Daily Papers

Pathology is the study of microscopic inspection of tissue, and a pathology diagnosis is often the medical gold standard to diagnose disease. Pathology images provide a unique challenge for computer-vision-based analysis: a single pathology Whole Slide Image (WSI) is gigapixel-sized and often contains hundreds of thousands to millions of objects of interest across multiple resolutions. In this work, we propose PathoLogy Universal TransfOrmer (PLUTO): a light-weight pathology FM that is pre-trained on a diverse dataset of 195 million image tiles collected from multiple sites and extracts meaningful representations across multiple WSI scales that enable a large variety of downstream pathology tasks. In particular, we design task-specific adaptation heads that utilize PLUTO's output embeddings for tasks which span pathology scales ranging from subcellular to slide-scale, including instance segmentation, tile classification, and slide-level prediction. We compare PLUTO's performance to other state-of-the-art methods on a diverse set of external and internal benchmarks covering multiple biologically relevant tasks, tissue types, resolutions, stains, and scanners. We find that PLUTO matches or outperforms existing task-specific baselines and pathology-specific foundation models, some of which use orders-of-magnitude larger datasets and model sizes when compared to PLUTO. Our findings present a path towards a universal embedding to power pathology image analysis, and motivate further exploration around pathology foundation models in terms of data diversity, architectural improvements, sample efficiency, and practical deployability in real-world applications.

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.

The Universal Transformer (UT) is a variant of the Transformer that shares parameters across its layers. Empirical evidence shows that UTs have better compositional generalization than Vanilla Transformers (VTs) in formal language tasks. The parameter-sharing also affords it better parameter efficiency than VTs. Despite its many advantages, scaling UT parameters is much more compute and memory intensive than scaling up a VT. This paper proposes the Sparse Universal Transformer (SUT), which leverages Sparse Mixture of Experts (SMoE) and a new stick-breaking-based dynamic halting mechanism to reduce UT's computation complexity while retaining its parameter efficiency and generalization ability. Experiments show that SUT achieves the same performance as strong baseline models while only using half computation and parameters on WMT'14 and strong generalization results on formal language tasks (Logical inference and CFQ). The new halting mechanism also enables around 50\% reduction in computation during inference with very little performance decrease on formal language tasks.

Pathology, the microscopic examination of diseased tissue, is critical for diagnosing various medical conditions, particularly cancers. Traditional methods are labor-intensive and prone to human error. Digital pathology, which converts glass slides into high-resolution digital images for analysis by computer algorithms, revolutionizes the field by enhancing diagnostic accuracy, consistency, and efficiency through automated image analysis and large-scale data processing. Foundational transformer pretraining is crucial for developing robust, generalizable models as it enables learning from vast amounts of unannotated data. This paper introduces the Hibou family of foundational vision transformers for pathology, leveraging the DINOv2 framework to pretrain two model variants, Hibou-B and Hibou-L, on a proprietary dataset of over 1 million whole slide images (WSIs) representing diverse tissue types and staining techniques. Our pretrained models demonstrate superior performance on both patch-level and slide-level benchmarks, surpassing existing state-of-the-art methods. Notably, Hibou-L achieves the highest average accuracy across multiple benchmark datasets. To support further research and application in the field, we have open-sourced the Hibou-B model, which can be accessed at https://github.com/HistAI/hibou

Universal transformers (UTs) have been widely used for complex reasoning tasks such as ARC-AGI and Sudoku, yet the specific sources of their performance gains remain underexplored. In this work, we systematically analyze UTs variants and show that improvements on ARC-AGI primarily arise from the recurrent inductive bias and strong nonlinear components of Transformer, rather than from elaborate architectural designs. Motivated by this finding, we propose the Universal Reasoning Model (URM), which enhances the UT with short convolution and truncated backpropagation. Our approach substantially improves reasoning performance, achieving state-of-the-art 53.8% pass@1 on ARC-AGI 1 and 16.0% pass@1 on ARC-AGI 2. Our code is avaliable at https://github.com/zitian-gao/URM.

Recently, many attempts have been made to construct a transformer base U-shaped architecture, and new methods have been proposed that outperformed CNN-based rivals. However, serious problems such as blockiness and cropped edges in predicted masks remain because of transformers' patch partitioning operations. In this work, we propose a new U-shaped architecture for medical image segmentation with the help of the newly introduced focal modulation mechanism. The proposed architecture has asymmetric depths for the encoder and decoder. Due to the ability of the focal module to aggregate local and global features, our model could simultaneously benefit the wide receptive field of transformers and local viewing of CNNs. This helps the proposed method balance the local and global feature usage to outperform one of the most powerful transformer-based U-shaped models called Swin-UNet. We achieved a 1.68% higher DICE score and a 0.89 better HD metric on the Synapse dataset. Also, with extremely limited data, we had a 4.25% higher DICE score on the NeoPolyp dataset. Our implementations are available at: https://github.com/givkashi/Focal-UNet

Pathology text mining is a challenging task given the reporting variability and constant new findings in cancer sub-type definitions. However, successful text mining of a large pathology database can play a critical role to advance 'big data' cancer research like similarity-based treatment selection, case identification, prognostication, surveillance, clinical trial screening, risk stratification, and many others. While there is a growing interest in developing language models for more specific clinical domains, no pathology-specific language space exist to support the rapid data-mining development in pathology space. In literature, a few approaches fine-tuned general transformer models on specialized corpora while maintaining the original tokenizer, but in fields requiring specialized terminology, these models often fail to perform adequately. We propose PathologyBERT - a pre-trained masked language model which was trained on 347,173 histopathology specimen reports and publicly released in the Huggingface repository. Our comprehensive experiments demonstrate that pre-training of transformer model on pathology corpora yields performance improvements on Natural Language Understanding (NLU) and Breast Cancer Diagnose Classification when compared to nonspecific language models.

Histopathology has played an essential role in cancer diagnosis. With the rapid advances in convolutional neural networks (CNN). Various CNN-based automated pathological image segmentation approaches have been developed in computer-assisted pathological image analysis. In the past few years, Transformer neural networks (Transformer) have shown the unique merit of capturing the global long-distance dependencies across the entire image as a new deep learning paradigm. Such merit is appealing for exploring spatially heterogeneous pathological images. However, there have been very few, if any, studies that have systematically evaluated the current Transformer-based approaches in pathological image segmentation. To assess the performance of Transformer segmentation models on whole slide images (WSI), we quantitatively evaluated six prevalent transformer-based models on tumor segmentation, using the widely used PAIP liver histopathological dataset. For a more comprehensive analysis, we also compare the transformer-based models with six major traditional CNN-based models. The results show that the Transformer-based models exhibit a general superior performance over the CNN-based models. In particular, Segmenter, Swin-Transformer and TransUNet-all transformer-based-came out as the best performers among the twelve evaluated models.

In the field of medical sciences, reliable detection and classification of brain tumors from images remains a formidable challenge due to the rarity of tumors within the population of patients. Therefore, the ability to detect tumors in anomaly scenarios is paramount for ensuring timely interventions and improved patient outcomes. This study addresses the issue by leveraging deep learning (DL) techniques to detect and classify brain tumors in challenging situations. The curated data set from the National Brain Mapping Lab (NBML) comprises 81 patients, including 30 Tumor cases and 51 Normal cases. The detection and classification pipelines are separated into two consecutive tasks. The detection phase involved comprehensive data analysis and pre-processing to modify the number of image samples and the number of patients of each class to anomaly distribution (9 Normal per 1 Tumor) to comply with real world scenarios. Next, in addition to common evaluation metrics for the testing, we employed a novel performance evaluation method called Patient to Patient (PTP), focusing on the realistic evaluation of the model. In the detection phase, we fine-tuned a YOLOv8n detection model to detect the tumor region. Subsequent testing and evaluation yielded competitive performance both in Common Evaluation Metrics and PTP metrics. Furthermore, using the Data Efficient Image Transformer (DeiT) module, we distilled a Vision Transformer (ViT) model from a fine-tuned ResNet152 as a teacher in the classification phase. This approach demonstrates promising strides in reliable tumor detection and classification, offering potential advancements in tumor diagnosis for real-world medical imaging scenarios.

Medical image segmentation is an essential prerequisite for developing healthcare systems, especially for disease diagnosis and treatment planning. On various medical image segmentation tasks, the u-shaped architecture, also known as U-Net, has become the de-facto standard and achieved tremendous success. However, due to the intrinsic locality of convolution operations, U-Net generally demonstrates limitations in explicitly modeling long-range dependency. Transformers, designed for sequence-to-sequence prediction, have emerged as alternative architectures with innate global self-attention mechanisms, but can result in limited localization abilities due to insufficient low-level details. In this paper, we propose TransUNet, which merits both Transformers and U-Net, as a strong alternative for medical image segmentation. On one hand, the Transformer encodes tokenized image patches from a convolution neural network (CNN) feature map as the input sequence for extracting global contexts. On the other hand, the decoder upsamples the encoded features which are then combined with the high-resolution CNN feature maps to enable precise localization. We argue that Transformers can serve as strong encoders for medical image segmentation tasks, with the combination of U-Net to enhance finer details by recovering localized spatial information. TransUNet achieves superior performances to various competing methods on different medical applications including multi-organ segmentation and cardiac segmentation. Code and models are available at https://github.com/Beckschen/TransUNet.

Previous work on Universal Transformers (UTs) has demonstrated the importance of parameter sharing across layers. By allowing recurrence in depth, UTs have advantages over standard Transformers in learning compositional generalizations, but layer-sharing comes with a practical limitation of parameter-compute ratio: it drastically reduces the parameter count compared to the non-shared model with the same dimensionality. Naively scaling up the layer size to compensate for the loss of parameters makes its computational resource requirements prohibitive. In practice, no previous work has succeeded in proposing a shared-layer Transformer design that is competitive in parameter count-dominated tasks such as language modeling. Here we propose MoEUT (pronounced "moot"), an effective mixture-of-experts (MoE)-based shared-layer Transformer architecture, which combines several recent advances in MoEs for both feedforward and attention layers of standard Transformers together with novel layer-normalization and grouping schemes that are specific and crucial to UTs. The resulting UT model, for the first time, slightly outperforms standard Transformers on language modeling tasks such as BLiMP and PIQA, while using significantly less compute and memory.

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

Nuclei detection and segmentation in hematoxylin and eosin-stained (H&E) tissue images are important clinical tasks and crucial for a wide range of applications. However, it is a challenging task due to nuclei variances in staining and size, overlapping boundaries, and nuclei clustering. While convolutional neural networks have been extensively used for this task, we explore the potential of Transformer-based networks in this domain. Therefore, we introduce a new method for automated instance segmentation of cell nuclei in digitized tissue samples using a deep learning architecture based on Vision Transformer called CellViT. CellViT is trained and evaluated on the PanNuke dataset, which is one of the most challenging nuclei instance segmentation datasets, consisting of nearly 200,000 annotated Nuclei into 5 clinically important classes in 19 tissue types. We demonstrate the superiority of large-scale in-domain and out-of-domain pre-trained Vision Transformers by leveraging the recently published Segment Anything Model and a ViT-encoder pre-trained on 104 million histological image patches - achieving state-of-the-art nuclei detection and instance segmentation performance on the PanNuke dataset with a mean panoptic quality of 0.50 and an F1-detection score of 0.83. The code is publicly available at https://github.com/TIO-IKIM/CellViT

Relative Positional Encoding (RPE), which encodes the relative distance between any pair of tokens, is one of the most successful modifications to the original Transformer. As far as we know, theoretical understanding of the RPE-based Transformers is largely unexplored. In this work, we mathematically analyze the power of RPE-based Transformers regarding whether the model is capable of approximating any continuous sequence-to-sequence functions. One may naturally assume the answer is in the affirmative -- RPE-based Transformers are universal function approximators. However, we present a negative result by showing there exist continuous sequence-to-sequence functions that RPE-based Transformers cannot approximate no matter how deep and wide the neural network is. One key reason lies in that most RPEs are placed in the softmax attention that always generates a right stochastic matrix. This restricts the network from capturing positional information in the RPEs and limits its capacity. To overcome the problem and make the model more powerful, we first present sufficient conditions for RPE-based Transformers to achieve universal function approximation. With the theoretical guidance, we develop a novel attention module, called Universal RPE-based (URPE) Attention, which satisfies the conditions. Therefore, the corresponding URPE-based Transformers become universal function approximators. Extensive experiments covering typical architectures and tasks demonstrate that our model is parameter-efficient and can achieve superior performance to strong baselines in a wide range of applications. The code will be made publicly available at https://github.com/lsj2408/URPE.

Pathology plays a critical role in diagnosing a wide range of diseases, yet existing approaches often rely heavily on task-specific models trained on extensive, well-labeled datasets. These methods face sustainability challenges due to the diversity of pathologies and the labor-intensive nature of data collection. To address these limitations, we highlight the need for universal multimodal embeddings that can support multiple downstream tasks. Previous approaches often involve fine-tuning CLIP-based models, which handle images and text separately, limiting their ability to capture complex multimodal relationships. Additionally, these models are evaluated across diverse datasets without a unified benchmark for assessing multimodal embeddings in pathology. To address these challenges, we propose MLLM4PUE, a novel framework that leverages Multimodal Large Language Models (MLLMs) to generate Pathology Universal Embeddings. The MLLM4PUE framework not only facilitates robust integration of images and text but also enhances understanding and fusion capabilities across various tasks. We further introduce the Pathology Multimodal Embedding Benchmark (PMEB), a comprehensive benchmark designed to assess the quality of pathology multimodal embeddings. PMEB comprises 15 original tasks drawn from 14 datasets, organized into three meta-tasks: retrieval, classification, and composed retrieval. Experimental results demonstrate the superiority of MLLM4PUE, illustrating MLLM-based models can effectively support a wide range of downstream tasks and unify the research direction for foundation models in pathology.

Multiparametric magnetic resonance imaging (mpMRI) has demonstrated promising results in prostate cancer (PCa) detection using deep convolutional neural networks (CNNs). Recently, transformers have achieved competitive performance compared to CNNs in computer vision. Large-scale transformers need abundant annotated data for training, which are difficult to obtain in medical imaging. Self-supervised learning can effectively leverage unlabeled data to extract useful semantic representations without annotation and its associated costs. This can improve model performance on downstream tasks with limited labelled data and increase generalizability. We introduce a novel end-to-end Cross-Shaped windows (CSwin) transformer UNet model, CSwin UNet, to detect clinically significant prostate cancer (csPCa) in prostate bi-parametric MR imaging (bpMRI) and demonstrate the effectiveness of our proposed self-supervised pre-training framework. Using a large prostate bpMRI dataset with 1500 patients, we first pre-train CSwin transformer using multi-task self-supervised learning to improve data-efficiency and network generalizability. We then finetuned using lesion annotations to perform csPCa detection. Five-fold cross validation shows that self-supervised CSwin UNet achieves 0.888 AUC and 0.545 Average Precision (AP), significantly outperforming four state-of-the-art models (Swin UNETR, DynUNet, Attention UNet, UNet). Using a separate bpMRI dataset with 158 patients, we evaluated our model robustness to external hold-out data. Self-supervised CSwin UNet achieves 0.79 AUC and 0.45 AP, still outperforming all other comparable methods and demonstrating generalization to a dataset shift.

Deep learning employs multi-layer neural networks trained via the backpropagation algorithm. This approach has achieved success across many domains and relies on adaptive gradient methods such as the Adam optimizer. Sequence modeling evolved from recurrent neural networks to attention-based models, culminating in the Transformer architecture. Transformers have achieved state-of-the-art performance in natural language processing (for example, BERT and GPT-3) and have been applied in computer vision and computational biology. However, theoretical understanding of these models remains limited. In this paper, we examine the mathematical foundations of deep learning and Transformers and present a novel theoretical result. We review key concepts from linear algebra, probability, and optimization that underpin deep learning, and we analyze the multi-head self-attention mechanism and the backpropagation algorithm in detail. Our main contribution is a universal approximation theorem for Transformers: we prove that a single-layer Transformer, comprising one self-attention layer followed by a position-wise feed-forward network with ReLU activation, can approximate any continuous sequence-to-sequence mapping on a compact domain to arbitrary precision. We provide a formal statement and a complete proof. Finally, we present case studies that demonstrate the practical implications of this result. Our findings advance the theoretical understanding of Transformer models and help bridge the gap between theory and practice.

This work introduces a highly efficient implementation of the transformer architecture on a Field-Programmable Gate Array (FPGA) by using the hls4ml tool. Given the demonstrated effectiveness of transformer models in addressing a wide range of problems, their application in experimental triggers within particle physics becomes a subject of significant interest. In this work, we have implemented critical components of a transformer model, such as multi-head attention and softmax layers. To evaluate the effectiveness of our implementation, we have focused on a particle physics jet flavor tagging problem, employing a public dataset. We recorded latency under 2 mus on the Xilinx UltraScale+ FPGA, which is compatible with hardware trigger requirements at the CERN Large Hadron Collider experiments.

With Artificial Intelligence (AI) increasingly permeating various aspects of society, including healthcare, the adoption of the Transformers neural network architecture is rapidly changing many applications. Transformer is a type of deep learning architecture initially developed to solve general-purpose Natural Language Processing (NLP) tasks and has subsequently been adapted in many fields, including healthcare. In this survey paper, we provide an overview of how this architecture has been adopted to analyze various forms of data, including medical imaging, structured and unstructured Electronic Health Records (EHR), social media, physiological signals, and biomolecular sequences. Those models could help in clinical diagnosis, report generation, data reconstruction, and drug/protein synthesis. We identified relevant studies using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. We also discuss the benefits and limitations of using transformers in healthcare and examine issues such as computational cost, model interpretability, fairness, alignment with human values, ethical implications, and environmental impact.

Efficiently quantifying renal structures can provide distinct spatial context and facilitate biomarker discovery for kidney morphology. However, the development and evaluation of the transformer model to segment the renal cortex, medulla, and collecting system remains challenging due to data inefficiency. Inspired by the hierarchical structures in vision transformer, we propose a novel method using a 3D block aggregation transformer for segmenting kidney components on contrast-enhanced CT scans. We construct the first cohort of renal substructures segmentation dataset with 116 subjects under institutional review board (IRB) approval. Our method yields the state-of-the-art performance (Dice of 0.8467) against the baseline approach of 0.8308 with the data-efficient design. The Pearson R achieves 0.9891 between the proposed method and manual standards and indicates the strong correlation and reproducibility for volumetric analysis. We extend the proposed method to the public KiTS dataset, the method leads to improved accuracy compared to transformer-based approaches. We show that the 3D block aggregation transformer can achieve local communication between sequence representations without modifying self-attention, and it can serve as an accurate and efficient quantification tool for characterizing renal structures.

This research introduces a novel AI techniques as Mixture-of-Experts Transformers with Group Relative Policy Optimization (GRPO) for voice health care applications on voice pathology detection. With the architectural innovations, we adopt advanced training paradigms inspired by reinforcement learning, namely Proximal Policy Optimization (PPO) and Group-wise Regularized Policy Optimization (GRPO), to enhance model stability and performance. Experiments conducted on a synthetically generated voice pathology dataset demonstrate that our proposed models significantly improve diagnostic accuracy, F1 score, and ROC-AUC compared to conventional approaches. These findings underscore the potential of integrating transformer architectures with novel training strategies to advance automated voice pathology detection and ultimately contribute to more effective healthcare delivery. The code we used to train and evaluate our models is available at https://github.com/enkhtogtokh/voicegrpo

Colorectal cancer is one of the most common cancers worldwide, so early pathological examination is very important. However, it is time-consuming and labor-intensive to identify the number and type of cells on H&E images in clinical. Therefore, automatic segmentation and classification task and counting the cellular composition of H&E images from pathological sections is proposed by CoNIC Challenge 2022. We proposed a multi-scale Swin transformer with HTC for this challenge, and also applied the known normalization methods to generate more augmentation data. Finally, our strategy showed that the multi-scale played a crucial role to identify different scale features and the augmentation arose the recognition of model.

Pancreatic cancer is one of the leading causes of cancer-related death. Accurate detection, segmentation, and differential diagnosis of the full taxonomy of pancreatic lesions, i.e., normal, seven major types of lesions, and other lesions, is critical to aid the clinical decision-making of patient management and treatment. However, existing works focus on segmentation and classification for very specific lesion types (PDAC) or groups. Moreover, none of the previous work considers using lesion prevalence-related non-imaging patient information to assist the differential diagnosis. To this end, we develop a meta-information-aware dual-path transformer and exploit the feasibility of classification and segmentation of the full taxonomy of pancreatic lesions. Specifically, the proposed method consists of a CNN-based segmentation path (S-path) and a transformer-based classification path (C-path). The S-path focuses on initial feature extraction by semantic segmentation using a UNet-based network. The C-path utilizes both the extracted features and meta-information for patient-level classification based on stacks of dual-path transformer blocks that enhance the modeling of global contextual information. A large-scale multi-phase CT dataset of 3,096 patients with pathology-confirmed pancreatic lesion class labels, voxel-wise manual annotations of lesions from radiologists, and patient meta-information, was collected for training and evaluations. Our results show that our method can enable accurate classification and segmentation of the full taxonomy of pancreatic lesions, approaching the accuracy of the radiologist's report and significantly outperforming previous baselines. Results also show that adding the common meta-information, i.e., gender and age, can boost the model's performance, thus demonstrating the importance of meta-information for aiding pancreatic disease diagnosis.

In recent years, the integration of advanced imaging techniques and deep learning methods has significantly advanced computer-aided diagnosis (CAD) systems for breast cancer detection and classification. Transformers, which have shown great promise in computer vision, are now being applied to medical image analysis. However, their application to histopathological images presents challenges due to the need for extensive manual annotations of whole-slide images (WSIs), as these models require large amounts of data to work effectively, which is costly and time-consuming. Furthermore, the quadratic computational cost of Vision Transformers (ViTs) is particularly prohibitive for large, high-resolution histopathological images, especially on edge devices with limited computational resources. In this study, we introduce a novel lightweight breast cancer classification approach using transformers that operates effectively without large datasets. By incorporating parallel processing pathways for Discrete Cosine Transform (DCT) Attention and MobileConv, we convert image data from the spatial domain to the frequency domain to utilize the benefits such as filtering out high frequencies in the image, which reduces computational cost. This demonstrates the potential of our approach to improve breast cancer classification in histopathological images, offering a more efficient solution with reduced reliance on extensive annotated datasets. Our proposed model achieves an accuracy of 96.00% pm 0.48% for binary classification and 87.85% pm 0.93% for multiclass classification, which is comparable to state-of-the-art models while significantly reducing computational costs. This demonstrates the potential of our approach to improve breast cancer classification in histopathological images, offering a more efficient solution with reduced reliance on extensive annotated datasets.

The recent surge in performance for image analysis of digitised pathology slides can largely be attributed to the advances in deep learning. Deep models can be used to initially localise various structures in the tissue and hence facilitate the extraction of interpretable features for biomarker discovery. However, these models are typically trained for a single task and therefore scale poorly as we wish to adapt the model for an increasing number of different tasks. Also, supervised deep learning models are very data hungry and therefore rely on large amounts of training data to perform well. In this paper, we present a multi-task learning approach for segmentation and classification of nuclei, glands, lumina and different tissue regions that leverages data from multiple independent data sources. While ensuring that our tasks are aligned by the same tissue type and resolution, we enable meaningful simultaneous prediction with a single network. As a result of feature sharing, we also show that the learned representation can be used to improve the performance of additional tasks via transfer learning, including nuclear classification and signet ring cell detection. As part of this work, we train our developed Cerberus model on a huge amount of data, consisting of over 600K objects for segmentation and 440K patches for classification. We use our approach to process 599 colorectal whole-slide images from TCGA, where we localise 377 million, 900K and 2.1 million nuclei, glands and lumina, respectively and make the results available to the community for downstream analysis.

Increasing the throughput of the Transformer architecture, a foundational component used in numerous state-of-the-art models for vision and language tasks (e.g., GPT, LLaVa), is an important problem in machine learning. One recent and effective strategy is to merge token representations within Transformer models, aiming to reduce computational and memory requirements while maintaining accuracy. Prior works have proposed algorithms based on Bipartite Soft Matching (BSM), which divides tokens into distinct sets and merges the top k similar tokens. However, these methods have significant drawbacks, such as sensitivity to token-splitting strategies and damage to informative tokens in later layers. This paper presents a novel paradigm called PiToMe, which prioritizes the preservation of informative tokens using an additional metric termed the energy score. This score identifies large clusters of similar tokens as high-energy, indicating potential candidates for merging, while smaller (unique and isolated) clusters are considered as low-energy and preserved. Experimental findings demonstrate that PiToMe saved from 40-60\% FLOPs of the base models while exhibiting superior off-the-shelf performance on image classification (0.5\% average performance drop of ViT-MAE-H compared to 2.6\% as baselines), image-text retrieval (0.3\% average performance drop of CLIP on Flickr30k compared to 4.5\% as others), and analogously in visual questions answering with LLaVa-7B. Furthermore, PiToMe is theoretically shown to preserve intrinsic spectral properties of the original token space under mild conditions

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

In this paper, a multi-scale visual transformer model, referred as GasHis-Transformer, is proposed for Gastric Histopathological Image Detection (GHID), which enables the automatic global detection of gastric cancer images. GasHis-Transformer model consists of two key modules designed to extract global and local information using a position-encoded transformer model and a convolutional neural network with local convolution, respectively. A publicly available hematoxylin and eosin (H&E) stained gastric histopathological image dataset is used in the experiment. Furthermore, a Dropconnect based lightweight network is proposed to reduce the model size and training time of GasHis-Transformer for clinical applications with improved confidence. Moreover, a series of contrast and extended experiments verify the robustness, extensibility and stability of GasHis-Transformer. In conclusion, GasHis-Transformer demonstrates high global detection performance and shows its significant potential in GHID task.

Quantum embedding with transformers is a novel and promising architecture for quantum machine learning to deliver exceptional capability on near-term devices or simulators. The research incorporated a vision transformer (ViT) to advance quantum significantly embedding ability and results for a single qubit classifier with around 3 percent in the median F1 score on the BirdCLEF-2021, a challenging high-dimensional dataset. The study showcases and analyzes empirical evidence that our transformer-based architecture is a highly versatile and practical approach to modern quantum machine learning problems.

This paper addresses complex challenges in histopathological image analysis through three key contributions. Firstly, it introduces a fast patch selection method, FPS, for whole-slide image (WSI) analysis, significantly reducing computational cost while maintaining accuracy. Secondly, it presents PathDino, a lightweight histopathology feature extractor with a minimal configuration of five Transformer blocks and only 9 million parameters, markedly fewer than alternatives. Thirdly, it introduces a rotation-agnostic representation learning paradigm using self-supervised learning, effectively mitigating overfitting. We also show that our compact model outperforms existing state-of-the-art histopathology-specific vision transformers on 12 diverse datasets, including both internal datasets spanning four sites (breast, liver, skin, and colorectal) and seven public datasets (PANDA, CAMELYON16, BRACS, DigestPath, Kather, PanNuke, and WSSS4LUAD). Notably, even with a training dataset of 6 million histopathology patches from The Cancer Genome Atlas (TCGA), our approach demonstrates an average 8.5% improvement in patch-level majority vote performance. These contributions provide a robust framework for enhancing image analysis in digital pathology, rigorously validated through extensive evaluation. Project Page: https://rhazeslab.github.io/PathDino-Page/

The use of artificial intelligence to enable precision medicine and decision support systems through the analysis of pathology images has the potential to revolutionize the diagnosis and treatment of cancer. Such applications will depend on models' abilities to capture the diverse patterns observed in pathology images. To address this challenge, we present Virchow, a foundation model for computational pathology. Using self-supervised learning empowered by the DINOv2 algorithm, Virchow is a vision transformer model with 632 million parameters trained on 1.5 million hematoxylin and eosin stained whole slide images from diverse tissue and specimen types, which is orders of magnitude more data than previous works. The Virchow model enables the development of a pan-cancer detection system with 0.949 overall specimen-level AUC across 17 different cancer types, while also achieving 0.937 AUC on 7 rare cancer types. The Virchow model sets the state-of-the-art on the internal and external image tile level benchmarks and slide level biomarker prediction tasks. The gains in performance highlight the importance of training on massive pathology image datasets, suggesting scaling up the data and network architecture can improve the accuracy for many high-impact computational pathology applications where limited amounts of training data are available.

Vision transformers are effective deep learning models for vision tasks, including medical image segmentation. However, they lack efficiency and translational invariance, unlike convolutional neural networks (CNNs). To model long-range interactions in 3D brain lesion segmentation, we propose an all-convolutional transformer block variant of the U-Net architecture. We demonstrate that our model provides the greatest compromise in three factors: performance competitive with the state-of-the-art; parameter efficiency of a CNN; and the favourable inductive biases of a transformer. Our public implementation is available at https://github.com/liamchalcroft/MDUNet .

The retroperitoneum hosts a variety of tumors, including rare benign and malignant types, which pose diagnostic and treatment challenges due to their infrequency and proximity to vital structures. Estimating tumor volume is difficult due to their irregular shapes, and manual segmentation is time-consuming. Automatic segmentation using U-Net and its variants, incorporating Vision Transformer (ViT) elements, has shown promising results but struggles with high computational demands. To address this, architectures like the Mamba State Space Model (SSM) and Extended Long-Short Term Memory (xLSTM) offer efficient solutions by handling long-range dependencies with lower resource consumption. This study evaluates U-Net enhancements, including CNN, ViT, Mamba, and xLSTM, on a new in-house CT dataset and a public organ segmentation dataset. The proposed ViLU-Net model integrates Vi-blocks for improved segmentation. Results highlight xLSTM's efficiency in the U-Net framework. The code is publicly accessible on GitHub.

The emerging area of computational pathology (CPath) is ripe ground for the application of deep learning (DL) methods to healthcare due to the sheer volume of raw pixel data in whole-slide images (WSIs) of cancerous tissue slides. However, it is imperative for the DL algorithms relying on nuclei-level details to be able to cope with data from `the clinical wild', which tends to be quite challenging. We study, and extend recently released PanNuke dataset consisting of ~200,000 nuclei categorized into 5 clinically important classes for the challenging tasks of segmenting and classifying nuclei in WSIs. Previous pan-cancer datasets consisted of only up to 9 different tissues and up to 21,000 unlabeled nuclei and just over 24,000 labeled nuclei with segmentation masks. PanNuke consists of 19 different tissue types that have been semi-automatically annotated and quality controlled by clinical pathologists, leading to a dataset with statistics similar to the clinical wild and with minimal selection bias. We study the performance of segmentation and classification models when applied to the proposed dataset and demonstrate the application of models trained on PanNuke to whole-slide images. We provide comprehensive statistics about the dataset and outline recommendations and research directions to address the limitations of existing DL tools when applied to real-world CPath applications.

Survival risk stratification is an important step in clinical decision making for breast cancer management. We propose a novel deep learning approach for this purpose by integrating histopathological imaging, genetic and clinical data. It employs vision transformers, specifically the MaxViT model, for image feature extraction, and self-attention to capture intricate image relationships at the patient level. A dual cross-attention mechanism fuses these features with genetic data, while clinical data is incorporated at the final layer to enhance predictive accuracy. Experiments on the public TCGA-BRCA dataset show that our model, trained using the negative log likelihood loss function, can achieve superior performance with a mean C-index of 0.64, surpassing existing methods. This advancement facilitates tailored treatment strategies, potentially leading to improved patient outcomes.

Expert interpretation of anatomical images of the human brain is the central part of neuro-radiology. Several machine learning-based techniques have been proposed to assist in the analysis process. However, the ML models typically need to be trained to perform a specific task, e.g., brain tumour segmentation or classification. Not only do the corresponding training data require laborious manual annotations, but a wide variety of abnormalities can be present in a human brain MRI - even more than one simultaneously, which renders representation of all possible anomalies very challenging. Hence, a possible solution is an unsupervised anomaly detection (UAD) system that can learn a data distribution from an unlabelled dataset of healthy subjects and then be applied to detect out of distribution samples. Such a technique can then be used to detect anomalies - lesions or abnormalities, for example, brain tumours, without explicitly training the model for that specific pathology. Several Variational Autoencoder (VAE) based techniques have been proposed in the past for this task. Even though they perform very well on controlled artificially simulated anomalies, many of them perform poorly while detecting anomalies in clinical data. This research proposes a compact version of the "context-encoding" VAE (ceVAE) model, combined with pre and post-processing steps, creating a UAD pipeline (StRegA), which is more robust on clinical data, and shows its applicability in detecting anomalies such as tumours in brain MRIs. The proposed pipeline achieved a Dice score of 0.642pm0.101 while detecting tumours in T2w images of the BraTS dataset and 0.859pm0.112 while detecting artificially induced anomalies, while the best performing baseline achieved 0.522pm0.135 and 0.783pm0.111, respectively.

Future surveys such as the Legacy Survey of Space and Time (LSST) of the Vera C. Rubin Observatory will observe an order of magnitude more astrophysical transient events than any previous survey before. With this deluge of photometric data, it will be impossible for all such events to be classified by humans alone. Recent efforts have sought to leverage machine learning methods to tackle the challenge of astronomical transient classification, with ever improving success. Transformers are a recently developed deep learning architecture, first proposed for natural language processing, that have shown a great deal of recent success. In this work we develop a new transformer architecture, which uses multi-head self attention at its core, for general multi-variate time-series data. Furthermore, the proposed time-series transformer architecture supports the inclusion of an arbitrary number of additional features, while also offering interpretability. We apply the time-series transformer to the task of photometric classification, minimising the reliance of expert domain knowledge for feature selection, while achieving results comparable to state-of-the-art photometric classification methods. We achieve a logarithmic-loss of 0.507 on imbalanced data in a representative setting using data from the Photometric LSST Astronomical Time-Series Classification Challenge (PLAsTiCC). Moreover, we achieve a micro-averaged receiver operating characteristic area under curve of 0.98 and micro-averaged precision-recall area under curve of 0.87.

This work presents a simple vision transformer design as a strong baseline for object localization and instance segmentation tasks. Transformers recently demonstrate competitive performance in image classification tasks. To adopt ViT to object detection and dense prediction tasks, many works inherit the multistage design from convolutional networks and highly customized ViT architectures. Behind this design, the goal is to pursue a better trade-off between computational cost and effective aggregation of multiscale global contexts. However, existing works adopt the multistage architectural design as a black-box solution without a clear understanding of its true benefits. In this paper, we comprehensively study three architecture design choices on ViT -- spatial reduction, doubled channels, and multiscale features -- and demonstrate that a vanilla ViT architecture can fulfill this goal without handcrafting multiscale features, maintaining the original ViT design philosophy. We further complete a scaling rule to optimize our model's trade-off on accuracy and computation cost / model size. By leveraging a constant feature resolution and hidden size throughout the encoder blocks, we propose a simple and compact ViT architecture called Universal Vision Transformer (UViT) that achieves strong performance on COCO object detection and instance segmentation tasks.

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

Medical image segmentation remains particularly challenging for complex and low-contrast anatomical structures. In this paper, we introduce the U-Transformer network, which combines a U-shaped architecture for image segmentation with self- and cross-attention from Transformers. U-Transformer overcomes the inability of U-Nets to model long-range contextual interactions and spatial dependencies, which are arguably crucial for accurate segmentation in challenging contexts. To this end, attention mechanisms are incorporated at two main levels: a self-attention module leverages global interactions between encoder features, while cross-attention in the skip connections allows a fine spatial recovery in the U-Net decoder by filtering out non-semantic features. Experiments on two abdominal CT-image datasets show the large performance gain brought out by U-Transformer compared to U-Net and local Attention U-Nets. We also highlight the importance of using both self- and cross-attention, and the nice interpretability features brought out by U-Transformer.

The adoption of Vision Transformers (ViTs) based architectures represents a significant advancement in 3D Medical Image (MI) segmentation, surpassing traditional Convolutional Neural Network (CNN) models by enhancing global contextual understanding. While this paradigm shift has significantly enhanced 3D segmentation performance, state-of-the-art architectures require extremely large and complex architectures with large scale computing resources for training and deployment. Furthermore, in the context of limited datasets, often encountered in medical imaging, larger models can present hurdles in both model generalization and convergence. In response to these challenges and to demonstrate that lightweight models are a valuable area of research in 3D medical imaging, we present SegFormer3D, a hierarchical Transformer that calculates attention across multiscale volumetric features. Additionally, SegFormer3D avoids complex decoders and uses an all-MLP decoder to aggregate local and global attention features to produce highly accurate segmentation masks. The proposed memory efficient Transformer preserves the performance characteristics of a significantly larger model in a compact design. SegFormer3D democratizes deep learning for 3D medical image segmentation by offering a model with 33x less parameters and a 13x reduction in GFLOPS compared to the current state-of-the-art (SOTA). We benchmark SegFormer3D against the current SOTA models on three widely used datasets Synapse, BRaTs, and ACDC, achieving competitive results. Code: https://github.com/OSUPCVLab/SegFormer3D.git

Automatic medical image segmentation has made great progress benefit from the development of deep learning. However, most existing methods are based on convolutional neural networks (CNNs), which fail to build long-range dependencies and global context connections due to the limitation of receptive field in convolution operation. Inspired by the success of Transformer in modeling the long-range contextual information, some researchers have expended considerable efforts in designing the robust variants of Transformer-based U-Net. Moreover, the patch division used in vision transformers usually ignores the pixel-level intrinsic structural features inside each patch. To alleviate these problems, we propose a novel deep medical image segmentation framework called Dual Swin Transformer U-Net (DS-TransUNet), which might be the first attempt to concurrently incorporate the advantages of hierarchical Swin Transformer into both encoder and decoder of the standard U-shaped architecture to enhance the semantic segmentation quality of varying medical images. Unlike many prior Transformer-based solutions, the proposed DS-TransUNet first adopts dual-scale encoder subnetworks based on Swin Transformer to extract the coarse and fine-grained feature representations of different semantic scales. As the core component for our DS-TransUNet, a well-designed Transformer Interactive Fusion (TIF) module is proposed to effectively establish global dependencies between features of different scales through the self-attention mechanism. Furthermore, we also introduce the Swin Transformer block into decoder to further explore the long-range contextual information during the up-sampling process. Extensive experiments across four typical tasks for medical image segmentation demonstrate the effectiveness of DS-TransUNet, and show that our approach significantly outperforms the state-of-the-art methods.

In healthcare, medical image segmentation is crucial for accurate disease diagnosis and the development of effective treatment strategies. Early detection can significantly aid in managing diseases and potentially prevent their progression. Machine learning, particularly deep convolutional neural networks, has emerged as a promising approach to addressing segmentation challenges. Traditional methods like U-Net use encoding blocks for local representation modeling and decoding blocks to uncover semantic relationships. However, these models often struggle with multi-scale objects exhibiting significant variations in texture and shape, and they frequently fail to capture long-range dependencies in the input data. Transformers designed for sequence-to-sequence predictions have been proposed as alternatives, utilizing global self-attention mechanisms. Yet, they can sometimes lack precise localization due to insufficient granular details. To overcome these limitations, we introduce TransDAE: a novel approach that reimagines the self-attention mechanism to include both spatial and channel-wise associations across the entire feature space, while maintaining computational efficiency. Additionally, TransDAE enhances the skip connection pathway with an inter-scale interaction module, promoting feature reuse and improving localization accuracy. Remarkably, TransDAE outperforms existing state-of-the-art methods on the Synaps multi-organ dataset, even without relying on pre-trained weights.

As advances in large language models (LLMs) and multimodal techniques continue to mature, the development of general-purpose multimodal large language models (MLLMs) has surged, offering significant applications in interpreting natural images. However, the field of pathology has largely remained untapped, particularly in gathering high-quality data and designing comprehensive model frameworks. To bridge the gap in pathology MLLMs, we present PathAsst, a multimodal generative foundation AI assistant to revolutionize diagnostic and predictive analytics in pathology. The development of PathAsst involves three pivotal steps: data acquisition, CLIP model adaptation, and the training of PathAsst's multimodal generative capabilities. Firstly, we collect over 207K high-quality pathology image-text pairs from authoritative sources. Leveraging the advanced power of ChatGPT, we generate over 180K instruction-following samples. Furthermore, we devise additional instruction-following data specifically tailored for invoking eight pathology-specific sub-models we prepared, allowing the PathAsst to effectively collaborate with these models, enhancing its diagnostic ability. Secondly, by leveraging the collected data, we construct PathCLIP, a pathology-dedicated CLIP, to enhance PathAsst's capabilities in interpreting pathology images. Finally, we integrate PathCLIP with the Vicuna-13b and utilize pathology-specific instruction-tuning data to enhance the multimodal generation capacity of PathAsst and bolster its synergistic interactions with sub-models. The experimental results of PathAsst show the potential of harnessing AI-powered generative foundation model to improve pathology diagnosis and treatment processes.

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.

Diagnosing a whole-slide image is an interactive, multi-stage process involving changes in magnification and movement between fields. Although recent pathology foundation models are strong, practical agentic systems that decide what field to examine next, adjust magnification, and deliver explainable diagnoses are still lacking. The blocker is data: scalable, clinically aligned supervision of expert viewing behavior that is tacit and experience-based, not written in textbooks or online, and therefore absent from large language model training. We introduce the AI Session Recorder, which works with standard WSI viewers to unobtrusively record routine navigation and convert the viewer logs into standardized behavioral commands (inspect or peek at discrete magnifications) and bounding boxes. A lightweight human-in-the-loop review turns AI-drafted rationales into the Pathology-CoT dataset, a form of paired "where to look" and "why it matters" supervision produced at roughly six times lower labeling time. Using this behavioral data, we build Pathologist-o3, a two-stage agent that first proposes regions of interest and then performs behavior-guided reasoning. On gastrointestinal lymph-node metastasis detection, it achieved 84.5% precision, 100.0% recall, and 75.4% accuracy, exceeding the state-of-the-art OpenAI o3 model and generalizing across backbones. To our knowledge, this constitutes one of the first behavior-grounded agentic systems in pathology. Turning everyday viewer logs into scalable, expert-validated supervision, our framework makes agentic pathology practical and establishes a path to human-aligned, upgradeable clinical AI.

When reading medical images such as a computed tomography (CT) scan, radiologists generally search across the image to find lesions, characterize and measure them, and then describe them in the radiological report. To automate this process, we propose a multitask universal lesion analysis network (MULAN) for joint detection, tagging, and segmentation of lesions in a variety of body parts, which greatly extends existing work of single-task lesion analysis on specific body parts. MULAN is based on an improved Mask R-CNN framework with three head branches and a 3D feature fusion strategy. It achieves the state-of-the-art accuracy in the detection and tagging tasks on the DeepLesion dataset, which contains 32K lesions in the whole body. We also analyze the relationship between the three tasks and show that tag predictions can improve detection accuracy via a score refinement layer.

Multiple instance learning (MIL) is the most widely used framework in computational pathology, encompassing sub-typing, diagnosis, prognosis, and more. However, the existing MIL paradigm typically requires an offline instance feature extractor, such as a pre-trained ResNet or a foundation model. This approach lacks the capability for feature fine-tuning within the specific downstream tasks, limiting its adaptability and performance. To address this issue, we propose a Re-embedded Regional Transformer (R^2T) for re-embedding the instance features online, which captures fine-grained local features and establishes connections across different regions. Unlike existing works that focus on pre-training powerful feature extractor or designing sophisticated instance aggregator, R^2T is tailored to re-embed instance features online. It serves as a portable module that can seamlessly integrate into mainstream MIL models. Extensive experimental results on common computational pathology tasks validate that: 1) feature re-embedding improves the performance of MIL models based on ResNet-50 features to the level of foundation model features, and further enhances the performance of foundation model features; 2) the R^2T can introduce more significant performance improvements to various MIL models; 3) R^2T-MIL, as an R^2T-enhanced AB-MIL, outperforms other latest methods by a large margin.The code is available at: https://github.com/DearCaat/RRT-MIL.

Whole Slide Image (WSI) classification with multiple instance learning (MIL) in digital pathology faces significant computational challenges. Current methods mostly rely on extensive self-supervised learning (SSL) for satisfactory performance, requiring long training periods and considerable computational resources. At the same time, no pre-training affects performance due to domain shifts from natural images to WSIs. We introduce Snuffy architecture, a novel MIL-pooling method based on sparse transformers that mitigates performance loss with limited pre-training and enables continual few-shot pre-training as a competitive option. Our sparsity pattern is tailored for pathology and is theoretically proven to be a universal approximator with the tightest probabilistic sharp bound on the number of layers for sparse transformers, to date. We demonstrate Snuffy's effectiveness on CAMELYON16 and TCGA Lung cancer datasets, achieving superior WSI and patch-level accuracies. The code is available on https://github.com/jafarinia/snuffy.

Real-world data contains a vast amount of multimodal information, among which vision and language are the two most representative modalities. Moreover, increasingly heavier models, e.g., Transformers, have attracted the attention of researchers to model compression. However, how to compress multimodal models, especially vison-language Transformers, is still under-explored. This paper proposes the Unified and Progressive Pruning (\emph{UPop}) as a universal vison-language Transformer compression framework, which incorporates 1) unifiedly searching multimodal subnets in a continuous optimization space from the original model, which enables automatic assignment of pruning ratios among compressible modalities and structures; 2) progressively searching and retraining the subnet, which maintains convergence between the search and retrain to attain higher compression ratios. Experiments on various tasks, datasets, and model architectures demonstrate the effectiveness and versatility of the proposed UPop framework. The code is available at https://github.com/sdc17/UPop.

Voice disorders significantly impact patient quality of life, yet non-invasive automated diagnosis remains under-explored due to both the scarcity of pathological voice data, and the variability in recording sources. This work introduces MVP (Multi-source Voice Pathology detection), a novel approach that leverages transformers operating directly on raw voice signals. We explore three fusion strategies to combine sentence reading and sustained vowel recordings: waveform concatenation, intermediate feature fusion, and decision-level combination. Empirical validation across the German, Portuguese, and Italian languages shows that intermediate feature fusion using transformers best captures the complementary characteristics of both recording types. Our approach achieves up to +13% AUC improvement over single-source methods.

Recent advances in vision language models (VLMs) have enabled broad progress in the general medical field. However, pathology still remains a more challenging subdomain, with current pathology specific VLMs exhibiting limitations in both diagnostic accuracy and reasoning plausibility. Such shortcomings are largely attributable to the nature of current pathology datasets, which are primarily composed of image description pairs that lack the depth and structured diagnostic paradigms employed by real world pathologists. In this study, we leverage pathology textbooks and real world pathology experts to construct high-quality, reasoning-oriented datasets. Building on this, we introduce Patho-R1, a multimodal RL-based pathology Reasoner, trained through a three-stage pipeline: (1) continued pretraining on 3.5 million image-text pairs for knowledge infusion; (2) supervised fine-tuning on 500k high-quality Chain-of-Thought samples for reasoning incentivizing; (3) reinforcement learning using Group Relative Policy Optimization and Decoupled Clip and Dynamic sAmpling Policy Optimization strategies for multimodal reasoning quality refinement. To further assess the alignment quality of our dataset, we propose PathoCLIP, trained on the same figure-caption corpus used for continued pretraining. Comprehensive experimental results demonstrate that both PathoCLIP and Patho-R1 achieve robust performance across a wide range of pathology-related tasks, including zero-shot classification, cross-modal retrieval, Visual Question Answering, and Multiple Choice Question. Our project is available at the Patho-R1 repository: https://github.com/Wenchuan-Zhang/Patho-R1.

As the field of artificial intelligence progresses, assistive technologies are becoming more widely used across all industries. The healthcare industry is no different, with numerous studies being done to develop assistive tools for healthcare professionals. Automatic diagnostic systems are one such beneficial tool that can assist with a variety of tasks, including collecting patient information, analyzing test results, and diagnosing patients. However, the idea of developing systems that can provide a differential diagnosis has been largely overlooked in most of these research studies. In this study, we propose a transformer-based approach for providing differential diagnoses based on a patient's age, sex, medical history, and symptoms. We use the DDXPlus dataset, which provides differential diagnosis information for patients based on 49 disease types. Firstly, we propose a method to process the tabular patient data from the dataset and engineer them into patient reports to make them suitable for our research. In addition, we introduce two data modification modules to diversify the training data and consequently improve the robustness of the models. We approach the task as a multi-label classification problem and conduct extensive experiments using four transformer models. All the models displayed promising results by achieving over 97% F1 score on the held-out test set. Moreover, we design additional behavioral tests to get a broader understanding of the models. In particular, for one of our test cases, we prepared a custom test set of 100 samples with the assistance of a doctor. The results on the custom set showed that our proposed data modification modules improved the model's generalization capabilities. We hope our findings will provide future researchers with valuable insights and inspire them to develop reliable systems for automatic differential diagnosis.

Despite being widely used to support clinical care, general-purpose large multimodal models (LMMs) have generally shown poor or inconclusive performance in medical image interpretation, particularly in pathology, where gigapixel images are used. However, prior studies have used either low-resolution thumbnails or random patches, which likely underestimated model performance. Here, we ask whether LMMs can be adapted to reason coherently and accurately in the evaluation of such images. In this study, we introduce Gigapixel Image Agent for Navigating Tissue (GIANT), the first framework that allows LMMs to iteratively navigate whole-slide images (WSIs) like a pathologist. Accompanying GIANT, we release MultiPathQA, a new benchmark, which comprises 934 WSI-level questions, encompassing five clinically-relevant tasks ranging from cancer diagnosis to open-ended reasoning. MultiPathQA also includes 128 questions, authored by two professional pathologists, requiring direct slide interpretation. Using MultiPathQA, we show that our simple agentic system substantially outperforms conventional patch- and thumbnail-based baselines, approaching or surpassing the performance of specialized models trained on millions of images. For example, on pathologist-authored questions, GPT-5 with GIANT achieves 62.5% accuracy, outperforming specialist pathology models such as TITAN (43.8%) and SlideChat (37.5%). Our findings reveal the strengths and limitations of current foundation models and ground future development of LMMs for expert reasoning in pathology.

With the advancement of language models, unified multimodal understanding and generation have made significant strides, with model architectures evolving from separated components to unified single-model frameworks. This paper explores an efficient training paradigm to build a single transformer for unified multimodal understanding and generation. Specifically, we propose a multimodal warmup strategy utilizing prior knowledge to extend capabilities. To address cross-modal compatibility challenges, we introduce feature pre-scaling and multimodal AdaLN techniques. Integrating the proposed technologies, we present the HaploOmni, a new single multimodal transformer. With limited training costs, HaploOmni achieves competitive performance across multiple image and video understanding and generation benchmarks over advanced unified models. All codes will be made public at https://github.com/Tencent/HaploVLM.

Tissue phenotyping is a fundamental computational pathology (CPath) task in learning objective characterizations of histopathologic biomarkers in anatomic pathology. However, whole-slide imaging (WSI) poses a complex computer vision problem in which the large-scale image resolutions of WSIs and the enormous diversity of morphological phenotypes preclude large-scale data annotation. Current efforts have proposed using pretrained image encoders with either transfer learning from natural image datasets or self-supervised pretraining on publicly-available histopathology datasets, but have not been extensively developed and evaluated across diverse tissue types at scale. We introduce UNI, a general-purpose self-supervised model for pathology, pretrained using over 100 million tissue patches from over 100,000 diagnostic haematoxylin and eosin-stained WSIs across 20 major tissue types, and evaluated on 33 representative CPath clinical tasks in CPath of varying diagnostic difficulties. In addition to outperforming previous state-of-the-art models, we demonstrate new modeling capabilities in CPath such as resolution-agnostic tissue classification, slide classification using few-shot class prototypes, and disease subtyping generalization in classifying up to 108 cancer types in the OncoTree code classification system. UNI advances unsupervised representation learning at scale in CPath in terms of both pretraining data and downstream evaluation, enabling data-efficient AI models that can generalize and transfer to a gamut of diagnostically-challenging tasks and clinical workflows in anatomic pathology.

We introduce Home-made Diffusion Model (HDM), an efficient yet powerful text-to-image diffusion model optimized for training (and inferring) on consumer-grade hardware. HDM achieves competitive 1024x1024 generation quality while maintaining a remarkably low training cost of $535-620 using four RTX5090 GPUs, representing a significant reduction in computational requirements compared to traditional approaches. Our key contributions include: (1) Cross-U-Transformer (XUT), a novel U-shape transformer, Cross-U-Transformer (XUT), that employs cross-attention for skip connections, providing superior feature integration that leads to remarkable compositional consistency; (2) a comprehensive training recipe that incorporates TREAD acceleration, a novel shifted square crop strategy for efficient arbitrary aspect-ratio training, and progressive resolution scaling; and (3) an empirical demonstration that smaller models (343M parameters) with carefully crafted architectures can achieve high-quality results and emergent capabilities, such as intuitive camera control. Our work provides an alternative paradigm of scaling, demonstrating a viable path toward democratizing high-quality text-to-image generation for individual researchers and smaller organizations with limited computational resources.

Vision Transformer (ViT) extends the application range of transformers from language processing to computer vision tasks as being an alternative architecture against the existing convolutional neural networks (CNN). Since the transformer-based architecture has been innovative for computer vision modeling, the design convention towards an effective architecture has been less studied yet. From the successful design principles of CNN, we investigate the role of spatial dimension conversion and its effectiveness on transformer-based architecture. We particularly attend to the dimension reduction principle of CNNs; as the depth increases, a conventional CNN increases channel dimension and decreases spatial dimensions. We empirically show that such a spatial dimension reduction is beneficial to a transformer architecture as well, and propose a novel Pooling-based Vision Transformer (PiT) upon the original ViT model. We show that PiT achieves the improved model capability and generalization performance against ViT. Throughout the extensive experiments, we further show PiT outperforms the baseline on several tasks such as image classification, object detection, and robustness evaluation. Source codes and ImageNet models are available at https://github.com/naver-ai/pit

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

Transformers have become the de-facto standard model in artificial intelligence since 2017 despite numerous shortcomings ranging from energy inefficiency to hallucinations. Research has made a lot of progress in improving elements of transformers, and, more generally, deep learning manifesting in many proposals for architectures, layers, optimization objectives, and optimization techniques. For researchers it is difficult to keep track of such developments on a broader level. We provide a comprehensive overview of the many important, recent works in these areas to those who already have a basic understanding of deep learning. Our focus differs from other works, as we target specifically novel, alternative potentially disruptive approaches to transformers as well as successful ideas of recent deep learning. We hope that such a holistic and unified treatment of influential, recent works and novel ideas helps researchers to form new connections between diverse areas of deep learning. We identify and discuss multiple patterns that summarize the key strategies for successful innovations over the last decade as well as works that can be seen as rising stars. Especially, we discuss attempts on how to improve on transformers covering (partially) proven methods such as state space models but also including far-out ideas in deep learning that seem promising despite not achieving state-of-the-art results. We also cover a discussion on recent state-of-the-art models such as OpenAI's GPT series and Meta's LLama models and, Google's Gemini model family.

Gastrointestinal (GI) diseases represent a clinically significant burden, necessitating precise diagnostic approaches to optimize patient outcomes. Conventional histopathological diagnosis suffers from limited reproducibility and diagnostic variability. To overcome these limitations, we develop Digepath, a specialized foundation model for GI pathology. Our framework introduces a dual-phase iterative optimization strategy combining pretraining with fine-screening, specifically designed to address the detection of sparsely distributed lesion areas in whole-slide images. Digepath is pretrained on over 353 million multi-scale images from 210,043 H&E-stained slides of GI diseases. It attains state-of-the-art performance on 33 out of 34 tasks related to GI pathology, including pathological diagnosis, protein expression status prediction, gene mutation prediction, and prognosis evaluation. We further translate the intelligent screening module for early GI cancer and achieve near-perfect 99.70% sensitivity across nine independent medical institutions. This work not only advances AI-driven precision pathology for GI diseases but also bridge critical gaps in histopathological practice.

A big convergence of model architectures across language, vision, speech, and multimodal is emerging. However, under the same name "Transformers", the above areas use different implementations for better performance, e.g., Post-LayerNorm for BERT, and Pre-LayerNorm for GPT and vision Transformers. We call for the development of Foundation Transformer for true general-purpose modeling, which serves as a go-to architecture for various tasks and modalities with guaranteed training stability. In this work, we introduce a Transformer variant, named Magneto, to fulfill the goal. Specifically, we propose Sub-LayerNorm for good expressivity, and the initialization strategy theoretically derived from DeepNet for stable scaling up. Extensive experiments demonstrate its superior performance and better stability than the de facto Transformer variants designed for various applications, including language modeling (i.e., BERT, and GPT), machine translation, vision pretraining (i.e., BEiT), speech recognition, and multimodal pretraining (i.e., BEiT-3).

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.

Transformers exhibit impressive capabilities but are often regarded as black boxes due to challenges in understanding the complex nonlinear relationships between features. Interpreting machine learning models is of paramount importance to mitigate risks, and mechanistic interpretability is in particular of current interest as it opens up a window for guiding manual modifications and reverse-engineering solutions. In this work, we introduce contextual decomposition for transformers (CD-T), extending a prior work on CD for RNNs and CNNs, to address mechanistic interpretation computationally efficiently. CD-T is a flexible interpretation method for transformers. It can capture contributions of combinations of input features or source internal components (e.g. attention heads, feed-forward networks) to (1) final predictions or (2) the output of any target internal component. Using CD-T, we propose a novel algorithm for circuit discovery. On a real-world pathology report classification task: we show CD-T distills a more faithful circuit of attention heads with improved computational efficiency (speed up 2x) than a prior benchmark, path patching. As a versatile interpretation method, CD-T also exhibits exceptional capabilities for local interpretations. CD-T is shown to reliably find words and phrases of contrasting sentiment/topic on SST-2 and AGNews datasets. Through human experiments, we demonstrate CD-T enables users to identify the more accurate of two models and to better trust a model's outputs compared to alternative interpretation methods such as SHAP and LIME.

Convolutional Neural Networks (CNNs) and Transformers have been the most popular architectures for biomedical image segmentation, but both of them have limited ability to handle long-range dependencies because of inherent locality or computational complexity. To address this challenge, we introduce U-Mamba, a general-purpose network for biomedical image segmentation. Inspired by the State Space Sequence Models (SSMs), a new family of deep sequence models known for their strong capability in handling long sequences, we design a hybrid CNN-SSM block that integrates the local feature extraction power of convolutional layers with the abilities of SSMs for capturing the long-range dependency. Moreover, U-Mamba enjoys a self-configuring mechanism, allowing it to automatically adapt to various datasets without manual intervention. We conduct extensive experiments on four diverse tasks, including the 3D abdominal organ segmentation in CT and MR images, instrument segmentation in endoscopy images, and cell segmentation in microscopy images. The results reveal that U-Mamba outperforms state-of-the-art CNN-based and Transformer-based segmentation networks across all tasks. This opens new avenues for efficient long-range dependency modeling in biomedical image analysis. The code, models, and data are publicly available at https://wanglab.ai/u-mamba.html.

Recurrent neural networks (RNNs) sequentially process data by updating their state with each new data point, and have long been the de facto choice for sequence modeling tasks. However, their inherently sequential computation makes them slow to train. Feed-forward and convolutional architectures have recently been shown to achieve superior results on some sequence modeling tasks such as machine translation, with the added advantage that they concurrently process all inputs in the sequence, leading to easy parallelization and faster training times. Despite these successes, however, popular feed-forward sequence models like the Transformer fail to generalize in many simple tasks that recurrent models handle with ease, e.g. copying strings or even simple logical inference when the string or formula lengths exceed those observed at training time. We propose the Universal Transformer (UT), a parallel-in-time self-attentive recurrent sequence model which can be cast as a generalization of the Transformer model and which addresses these issues. UTs combine the parallelizability and global receptive field of feed-forward sequence models like the Transformer with the recurrent inductive bias of RNNs. We also add a dynamic per-position halting mechanism and find that it improves accuracy on several tasks. In contrast to the standard Transformer, under certain assumptions, UTs can be shown to be Turing-complete. Our experiments show that UTs outperform standard Transformers on a wide range of algorithmic and language understanding tasks, including the challenging LAMBADA language modeling task where UTs achieve a new state of the art, and machine translation where UTs achieve a 0.9 BLEU improvement over Transformers on the WMT14 En-De dataset.

Convolutional Neural Networks (CNNs) and Vision Transformers (ViT) have been pivotal in biomedical image segmentation, yet their ability to manage long-range dependencies remains constrained by inherent locality and computational overhead. To overcome these challenges, in this technical report, we first propose xLSTM-UNet, a UNet structured deep learning neural network that leverages Vision-LSTM (xLSTM) as its backbone for medical image segmentation. xLSTM is a recently proposed as the successor of Long Short-Term Memory (LSTM) networks and have demonstrated superior performance compared to Transformers and State Space Models (SSMs) like Mamba in Neural Language Processing (NLP) and image classification (as demonstrated in Vision-LSTM, or ViL implementation). Here, xLSTM-UNet we designed extend the success in biomedical image segmentation domain. By integrating the local feature extraction strengths of convolutional layers with the long-range dependency capturing abilities of xLSTM, xLSTM-UNet offers a robust solution for comprehensive image analysis. We validate the efficacy of xLSTM-UNet through experiments. Our findings demonstrate that xLSTM-UNet consistently surpasses the performance of leading CNN-based, Transformer-based, and Mamba-based segmentation networks in multiple datasets in biomedical segmentation including organs in abdomen MRI, instruments in endoscopic images, and cells in microscopic images. With comprehensive experiments performed, this technical report highlights the potential of xLSTM-based architectures in advancing biomedical image analysis in both 2D and 3D. The code, models, and datasets are publicly available at http://tianrun-chen.github.io/xLSTM-UNet/{http://tianrun-chen.github.io/xLSTM-Unet/}

The complexity and variability inherent in high-resolution pathological images present significant challenges in computational pathology. While pathology foundation models leveraging AI have catalyzed transformative advancements, their development demands large-scale datasets, considerable storage capacity, and substantial computational resources. Furthermore, ensuring their clinical applicability and generalizability requires rigorous validation across a broad spectrum of clinical tasks. Here, we present PathOrchestra, a versatile pathology foundation model trained via self-supervised learning on a dataset comprising 300K pathological slides from 20 tissue and organ types across multiple centers. The model was rigorously evaluated on 112 clinical tasks using a combination of 61 private and 51 public datasets. These tasks encompass digital slide preprocessing, pan-cancer classification, lesion identification, multi-cancer subtype classification, biomarker assessment, gene expression prediction, and the generation of structured reports. PathOrchestra demonstrated exceptional performance across 27,755 WSIs and 9,415,729 ROIs, achieving over 0.950 accuracy in 47 tasks, including pan-cancer classification across various organs, lymphoma subtype diagnosis, and bladder cancer screening. Notably, it is the first model to generate structured reports for high-incidence colorectal cancer and diagnostically complex lymphoma-areas that are infrequently addressed by foundational models but hold immense clinical potential. Overall, PathOrchestra exemplifies the feasibility and efficacy of a large-scale, self-supervised pathology foundation model, validated across a broad range of clinical-grade tasks. Its high accuracy and reduced reliance on extensive data annotation underline its potential for clinical integration, offering a pathway toward more efficient and high-quality medical services.

Solid results from Transformers have made them prevailing architectures in various natural language and vision tasks. As a default component in Transformers, Layer Normalization (LN) normalizes activations within each token to boost the robustness. However, LN requires on-the-fly statistics calculation in inference as well as division and square root operations, leading to inefficiency on hardware. What is more, replacing LN with other hardware-efficient normalization schemes (e.g., Batch Normalization) results in inferior performance, even collapse in training. We find that this dilemma is caused by abnormal behaviors of activation statistics, including large fluctuations over iterations and extreme outliers across layers. To tackle these issues, we propose Unified Normalization (UN), which can speed up the inference by being fused with other linear operations and achieve comparable performance on par with LN. UN strives to boost performance by calibrating the activation and gradient statistics with a tailored fluctuation smoothing strategy. Meanwhile, an adaptive outlier filtration strategy is applied to avoid collapse in training whose effectiveness is theoretically proved and experimentally verified in this paper. We demonstrate that UN can be an efficient drop-in alternative to LN by conducting extensive experiments on language and vision tasks. Besides, we evaluate the efficiency of our method on GPU. Transformers equipped with UN enjoy about 31% inference speedup and nearly 18% memory reduction. Code will be released at https://github.com/hikvision-research/Unified-Normalization.

We propose Universal Document Processing (UDOP), a foundation Document AI model which unifies text, image, and layout modalities together with varied task formats, including document understanding and generation. UDOP leverages the spatial correlation between textual content and document image to model image, text, and layout modalities with one uniform representation. With a novel Vision-Text-Layout Transformer, UDOP unifies pretraining and multi-domain downstream tasks into a prompt-based sequence generation scheme. UDOP is pretrained on both large-scale unlabeled document corpora using innovative self-supervised objectives and diverse labeled data. UDOP also learns to generate document images from text and layout modalities via masked image reconstruction. To the best of our knowledge, this is the first time in the field of document AI that one model simultaneously achieves high-quality neural document editing and content customization. Our method sets the state-of-the-art on 8 Document AI tasks, e.g., document understanding and QA, across diverse data domains like finance reports, academic papers, and websites. UDOP ranks first on the leaderboard of the Document Understanding Benchmark.

Segmenting biomarkers in medical images is crucial for various biotech applications. Despite advances, Transformer and CNN based methods often struggle with variations in staining and morphology, limiting feature extraction. In medical image segmentation, where datasets often have limited sample availability, recent state-of-the-art (SOTA) methods achieve higher accuracy by leveraging pre-trained encoders, whereas end-to-end methods tend to underperform. This is due to challenges in effectively transferring rich multiscale features from encoders to decoders, as well as limitations in decoder efficiency. To address these issues, we propose an architecture that captures multi-scale local and global contextual information and a novel decoder design, which effectively integrates features from the encoder, emphasizes important channels and regions, and reconstructs spatial dimensions to enhance segmentation accuracy. Our method, compatible with various encoders, outperforms SOTA methods, as demonstrated by experiments on four datasets and ablation studies. Specifically, our method achieves absolute performance gains of 2.76% on MoNuSeg, 3.12% on DSB, 2.87% on Electron Microscopy, and 4.03% on TNBC datasets compared to existing SOTA methods. Code: https://github.com/saadwazir/MCADS-Decoder

In this study, we evaluate the performance of the Segment Anything Model (SAM) in clinical radiotherapy. Our results indicate that SAM's 'segment anything' mode can achieve clinically acceptable segmentation results in most organs-at-risk (OARs) with Dice scores higher than 0.7. SAM's 'box prompt' mode further improves the Dice scores by 0.1 to 0.5. Considering the size of the organ and the clarity of its boundary, SAM displays better performance for large organs with clear boundaries but performs worse for smaller organs with unclear boundaries. Given that SAM, a model pre-trained purely on natural images, can handle the delineation of OARs from medical images with clinically acceptable accuracy, these results highlight SAM's robust generalization capabilities with consistent accuracy in automatic segmentation for radiotherapy. In other words, SAM can achieve delineation of different OARs at different sites using a generic automatic segmentation model. SAM's generalization capabilities across different disease sites suggest that it is technically feasible to develop a generic model for automatic segmentation in radiotherapy.

Non-ideal measurement computed tomography (NICT), which sacrifices optimal imaging standards for new advantages in CT imaging, is expanding the clinical application scope of CT images. However, with the reduction of imaging standards, the image quality has also been reduced, extremely limiting the clinical acceptability. Although numerous studies have demonstrated the feasibility of deep learning for the NICT enhancement in specific scenarios, their high data cost and limited generalizability have become large obstacles. The recent research on the foundation model has brought new opportunities for building a universal NICT enhancement model - bridging the image quality degradation with minimal data cost. However, owing to the challenges in the collection of large pre-training datasets and the compatibility of data variation, no success has been reported. In this paper, we propose a multi-scale integrated Transformer AMPlifier (TAMP), the first imaging foundation model for universal NICT enhancement. It has been pre-trained on a large-scale physical-driven simulation dataset with 3.6 million NICT-ICT image pairs, and is able to directly generalize to the NICT enhancement tasks with various non-ideal settings and body regions. Via the adaptation with few data, it can further achieve professional performance in real-world specific scenarios. Our extensive experiments have demonstrated that the proposed TAMP has significant potential for promoting the exploration and application of NICT and serving a wider range of medical scenarios.

Head and neck tumor segmentation challenge (HECKTOR) 2022 offers a platform for researchers to compare their solutions to segmentation of tumors and lymph nodes from 3D CT and PET images. In this work, we describe our solution to HECKTOR 2022 segmentation task. We re-sample all images to a common resolution, crop around head and neck region, and train SegResNet semantic segmentation network from MONAI. We use 5-fold cross validation to select best model checkpoints. The final submission is an ensemble of 15 models from 3 runs. Our solution (team name NVAUTO) achieves the 1st place on the HECKTOR22 challenge leaderboard with an aggregated dice score of 0.78802.

Transformers have achieved remarkable success across multiple fields, yet their impact on 3D medical image segmentation remains limited with convolutional networks still dominating major benchmarks. In this work, we a) analyze current Transformer-based segmentation models and identify critical shortcomings, particularly their over-reliance on convolutional blocks. Further, we demonstrate that in some architectures, performance is unaffected by the absence of the Transformer, thereby demonstrating their limited effectiveness. To address these challenges, we move away from hybrid architectures and b) introduce a fully Transformer-based segmentation architecture, termed Primus. Primus leverages high-resolution tokens, combined with advances in positional embeddings and block design, to maximally leverage its Transformer blocks. Through these adaptations Primus surpasses current Transformer-based methods and competes with state-of-the-art convolutional models on multiple public datasets. By doing so, we create the first pure Transformer architecture and take a significant step towards making Transformers state-of-the-art for 3D medical image segmentation.

Deep learning based automated pathological diagnosis has markedly improved diagnostic efficiency and reduced variability between observers, yet its clinical adoption remains limited by opaque model decisions and a lack of traceable rationale. To address this, recent multimodal visual reasoning architectures provide a unified framework that generates segmentation masks at the pixel level alongside semantically aligned textual explanations. By localizing lesion regions and producing expert style diagnostic narratives, these models deliver the transparent and interpretable insights necessary for dependable AI assisted pathology. Building on these advancements, we propose PathMR, a cell-level Multimodal visual Reasoning framework for Pathological image analysis. Given a pathological image and a textual query, PathMR generates expert-level diagnostic explanations while simultaneously predicting cell distribution patterns. To benchmark its performance, we evaluated our approach on the publicly available PathGen dataset as well as on our newly developed GADVR dataset. Extensive experiments on these two datasets demonstrate that PathMR consistently outperforms state-of-the-art visual reasoning methods in text generation quality, segmentation accuracy, and cross-modal alignment. These results highlight the potential of PathMR for improving interpretability in AI-driven pathological diagnosis. The code will be publicly available in https://github.com/zhangye-zoe/PathMR.

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.

Remarkable strides in computational pathology have been made in the task-agnostic foundation model that advances the performance of a wide array of downstream clinical tasks. Despite the promising performance, there are still several challenges. First, prior works have resorted to either vision-only or image-caption data, disregarding pathology reports with more clinically authentic information from pathologists and gene expression profiles which respectively offer distinct knowledge for versatile clinical applications. Second, the current progress in pathology FMs predominantly concentrates on the patch level, where the restricted context of patch-level pretraining fails to capture whole-slide patterns. Even recent slide-level FMs still struggle to provide whole-slide context for patch representation. In this study, for the first time, we develop a pathology foundation model incorporating three levels of modalities: pathology slides, pathology reports, and gene expression data, which resulted in 26,169 slide-level modality pairs from 10,275 patients across 32 cancer types, amounting to over 116 million pathological patch images. To leverage these data for CPath, we propose a novel whole-slide pretraining paradigm that injects the multimodal whole-slide context into the patch representation, called Multimodal Self-TAught PRetraining (mSTAR). The proposed paradigm revolutionizes the pretraining workflow for CPath, enabling the pathology FM to acquire the whole-slide context. To the best of our knowledge, this is the first attempt to incorporate three modalities at the whole-slide context for enhancing pathology FMs. To systematically evaluate the capabilities of mSTAR, we built the largest spectrum of oncological benchmark, spanning 7 categories of oncological applications in 15 types of 97 practical oncological tasks.

Since radiology reports needed for clinical practice and research are written and stored in free-text narrations, extraction of relative information for further analysis is difficult. In these circumstances, natural language processing (NLP) techniques can facilitate automatic information extraction and transformation of free-text formats to structured data. In recent years, deep learning (DL)-based models have been adapted for NLP experiments with promising results. Despite the significant potential of DL models based on artificial neural networks (ANN) and convolutional neural networks (CNN), the models face some limitations to implement in clinical practice. Transformers, another new DL architecture, have been increasingly applied to improve the process. Therefore, in this study, we propose a transformer-based fine-grained named entity recognition (NER) architecture for clinical information extraction. We collected 88 abdominopelvic sonography reports in free-text formats and annotated them based on our developed information schema. The text-to-text transfer transformer model (T5) and Scifive, a pre-trained domain-specific adaptation of the T5 model, were applied for fine-tuning to extract entities and relations and transform the input into a structured format. Our transformer-based model in this study outperformed previously applied approaches such as ANN and CNN models based on ROUGE-1, ROUGE-2, ROUGE-L, and BLEU scores of 0.816, 0.668, 0.528, and 0.743, respectively, while providing an interpretable structured report.

Endorectal ultrasound (ERUS) is an important imaging modality that provides high reliability for diagnosing the depth and boundary of invasion in colorectal cancer. However, the lack of a large-scale ERUS dataset with high-quality annotations hinders the development of automatic ultrasound diagnostics. In this paper, we collected and annotated the first benchmark dataset that covers diverse ERUS scenarios, i.e. colorectal cancer segmentation, detection, and infiltration depth staging. Our ERUS-10K dataset comprises 77 videos and 10,000 high-resolution annotated frames. Based on this dataset, we further introduce a benchmark model for colorectal cancer segmentation, named the Adaptive Sparse-context TRansformer (ASTR). ASTR is designed based on three considerations: scanning mode discrepancy, temporal information, and low computational complexity. For generalizing to different scanning modes, the adaptive scanning-mode augmentation is proposed to convert between raw sector images and linear scan ones. For mining temporal information, the sparse-context transformer is incorporated to integrate inter-frame local and global features. For reducing computational complexity, the sparse-context block is introduced to extract contextual features from auxiliary frames. Finally, on the benchmark dataset, the proposed ASTR model achieves a 77.6% Dice score in rectal cancer segmentation, largely outperforming previous state-of-the-art methods.

Transformers have become one of the dominant architectures in deep learning, particularly as a powerful alternative to convolutional neural networks (CNNs) in computer vision. However, Transformer training and inference in previous works can be prohibitively expensive due to the quadratic complexity of self-attention over a long sequence of representations, especially for high-resolution dense prediction tasks. To this end, we present a novel Less attention vIsion Transformer (LIT), building upon the fact that the early self-attention layers in Transformers still focus on local patterns and bring minor benefits in recent hierarchical vision Transformers. Specifically, we propose a hierarchical Transformer where we use pure multi-layer perceptrons (MLPs) to encode rich local patterns in the early stages while applying self-attention modules to capture longer dependencies in deeper layers. Moreover, we further propose a learned deformable token merging module to adaptively fuse informative patches in a non-uniform manner. The proposed LIT achieves promising performance on image recognition tasks, including image classification, object detection and instance segmentation, serving as a strong backbone for many vision tasks. Code is available at: https://github.com/zhuang-group/LIT

Transformers have achieved great success in many artificial intelligence fields, such as natural language processing, computer vision, and audio processing. Therefore, it is natural to attract lots of interest from academic and industry researchers. Up to the present, a great variety of Transformer variants (a.k.a. X-formers) have been proposed, however, a systematic and comprehensive literature review on these Transformer variants is still missing. In this survey, we provide a comprehensive review of various X-formers. We first briefly introduce the vanilla Transformer and then propose a new taxonomy of X-formers. Next, we introduce the various X-formers from three perspectives: architectural modification, pre-training, and applications. Finally, we outline some potential directions for future research.

With the rapid advancement of deep learning, particularly in the field of medical image analysis, an increasing number of Vision-Language Models (VLMs) are being widely applied to solve complex health and biomedical challenges. However, existing research has primarily focused on specific tasks or single modalities, which limits their applicability and generalization across diverse medical scenarios. To address this challenge, we propose UMIT, a unified multi-modal, multi-task VLM designed specifically for medical imaging tasks. UMIT is able to solve various tasks, including visual question answering, disease detection, and medical report generation. In addition, it is applicable to multiple imaging modalities (e.g., X-ray, CT and PET), covering a wide range of applications from basic diagnostics to complex lesion analysis. Moreover, UMIT supports both English and Chinese, expanding its applicability globally and ensuring accessibility to healthcare services in different linguistic contexts. To enhance the model's adaptability and task-handling capability, we design a unique two-stage training strategy and fine-tune UMIT with designed instruction templates. Through extensive empirical evaluation, UMIT outperforms previous methods in five tasks across multiple datasets. The performance of UMIT indicates that it can significantly enhance diagnostic accuracy and workflow efficiency, thus providing effective solutions for medical imaging applications.

With ChatGPT as a representative, tons of companies have began to provide services based on large Transformers models. However, using such a service inevitably leak users' prompts to the model provider. Previous studies have studied secure inference for Transformer models using secure multiparty computation (MPC), where model parameters and clients' prompts are kept secret. Despite this, these frameworks are still limited in terms of model performance, efficiency, and deployment. To address these limitations, we propose framework PUMA to enable fast and secure Transformer model inference. Our framework designs high quality approximations for expensive functions, such as GeLU and Softmax, which significantly reduce the cost of secure inference while preserving the model performance. Additionally, we design secure Embedding and LayerNorm procedures that faithfully implement the desired functionality without undermining the Transformer architecture. PUMA is about 2x faster than the state-of-the-art MPC framework MPCFORMER(ICLR 2023) and has similar accuracy as plaintext models without fine-tuning (which the previous works failed to achieve). One more thing, PUMA can evaluate LLaMA-7B in around 5 minutes to generate 1 token. To our best knowledge, this is the first time that a model with such a parameter size is able to be evaluated under MPC. PUMA has been open-sourced in the Github repository of SecretFlow-SPU.

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

Precise and scalable instance segmentation of cell nuclei is essential for computational pathology, yet gigapixel Whole-Slide Images pose major computational challenges. Existing approaches rely on patch-based processing and costly post-processing for instance separation, sacrificing context and efficiency. We introduce LSP-DETR (Local Star Polygon DEtection TRansformer), a fully end-to-end framework that uses a lightweight transformer with linear complexity to process substantially larger images without additional computational cost. Nuclei are represented as star-convex polygons, and a novel radial distance loss function allows the segmentation of overlapping nuclei to emerge naturally, without requiring explicit overlap annotations or handcrafted post-processing. Evaluations on PanNuke and MoNuSeg show strong generalization across tissues and state-of-the-art efficiency, with LSP-DETR being over five times faster than the next-fastest leading method. Code and models are available at https://github.com/RationAI/lsp-detr.

According to the considerable growth in the avail of chest X-ray images in diagnosing various diseases, as well as gathering extensive datasets, having an automated diagnosis procedure using deep neural networks has occupied the minds of experts. Most of the available methods in computer vision use a CNN backbone to acquire high accuracy on the classification problems. Nevertheless, recent researches show that transformers, established as the de facto method in NLP, can also outperform many CNN-based models in vision. This paper proposes a multi-label classification deep model based on the Swin Transformer as the backbone to achieve state-of-the-art diagnosis classification. It leverages Multi-Layer Perceptron, also known as MLP, for the head architecture. We evaluate our model on one of the most widely-used and largest x-ray datasets called "Chest X-ray14," which comprises more than 100,000 frontal/back-view images from over 30,000 patients with 14 famous chest diseases. Our model has been tested with several number of MLP layers for the head setting, each achieves a competitive AUC score on all classes. Comprehensive experiments on Chest X-ray14 have shown that a 3-layer head attains state-of-the-art performance with an average AUC score of 0.810, compared to the former SOTA average AUC of 0.799. We propose an experimental setup for the fair benchmarking of existing methods, which could be used as a basis for the future studies. Finally, we followed up our results by confirming that the proposed method attends to the pathologically relevant areas of the chest.

Digital healthcare infrastructure is crucial for global medical service delivery. Egypt faces EHR adoption barriers: only 314 hospitals had such systems as of Oct 2024. This limits data management and decision-making. This project introduces an EHR system for Egypt's Universal Health Insurance and healthcare ecosystem. It simplifies data management by centralizing medical histories with a scalable micro-services architecture and polyglot persistence for real-time access and provider communication. Clinical workflows are enhanced via patient examination and history tracking. The system uses the Llama3-OpenBioLLM-70B model to generate summaries of medical histories, provide chatbot features, and generate AI-based medical reports, enabling efficient searches during consultations. A Vision Transformer (ViT) aids in pneumonia classification. Evaluations show the AI excels in capturing details (high recall) but needs improvement in concise narratives. With optimization (retrieval-augmented generation, local data fine-tuning, interoperability protocols), this AI-driven EHR could enhance diagnostic support, decision-making, and healthcare delivery in Egypt.

This paper presents a unified Vision-Language Pre-training (VLP) model. The model is unified in that (1) it can be fine-tuned for either vision-language generation (e.g., image captioning) or understanding (e.g., visual question answering) tasks, and (2) it uses a shared multi-layer transformer network for both encoding and decoding, which differs from many existing methods where the encoder and decoder are implemented using separate models. The unified VLP model is pre-trained on a large amount of image-text pairs using the unsupervised learning objectives of two tasks: bidirectional and sequence-to-sequence (seq2seq) masked vision-language prediction. The two tasks differ solely in what context the prediction conditions on. This is controlled by utilizing specific self-attention masks for the shared transformer network. To the best of our knowledge, VLP is the first reported model that achieves state-of-the-art results on both vision-language generation and understanding tasks, as disparate as image captioning and visual question answering, across three challenging benchmark datasets: COCO Captions, Flickr30k Captions, and VQA 2.0. The code and the pre-trained models are available at https://github.com/LuoweiZhou/VLP.

Automatic diabetic retinopathy (DR) lesions segmentation makes great sense of assisting ophthalmologists in diagnosis. Although many researches have been conducted on this task, most prior works paid too much attention to the designs of networks instead of considering the pathological association for lesions. Through investigating the pathogenic causes of DR lesions in advance, we found that certain lesions are closed to specific vessels and present relative patterns to each other. Motivated by the observation, we propose a relation transformer block (RTB) to incorporate attention mechanisms at two main levels: a self-attention transformer exploits global dependencies among lesion features, while a cross-attention transformer allows interactions between lesion and vessel features by integrating valuable vascular information to alleviate ambiguity in lesion detection caused by complex fundus structures. In addition, to capture the small lesion patterns first, we propose a global transformer block (GTB) which preserves detailed information in deep network. By integrating the above blocks of dual-branches, our network segments the four kinds of lesions simultaneously. Comprehensive experiments on IDRiD and DDR datasets well demonstrate the superiority of our approach, which achieves competitive performance compared to state-of-the-arts.

We introduce the Nemotron 3 family of models - Nano, Super, and Ultra. These models deliver strong agentic, reasoning, and conversational capabilities. The Nemotron 3 family uses a Mixture-of-Experts hybrid Mamba-Transformer architecture to provide best-in-class throughput and context lengths of up to 1M tokens. Super and Ultra models are trained with NVFP4 and incorporate LatentMoE, a novel approach that improves model quality. The two larger models also include MTP layers for faster text generation. All Nemotron 3 models are post-trained using multi-environment reinforcement learning enabling reasoning, multi-step tool use, and support granular reasoning budget control. Nano, the smallest model, outperforms comparable models in accuracy while remaining extremely cost-efficient for inference. Super is optimized for collaborative agents and high-volume workloads such as IT ticket automation. Ultra, the largest model, provides state-of-the-art accuracy and reasoning performance. Nano is released together with its technical report and this white paper, while Super and Ultra will follow in the coming months. We will openly release the model weights, pre- and post-training software, recipes, and all data for which we hold redistribution rights.

We introduce UniGraspTransformer, a universal Transformer-based network for dexterous robotic grasping that simplifies training while enhancing scalability and performance. Unlike prior methods such as UniDexGrasp++, which require complex, multi-step training pipelines, UniGraspTransformer follows a streamlined process: first, dedicated policy networks are trained for individual objects using reinforcement learning to generate successful grasp trajectories; then, these trajectories are distilled into a single, universal network. Our approach enables UniGraspTransformer to scale effectively, incorporating up to 12 self-attention blocks for handling thousands of objects with diverse poses. Additionally, it generalizes well to both idealized and real-world inputs, evaluated in state-based and vision-based settings. Notably, UniGraspTransformer generates a broader range of grasping poses for objects in various shapes and orientations, resulting in more diverse grasp strategies. Experimental results demonstrate significant improvements over state-of-the-art, UniDexGrasp++, across various object categories, achieving success rate gains of 3.5%, 7.7%, and 10.1% on seen objects, unseen objects within seen categories, and completely unseen objects, respectively, in the vision-based setting. Project page: https://dexhand.github.io/UniGraspTransformer.

Foundation models are rapidly being developed for computational pathology applications. However, it remains an open question which factors are most important for downstream performance with data scale and diversity, model size, and training algorithm all playing a role. In this work, we present the result of scaling both data and model size, surpassing previous studies in both dimensions, and introduce two new models: Virchow 2, a 632M parameter vision transformer, and Virchow 2G, a 1.85B parameter vision transformer, each trained with 3.1M histopathology whole slide images. To support this scale, we propose domain-inspired adaptations to the DINOv2 training algorithm, which is quickly becoming the default method in self-supervised learning for computational pathology. We achieve state of the art performance on twelve tile-level tasks, as compared to the top performing competing models. Our results suggest that data diversity and domain-specific training can outperform models that only scale in the number of parameters, but, on average, performance benefits from domain-tailoring, data scale, and model scale.

With the achievements of Transformer in the field of natural language processing, the encoder-decoder and the attention mechanism in Transformer have been applied to computer vision. Recently, in multiple tasks of computer vision (image classification, object detection, semantic segmentation, etc.), state-of-the-art convolutional neural networks have introduced some concepts of Transformer. This proves that Transformer has a good prospect in the field of image recognition. After Vision Transformer was proposed, more and more works began to use self-attention to completely replace the convolutional layer. This work is based on Vision Transformer, combined with the pyramid architecture, using Split-transform-merge to propose the group encoder and name the network architecture Aggregated Pyramid Vision Transformer (APVT). We perform image classification tasks on the CIFAR-10 dataset and object detection tasks on the COCO 2017 dataset. Compared with other network architectures that use Transformer as the backbone, APVT has excellent results while reducing the computational cost. We hope this improved strategy can provide a reference for future Transformer research in computer vision.

Transformers have achieved great success in pluralistic image inpainting recently. However, we find existing transformer based solutions regard each pixel as a token, thus suffer from information loss issue from two aspects: 1) They downsample the input image into much lower resolutions for efficiency consideration, incurring information loss and extra misalignment for the boundaries of masked regions. 2) They quantize 256^3 RGB pixels to a small number (such as 512) of quantized pixels. The indices of quantized pixels are used as tokens for the inputs and prediction targets of transformer. Although an extra CNN network is used to upsample and refine the low-resolution results, it is difficult to retrieve the lost information back.To keep input information as much as possible, we propose a new transformer based framework "PUT". Specifically, to avoid input downsampling while maintaining the computation efficiency, we design a patch-based auto-encoder P-VQVAE, where the encoder converts the masked image into non-overlapped patch tokens and the decoder recovers the masked regions from inpainted tokens while keeping the unmasked regions unchanged. To eliminate the information loss caused by quantization, an Un-Quantized Transformer (UQ-Transformer) is applied, which directly takes the features from P-VQVAE encoder as input without quantization and regards the quantized tokens only as prediction targets. Extensive experiments show that PUT greatly outperforms state-of-the-art methods on image fidelity, especially for large masked regions and complex large-scale datasets. Code is available at https://github.com/liuqk3/PUT

With the rapid development of computational pathology, many AI-assisted diagnostic tasks have emerged. Cellular nuclei segmentation can segment various types of cells for downstream analysis, but it relies on predefined categories and lacks flexibility. Moreover, pathology visual question answering can perform image-level understanding but lacks region-level detection capability. To address this, we propose a new benchmark called Pathology Visual Grounding (PathVG), which aims to detect regions based on expressions with different attributes. To evaluate PathVG, we create a new dataset named RefPath which contains 27,610 images with 33,500 language-grounded boxes. Compared to visual grounding in other domains, PathVG presents pathological images at multi-scale and contains expressions with pathological knowledge. In the experimental study, we found that the biggest challenge was the implicit information underlying the pathological expressions. Based on this, we proposed Pathology Knowledge-enhanced Network (PKNet) as the baseline model for PathVG. PKNet leverages the knowledge-enhancement capabilities of Large Language Models (LLMs) to convert pathological terms with implicit information into explicit visual features, and fuses knowledge features with expression features through the designed Knowledge Fusion Module (KFM). The proposed method achieves state-of-the-art performance on the PathVG benchmark.

The Transformer is an extremely powerful and prominent deep learning architecture. In this work, we challenge the commonly held belief in deep learning that going deeper is better, and show an alternative design approach that is building wider attention Transformers. We demonstrate that wide single layer Transformer models can compete with or outperform deeper ones in a variety of Natural Language Processing (NLP) tasks when both are trained from scratch. The impact of changing the model aspect ratio on Transformers is then studied systematically. This ratio balances the number of layers and the number of attention heads per layer while keeping the total number of attention heads and all other hyperparameters constant. On average, across 4 NLP tasks and 10 attention types, single layer wide models perform 0.3% better than their deep counterparts. We show an in-depth evaluation and demonstrate how wide models require a far smaller memory footprint and can run faster on commodity hardware, in addition, these wider models are also more interpretable. For example, a single layer Transformer on the IMDb byte level text classification has 3.1x faster inference latency on a CPU than its equally accurate deeper counterpart, and is half the size. We therefore put forward wider and shallower models as a viable and desirable alternative for small models on NLP tasks, and as an important area of research for domains beyond this.

Transformer is a new kind of neural architecture which encodes the input data as powerful features via the attention mechanism. Basically, the visual transformers first divide the input images into several local patches and then calculate both representations and their relationship. Since natural images are of high complexity with abundant detail and color information, the granularity of the patch dividing is not fine enough for excavating features of objects in different scales and locations. In this paper, we point out that the attention inside these local patches are also essential for building visual transformers with high performance and we explore a new architecture, namely, Transformer iN Transformer (TNT). Specifically, we regard the local patches (e.g., 16times16) as "visual sentences" and present to further divide them into smaller patches (e.g., 4times4) as "visual words". The attention of each word will be calculated with other words in the given visual sentence with negligible computational costs. Features of both words and sentences will be aggregated to enhance the representation ability. Experiments on several benchmarks demonstrate the effectiveness of the proposed TNT architecture, e.g., we achieve an 81.5% top-1 accuracy on the ImageNet, which is about 1.7% higher than that of the state-of-the-art visual transformer with similar computational cost. The PyTorch code is available at https://github.com/huawei-noah/CV-Backbones, and the MindSpore code is available at https://gitee.com/mindspore/models/tree/master/research/cv/TNT.

Vision Transformer (ViT) has become one of the most popular neural architectures due to its great scalability, computational efficiency, and compelling performance in many vision tasks. However, ViT has shown inferior performance to Convolutional Neural Network (CNN) on medical tasks due to its data-hungry nature and the lack of annotated medical data. In this paper, we pre-train ViTs on 266,340 chest X-rays using Masked Autoencoders (MAE) which reconstruct missing pixels from a small part of each image. For comparison, CNNs are also pre-trained on the same 266,340 X-rays using advanced self-supervised methods (e.g., MoCo v2). The results show that our pre-trained ViT performs comparably (sometimes better) to the state-of-the-art CNN (DenseNet-121) for multi-label thorax disease classification. This performance is attributed to the strong recipes extracted from our empirical studies for pre-training and fine-tuning ViT. The pre-training recipe signifies that medical reconstruction requires a much smaller proportion of an image (10% vs. 25%) and a more moderate random resized crop range (0.5~1.0 vs. 0.2~1.0) compared with natural imaging. Furthermore, we remark that in-domain transfer learning is preferred whenever possible. The fine-tuning recipe discloses that layer-wise LR decay, RandAug magnitude, and DropPath rate are significant factors to consider. We hope that this study can direct future research on the application of Transformers to a larger variety of medical imaging tasks.

We present a unified transformer, i.e., Show-o, that unifies multimodal understanding and generation. Unlike fully autoregressive models, Show-o unifies autoregressive and (discrete) diffusion modeling to adaptively handle inputs and outputs of various and mixed modalities. The unified model flexibly supports a wide range of vision-language tasks including visual question-answering, text-to-image generation, text-guided inpainting/extrapolation, and mixed-modality generation. Across various benchmarks, it demonstrates comparable or superior performance to existing individual models with an equivalent or larger number of parameters tailored for understanding or generation. This significantly highlights its potential as a next-generation foundation model. Code and models are released at https://github.com/showlab/Show-o.

Transformers have empowered many milestones across various fields and have recently been applied to solve partial differential equations (PDEs). However, since PDEs are typically discretized into large-scale meshes with complex geometries, it is challenging for Transformers to capture intricate physical correlations directly from massive individual points. Going beyond superficial and unwieldy meshes, we present Transolver based on a more foundational idea, which is learning intrinsic physical states hidden behind discretized geometries. Specifically, we propose a new Physics-Attention to adaptively split the discretized domain into a series of learnable slices of flexible shapes, where mesh points under similar physical states will be ascribed to the same slice. By calculating attention to physics-aware tokens encoded from slices, Transovler can effectively capture intricate physical correlations under complex geometrics, which also empowers the solver with endogenetic geometry-general modeling capacity and can be efficiently computed in linear complexity. Transolver achieves consistent state-of-the-art with 22% relative gain across six standard benchmarks and also excels in large-scale industrial simulations, including car and airfoil designs. Code is available at https://github.com/thuml/Transolver.

While machine learning is currently transforming the field of histopathology, the domain lacks a comprehensive evaluation of state-of-the-art models based on essential but complementary quality requirements beyond a mere classification accuracy. In order to fill this gap, we developed a new methodology to extensively evaluate a wide range of classification models, including recent vision transformers, and convolutional neural networks such as: ConvNeXt, ResNet (BiT), Inception, ViT and Swin transformer, with and without supervised or self-supervised pretraining. We thoroughly tested the models on five widely used histopathology datasets containing whole slide images of breast, gastric, and colorectal cancer and developed a novel approach using an image-to-image translation model to assess the robustness of a cancer classification model against stain variations. Further, we extended existing interpretability methods to previously unstudied models and systematically reveal insights of the models' classifications strategies that can be transferred to future model architectures.

Computer-aided medical image segmentation has been applied widely in diagnosis and treatment to obtain clinically useful information of shapes and volumes of target organs and tissues. In the past several years, convolutional neural network (CNN) based methods (e.g., U-Net) have dominated this area, but still suffered from inadequate long-range information capturing. Hence, recent work presented computer vision Transformer variants for medical image segmentation tasks and obtained promising performances. Such Transformers model long-range dependency by computing pair-wise patch relations. However, they incur prohibitive computational costs, especially on 3D medical images (e.g., CT and MRI). In this paper, we propose a new method called Dilated Transformer, which conducts self-attention for pair-wise patch relations captured alternately in local and global scopes. Inspired by dilated convolution kernels, we conduct the global self-attention in a dilated manner, enlarging receptive fields without increasing the patches involved and thus reducing computational costs. Based on this design of Dilated Transformer, we construct a U-shaped encoder-decoder hierarchical architecture called D-Former for 3D medical image segmentation. Experiments on the Synapse and ACDC datasets show that our D-Former model, trained from scratch, outperforms various competitive CNN-based or Transformer-based segmentation models at a low computational cost without time-consuming per-training process.

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.

Unsupervised reconstruction networks using self-attention transformers have achieved state-of-the-art performance for multi-class (unified) anomaly detection with a single model. However, these self-attention reconstruction models primarily operate on target features, which may result in perfect reconstruction for both normal and anomaly features due to high consistency with context, leading to failure in detecting anomalies. Additionally, these models often produce inaccurate anomaly segmentation due to performing reconstruction in a low spatial resolution latent space. To enable reconstruction models enjoying high efficiency while enhancing their generalization for unified anomaly detection, we propose a simple yet effective method that reconstructs normal features and restores anomaly features with just One Normal Image Prompt (OneNIP). In contrast to previous work, OneNIP allows for the first time to reconstruct or restore anomalies with just one normal image prompt, effectively boosting unified anomaly detection performance. Furthermore, we propose a supervised refiner that regresses reconstruction errors by using both real normal and synthesized anomalous images, which significantly improves pixel-level anomaly segmentation. OneNIP outperforms previous methods on three industry anomaly detection benchmarks: MVTec, BTAD, and VisA. The code and pre-trained models are available at https://github.com/gaobb/OneNIP.

Diffusion Transformers have emerged as the foundation for vision generative models, but their scalability is limited by the high cost of hyperparameter (HP) tuning at large scales. Recently, Maximal Update Parametrization (muP) was proposed for vanilla Transformers, which enables stable HP transfer from small to large language models, and dramatically reduces tuning costs. However, it remains unclear whether muP of vanilla Transformers extends to diffusion Transformers, which differ architecturally and objectively. In this work, we generalize standard muP to diffusion Transformers and validate its effectiveness through large-scale experiments. First, we rigorously prove that muP of mainstream diffusion Transformers, including DiT, U-ViT, PixArt-alpha, and MMDiT, aligns with that of the vanilla Transformer, enabling the direct application of existing muP methodologies. Leveraging this result, we systematically demonstrate that DiT-muP enjoys robust HP transferability. Notably, DiT-XL-2-muP with transferred learning rate achieves 2.9 times faster convergence than the original DiT-XL-2. Finally, we validate the effectiveness of muP on text-to-image generation by scaling PixArt-alpha from 0.04B to 0.61B and MMDiT from 0.18B to 18B. In both cases, models under muP outperform their respective baselines while requiring small tuning cost, only 5.5% of one training run for PixArt-alpha and 3% of consumption by human experts for MMDiT-18B. These results establish muP as a principled and efficient framework for scaling diffusion Transformers.

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.

Mathematical formulas are a fundamental and widely used component in various scientific fields, serving as a universal language for expressing complex concepts and relationships. While state-of-the-art transformer models excel in processing and understanding natural language, they encounter challenges with mathematical notation, which involves a complex structure and diverse representations. This study focuses on the development of specialized training datasets to enhance the encoding of mathematical content. We introduce Math Mutator (MAMUT), a framework capable of generating equivalent and falsified versions of a given mathematical formula in LaTeX notation, effectively capturing the mathematical variety in notation of the same concept. Based on MAMUT, we have generated four large mathematical datasets containing diverse notation, which can be used to train language models with enhanced mathematical embeddings.

We introduce SeaS, a unified industrial generative model for automatically creating diverse anomalies, authentic normal products, and precise anomaly masks. While extensive research exists, most efforts either focus on specific tasks, i.e., anomalies or normal products only, or require separate models for each anomaly type. Consequently, prior methods either offer limited generative capability or depend on a vast array of anomaly-specific models. We demonstrate that U-Net's differentiated learning ability captures the distinct visual traits of slightly-varied normal products and diverse anomalies, enabling us to construct a unified model for all tasks. Specifically, we first introduce an Unbalanced Abnormal (UA) Text Prompt, comprising one normal token and multiple anomaly tokens. More importantly, our Decoupled Anomaly Alignment (DA) loss decouples anomaly attributes and binds them to distinct anomaly tokens of UA, enabling SeaS to create unseen anomalies by recombining these attributes. Furthermore, our Normal-image Alignment (NA) loss aligns the normal token to normal patterns, making generated normal products globally consistent and locally varied. Finally, SeaS produces accurate anomaly masks by fusing discriminative U-Net features with high-resolution VAE features. SeaS sets a new benchmark for industrial generation, significantly enhancing downstream applications, with average improvements of +8.66% pixel-level AP for synthesis-based AD approaches, +1.10% image-level AP for unsupervised AD methods, and +12.79% IoU for supervised segmentation models. Code is available at https://github.com/HUST-SLOW/SeaS{https://github.com/HUST-SLOW/SeaS}.

Training large transformer models is one of the most important computational challenges of modern AI. In this paper, we show how to significantly accelerate training of large transformer models by reducing activation recomputation. Activation recomputation is commonly used to work around memory capacity constraints. Rather than storing activations for backpropagation, they are traditionally recomputed, which saves memory but adds redundant compute. In this work, we show most of this redundant compute is unnecessary because we can reduce memory consumption sufficiently without it. We present two novel yet very simple techniques: sequence parallelism and selective activation recomputation. In conjunction with tensor parallelism, these techniques almost eliminate the need to recompute activations. We evaluate our approach on language models up to one trillion parameters in scale and show that our method reduces activation memory by 5x, while reducing execution time overhead from activation recomputation by over 90%. For example, when training a 530B parameter GPT-3 style model on 2240 NVIDIA A100 GPUs, we achieve a Model Flops Utilization of 54.2%, which is 29% faster than the 42.1% we achieve using recomputation. Our implementation will be available in both Megatron-LM and NeMo-Megatron.

In medical applications, deep learning methods are built to automate diagnostic tasks. However, a clinically relevant question that practitioners usually face, is how to predict the future trajectory of a disease (prognosis). Current methods for such a problem often require domain knowledge, and are complicated to apply. In this paper, we formulate the prognosis prediction problem as a one-to-many forecasting problem from multimodal data. Inspired by a clinical decision-making process with two agents -- a radiologist and a general practitioner, we model a prognosis prediction problem with two transformer-based components that share information between each other. The first block in this model aims to analyze the imaging data, and the second block leverages the internal representations of the first one as inputs, also fusing them with auxiliary patient data. We show the effectiveness of our method in predicting the development of structural knee osteoarthritis changes over time. Our results show that the proposed method outperforms the state-of-the-art baselines in terms of various performance metrics. In addition, we empirically show that the existence of the multi-agent transformers with depths of 2 is sufficient to achieve good performances. Our code is publicly available at https://github.com/MIPT-Oulu/CLIMAT.

We propose a novel neural network architecture, the normalized Transformer (nGPT) with representation learning on the hypersphere. In nGPT, all vectors forming the embeddings, MLP, attention matrices and hidden states are unit norm normalized. The input stream of tokens travels on the surface of a hypersphere, with each layer contributing a displacement towards the target output predictions. These displacements are defined by the MLP and attention blocks, whose vector components also reside on the same hypersphere. Experiments show that nGPT learns much faster, reducing the number of training steps required to achieve the same accuracy by a factor of 4 to 20, depending on the sequence length.

Transformers are transforming the landscape of computer vision, especially for recognition tasks. Detection transformers are the first fully end-to-end learning systems for object detection, while vision transformers are the first fully transformer-based architecture for image classification. In this paper, we integrate Vision and Detection Transformers (ViDT) to build an effective and efficient object detector. ViDT introduces a reconfigured attention module to extend the recent Swin Transformer to be a standalone object detector, followed by a computationally efficient transformer decoder that exploits multi-scale features and auxiliary techniques essential to boost the detection performance without much increase in computational load. Extensive evaluation results on the Microsoft COCO benchmark dataset demonstrate that ViDT obtains the best AP and latency trade-off among existing fully transformer-based object detectors, and achieves 49.2AP owing to its high scalability for large models. We will release the code and trained models at https://github.com/naver-ai/vidt

We empirically study the scaling properties of various Diffusion Transformers (DiTs) for text-to-image generation by performing extensive and rigorous ablations, including training scaled DiTs ranging from 0.3B upto 8B parameters on datasets up to 600M images. We find that U-ViT, a pure self-attention based DiT model provides a simpler design and scales more effectively in comparison with cross-attention based DiT variants, which allows straightforward expansion for extra conditions and other modalities. We identify a 2.3B U-ViT model can get better performance than SDXL UNet and other DiT variants in controlled setting. On the data scaling side, we investigate how increasing dataset size and enhanced long caption improve the text-image alignment performance and the learning efficiency.

Attention-based transformers have become the standard architecture in many deep learning fields, primarily due to their ability to model long-range dependencies and handle variable-length input sequences. However, the attention mechanism with its quadratic complexity is a significant bottleneck in the transformer architecture. This algorithm is only uni-directional in the decoder and converges to a static pattern in over-parametrized decoder-only models. I address this issue by developing a generative function as attention or activation replacement. It still has the auto-regressive character by comparing each token with the previous one. In my test setting with nanoGPT this yields a smaller loss while having a smaller model. The loss further drops by incorporating an average context vector. This concept of attention replacement is distributed under the GNU AGPL v3 license at https://gitlab.com/Bachstelze/causal_generation.

The emergence of large multimodal models has unlocked remarkable potential in AI, particularly in pathology. However, the lack of specialized, high-quality benchmark impeded their development and precise evaluation. To address this, we introduce PathMMU, the largest and highest-quality expert-validated pathology benchmark for LMMs. It comprises 33,573 multimodal multi-choice questions and 21,599 images from various sources, and an explanation for the correct answer accompanies each question. The construction of PathMMU capitalizes on the robust capabilities of GPT-4V, utilizing approximately 30,000 gathered image-caption pairs to generate Q\&As. Significantly, to maximize PathMMU's authority, we invite six pathologists to scrutinize each question under strict standards in PathMMU's validation and test sets, while simultaneously setting an expert-level performance benchmark for PathMMU. We conduct extensive evaluations, including zero-shot assessments of 14 open-sourced and three closed-sourced LMMs and their robustness to image corruption. We also fine-tune representative LMMs to assess their adaptability to PathMMU. The empirical findings indicate that advanced LMMs struggle with the challenging PathMMU benchmark, with the top-performing LMM, GPT-4V, achieving only a 51.7\% zero-shot performance, significantly lower than the 71.4\% demonstrated by human pathologists. After fine-tuning, even open-sourced LMMs can surpass GPT-4V with a performance of over 60\%, but still fall short of the expertise shown by pathologists. We hope that the PathMMU will offer valuable insights and foster the development of more specialized, next-generation LLMs for pathology.

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.

Transformers evaluated in a single, fixed-depth pass are provably limited in expressive power to the constant-depth circuit class TC0. Running a Transformer autoregressively removes that ceiling -- first in next-token prediction and, more recently, in chain-of-thought reasoning. Both regimes rely on feedback loops that decode internal states into tokens only to re-encode them in subsequent steps. While this "thinking aloud" mirrors human reasoning, biological brains iterate without externalising intermediate states as language. To boost the expressive power of encoder Transformers without resorting to token-level autoregression, we introduce the SELF-Transformer: an encoder layer that iteratively refines its own attention weights to a fixed point. Instead of producing -- in one pass -- the alignment matrix that remixes the input sequence, the SELF-Transformer iteratively updates that matrix internally, scaling test-time computation with input difficulty. This adaptivity yields up to 20\% accuracy gains on encoder-style benchmarks without increasing parameter count, demonstrating that input-adaptive alignment at test time offers substantial benefits for only a modest extra compute budget. Self-Transformers thus recover much of the expressive power of iterative reasoning while preserving the simplicity of pure encoder architectures.

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.

Transformers and their derivatives have achieved state-of-the-art performance across text, vision, and speech recognition tasks. However, minimal effort has been made to train transformers capable of evaluating the output quality of other models. This paper examines SwinV2-based reward models, called the Input-Output Transformer (IO Transformer) and the Output Transformer. These reward models can be leveraged for tasks such as inference quality evaluation, data categorization, and policy optimization. Our experiments demonstrate highly accurate model output quality assessment across domains where the output is entirely dependent on the input, with the IO Transformer achieving perfect evaluation accuracy on the Change Dataset 25 (CD25). We also explore modified Swin V2 architectures. Ultimately Swin V2 remains on top with a score of 95.41 % on the IO Segmentation Dataset, outperforming the IO Transformer in scenarios where the output is not entirely dependent on the input. Our work expands the application of transformer architectures to reward modeling in computer vision and provides critical insights into optimizing these models for various tasks.