for enhancing surgical assistance, situational awareness, and patient safety. Current datasets fall short in scale, realism and do not capture the multimodal nature of OR scenes, limiting progress in OR modeling. To this end, we introduce MM-OR, a realistic and large-scale multimodal spatiotemporal OR dataset, and the first dataset to enable multimodal scene graph generation. MM-OR captures comprehensive OR scenes containing RGB-D data, detail views, audio, speech transcripts, robotic logs, and tracking data and is annotated with panoptic segmentations, semantic scene graphs, and downstream task labels. Further, we propose MM2SG, the first multimodal large vision-language model for scene graph generation, and through extensive experiments, demonstrate its ability to effectively leverage multimodal inputs. Together, MM-OR and MM2SG establish a new benchmark for holistic OR understanding, and open the path towards multimodal scene analysis in complex, high-stakes environments. Our code, and data is available at https://github.com/egeozsoy/MM-OR.

Language models demonstrate remarkable capacity to generalize representations learned in one modality to downstream tasks in other modalities. Can we trace this ability to individual neurons? We study the case where a frozen text transformer is augmented with vision using a self-supervised visual encoder and a single linear projection learned on an image-to-text task. Outputs of the projection layer are not immediately decodable into language describing image content; instead, we find that translation between modalities occurs deeper within the transformer. We introduce a procedure for identifying "multimodal neurons" that convert visual representations into corresponding text, and decoding the concepts they inject into the model's residual stream. In a series of experiments, we show that multimodal neurons operate on specific visual concepts across inputs, and have a systematic causal effect on image captioning.

Modern operating room is becoming increasingly complex, requiring innovative intra-operative support systems. While the focus of surgical data science has largely been on video analysis, integrating surgical computer vision with language capabilities is emerging as a necessity. Our work aims to advance Visual Question Answering (VQA) in the surgical context with scene graph knowledge, addressing two main challenges in the current surgical VQA systems: removing question-condition bias in the surgical VQA dataset and incorporating scene-aware reasoning in the surgical VQA model design. First, we propose a Surgical Scene Graph-based dataset, SSG-QA, generated by employing segmentation and detection models on publicly available datasets. We build surgical scene graphs using spatial and action information of instruments and anatomies. These graphs are fed into a question engine, generating diverse QA pairs. Our SSG-QA dataset provides a more complex, diverse, geometrically grounded, unbiased, and surgical action-oriented dataset compared to existing surgical VQA datasets. We then propose SSG-QA-Net, a novel surgical VQA model incorporating a lightweight Scene-embedded Interaction Module (SIM), which integrates geometric scene knowledge in the VQA model design by employing cross-attention between the textual and the scene features. Our comprehensive analysis of the SSG-QA dataset shows that SSG-QA-Net outperforms existing methods across different question types and complexities. We highlight that the primary limitation in the current surgical VQA systems is the lack of scene knowledge to answer complex queries. We present a novel surgical VQA dataset and model and show that results can be significantly improved by incorporating geometric scene features in the VQA model design. The source code and the dataset will be made publicly available at: https://github.com/CAMMA-public/SSG-QA

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

Even though convolutional neural networks (CNNs) are driving progress in medical image segmentation, standard models still have some drawbacks. First, the use of multi-scale approaches, i.e., encoder-decoder architectures, leads to a redundant use of information, where similar low-level features are extracted multiple times at multiple scales. Second, long-range feature dependencies are not efficiently modeled, resulting in non-optimal discriminative feature representations associated with each semantic class. In this paper we attempt to overcome these limitations with the proposed architecture, by capturing richer contextual dependencies based on the use of guided self-attention mechanisms. This approach is able to integrate local features with their corresponding global dependencies, as well as highlight interdependent channel maps in an adaptive manner. Further, the additional loss between different modules guides the attention mechanisms to neglect irrelevant information and focus on more discriminant regions of the image by emphasizing relevant feature associations. We evaluate the proposed model in the context of semantic segmentation on three different datasets: abdominal organs, cardiovascular structures and brain tumors. A series of ablation experiments support the importance of these attention modules in the proposed architecture. In addition, compared to other state-of-the-art segmentation networks our model yields better segmentation performance, increasing the accuracy of the predictions while reducing the standard deviation. This demonstrates the efficiency of our approach to generate precise and reliable automatic segmentations of medical images. Our code is made publicly available at https://github.com/sinAshish/Multi-Scale-Attention

Tumor segmentation in CT scans is key for diagnosis, surgery, and prognosis, yet segmentation masks are scarce because their creation requires time and expertise. Public abdominal CT datasets have from dozens to a couple thousand tumor masks, but hospitals have hundreds of thousands of tumor CTs with radiology reports. Thus, leveraging reports to improve segmentation is key for scaling. In this paper, we propose a report-supervision loss (R-Super) that converts radiology reports into voxel-wise supervision for tumor segmentation AI. We created a dataset with 6,718 CT-Report pairs (from the UCSF Hospital), and merged it with public CT-Mask datasets (from AbdomenAtlas 2.0). We used our R-Super to train with these masks and reports, and strongly improved tumor segmentation in internal and external validation--F1 Score increased by up to 16% with respect to training with masks only. By leveraging readily available radiology reports to supplement scarce segmentation masks, R-Super strongly improves AI performance both when very few training masks are available (e.g., 50), and when many masks were available (e.g., 1.7K). Project: https://github.com/MrGiovanni/R-Super

The success of deep learning in vision can be attributed to: (a) models with high capacity; (b) increased computational power; and (c) availability of large-scale labeled data. Since 2012, there have been significant advances in representation capabilities of the models and computational capabilities of GPUs. But the size of the biggest dataset has surprisingly remained constant. What will happen if we increase the dataset size by 10x or 100x? This paper takes a step towards clearing the clouds of mystery surrounding the relationship between `enormous data' and visual deep learning. By exploiting the JFT-300M dataset which has more than 375M noisy labels for 300M images, we investigate how the performance of current vision tasks would change if this data was used for representation learning. Our paper delivers some surprising (and some expected) findings. First, we find that the performance on vision tasks increases logarithmically based on volume of training data size. Second, we show that representation learning (or pre-training) still holds a lot of promise. One can improve performance on many vision tasks by just training a better base model. Finally, as expected, we present new state-of-the-art results for different vision tasks including image classification, object detection, semantic segmentation and human pose estimation. Our sincere hope is that this inspires vision community to not undervalue the data and develop collective efforts in building larger datasets.

Limited labeled data makes it hard to train models from scratch in medical domain, and an important paradigm is pre-training and then fine-tuning. Large pre-trained models contain rich representations, which can be adapted to downstream medical tasks. However, existing methods either tune all the parameters or the task-specific layers of the pre-trained models, ignoring the input variations of medical images, and thus they are not efficient or effective. In this work, we aim to study parameter-efficient fine-tuning (PEFT) for medical image analysis, and propose a dynamic visual prompt tuning method, named DVPT. It can extract knowledge beneficial to downstream tasks from large models with a few trainable parameters. Firstly, the frozen features are transformed by an lightweight bottleneck layer to learn the domain-specific distribution of downstream medical tasks, and then a few learnable visual prompts are used as dynamic queries and then conduct cross-attention with the transformed features, attempting to acquire sample-specific knowledge that are suitable for each sample. Finally, the features are projected to original feature dimension and aggregated with the frozen features. This DVPT module can be shared between different Transformer layers, further reducing the trainable parameters. To validate DVPT, we conduct extensive experiments with different pre-trained models on medical classification and segmentation tasks. We find such PEFT method can not only efficiently adapt the pre-trained models to the medical domain, but also brings data efficiency with partial labeled data. For example, with 0.5\% extra trainable parameters, our method not only outperforms state-of-the-art PEFT methods, even surpasses the full fine-tuning by more than 2.20\% Kappa score on medical classification task. It can saves up to 60\% labeled data and 99\% storage cost of ViT-B/16.

Large-scale pre-trained Vision-Language Models (VLMs) have become essential for transfer learning across diverse tasks. However, adapting these models with limited few-shot data often leads to overfitting, diminishing their performance on new tasks. To tackle this issue, we propose a novel Multi-Modal Representation Learning (MMRL) framework that introduces a shared, learnable, and modality-agnostic representation space. MMRL projects the space tokens to text and image representation tokens, facilitating more effective multi-modal interactions. Unlike previous approaches that solely optimize class token features, MMRL integrates representation tokens at higher layers of the encoders--where dataset-specific features are more prominent--while preserving generalized knowledge in the lower layers. During training, both representation and class features are optimized, with trainable projection layer applied to the representation tokens, whereas the class token projection layer remains frozen to retain pre-trained knowledge. Furthermore, a regularization term is introduced to align the class features and text features with the zero-shot features from the frozen VLM, thereby safeguarding the model's generalization capacity. For inference, a decoupling strategy is employed, wherein both representation and class features are utilized for base classes, while only the class features, which retain more generalized knowledge, are used for new tasks. Extensive experiments across 15 datasets demonstrate that MMRL outperforms state-of-the-art methods, achieving a balanced trade-off between task-specific adaptation and generalization. Code is available at https://github.com/yunncheng/MMRL.

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.

Small sample sizes are common in many disciplines, which necessitates pooling roughly similar datasets across multiple institutions to study weak but relevant associations between images and disease outcomes. Such data often manifest shift/imbalance in covariates (i.e., secondary non-imaging data). Controlling for such nuisance variables is common within standard statistical analysis, but the ideas do not directly apply to overparameterized models. Consequently, recent work has shown how strategies from invariant representation learning provides a meaningful starting point, but the current repertoire of methods is limited to accounting for shifts/imbalances in just a couple of covariates at a time. In this paper, we show how viewing this problem from the perspective of Category theory provides a simple and effective solution that completely avoids elaborate multi-stage training pipelines that would otherwise be needed. We show the effectiveness of this approach via extensive experiments on real datasets. Further, we discuss how this style of formulation offers a unified perspective on at least 5+ distinct problem settings, from self-supervised learning to matching problems in 3D reconstruction.

We introduce a self-supervised vision representation model BEiT, which stands for Bidirectional Encoder representation from Image Transformers. Following BERT developed in the natural language processing area, we propose a masked image modeling task to pretrain vision Transformers. Specifically, each image has two views in our pre-training, i.e, image patches (such as 16x16 pixels), and visual tokens (i.e., discrete tokens). We first "tokenize" the original image into visual tokens. Then we randomly mask some image patches and fed them into the backbone Transformer. The pre-training objective is to recover the original visual tokens based on the corrupted image patches. After pre-training BEiT, we directly fine-tune the model parameters on downstream tasks by appending task layers upon the pretrained encoder. Experimental results on image classification and semantic segmentation show that our model achieves competitive results with previous pre-training methods. For example, base-size BEiT achieves 83.2% top-1 accuracy on ImageNet-1K, significantly outperforming from-scratch DeiT training (81.8%) with the same setup. Moreover, large-size BEiT obtains 86.3% only using ImageNet-1K, even outperforming ViT-L with supervised pre-training on ImageNet-22K (85.2%). The code and pretrained models are available at https://aka.ms/beit.

Deep learning, particularly convolutional neural networks (CNNs) and Transformers, has significantly advanced 3D medical image segmentation. While CNNs are highly effective at capturing local features, their limited receptive fields may hinder performance in complex clinical scenarios. In contrast, Transformers excel at modeling long-range dependencies but are computationally intensive, making them expensive to train and deploy. Recently, the Mamba architecture, based on the State Space Model (SSM), has been proposed to efficiently model long-range dependencies while maintaining linear computational complexity. However, its application in medical image segmentation reveals shortcomings, particularly in capturing critical local features essential for accurate delineation of clinical regions. In this study, we propose MambaClinix, a novel U-shaped architecture for medical image segmentation that integrates a hierarchical gated convolutional network(HGCN) with Mamba in an adaptive stage-wise framework. This design significantly enhances computational efficiency and high-order spatial interactions, enabling the model to effectively capture both proximal and distal relationships in medical images. Specifically, our HGCN is designed to mimic the attention mechanism of Transformers by a purely convolutional structure, facilitating high-order spatial interactions in feature maps while avoiding the computational complexity typically associated with Transformer-based methods. Additionally, we introduce a region-specific Tversky loss, which emphasizes specific pixel regions to improve auto-segmentation performance, thereby optimizing the model's decision-making process. Experimental results on five benchmark datasets demonstrate that the proposed MambaClinix achieves high segmentation accuracy while maintaining low model complexity.

Automated radiology report generation offers an effective solution to alleviate radiologists' workload. However, most existing methods focus primarily on single or fixed-view images to model current disease conditions, which limits diagnostic accuracy and overlooks disease progression. Although some approaches utilize longitudinal data to track disease progression, they still rely on single images to analyze current visits. To address these issues, we propose enhanced contrastive learning with Multi-view Longitudinal data to facilitate chest X-ray Report Generation, named MLRG. Specifically, we introduce a multi-view longitudinal contrastive learning method that integrates spatial information from current multi-view images and temporal information from longitudinal data. This method also utilizes the inherent spatiotemporal information of radiology reports to supervise the pre-training of visual and textual representations. Subsequently, we present a tokenized absence encoding technique to flexibly handle missing patient-specific prior knowledge, allowing the model to produce more accurate radiology reports based on available prior knowledge. Extensive experiments on MIMIC-CXR, MIMIC-ABN, and Two-view CXR datasets demonstrate that our MLRG outperforms recent state-of-the-art methods, achieving a 2.3% BLEU-4 improvement on MIMIC-CXR, a 5.5% F1 score improvement on MIMIC-ABN, and a 2.7% F1 RadGraph improvement on Two-view CXR.

Since the introduction of TotalSegmentator CT, there is demand for a similar robust automated MRI segmentation tool that can be applied across all MRI sequences and anatomic structures. In this retrospective study, a nnU-Net model (TotalSegmentator) was trained on MRI and CT examinations to segment 80 anatomic structures relevant for use cases such as organ volumetry, disease characterization, surgical planning and opportunistic screening. Examinations were randomly sampled from routine clinical studies to represent real-world examples. Dice scores were calculated between the predicted segmentations and expert radiologist reference standard segmentations to evaluate model performance on an internal test set, two external test sets and against two publicly available models, and TotalSegmentator CT. The model was applied to an internal dataset containing abdominal MRIs to investigate age-dependent volume changes. A total of 1143 examinations (616 MRIs, 527 CTs) (median age 61 years, IQR 50-72) were split into training (n=1088, CT and MRI) and an internal test set (n=55; only MRI), two external test sets (AMOS, n=20; CHAOS, n=20; only MRI), and an internal aging-study dataset of 8672 abdominal MRIs (median age 59 years, IQR 45-70) were included. The model showed a Dice Score of 0.839 on the internal test set and outperformed two other models (Dice Score, 0.862 versus 0.759; and 0.838 versus 0.560; p<.001 for both). The proposed open-source, easy-to-use model allows for automatic, robust segmentation of 80 structures, extending the capabilities of TotalSegmentator to MRIs of any sequence. The ready-to-use online tool is available at https://totalsegmentator.com, the model at https://github.com/wasserth/TotalSegmentator, and the dataset at https://zenodo.org/records/14710732.

Neuroimage processing tasks like segmentation, reconstruction, and registration are central to the study of neuroscience. Robust deep learning strategies and architectures used to solve these tasks are often similar. Yet, when presented with a new task or a dataset with different visual characteristics, practitioners most often need to train a new model, or fine-tune an existing one. This is a time-consuming process that poses a substantial barrier for the thousands of neuroscientists and clinical researchers who often lack the resources or machine-learning expertise to train deep learning models. In practice, this leads to a lack of adoption of deep learning, and neuroscience tools being dominated by classical frameworks. We introduce Neuralizer, a single model that generalizes to previously unseen neuroimaging tasks and modalities without the need for re-training or fine-tuning. Tasks do not have to be known a priori, and generalization happens in a single forward pass during inference. The model can solve processing tasks across multiple image modalities, acquisition methods, and datasets, and generalize to tasks and modalities it has not been trained on. Our experiments on coronal slices show that when few annotated subjects are available, our multi-task network outperforms task-specific baselines without training on the task.

Neural volume rendering became increasingly popular recently due to its success in synthesizing novel views of a scene from a sparse set of input images. So far, the geometry learned by neural volume rendering techniques was modeled using a generic density function. Furthermore, the geometry itself was extracted using an arbitrary level set of the density function leading to a noisy, often low fidelity reconstruction. The goal of this paper is to improve geometry representation and reconstruction in neural volume rendering. We achieve that by modeling the volume density as a function of the geometry. This is in contrast to previous work modeling the geometry as a function of the volume density. In more detail, we define the volume density function as Laplace's cumulative distribution function (CDF) applied to a signed distance function (SDF) representation. This simple density representation has three benefits: (i) it provides a useful inductive bias to the geometry learned in the neural volume rendering process; (ii) it facilitates a bound on the opacity approximation error, leading to an accurate sampling of the viewing ray. Accurate sampling is important to provide a precise coupling of geometry and radiance; and (iii) it allows efficient unsupervised disentanglement of shape and appearance in volume rendering. Applying this new density representation to challenging scene multiview datasets produced high quality geometry reconstructions, outperforming relevant baselines. Furthermore, switching shape and appearance between scenes is possible due to the disentanglement of the two.

The ability for robots to perform efficient and zero-shot grasping of object parts is crucial for practical applications and is becoming prevalent with recent advances in Vision-Language Models (VLMs). To bridge the 2D-to-3D gap for representations to support such a capability, existing methods rely on neural fields (NeRFs) via differentiable rendering or point-based projection methods. However, we demonstrate that NeRFs are inappropriate for scene changes due to their implicitness and point-based methods are inaccurate for part localization without rendering-based optimization. To amend these issues, we propose GraspSplats. Using depth supervision and a novel reference feature computation method, GraspSplats generates high-quality scene representations in under 60 seconds. We further validate the advantages of Gaussian-based representation by showing that the explicit and optimized geometry in GraspSplats is sufficient to natively support (1) real-time grasp sampling and (2) dynamic and articulated object manipulation with point trackers. With extensive experiments on a Franka robot, we demonstrate that GraspSplats significantly outperforms existing methods under diverse task settings. In particular, GraspSplats outperforms NeRF-based methods like F3RM and LERF-TOGO, and 2D detection methods.

We frame the problem of unifying representations in neural models as one of sparse model recovery and introduce a framework that extends sparse autoencoders (SAEs) to lifted spaces and infinite-dimensional function spaces, enabling mechanistic interpretability of large neural operators (NO). While the Platonic Representation Hypothesis suggests that neural networks converge to similar representations across architectures, the representational properties of neural operators remain underexplored despite their growing importance in scientific computing. We compare the inference and training dynamics of SAEs, lifted-SAE, and SAE neural operators. We highlight how lifting and operator modules introduce beneficial inductive biases, enabling faster recovery, improved recovery of smooth concepts, and robust inference across varying resolutions, a property unique to neural operators.

Learning compatible representations enables the interchangeable use of semantic features as models are updated over time. This is particularly relevant in search and retrieval systems where it is crucial to avoid reprocessing of the gallery images with the updated model. While recent research has shown promising empirical evidence, there is still a lack of comprehensive theoretical understanding about learning compatible representations. In this paper, we demonstrate that the stationary representations learned by the d-Simplex fixed classifier optimally approximate compatibility representation according to the two inequality constraints of its formal definition. This not only establishes a solid foundation for future works in this line of research but also presents implications that can be exploited in practical learning scenarios. An exemplary application is the now-standard practice of downloading and fine-tuning new pre-trained models. Specifically, we show the strengths and critical issues of stationary representations in the case in which a model undergoing sequential fine-tuning is asynchronously replaced by downloading a better-performing model pre-trained elsewhere. Such a representation enables seamless delivery of retrieval service (i.e., no reprocessing of gallery images) and offers improved performance without operational disruptions during model replacement. Code available at: https://github.com/miccunifi/iamcl2r.

The ability of deep neural networks to continually learn and adapt to a sequence of tasks has remained challenging due to catastrophic forgetting of previously learned tasks. Humans, on the other hand, have a remarkable ability to acquire, assimilate, and transfer knowledge across tasks throughout their lifetime without catastrophic forgetting. The versatility of the brain can be attributed to the rehearsal of abstract experiences through a complementary learning system. However, representation rehearsal in vision transformers lacks diversity, resulting in overfitting and consequently, performance drops significantly compared to raw image rehearsal. Therefore, we propose BiRT, a novel representation rehearsal-based continual learning approach using vision transformers. Specifically, we introduce constructive noises at various stages of the vision transformer and enforce consistency in predictions with respect to an exponential moving average of the working model. Our method provides consistent performance gain over raw image and vanilla representation rehearsal on several challenging CL benchmarks, while being memory efficient and robust to natural and adversarial corruptions.

Continuum robots are advancing bronchoscopy procedures by accessing complex lung airways and enabling targeted interventions. However, their development is limited by the lack of realistic training and test environments: Real data is difficult to collect due to ethical constraints and patient safety concerns, and developing autonomy algorithms requires realistic imaging and physical feedback. We present ROOM (Realistic Optical Observation in Medicine), a comprehensive simulation framework designed for generating photorealistic bronchoscopy training data. By leveraging patient CT scans, our pipeline renders multi-modal sensor data including RGB images with realistic noise and light specularities, metric depth maps, surface normals, optical flow and point clouds at medically relevant scales. We validate the data generated by ROOM in two canonical tasks for medical robotics -- multi-view pose estimation and monocular depth estimation, demonstrating diverse challenges that state-of-the-art methods must overcome to transfer to these medical settings. Furthermore, we show that the data produced by ROOM can be used to fine-tune existing depth estimation models to overcome these challenges, also enabling other downstream applications such as navigation. We expect that ROOM will enable large-scale data generation across diverse patient anatomies and procedural scenarios that are challenging to capture in clinical settings. Code and data: https://github.com/iamsalvatore/room.

Medical image segmentation remains a formidable challenge due to the label scarcity. Pre-training Vision Transformer (ViT) through masked image modeling (MIM) on large-scale unlabeled medical datasets presents a promising solution, providing both computational efficiency and model generalization for various downstream tasks. However, current ViT-based MIM pre-training frameworks predominantly emphasize local aggregation representations in output layers and fail to exploit the rich representations across different ViT layers that better capture fine-grained semantic information needed for more precise medical downstream tasks. To fill the above gap, we hereby present Hierarchical Encoder-driven MAE (Hi-End-MAE), a simple yet effective ViT-based pre-training solution, which centers on two key innovations: (1) Encoder-driven reconstruction, which encourages the encoder to learn more informative features to guide the reconstruction of masked patches; and (2) Hierarchical dense decoding, which implements a hierarchical decoding structure to capture rich representations across different layers. We pre-train Hi-End-MAE on a large-scale dataset of 10K CT scans and evaluated its performance across seven public medical image segmentation benchmarks. Extensive experiments demonstrate that Hi-End-MAE achieves superior transfer learning capabilities across various downstream tasks, revealing the potential of ViT in medical imaging applications. The code is available at: https://github.com/FengheTan9/Hi-End-MAE

Most benchmarks for studying surgical interventions focus on a specific challenge instead of leveraging the intrinsic complementarity among different tasks. In this work, we present a new experimental framework towards holistic surgical scene understanding. First, we introduce the Phase, Step, Instrument, and Atomic Visual Action recognition (PSI-AVA) Dataset. PSI-AVA includes annotations for both long-term (Phase and Step recognition) and short-term reasoning (Instrument detection and novel Atomic Action recognition) in robot-assisted radical prostatectomy videos. Second, we present Transformers for Action, Phase, Instrument, and steps Recognition (TAPIR) as a strong baseline for surgical scene understanding. TAPIR leverages our dataset's multi-level annotations as it benefits from the learned representation on the instrument detection task to improve its classification capacity. Our experimental results in both PSI-AVA and other publicly available databases demonstrate the adequacy of our framework to spur future research on holistic surgical scene understanding.

A prominent approach to visual Reinforcement Learning (RL) is to learn an internal state representation using self-supervised methods, which has the potential benefit of improved sample-efficiency and generalization through additional learning signal and inductive biases. However, while the real world is inherently 3D, prior efforts have largely been focused on leveraging 2D computer vision techniques as auxiliary self-supervision. In this work, we present a unified framework for self-supervised learning of 3D representations for motor control. Our proposed framework consists of two phases: a pretraining phase where a deep voxel-based 3D autoencoder is pretrained on a large object-centric dataset, and a finetuning phase where the representation is jointly finetuned together with RL on in-domain data. We empirically show that our method enjoys improved sample efficiency in simulated manipulation tasks compared to 2D representation learning methods. Additionally, our learned policies transfer zero-shot to a real robot setup with only approximate geometric correspondence, and successfully solve motor control tasks that involve grasping and lifting from a single, uncalibrated RGB camera. Code and videos are available at https://yanjieze.com/3d4rl/ .

Segmentation of surgical instruments is crucial for enhancing surgeon performance and ensuring patient safety. Conventional techniques such as binary, semantic, and instance segmentation share a common drawback: they do not accommodate the parts of instruments obscured by tissues or other instruments. Precisely predicting the full extent of these occluded instruments can significantly improve laparoscopic surgeries by providing critical guidance during operations and assisting in the analysis of potential surgical errors, as well as serving educational purposes. In this paper, we introduce Amodal Segmentation to the realm of surgical instruments in the medical field. This technique identifies both the visible and occluded parts of an object. To achieve this, we introduce a new Amoal Instruments Segmentation (AIS) dataset, which was developed by reannotating each instrument with its complete mask, utilizing the 2017 MICCAI EndoVis Robotic Instrument Segmentation Challenge dataset. Additionally, we evaluate several leading amodal segmentation methods to establish a benchmark for this new dataset.

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

Convolutional Neural Networks (CNNs) have advanced existing medical systems for automatic disease diagnosis. However, there are still concerns about the reliability of deep medical diagnosis systems against the potential threats of adversarial attacks since inaccurate diagnosis could lead to disastrous consequences in the safety realm. In this study, we propose a highly robust yet efficient CNN-Transformer hybrid model which is equipped with the locality of CNNs as well as the global connectivity of vision Transformers. To mitigate the high quadratic complexity of the self-attention mechanism while jointly attending to information in various representation subspaces, we construct our attention mechanism by means of an efficient convolution operation. Moreover, to alleviate the fragility of our Transformer model against adversarial attacks, we attempt to learn smoother decision boundaries. To this end, we augment the shape information of an image in the high-level feature space by permuting the feature mean and variance within mini-batches. With less computational complexity, our proposed hybrid model demonstrates its high robustness and generalization ability compared to the state-of-the-art studies on a large-scale collection of standardized MedMNIST-2D datasets.

In 2015 we began a sub-challenge at the EndoVis workshop at MICCAI in Munich using endoscope images of ex-vivo tissue with automatically generated annotations from robot forward kinematics and instrument CAD models. However, the limited background variation and simple motion rendered the dataset uninformative in learning about which techniques would be suitable for segmentation in real surgery. In 2017, at the same workshop in Quebec we introduced the robotic instrument segmentation dataset with 10 teams participating in the challenge to perform binary, articulating parts and type segmentation of da Vinci instruments. This challenge included realistic instrument motion and more complex porcine tissue as background and was widely addressed with modifications on U-Nets and other popular CNN architectures. In 2018 we added to the complexity by introducing a set of anatomical objects and medical devices to the segmented classes. To avoid over-complicating the challenge, we continued with porcine data which is dramatically simpler than human tissue due to the lack of fatty tissue occluding many organs.

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

The high cure rate of cancer is inextricably linked to physicians' accuracy in diagnosis and treatment, therefore a model that can accomplish high-precision tumor segmentation has become a necessity in many applications of the medical industry. It can effectively lower the rate of misdiagnosis while considerably lessening the burden on clinicians. However, fully automated target organ segmentation is problematic due to the irregular stereo structure of 3D volume organs. As a basic model for this class of real applications, U-Net excels. It can learn certain global and local features, but still lacks the capacity to grasp spatial long-range relationships and contextual information at multiple scales. This paper proposes a tumor segmentation model MPU-Net for patient volume CT images, which is inspired by Transformer with a global attention mechanism. By combining image serialization with the Position Attention Module, the model attempts to comprehend deeper contextual dependencies and accomplish precise positioning. Each layer of the decoder is also equipped with a multi-scale module and a cross-attention mechanism. The capability of feature extraction and integration at different levels has been enhanced, and the hybrid loss function developed in this study can better exploit high-resolution characteristic information. Moreover, the suggested architecture is tested and evaluated on the Liver Tumor Segmentation Challenge 2017 (LiTS 2017) dataset. Compared with the benchmark model U-Net, MPU-Net shows excellent segmentation results. The dice, accuracy, precision, specificity, IOU, and MCC metrics for the best model segmentation results are 92.17%, 99.08%, 91.91%, 99.52%, 85.91%, and 91.74%, respectively. Outstanding indicators in various aspects illustrate the exceptional performance of this framework in automatic medical image segmentation.

With the recent advancements in single-image-based human mesh recovery, there is a growing interest in enhancing its performance in certain extreme scenarios, such as occlusion, while maintaining overall model accuracy. Although obtaining accurately annotated 3D human poses under occlusion is challenging, there is still a wealth of rich and precise 2D pose annotations that can be leveraged. However, existing works mostly focus on directly leveraging 2D pose coordinates to estimate 3D pose and mesh. In this paper, we present PostoMETRO(Pose token enhanced MEsh TRansfOrmer), which integrates occlusion-resilient 2D pose representation into transformers in a token-wise manner. Utilizing a specialized pose tokenizer, we efficiently condense 2D pose data to a compact sequence of pose tokens and feed them to the transformer together with the image tokens. This process not only ensures a rich depiction of texture from the image but also fosters a robust integration of pose and image information. Subsequently, these combined tokens are queried by vertex and joint tokens to decode 3D coordinates of mesh vertices and human joints. Facilitated by the robust pose token representation and the effective combination, we are able to produce more precise 3D coordinates, even under extreme scenarios like occlusion. Experiments on both standard and occlusion-specific benchmarks demonstrate the effectiveness of PostoMETRO. Qualitative results further illustrate the clarity of how 2D pose can help 3D reconstruction. Code will be made available.

Visual representations are central to the learning and generalization capabilities of robotic manipulation policies. While existing methods rely on global or dense features, such representations often entangle task-relevant and irrelevant scene information, limiting robustness under distribution shifts. In this work, we investigate object-centric representations (OCR) as a structured alternative that segments visual input into a finished set of entities, introducing inductive biases that align more naturally with manipulation tasks. We benchmark a range of visual encoders-object-centric, global and dense methods-across a suite of simulated and real-world manipulation tasks ranging from simple to complex, and evaluate their generalization under diverse visual conditions including changes in lighting, texture, and the presence of distractors. Our findings reveal that OCR-based policies outperform dense and global representations in generalization settings, even without task-specific pretraining. These insights suggest that OCR is a promising direction for designing visual systems that generalize effectively in dynamic, real-world robotic environments.

Background: General-purpose large language models that utilize both text and images have not been evaluated on a diverse array of challenging medical cases. Methods: Using 934 cases from the NEJM Image Challenge published between 2005 and 2023, we evaluated the accuracy of the recently released Generative Pre-trained Transformer 4 with Vision model (GPT-4V) compared to human respondents overall and stratified by question difficulty, image type, and skin tone. We further conducted a physician evaluation of GPT-4V on 69 NEJM clinicopathological conferences (CPCs). Analyses were conducted for models utilizing text alone, images alone, and both text and images. Results: GPT-4V achieved an overall accuracy of 61% (95% CI, 58 to 64%) compared to 49% (95% CI, 49 to 50%) for humans. GPT-4V outperformed humans at all levels of difficulty and disagreement, skin tones, and image types; the exception was radiographic images, where performance was equivalent between GPT-4V and human respondents. Longer, more informative captions were associated with improved performance for GPT-4V but similar performance for human respondents. GPT-4V included the correct diagnosis in its differential for 80% (95% CI, 68 to 88%) of CPCs when using text alone, compared to 58% (95% CI, 45 to 70%) of CPCs when using both images and text. Conclusions: GPT-4V outperformed human respondents on challenging medical cases and was able to synthesize information from both images and text, but performance deteriorated when images were added to highly informative text. Overall, our results suggest that multimodal AI models may be useful in medical diagnostic reasoning but that their accuracy may depend heavily on context.

Enabling effective brain-computer interfaces requires understanding how the human brain encodes stimuli across modalities such as visual, language (or text), etc. Brain encoding aims at constructing fMRI brain activity given a stimulus. There exists a plethora of neural encoding models which study brain encoding for single mode stimuli: visual (pretrained CNNs) or text (pretrained language models). Few recent papers have also obtained separate visual and text representation models and performed late-fusion using simple heuristics. However, previous work has failed to explore: (a) the effectiveness of image Transformer models for encoding visual stimuli, and (b) co-attentive multi-modal modeling for visual and text reasoning. In this paper, we systematically explore the efficacy of image Transformers (ViT, DEiT, and BEiT) and multi-modal Transformers (VisualBERT, LXMERT, and CLIP) for brain encoding. Extensive experiments on two popular datasets, BOLD5000 and Pereira, provide the following insights. (1) To the best of our knowledge, we are the first to investigate the effectiveness of image and multi-modal Transformers for brain encoding. (2) We find that VisualBERT, a multi-modal Transformer, significantly outperforms previously proposed single-mode CNNs, image Transformers as well as other previously proposed multi-modal models, thereby establishing new state-of-the-art. The supremacy of visio-linguistic models raises the question of whether the responses elicited in the visual regions are affected implicitly by linguistic processing even when passively viewing images. Future fMRI tasks can verify this computational insight in an appropriate experimental setting.

Pre-training lays the foundation for recent successes in radiograph analysis supported by deep learning. It learns transferable image representations by conducting large-scale fully-supervised or self-supervised learning on a source domain. However, supervised pre-training requires a complex and labor intensive two-stage human-assisted annotation process while self-supervised learning cannot compete with the supervised paradigm. To tackle these issues, we propose a cross-supervised methodology named REviewing FreE-text Reports for Supervision (REFERS), which acquires free supervision signals from original radiology reports accompanying the radiographs. The proposed approach employs a vision transformer and is designed to learn joint representations from multiple views within every patient study. REFERS outperforms its transfer learning and self-supervised learning counterparts on 4 well-known X-ray datasets under extremely limited supervision. Moreover, REFERS even surpasses methods based on a source domain of radiographs with human-assisted structured labels. Thus REFERS has the potential to replace canonical pre-training methodologies.

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

The pre-training of visual representations has enhanced the efficiency of robot learning. Due to the lack of large-scale in-domain robotic datasets, prior works utilize in-the-wild human videos to pre-train robotic visual representation. Despite their promising results, representations from human videos are inevitably subject to distribution shifts and lack the dynamics information crucial for task completion. We first evaluate various pre-trained representations in terms of their correlation to the downstream robotic manipulation tasks (i.e., manipulation centricity). Interestingly, we find that the "manipulation centricity" is a strong indicator of success rates when applied to downstream tasks. Drawing from these findings, we propose Manipulation Centric Representation (MCR), a foundation representation learning framework capturing both visual features and the dynamics information such as actions and proprioceptions of manipulation tasks to improve manipulation centricity. Specifically, we pre-train a visual encoder on the DROID robotic dataset and leverage motion-relevant data such as robot proprioceptive states and actions. We introduce a novel contrastive loss that aligns visual observations with the robot's proprioceptive state-action dynamics, combined with a behavior cloning (BC)-like actor loss to predict actions during pre-training, along with a time contrastive loss. Empirical results across 4 simulation domains with 20 tasks verify that MCR outperforms the strongest baseline method by 14.8%. Moreover, MCR boosts the performance of data-efficient learning with a UR5e arm on 3 real-world tasks by 76.9%. Project website: https://robots-pretrain-robots.github.io/.

In the radiation therapy of nasopharyngeal carcinoma (NPC), clinicians typically delineate the gross tumor volume (GTV) using non-contrast planning computed tomography to ensure accurate radiation dose delivery. However, the low contrast between tumors and adjacent normal tissues necessitates that radiation oncologists manually delineate the tumors, often relying on diagnostic MRI for guidance. % In this study, we propose a novel approach to directly segment NPC gross tumors on non-contrast planning CT images, circumventing potential registration errors when aligning MRI or MRI-derived tumor masks to planning CT. To address the low contrast issues between tumors and adjacent normal structures in planning CT, we introduce a 3D Semantic Asymmetry Tumor segmentation (SATs) method. Specifically, we posit that a healthy nasopharyngeal region is characteristically bilaterally symmetric, whereas the emergence of nasopharyngeal carcinoma disrupts this symmetry. Then, we propose a Siamese contrastive learning segmentation framework that minimizes the voxel-wise distance between original and flipped areas without tumor and encourages a larger distance between original and flipped areas with tumor. Thus, our approach enhances the sensitivity of features to semantic asymmetries. % Extensive experiments demonstrate that the proposed SATs achieves the leading NPC GTV segmentation performance in both internal and external testing, e.g., with at least 2\% absolute Dice score improvement and 12\% average distance error reduction when compared to other state-of-the-art methods in the external testing.

We present a self-supervised sensorimotor pre-training approach for robotics. Our model, called RPT, is a Transformer that operates on sequences of sensorimotor tokens. Given a sequence of camera images, proprioceptive robot states, and past actions, we encode the interleaved sequence into tokens, mask out a random subset, and train a model to predict the masked-out content. We hypothesize that if the robot can predict the missing content it has acquired a good model of the physical world that can enable it to act. RPT is designed to operate on latent visual representations which makes prediction tractable, enables scaling to 10x larger models, and 10 Hz inference on a real robot. To evaluate our approach, we collect a dataset of 20,000 real-world trajectories over 9 months using a combination of motion planning and model-based grasping algorithms. We find that pre-training on this data consistently outperforms training from scratch, leads to 2x improvements in the block stacking task, and has favorable scaling properties.

Radiology reports are crucial for planning treatment strategies and enhancing doctor-patient communication, yet manually writing these reports is burdensome for radiologists. While automatic report generation offers a solution, existing methods often rely on single-view radiographs, limiting diagnostic accuracy. To address this problem, we propose MCL, a Multi-view enhanced Contrastive Learning method for chest X-ray report generation. Specifically, we first introduce multi-view enhanced contrastive learning for visual representation by maximizing agreements between multi-view radiographs and their corresponding report. Subsequently, to fully exploit patient-specific indications (e.g., patient's symptoms) for report generation, we add a transitional ``bridge" for missing indications to reduce embedding space discrepancies caused by their presence or absence. Additionally, we construct Multi-view CXR and Two-view CXR datasets from public sources to support research on multi-view report generation. Our proposed MCL surpasses recent state-of-the-art methods across multiple datasets, achieving a 5.0% F1 RadGraph improvement on MIMIC-CXR, a 7.3% BLEU-1 improvement on MIMIC-ABN, a 3.1% BLEU-4 improvement on Multi-view CXR, and an 8.2% F1 CheXbert improvement on Two-view CXR.

Surgical workflow recognition has numerous potential medical applications, such as the automatic indexing of surgical video databases and the optimization of real-time operating room scheduling, among others. As a result, phase recognition has been studied in the context of several kinds of surgeries, such as cataract, neurological, and laparoscopic surgeries. In the literature, two types of features are typically used to perform this task: visual features and tool usage signals. However, the visual features used are mostly handcrafted. Furthermore, the tool usage signals are usually collected via a manual annotation process or by using additional equipment. In this paper, we propose a novel method for phase recognition that uses a convolutional neural network (CNN) to automatically learn features from cholecystectomy videos and that relies uniquely on visual information. In previous studies, it has been shown that the tool signals can provide valuable information in performing the phase recognition task. Thus, we present a novel CNN architecture, called EndoNet, that is designed to carry out the phase recognition and tool presence detection tasks in a multi-task manner. To the best of our knowledge, this is the first work proposing to use a CNN for multiple recognition tasks on laparoscopic videos. Extensive experimental comparisons to other methods show that EndoNet yields state-of-the-art results for both tasks.

Recent advancements in multimodal fusion have witnessed the remarkable success of vision-language (VL) models, which excel in various multimodal applications such as image captioning and visual question answering. However, building VL models requires substantial hardware resources, where efficiency is restricted by two key factors: the extended input sequence of the language model with vision features demands more computational operations, and a large number of additional learnable parameters increase memory complexity. These challenges significantly restrict the broader applicability of such models. To bridge this gap, we propose ADEM-VL, an efficient vision-language method that tunes VL models based on pretrained large language models (LLMs) by adopting a parameter-free cross-attention mechanism for similarity measurements in multimodal fusion. This approach only requires embedding vision features into the language space, significantly reducing the number of trainable parameters and accelerating both training and inference speeds. To enhance representation learning in fusion module, we introduce an efficient multiscale feature generation scheme that requires only a single forward pass through the vision encoder. Moreover, we propose an adaptive fusion scheme that dynamically discards less relevant visual information for each text token based on its attention score. This ensures that the fusion process prioritizes the most pertinent visual features. With experiments on various tasks including visual question answering, image captioning, and instruction-following, we demonstrate that our framework outperforms existing approaches. Specifically, our method surpasses existing methods by an average accuracy of 0.77% on ScienceQA dataset, with reduced training and inference latency, demonstrating the superiority of our framework. The code is available at https://github.com/Hao840/ADEM-VL.

Vision Transformers (ViTs) have gained significant popularity in recent years and have proliferated into many applications. However, their behavior under different learning paradigms is not well explored. We compare ViTs trained through different methods of supervision, and show that they learn a diverse range of behaviors in terms of their attention, representations, and downstream performance. We also discover ViT behaviors that are consistent across supervision, including the emergence of Offset Local Attention Heads. These are self-attention heads that attend to a token adjacent to the current token with a fixed directional offset, a phenomenon that to the best of our knowledge has not been highlighted in any prior work. Our analysis shows that ViTs are highly flexible and learn to process local and global information in different orders depending on their training method. We find that contrastive self-supervised methods learn features that are competitive with explicitly supervised features, and they can even be superior for part-level tasks. We also find that the representations of reconstruction-based models show non-trivial similarity to contrastive self-supervised models. Project website (https://www.cs.umd.edu/~sakshams/vit_analysis) and code (https://www.github.com/mwalmer-umd/vit_analysis) are publicly available.

Learning visual representations of medical images (e.g., X-rays) is core to medical image understanding but its progress has been held back by the scarcity of human annotations. Existing work commonly relies on fine-tuning weights transferred from ImageNet pretraining, which is suboptimal due to drastically different image characteristics, or rule-based label extraction from the textual report data paired with medical images, which is inaccurate and hard to generalize. Meanwhile, several recent studies show exciting results from unsupervised contrastive learning from natural images, but we find these methods help little on medical images because of their high inter-class similarity. We propose ConVIRT, an alternative unsupervised strategy to learn medical visual representations by exploiting naturally occurring paired descriptive text. Our new method of pretraining medical image encoders with the paired text data via a bidirectional contrastive objective between the two modalities is domain-agnostic, and requires no additional expert input. We test ConVIRT by transferring our pretrained weights to 4 medical image classification tasks and 2 zero-shot retrieval tasks, and show that it leads to image representations that considerably outperform strong baselines in most settings. Notably, in all 4 classification tasks, our method requires only 10\% as much labeled training data as an ImageNet initialized counterpart to achieve better or comparable performance, demonstrating superior data efficiency.

The effect of underrepresentation on the performance of minority groups is known to be a serious problem in supervised learning settings; however, it has been underexplored so far in the context of self-supervised learning (SSL). In this paper, we demonstrate that contrastive learning (CL), a popular variant of SSL, tends to collapse representations of minority groups with certain majority groups. We refer to this phenomenon as representation harm and demonstrate it on image and text datasets using the corresponding popular CL methods. Furthermore, our causal mediation analysis of allocation harm on a downstream classification task reveals that representation harm is partly responsible for it, thus emphasizing the importance of studying and mitigating representation harm. Finally, we provide a theoretical explanation for representation harm using a stochastic block model that leads to a representational neural collapse in a contrastive learning setting.