Daily Papers

Point-drag-based image editing methods, like DragDiffusion, have attracted significant attention. However, point-drag-based approaches suffer from computational overhead and misinterpretation of user intentions due to the sparsity of point-based editing instructions. In this paper, we propose a region-based copy-and-paste dragging method, RegionDrag, to overcome these limitations. RegionDrag allows users to express their editing instructions in the form of handle and target regions, enabling more precise control and alleviating ambiguity. In addition, region-based operations complete editing in one iteration and are much faster than point-drag-based methods. We also incorporate the attention-swapping technique for enhanced stability during editing. To validate our approach, we extend existing point-drag-based datasets with region-based dragging instructions. Experimental results demonstrate that RegionDrag outperforms existing point-drag-based approaches in terms of speed, accuracy, and alignment with user intentions. Remarkably, RegionDrag completes the edit on an image with a resolution of 512x512 in less than 2 seconds, which is more than 100x faster than DragDiffusion, while achieving better performance. Project page: https://visual-ai.github.io/regiondrag.

The performance of reinforcement learning (RL) agents depends critically on the quality of the underlying feature representations. Hyperbolic feature spaces are well-suited for this purpose, as they naturally capture hierarchical and relational structure often present in complex RL environments. However, leveraging these spaces commonly faces optimization challenges due to the nonstationarity of RL. In this work, we identify key factors that determine the success and failure of training hyperbolic deep RL agents. By analyzing the gradients of core operations in the Poincaré Ball and Hyperboloid models of hyperbolic geometry, we show that large-norm embeddings destabilize gradient-based training, leading to trust-region violations in proximal policy optimization (PPO). Based on these insights, we introduce Hyper++, a new hyperbolic PPO agent that consists of three components: (i) stable critic training through a categorical value loss instead of regression; (ii) feature regularization guaranteeing bounded norms while avoiding the curse of dimensionality from clipping; and (iii) using a more optimization-friendly formulation of hyperbolic network layers. In experiments on ProcGen, we show that Hyper++ guarantees stable learning, outperforms prior hyperbolic agents, and reduces wall-clock time by approximately 30%. On Atari-5 with Double DQN, Hyper++ strongly outperforms Euclidean and hyperbolic baselines. We release our code at https://github.com/Probabilistic-and-Interactive-ML/hyper-rl .

Convolutional neural networks (CNN) are capable of learning robust representation with different regularization methods and activations as convolutional layers are spatially correlated. Based on this property, a large variety of regional dropout strategies have been proposed, such as Cutout, DropBlock, CutMix, etc. These methods aim to promote the network to generalize better by partially occluding the discriminative parts of objects. However, all of them perform this operation randomly, without capturing the most important region(s) within an object. In this paper, we propose Attentive CutMix, a naturally enhanced augmentation strategy based on CutMix. In each training iteration, we choose the most descriptive regions based on the intermediate attention maps from a feature extractor, which enables searching for the most discriminative parts in an image. Our proposed method is simple yet effective, easy to implement and can boost the baseline significantly. Extensive experiments on CIFAR-10/100, ImageNet datasets with various CNN architectures (in a unified setting) demonstrate the effectiveness of our proposed method, which consistently outperforms the baseline CutMix and other methods by a significant margin.

Image editing has advanced significantly with the development of diffusion models using both inversion-based and instruction-based methods. However, current inversion-based approaches struggle with big modifications (e.g., adding or removing objects) due to the structured nature of inversion noise, which hinders substantial changes. Meanwhile, instruction-based methods often constrain users to black-box operations, limiting direct interaction for specifying editing regions and intensity. To address these limitations, we propose BrushEdit, a novel inpainting-based instruction-guided image editing paradigm, which leverages multimodal large language models (MLLMs) and image inpainting models to enable autonomous, user-friendly, and interactive free-form instruction editing. Specifically, we devise a system enabling free-form instruction editing by integrating MLLMs and a dual-branch image inpainting model in an agent-cooperative framework to perform editing category classification, main object identification, mask acquisition, and editing area inpainting. Extensive experiments show that our framework effectively combines MLLMs and inpainting models, achieving superior performance across seven metrics including mask region preservation and editing effect coherence.

Recently, instruction-based image editing (IIE) has received widespread attention. In practice, IIE often modifies only specific regions of an image, while the remaining areas largely remain unchanged. Although these two types of regions differ significantly in generation difficulty and computational redundancy, existing IIE models do not account for this distinction, instead applying a uniform generation process across the entire image. This motivates us to propose RegionE, an adaptive, region-aware generation framework that accelerates IIE tasks without additional training. Specifically, the RegionE framework consists of three main components: 1) Adaptive Region Partition. We observed that the trajectory of unedited regions is straight, allowing for multi-step denoised predictions to be inferred in a single step. Therefore, in the early denoising stages, we partition the image into edited and unedited regions based on the difference between the final estimated result and the reference image. 2) Region-Aware Generation. After distinguishing the regions, we replace multi-step denoising with one-step prediction for unedited areas. For edited regions, the trajectory is curved, requiring local iterative denoising. To improve the efficiency and quality of local iterative generation, we propose the Region-Instruction KV Cache, which reduces computational cost while incorporating global information. 3) Adaptive Velocity Decay Cache. Observing that adjacent timesteps in edited regions exhibit strong velocity similarity, we further propose an adaptive velocity decay cache to accelerate the local denoising process. We applied RegionE to state-of-the-art IIE base models, including Step1X-Edit, FLUX.1 Kontext, and Qwen-Image-Edit. RegionE achieved acceleration factors of 2.57, 2.41, and 2.06. Evaluations by GPT-4o confirmed that semantic and perceptual fidelity were well preserved.

In this paper, we present RAG, a Regional-Aware text-to-image Generation method conditioned on regional descriptions for precise layout composition. Regional prompting, or compositional generation, which enables fine-grained spatial control, has gained increasing attention for its practicality in real-world applications. However, previous methods either introduce additional trainable modules, thus only applicable to specific models, or manipulate on score maps within cross-attention layers using attention masks, resulting in limited control strength when the number of regions increases. To handle these limitations, we decouple the multi-region generation into two sub-tasks, the construction of individual region (Regional Hard Binding) that ensures the regional prompt is properly executed, and the overall detail refinement (Regional Soft Refinement) over regions that dismiss the visual boundaries and enhance adjacent interactions. Furthermore, RAG novelly makes repainting feasible, where users can modify specific unsatisfied regions in the last generation while keeping all other regions unchanged, without relying on additional inpainting models. Our approach is tuning-free and applicable to other frameworks as an enhancement to the prompt following property. Quantitative and qualitative experiments demonstrate that RAG achieves superior performance over attribute binding and object relationship than previous tuning-free methods.

Vision-specific concepts such as "region" have played a key role in extending general machine learning frameworks to tasks like object detection. Given the success of region-based detectors for supervised learning and the progress of intra-image methods for contrastive learning, we explore the use of regions for reconstructive pre-training. Starting from Masked Autoencoding (MAE) both as a baseline and an inspiration, we propose a parallel pre-text task tailored to address the one-to-many mapping between images and regions. Since such regions can be generated in an unsupervised way, our approach (R-MAE) inherits the wide applicability from MAE, while being more "region-aware". We conduct thorough analyses during the development of R-MAE, and converge on a variant that is both effective and efficient (1.3% overhead over MAE). Moreover, it shows consistent quantitative improvements when generalized to various pre-training data and downstream detection and segmentation benchmarks. Finally, we provide extensive qualitative visualizations to enhance the understanding of R-MAE's behaviour and potential. Code will be made available at https://github.com/facebookresearch/r-mae.

Vision language models (VLMs) have experienced rapid advancements through the integration of large language models (LLMs) with image-text pairs, yet they struggle with detailed regional visual understanding due to limited spatial awareness of the vision encoder, and the use of coarse-grained training data that lacks detailed, region-specific captions. To address this, we introduce RegionGPT (short as RGPT), a novel framework designed for complex region-level captioning and understanding. RGPT enhances the spatial awareness of regional representation with simple yet effective modifications to existing visual encoders in VLMs. We further improve performance on tasks requiring a specific output scope by integrating task-guided instruction prompts during both training and inference phases, while maintaining the model's versatility for general-purpose tasks. Additionally, we develop an automated region caption data generation pipeline, enriching the training set with detailed region-level captions. We demonstrate that a universal RGPT model can be effectively applied and significantly enhancing performance across a range of region-level tasks, including but not limited to complex region descriptions, reasoning, object classification, and referring expressions comprehension.

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

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

Recent works in self-supervised learning have demonstrated strong performance on scene-level dense prediction tasks by pretraining with object-centric or region-based correspondence objectives. In this paper, we present Region-to-Object Representation Learning (R2O) which unifies region-based and object-centric pretraining. R2O operates by training an encoder to dynamically refine region-based segments into object-centric masks and then jointly learns representations of the contents within the mask. R2O uses a "region refinement module" to group small image regions, generated using a region-level prior, into larger regions which tend to correspond to objects by clustering region-level features. As pretraining progresses, R2O follows a region-to-object curriculum which encourages learning region-level features early on and gradually progresses to train object-centric representations. Representations learned using R2O lead to state-of-the art performance in semantic segmentation for PASCAL VOC (+0.7 mIOU) and Cityscapes (+0.4 mIOU) and instance segmentation on MS COCO (+0.3 mask AP). Further, after pretraining on ImageNet, R2O pretrained models are able to surpass existing state-of-the-art in unsupervised object segmentation on the Caltech-UCSD Birds 200-2011 dataset (+2.9 mIoU) without any further training. We provide the code/models from this work at https://github.com/KKallidromitis/r2o.

Integration of Vision-Language Models (VLMs) in surgical intelligence is hindered by hallucinations, domain knowledge gaps, and limited understanding of task interdependencies within surgical scenes, undermining clinical reliability. While recent VLMs demonstrate strong general reasoning and thinking capabilities, they still lack the domain expertise and task-awareness required for precise surgical scene interpretation. Although Chain-of-Thought (CoT) can structure reasoning more effectively, current approaches rely on self-generated CoT steps, which often exacerbate inherent domain gaps and hallucinations. To overcome this, we present SurgRAW, a CoT-driven multi-agent framework that delivers transparent, interpretable insights for most tasks in robotic-assisted surgery. By employing specialized CoT prompts across five tasks: instrument recognition, action recognition, action prediction, patient data extraction, and outcome assessment, SurgRAW mitigates hallucinations through structured, domain-aware reasoning. Retrieval-Augmented Generation (RAG) is also integrated to external medical knowledge to bridge domain gaps and improve response reliability. Most importantly, a hierarchical agentic system ensures that CoT-embedded VLM agents collaborate effectively while understanding task interdependencies, with a panel discussion mechanism promotes logical consistency. To evaluate our method, we introduce SurgCoTBench, the first reasoning-based dataset with structured frame-level annotations. With comprehensive experiments, we demonstrate the effectiveness of proposed SurgRAW with 29.32% accuracy improvement over baseline VLMs on 12 robotic procedures, achieving the state-of-the-art performance and advancing explainable, trustworthy, and autonomous surgical assistance.

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

Recent research has made significant progress in localizing and editing image regions based on text. However, most approaches treat these regions in isolation, relying solely on local cues without accounting for how each part contributes to the overall visual and semantic composition. This often results in inconsistent edits, unnatural transitions, or loss of coherence across the image. In this work, we propose Region in Context, a novel framework for text-conditioned image editing that performs multilevel semantic alignment between vision and language, inspired by the human ability to reason about edits in relation to the whole scene. Our method encourages each region to understand its role within the global image context, enabling precise and harmonized changes. At its core, the framework introduces a dual-level guidance mechanism: regions are represented with full-image context and aligned with detailed region-level descriptions, while the entire image is simultaneously matched to a comprehensive scene-level description generated by a large vision-language model. These descriptions serve as explicit verbal references of the intended content, guiding both local modifications and global structure. Experiments show that it produces more coherent and instruction-aligned results. Code is available at: https://github.com/thuyvuphuong/Region-in-Context.git

Recently, large-scale text-to-image (T2I) models have shown impressive performance in generating high-fidelity images, but with limited controllability, e.g., precisely specifying the content in a specific region with a free-form text description. In this paper, we propose an effective technique for such regional control in T2I generation. We augment T2I models' inputs with an extra set of position tokens, which represent the quantized spatial coordinates. Each region is specified by four position tokens to represent the top-left and bottom-right corners, followed by an open-ended natural language regional description. Then, we fine-tune a pre-trained T2I model with such new input interface. Our model, dubbed as ReCo (Region-Controlled T2I), enables the region control for arbitrary objects described by open-ended regional texts rather than by object labels from a constrained category set. Empirically, ReCo achieves better image quality than the T2I model strengthened by positional words (FID: 8.82->7.36, SceneFID: 15.54->6.51 on COCO), together with objects being more accurately placed, amounting to a 20.40% region classification accuracy improvement on COCO. Furthermore, we demonstrate that ReCo can better control the object count, spatial relationship, and region attributes such as color/size, with the free-form regional description. Human evaluation on PaintSkill shows that ReCo is +19.28% and +17.21% more accurate in generating images with correct object count and spatial relationship than the T2I model.

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

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

The efficient rendering and explicit nature of 3DGS promote the advancement of 3D scene manipulation. However, existing methods typically encounter challenges in controlling the manipulation region and are unable to furnish the user with interactive feedback, which inevitably leads to unexpected results. Intuitively, incorporating interactive 3D segmentation tools can compensate for this deficiency. Nevertheless, existing segmentation frameworks impose a pre-processing step of scene-specific parameter training, which limits the efficiency and flexibility of scene manipulation. To deliver a 3D region control module that is well-suited for scene manipulation with reliable efficiency, we propose interactive Segment-and-Manipulate 3D Gaussians (iSegMan), an interactive segmentation and manipulation framework that only requires simple 2D user interactions in any view. To propagate user interactions to other views, we propose Epipolar-guided Interaction Propagation (EIP), which innovatively exploits epipolar constraint for efficient and robust interaction matching. To avoid scene-specific training to maintain efficiency, we further propose the novel Visibility-based Gaussian Voting (VGV), which obtains 2D segmentations from SAM and models the region extraction as a voting game between 2D Pixels and 3D Gaussians based on Gaussian visibility. Taking advantage of the efficient and precise region control of EIP and VGV, we put forth a Manipulation Toolbox to implement various functions on selected regions, enhancing the controllability, flexibility and practicality of scene manipulation. Extensive results on 3D scene manipulation and segmentation tasks fully demonstrate the significant advantages of iSegMan. Project page is available at https://zhao-yian.github.io/iSegMan.

Point clouds are often the default choice for many applications as they exhibit more flexibility and efficiency than volumetric data. Nevertheless, their unorganized nature -- points are stored in an unordered way -- makes them less suited to be processed by deep learning pipelines. In this paper, we propose a method for 3D object completion and classification based on point clouds. We introduce a new way of organizing the extracted features based on their activations, which we name soft pooling. For the decoder stage, we propose regional convolutions, a novel operator aimed at maximizing the global activation entropy. Furthermore, inspired by the local refining procedure in Point Completion Network (PCN), we also propose a patch-deforming operation to simulate deconvolutional operations for point clouds. This paper proves that our regional activation can be incorporated in many point cloud architectures like AtlasNet and PCN, leading to better performance for geometric completion. We evaluate our approach on different 3D tasks such as object completion and classification, achieving state-of-the-art accuracy.

Instruction tuning large language model (LLM) on image-text pairs has achieved unprecedented vision-language multimodal abilities. However, their vision-language alignments are only built on image-level, the lack of region-level alignment limits their advancements to fine-grained multimodal understanding. In this paper, we propose instruction tuning on region-of-interest. The key design is to reformulate the bounding box as the format of spatial instruction. The interleaved sequences of visual features extracted by the spatial instruction and the language embedding are input to LLM, and trained on the transformed region-text data in instruction tuning format. Our region-level vision-language model, termed as GPT4RoI, brings brand new conversational and interactive experience beyond image-level understanding. (1) Controllability: Users can interact with our model by both language and spatial instructions to flexibly adjust the detail level of the question. (2) Capacities: Our model supports not only single-region spatial instruction but also multi-region. This unlocks more region-level multimodal capacities such as detailed region caption and complex region reasoning. (3) Composition: Any off-the-shelf object detector can be a spatial instruction provider so as to mine informative object attributes from our model, like color, shape, material, action, relation to other objects, etc. The code, data, and demo can be found at https://github.com/jshilong/GPT4RoI.

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

Research on autonomous surgery has largely focused on simple task automation in controlled environments. However, real-world surgical applications demand dexterous manipulation over extended durations and generalization to the inherent variability of human tissue. These challenges remain difficult to address using existing logic-based or conventional end-to-end learning approaches. To address this gap, we propose a hierarchical framework for performing dexterous, long-horizon surgical steps. Our approach utilizes a high-level policy for task planning and a low-level policy for generating robot trajectories. The high-level planner plans in language space, generating task-level or corrective instructions that guide the robot through the long-horizon steps and correct for the low-level policy's errors. We validate our framework through ex vivo experiments on cholecystectomy, a commonly-practiced minimally invasive procedure, and conduct ablation studies to evaluate key components of the system. Our method achieves a 100\% success rate across eight unseen ex vivo gallbladders, operating fully autonomously without human intervention. This work demonstrates step-level autonomy in a surgical procedure, marking a milestone toward clinical deployment of autonomous surgical systems.

Vision Language Models (VLMs) have demonstrated remarkable performance in 2D vision and language tasks. However, their ability to reason about spatial arrangements remains limited. In this work, we introduce Spatial Region GPT (SpatialRGPT) to enhance VLMs' spatial perception and reasoning capabilities. SpatialRGPT advances VLMs' spatial understanding through two key innovations: (1) a data curation pipeline that enables effective learning of regional representation from 3D scene graphs, and (2) a flexible plugin module for integrating depth information into the visual encoder of existing VLMs. During inference, when provided with user-specified region proposals, SpatialRGPT can accurately perceive their relative directions and distances. Additionally, we propose SpatialRGBT-Bench, a benchmark with ground-truth 3D annotations encompassing indoor, outdoor, and simulated environments, for evaluating 3D spatial cognition in VLMs. Our results demonstrate that SpatialRGPT significantly enhances performance in spatial reasoning tasks, both with and without local region prompts. The model also exhibits strong generalization capabilities, effectively reasoning about complex spatial relations and functioning as a region-aware dense reward annotator for robotic tasks. Code, dataset, and benchmark are released at https://www.anjiecheng.me/SpatialRGPT

Recent advances in vision-language models like Stable Diffusion have shown remarkable power in creative image synthesis and editing.However, most existing text-to-image editing methods encounter two obstacles: First, the text prompt needs to be carefully crafted to achieve good results, which is not intuitive or user-friendly. Second, they are insensitive to local edits and can irreversibly affect non-edited regions, leaving obvious editing traces. To tackle these problems, we propose a Zero-shot instructiON-guided local image Editing approach, termed ZONE. We first convert the editing intent from the user-provided instruction (e.g., "make his tie blue") into specific image editing regions through InstructPix2Pix. We then propose a Region-IoU scheme for precise image layer extraction from an off-the-shelf segment model. We further develop an edge smoother based on FFT for seamless blending between the layer and the image.Our method allows for arbitrary manipulation of a specific region with a single instruction while preserving the rest. Extensive experiments demonstrate that our ZONE achieves remarkable local editing results and user-friendliness, outperforming state-of-the-art methods. Code is available at https://github.com/lsl001006/ZONE.

While Multimodal Large Language Models (MLLMs) excel at holistic understanding, they struggle in capturing the dense world with complex scenes, requiring fine-grained analysis of intricate details and object inter-relationships. Region-level MLLMs have been a promising step. However, previous attempts are generally optimized to understand given regions in isolation, neglecting crucial global contexts. To address this, we introduce Grasp Any Region (GAR) for comprehen- sive region-level visual understanding. Empowered by an effective RoI-aligned feature replay technique, GAR supports (1) precise perception by leveraging necessary global contexts, and (2) modeling interactions between multiple prompts. Together, it then naturally achieves (3) advanced compositional reasoning to answer specific free-form questions about any region, shifting the paradigm from passive description to active dialogue. Moreover, we construct GAR-Bench, which not only provides a more accurate evaluation of single-region comprehension, but also, more importantly, measures interactions and complex reasoning across multiple regions. Extensive experiments have demonstrated that GAR-1B not only maintains the state-of-the-art captioning capabilities, e.g., outperforming DAM-3B +4.5 on DLC-Bench, but also excels at modeling relationships between multiple prompts with advanced comprehension capabilities, even surpassing InternVL3-78B on GAR-Bench-VQA. More importantly, our zero-shot GAR-8B even outperforms in-domain VideoRefer-7B on VideoRefer-BenchQ, indicating its strong capabilities can be easily transferred to videos.

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

Self-training has greatly facilitated domain adaptive semantic segmentation, which iteratively generates pseudo labels on unlabeled target data and retrains the network. However, realistic segmentation datasets are highly imbalanced, pseudo labels are typically biased to the majority classes and basically noisy, leading to an error-prone and suboptimal model. In this paper, we propose a simple region-based active learning approach for semantic segmentation under a domain shift, aiming to automatically query a small partition of image regions to be labeled while maximizing segmentation performance. Our algorithm, Region Impurity and Prediction Uncertainty (RIPU), introduces a new acquisition strategy characterizing the spatial adjacency of image regions along with the prediction confidence. We show that the proposed region-based selection strategy makes more efficient use of a limited budget than image-based or point-based counterparts. Further, we enforce local prediction consistency between a pixel and its nearest neighbors on a source image. Alongside, we develop a negative learning loss to make the features more discriminative. Extensive experiments demonstrate that our method only requires very few annotations to almost reach the supervised performance and substantially outperforms state-of-the-art methods. The code is available at https://github.com/BIT-DA/RIPU.

Multi-modal Retrieval-Augmented Generation (RAG) has become a critical method for empowering LLMs by leveraging candidate visual documents. However, current methods consider the entire document as the basic retrieval unit, introducing substantial irrelevant visual content in two ways: 1) Relevant documents often contain large regions unrelated to the query, diluting the focus on salient information; 2) Retrieving multiple documents to increase recall further introduces redundant and irrelevant documents. These redundant contexts distract the model's attention and further degrade the performance. To address this challenge, we propose RegionRAG, a novel framework that shifts the retrieval paradigm from the document level to the region level. During training, we design a hybrid supervision strategy from both labeled data and unlabeled data to pinpoint relevant patches. During inference, we propose a dynamic pipeline that intelligently groups salient patches into complete semantic regions. By delegating the task of identifying relevant regions to the retriever, RegionRAG enables the generator to focus solely on concise, query-relevant visual content, improving both efficiency and accuracy. Experiments on six benchmarks demonstrate that RegionRAG achieves state-of-the-art performance. It improves retrieval accuracy by 10.02% in R@1 on average, and boosts question answering accuracy by 3.56% while using only 71.42% visual tokens compared with prior methods.

This paper concerns the research problem of point cloud registration to find the rigid transformation to optimally align the source point set with the target one. Learning robust point cloud registration models with deep neural networks has emerged as a powerful paradigm, offering promising performance in predicting the global geometric transformation for a pair of point sets. Existing methods firstly leverage an encoder to regress a latent shape embedding, which is then decoded into a shape-conditioned transformation via concatenation-based conditioning. However, different regions of a 3D shape vary in their geometric structures which makes it more sense that we have a region-conditioned transformation instead of the shape-conditioned one. In this paper we present a Region-Aware point cloud Registration, denoted as RAR, to predict transformation for pairwise point sets in the self-supervised learning fashion. More specifically, we develop a novel region-aware decoder (RAD) module that is formed with an implicit neural region representation parameterized by neural networks. The implicit neural region representation is learned with a self-supervised 3D shape reconstruction loss without the need for region labels. Consequently, the region-aware decoder (RAD) module guides the training of the region-aware transformation (RAT) module and region-aware weight (RAW) module, which predict the transforms and weights for different regions respectively. The global geometric transformation from source point set to target one is then formed by the weighted fusion of region-aware transforms. Compared to the state-of-the-art approaches, our experiments show that our RAR achieves superior registration performance over various benchmark datasets (e.g. ModelNet40).

Learning visual representations is foundational for a broad spectrum of downstream tasks. Although recent vision-language contrastive models, such as CLIP and SigLIP, have achieved impressive zero-shot performance via large-scale vision-language alignment, their reliance on global representations constrains their effectiveness for dense prediction tasks, such as grounding, OCR, and segmentation. To address this gap, we introduce Region-Aware Cluster Discrimination (RICE), a novel method that enhances region-level visual and OCR capabilities. We first construct a billion-scale candidate region dataset and propose a Region Transformer layer to extract rich regional semantics. We further design a unified region cluster discrimination loss that jointly supports object and OCR learning within a single classification framework, enabling efficient and scalable distributed training on large-scale data. Extensive experiments show that RICE consistently outperforms previous methods on tasks, including segmentation, dense detection, and visual perception for Multimodal Large Language Models (MLLMs). The pre-trained models have been released at https://github.com/deepglint/MVT.

In this work, we investigate extending the comprehension of Multi-modal Large Language Models (MLLMs) to regional objects. To this end, we propose to extract features corresponding to regional objects as soft prompts for LLM, which provides a straightforward and scalable approach and eliminates the need for LLM fine-tuning. To effectively extract regional features from regular image features and irregular point cloud features, we present a novel and unified position-assisted feature extraction module. Furthermore, training an MLLM from scratch is highly time-consuming. Thus, we propose incrementally extending existing pre-trained MLLMs to comprehend more modalities and the regional objects of those modalities. Specifically, we freeze the Q-Former from BLIP-2, an impressive MLLM, and optimize the modality-specific Lora parameters in Q-Former and LLM for each newly introduced modality. The freezing of the Q-Former eliminates the need for extensive pre-training on massive image-text data. The freezed Q-Former pre-trained from massive image-text data is also beneficial for the pre-training on image-region-text data. We name our framework RegionBLIP. We pre-train RegionBLIP on image-region-text, point-cloud-text, and point-cloud-region-text data. Experimental results verify that can preserve the image comprehension capability of BILP-2 and further gain a comprehension of the newly introduced point cloud modality and regional objects. The Data, Code, and Pre-trained models will be available at https://github.com/mightyzau/RegionBLIP.

Both convolutional and recurrent operations are building blocks that process one local neighborhood at a time. In this paper, we present non-local operations as a generic family of building blocks for capturing long-range dependencies. Inspired by the classical non-local means method in computer vision, our non-local operation computes the response at a position as a weighted sum of the features at all positions. This building block can be plugged into many computer vision architectures. On the task of video classification, even without any bells and whistles, our non-local models can compete or outperform current competition winners on both Kinetics and Charades datasets. In static image recognition, our non-local models improve object detection/segmentation and pose estimation on the COCO suite of tasks. Code is available at https://github.com/facebookresearch/video-nonlocal-net .

Recently, reasoning-based MLLMs have achieved a degree of success in generating long-form textual reasoning chains. However, they still struggle with complex tasks that necessitate dynamic and iterative focusing on and revisiting of visual regions to achieve precise grounding of textual reasoning in visual evidence. We introduce VLM-R^3 (Visual Language Model with Region Recognition and Reasoning), a framework that equips an MLLM with the ability to (i) decide when additional visual evidence is needed, (ii) determine where to ground within the image, and (iii) seamlessly weave the relevant sub-image content back into an interleaved chain-of-thought. The core of our method is Region-Conditioned Reinforcement Policy Optimization (R-GRPO), a training paradigm that rewards the model for selecting informative regions, formulating appropriate transformations (e.g.\ crop, zoom), and integrating the resulting visual context into subsequent reasoning steps. To bootstrap this policy, we compile a modest but carefully curated Visuo-Lingual Interleaved Rationale (VLIR) corpus that provides step-level supervision on region selection and textual justification. Extensive experiments on MathVista, ScienceQA, and other benchmarks show that VLM-R^3 sets a new state of the art in zero-shot and few-shot settings, with the largest gains appearing on questions demanding subtle spatial reasoning or fine-grained visual cue extraction.

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

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

Vision-Language Models (VLMs) excel at many multimodal tasks, yet they frequently struggle with tasks requiring precise understanding and handling of fine-grained visual elements. This is mainly due to information loss during image encoding or insufficient attention to critical regions. Recent work has shown promise by incorporating pixel-level visual information into the reasoning process, enabling VLMs to access high-resolution visual details during their thought process. However, this pixel-level information is often overused, leading to inefficiency and distraction from irrelevant visual details. To address these challenges, we propose the first framework for adaptive pixel reasoning that dynamically determines necessary pixel-level operations based on the input query. Specifically, we first apply operation-aware supervised fine-tuning to establish baseline competence in textual reasoning and visual operations, then design a novel rollout-guided reinforcement learning framework relying on feedback of the model's own responses, which enables the VLM to determine when pixel operations should be invoked based on query difficulty. Experiments on extensive multimodal reasoning benchmarks show that our model achieves superior performance while significantly reducing unnecessary visual operations. Impressively, our model achieves 73.4\% accuracy on HR-Bench 4K while maintaining a tool usage ratio of only 20.1\%, improving accuracy and simultaneously reducing tool usage by 66.5\% compared to the previous methods.

We propose a training-free approach to 3D editing that enables the editing of a single shape within a few minutes. The edited 3D mesh aligns well with the prompts, and remains identical for regions that are not intended to be altered. To this end, we first project the 3D object onto 4-view images and perform synchronized multi-view image editing along with user-guided text prompts and user-provided rough masks. However, the targeted regions to be edited are ambiguous due to projection from 3D to 2D. To ensure precise editing only in intended regions, we develop a 3D segmentation pipeline that detects edited areas in 3D space, followed by a merging algorithm to seamlessly integrate edited 3D regions with the original input. Extensive experiments demonstrate the superiority of our method over previous approaches, enabling fast, high-quality editing while preserving unintended regions.

Data scarcity remains a fundamental barrier to achieving fully autonomous surgical robots. While large scale vision language action (VLA) models have shown impressive generalization in household and industrial manipulation by leveraging paired video action data from diverse domains, surgical robotics suffers from the paucity of datasets that include both visual observations and accurate robot kinematics. In contrast, vast corpora of surgical videos exist, but they lack corresponding action labels, preventing direct application of imitation learning or VLA training. In this work, we aim to alleviate this problem by learning policy models from SurgWorld, a world model designed for surgical physical AI. We curated the Surgical Action Text Alignment (SATA) dataset with detailed action description specifically for surgical robots. Then we built SurgeWorld based on the most advanced physical AI world model and SATA. It's able to generate diverse, generalizable and realistic surgery videos. We are also the first to use an inverse dynamics model to infer pseudokinematics from synthetic surgical videos, producing synthetic paired video action data. We demonstrate that a surgical VLA policy trained with these augmented data significantly outperforms models trained only on real demonstrations on a real surgical robot platform. Our approach offers a scalable path toward autonomous surgical skill acquisition by leveraging the abundance of unlabeled surgical video and generative world modeling, thus opening the door to generalizable and data efficient surgical robot policies.

Understanding the semantics of individual regions or patches within unconstrained images, such as in open-world object detection, represents a critical yet challenging task in computer vision. Building on the success of powerful image-level vision-language (ViL) foundation models like CLIP, recent efforts have sought to harness their capabilities by either training a contrastive model from scratch with an extensive collection of region-label pairs or aligning the outputs of a detection model with image-level representations of region proposals. Despite notable progress, these approaches are plagued by computationally intensive training requirements, susceptibility to data noise, and deficiency in contextual information. To address these limitations, we explore the synergistic potential of off-the-shelf foundation models, leveraging their respective strengths in localization and semantics. We introduce a novel, generic, and efficient region recognition architecture, named RegionSpot, designed to integrate position-aware localization knowledge from a localization foundation model (e.g., SAM) with semantic information extracted from a ViL model (e.g., CLIP). To fully exploit pretrained knowledge while minimizing training overhead, we keep both foundation models frozen, focusing optimization efforts solely on a lightweight attention-based knowledge integration module. Through extensive experiments in the context of open-world object recognition, our RegionSpot demonstrates significant performance improvements over prior alternatives, while also providing substantial computational savings. For instance, training our model with 3 million data in a single day using 8 V100 GPUs. Our model outperforms GLIP by 6.5 % in mean average precision (mAP), with an even larger margin by 14.8 % for more challenging and rare categories.

Drag-based image editing has long suffered from distortions in the target region, largely because the priors of earlier base models, Stable Diffusion, are insufficient to project optimized latents back onto the natural image manifold. With the shift from UNet-based DDPMs to more scalable DiT with flow matching (e.g., SD3.5, FLUX), generative priors have become significantly stronger, enabling advances across diverse editing tasks. However, drag-based editing has yet to benefit from these stronger priors. This work proposes the first framework to effectively harness FLUX's rich prior for drag-based editing, dubbed DragFlow, achieving substantial gains over baselines. We first show that directly applying point-based drag editing to DiTs performs poorly: unlike the highly compressed features of UNets, DiT features are insufficiently structured to provide reliable guidance for point-wise motion supervision. To overcome this limitation, DragFlow introduces a region-based editing paradigm, where affine transformations enable richer and more consistent feature supervision. Additionally, we integrate pretrained open-domain personalization adapters (e.g., IP-Adapter) to enhance subject consistency, while preserving background fidelity through gradient mask-based hard constraints. Multimodal large language models (MLLMs) are further employed to resolve task ambiguities. For evaluation, we curate a novel Region-based Dragging benchmark (ReD Bench) featuring region-level dragging instructions. Extensive experiments on DragBench-DR and ReD Bench show that DragFlow surpasses both point-based and region-based baselines, setting a new state-of-the-art in drag-based image editing. Code and datasets will be publicly available upon publication.

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

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

Surgical instrument segmentation under Federated Learning (FL) is a promising direction, which enables multiple surgical sites to collaboratively train the model without centralizing datasets. However, there exist very limited FL works in surgical data science, and FL methods for other modalities do not consider inherent characteristics in surgical domain: i) different scenarios show diverse anatomical backgrounds while highly similar instrument representation; ii) there exist surgical simulators which promote large-scale synthetic data generation with minimal efforts. In this paper, we propose a novel Personalized FL scheme, Spatio-Temporal Representation Decoupling and Enhancement (FedST), which wisely leverages surgical domain knowledge during both local-site and global-server training to boost segmentation. Concretely, our model embraces a Representation Separation and Cooperation (RSC) mechanism in local-site training, which decouples the query embedding layer to be trained privately, to encode respective backgrounds. Meanwhile, other parameters are optimized globally to capture the consistent representations of instruments, including the temporal layer to capture similar motion patterns. A textual-guided channel selection is further designed to highlight site-specific features, facilitating model adapta tion to each site. Moreover, in global-server training, we propose Synthesis-based Explicit Representation Quantification (SERQ), which defines an explicit representation target based on synthetic data to synchronize the model convergence during fusion for improving model generalization.

Medical video generation has transformative potential for enhancing surgical understanding and pathology insights through precise and controllable visual representations. However, current models face limitations in controllability and authenticity. To bridge this gap, we propose SurgSora, a motion-controllable surgical video generation framework that uses a single input frame and user-controllable motion cues. SurgSora consists of three key modules: the Dual Semantic Injector (DSI), which extracts object-relevant RGB and depth features from the input frame and integrates them with segmentation cues to capture detailed spatial features of complex anatomical structures; the Decoupled Flow Mapper (DFM), which fuses optical flow with semantic-RGB-D features at multiple scales to enhance temporal understanding and object spatial dynamics; and the Trajectory Controller (TC), which allows users to specify motion directions and estimates sparse optical flow, guiding the video generation process. The fused features are used as conditions for a frozen Stable Diffusion model to produce realistic, temporally coherent surgical videos. Extensive evaluations demonstrate that SurgSora outperforms state-of-the-art methods in controllability and authenticity, showing its potential to advance surgical video generation for medical education, training, and research.

Diffusion models have demonstrated excellent capabilities in text-to-image generation. Their semantic understanding (i.e., prompt following) ability has also been greatly improved with large language models (e.g., T5, Llama). However, existing models cannot perfectly handle long and complex text prompts, especially when the text prompts contain various objects with numerous attributes and interrelated spatial relationships. While many regional prompting methods have been proposed for UNet-based models (SD1.5, SDXL), but there are still no implementations based on the recent Diffusion Transformer (DiT) architecture, such as SD3 and FLUX.1.In this report, we propose and implement regional prompting for FLUX.1 based on attention manipulation, which enables DiT with fined-grained compositional text-to-image generation capability in a training-free manner. Code is available at https://github.com/antonioo-c/Regional-Prompting-FLUX.

The recent Segment Anything Model (SAM) 2 has demonstrated remarkable foundational competence in semantic segmentation, with its memory mechanism and mask decoder further addressing challenges in video tracking and object occlusion, thereby achieving superior results in interactive segmentation for both images and videos. Building upon our previous empirical studies, we further explore the zero-shot segmentation performance of SAM 2 in robot-assisted surgery based on prompts, alongside its robustness against real-world corruption. For static images, we employ two forms of prompts: 1-point and bounding box, while for video sequences, the 1-point prompt is applied to the initial frame. Through extensive experimentation on the MICCAI EndoVis 2017 and EndoVis 2018 benchmarks, SAM 2, when utilizing bounding box prompts, outperforms state-of-the-art (SOTA) methods in comparative evaluations. The results with point prompts also exhibit a substantial enhancement over SAM's capabilities, nearing or even surpassing existing unprompted SOTA methodologies. Besides, SAM 2 demonstrates improved inference speed and less performance degradation against various image corruption. Although slightly unsatisfactory results remain in specific edges or regions, SAM 2's robust adaptability to 1-point prompts underscores its potential for downstream surgical tasks with limited prompt requirements.

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

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

Object detection performance, as measured on the canonical PASCAL VOC dataset, has plateaued in the last few years. The best-performing methods are complex ensemble systems that typically combine multiple low-level image features with high-level context. In this paper, we propose a simple and scalable detection algorithm that improves mean average precision (mAP) by more than 30% relative to the previous best result on VOC 2012---achieving a mAP of 53.3%. Our approach combines two key insights: (1) one can apply high-capacity convolutional neural networks (CNNs) to bottom-up region proposals in order to localize and segment objects and (2) when labeled training data is scarce, supervised pre-training for an auxiliary task, followed by domain-specific fine-tuning, yields a significant performance boost. Since we combine region proposals with CNNs, we call our method R-CNN: Regions with CNN features. We also compare R-CNN to OverFeat, a recently proposed sliding-window detector based on a similar CNN architecture. We find that R-CNN outperforms OverFeat by a large margin on the 200-class ILSVRC2013 detection dataset. Source code for the complete system is available at http://www.cs.berkeley.edu/~rbg/rcnn.

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

Language has emerged as a natural interface for image editing. In this paper, we introduce a method for region-based image editing driven by textual prompts, without the need for user-provided masks or sketches. Specifically, our approach leverages an existing pretrained text-to-image model and introduces a bounding box generator to find the edit regions that are aligned with the textual prompts. We show that this simple approach enables flexible editing that is compatible with current image generation models, and is able to handle complex prompts featuring multiple objects, complex sentences or long paragraphs. We conduct an extensive user study to compare our method against state-of-the-art methods. Experiments demonstrate the competitive performance of our method in manipulating images with high fidelity and realism that align with the language descriptions provided. Our project webpage: https://yuanze-lin.me/LearnableRegions_page.

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

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

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

Editing a local region or a specific object in a 3D scene represented by a NeRF is challenging, mainly due to the implicit nature of the scene representation. Consistently blending a new realistic object into the scene adds an additional level of difficulty. We present Blended-NeRF, a robust and flexible framework for editing a specific region of interest in an existing NeRF scene, based on text prompts or image patches, along with a 3D ROI box. Our method leverages a pretrained language-image model to steer the synthesis towards a user-provided text prompt or image patch, along with a 3D MLP model initialized on an existing NeRF scene to generate the object and blend it into a specified region in the original scene. We allow local editing by localizing a 3D ROI box in the input scene, and seamlessly blend the content synthesized inside the ROI with the existing scene using a novel volumetric blending technique. To obtain natural looking and view-consistent results, we leverage existing and new geometric priors and 3D augmentations for improving the visual fidelity of the final result. We test our framework both qualitatively and quantitatively on a variety of real 3D scenes and text prompts, demonstrating realistic multi-view consistent results with much flexibility and diversity compared to the baselines. Finally, we show the applicability of our framework for several 3D editing applications, including adding new objects to a scene, removing/replacing/altering existing objects, and texture conversion.

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

Referring Expression Segmentation (RES) aims to generate a segmentation mask for the object described by a given language expression. Existing classic RES datasets and methods commonly support single-target expressions only, i.e., one expression refers to one target object. Multi-target and no-target expressions are not considered. This limits the usage of RES in practice. In this paper, we introduce a new benchmark called Generalized Referring Expression Segmentation (GRES), which extends the classic RES to allow expressions to refer to an arbitrary number of target objects. Towards this, we construct the first large-scale GRES dataset called gRefCOCO that contains multi-target, no-target, and single-target expressions. GRES and gRefCOCO are designed to be well-compatible with RES, facilitating extensive experiments to study the performance gap of the existing RES methods on the GRES task. In the experimental study, we find that one of the big challenges of GRES is complex relationship modeling. Based on this, we propose a region-based GRES baseline ReLA that adaptively divides the image into regions with sub-instance clues, and explicitly models the region-region and region-language dependencies. The proposed approach ReLA achieves new state-of-the-art performance on the both newly proposed GRES and classic RES tasks. The proposed gRefCOCO dataset and method are available at https://henghuiding.github.io/GRES.

We introduce RegionFocus, a visual test-time scaling approach for Vision Language Model Agents. Understanding webpages is challenging due to the visual complexity of GUI images and the large number of interface elements, making accurate action selection difficult. Our approach dynamically zooms in on relevant regions, reducing background clutter and improving grounding accuracy. To support this process, we propose an image-as-map mechanism that visualizes key landmarks at each step, providing a transparent action record and enables the agent to effectively choose among action candidates. Even with a simple region selection strategy, we observe significant performance gains of 28+\% on Screenspot-pro and 24+\% on WebVoyager benchmarks on top of two state-of-the-art open vision language model agents, UI-TARS and Qwen2.5-VL, highlighting the effectiveness of visual test-time scaling in interactive settings. We achieve a new state-of-the-art grounding performance of 61.6\% on the ScreenSpot-Pro benchmark by applying RegionFocus to a Qwen2.5-VL-72B model. Our code will be released publicly at https://github.com/tiangeluo/RegionFocus.

Surgical video segmentation is crucial for computer-assisted surgery, enabling precise localization and tracking of instruments and tissues. Interactive Video Object Segmentation (iVOS) models such as Segment Anything Model 2 (SAM2) provide prompt-based flexibility beyond methods with predefined categories, but face challenges in surgical scenarios due to the domain gap and limited long-term tracking. To address these limitations, we construct SA-SV, the largest surgical iVOS benchmark with instance-level spatio-temporal annotations (masklets) spanning eight procedure types (61k frames, 1.6k masklets), enabling comprehensive development and evaluation for long-term tracking and zero-shot generalization. Building on SA-SV, we propose SAM2S, a foundation model enhancing SAM2 for Surgical iVOS through: (1) DiveMem, a trainable diverse memory mechanism for robust long-term tracking; (2) temporal semantic learning for instrument understanding; and (3) ambiguity-resilient learning to mitigate annotation inconsistencies across multi-source datasets. Extensive experiments demonstrate that fine-tuning on SA-SV enables substantial performance gains, with SAM2 improving by 12.99 average J\&F over vanilla SAM2. SAM2S further advances performance to 80.42 average J\&F, surpassing vanilla and fine-tuned SAM2 by 17.10 and 4.11 points respectively, while maintaining 68 FPS real-time inference and strong zero-shot generalization. Code and dataset will be released at https://jinlab-imvr.github.io/SAM2S.

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

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

Most studies on surgical activity recognition utilizing Artificial intelligence (AI) have focused mainly on recognizing one type of activity from small and mono-centric surgical video datasets. It remains speculative whether those models would generalize to other centers. In this work, we introduce a large multi-centric multi-activity dataset consisting of 140 videos (MultiBypass140) of laparoscopic Roux-en-Y gastric bypass (LRYGB) surgeries performed at two medical centers: the University Hospital of Strasbourg (StrasBypass70) and Inselspital, Bern University Hospital (BernBypass70). The dataset has been fully annotated with phases and steps. Furthermore, we assess the generalizability and benchmark different deep learning models in 7 experimental studies: 1) Training and evaluation on BernBypass70; 2) Training and evaluation on StrasBypass70; 3) Training and evaluation on the MultiBypass140; 4) Training on BernBypass70, evaluation on StrasBypass70; 5) Training on StrasBypass70, evaluation on BernBypass70; Training on MultiBypass140, evaluation 6) on BernBypass70 and 7) on StrasBypass70. The model's performance is markedly influenced by the training data. The worst results were obtained in experiments 4) and 5) confirming the limited generalization capabilities of models trained on mono-centric data. The use of multi-centric training data, experiments 6) and 7), improves the generalization capabilities of the models, bringing them beyond the level of independent mono-centric training and validation (experiments 1) and 2)). MultiBypass140 shows considerable variation in surgical technique and workflow of LRYGB procedures between centers. Therefore, generalization experiments demonstrate a remarkable difference in model performance. These results highlight the importance of multi-centric datasets for AI model generalization to account for variance in surgical technique and workflows.

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

Acquiring contact patterns between hands and nonrigid objects is a common concern in the vision and robotics community. However, existing learning-based methods focus more on contact with rigid ones from monocular images. When adopting them for nonrigid contact, a major problem is that the existing contact representation is restricted by the geometry of the object. Consequently, contact neighborhoods are stored in an unordered manner and contact features are difficult to align with image cues. At the core of our approach lies a novel hand-object contact representation called RUPs (Region Unwrapping Profiles), which unwrap the roughly estimated hand-object surfaces as multiple high-resolution 2D regional profiles. The region grouping strategy is consistent with the hand kinematic bone division because they are the primitive initiators for a composite contact pattern. Based on this representation, our Regional Unwrapping Transformer (RUFormer) learns the correlation priors across regions from monocular inputs and predicts corresponding contact and deformed transformations. Our experiments demonstrate that the proposed framework can robustly estimate the deformed degrees and deformed transformations, which makes it suitable for both nonrigid and rigid contact.

Real-world medical image segmentation has tremendous long-tailed complexity of objects, among which tail conditions correlate with relatively rare diseases and are clinically significant. A trustworthy medical AI algorithm should demonstrate its effectiveness on tail conditions to avoid clinically dangerous damage in these out-of-distribution (OOD) cases. In this paper, we adopt the concept of object queries in Mask Transformers to formulate semantic segmentation as a soft cluster assignment. The queries fit the feature-level cluster centers of inliers during training. Therefore, when performing inference on a medical image in real-world scenarios, the similarity between pixels and the queries detects and localizes OOD regions. We term this OOD localization as MaxQuery. Furthermore, the foregrounds of real-world medical images, whether OOD objects or inliers, are lesions. The difference between them is less than that between the foreground and background, possibly misleading the object queries to focus redundantly on the background. Thus, we propose a query-distribution (QD) loss to enforce clear boundaries between segmentation targets and other regions at the query level, improving the inlier segmentation and OOD indication. Our proposed framework is tested on two real-world segmentation tasks, i.e., segmentation of pancreatic and liver tumors, outperforming previous state-of-the-art algorithms by an average of 7.39% on AUROC, 14.69% on AUPR, and 13.79% on FPR95 for OOD localization. On the other hand, our framework improves the performance of inlier segmentation by an average of 5.27% DSC when compared with the leading baseline nnUNet.

Accurate segmentation of brain tumors plays a key role in the diagnosis and treatment of brain tumor diseases. It serves as a critical technology for quantifying tumors and extracting their features. With the increasing application of deep learning methods, the computational burden has become progressively heavier. To achieve a lightweight model with good segmentation performance, this study proposes the MBDRes-U-Net model using the three-dimensional (3D) U-Net codec framework, which integrates multibranch residual blocks and fused attention into the model. The computational burden of the model is reduced by the branch strategy, which effectively uses the rich local features in multimodal images and enhances the segmentation performance of subtumor regions. Additionally, during encoding, an adaptive weighted expansion convolution layer is introduced into the multi-branch residual block, which enriches the feature expression and improves the segmentation accuracy of the model. Experiments on the Brain Tumor Segmentation (BraTS) Challenge 2018 and 2019 datasets show that the architecture could maintain a high precision of brain tumor segmentation while considerably reducing the calculation overhead.Our code is released at https://github.com/Huaibei-normal-university-cv-laboratory/mbdresunet

Automated surgical instrument localization is an important technology to understand the surgical process and in order to analyze them to provide meaningful guidance during surgery or surgical index after surgery to the surgeon. We introduce a new dataset that reflects the kinematic characteristics of surgical instruments for automated surgical instrument localization of surgical videos. The hSDB(hutom Surgery DataBase)-instrument dataset consists of instrument localization information from 24 cases of laparoscopic cholecystecomy and 24 cases of robotic gastrectomy. Localization information for all instruments is provided in the form of a bounding box for object detection. To handle class imbalance problem between instruments, synthesized instruments modeled in Unity for 3D models are included as training data. Besides, for 3D instrument data, a polygon annotation is provided to enable instance segmentation of the tool. To reflect the kinematic characteristics of all instruments, they are annotated with head and body parts for laparoscopic instruments, and with head, wrist, and body parts for robotic instruments separately. Annotation data of assistive tools (specimen bag, needle, etc.) that are frequently used for surgery are also included. Moreover, we provide statistical information on the hSDB-instrument dataset and the baseline localization performances of the object detection networks trained by the MMDetection library and resulting analyses.

Surgical video segmentation is a critical task in computer-assisted surgery and is vital for enhancing surgical quality and patient outcomes. Recently, the Segment Anything Model 2 (SAM2) framework has shown superior advancements in image and video segmentation. However, SAM2 struggles with efficiency due to the high computational demands of processing high-resolution images and complex and long-range temporal dynamics in surgical videos. To address these challenges, we introduce Surgical SAM 2 (SurgSAM-2), an advanced model to utilize SAM2 with an Efficient Frame Pruning (EFP) mechanism, to facilitate real-time surgical video segmentation. The EFP mechanism dynamically manages the memory bank by selectively retaining only the most informative frames, reducing memory usage and computational cost while maintaining high segmentation accuracy. Our extensive experiments demonstrate that SurgSAM-2 significantly improves both efficiency and segmentation accuracy compared to the vanilla SAM2. Remarkably, SurgSAM-2 achieves a 3times FPS compared with SAM2, while also delivering state-of-the-art performance after fine-tuning with lower-resolution data. These advancements establish SurgSAM-2 as a leading model for surgical video analysis, making real-time surgical video segmentation in resource-constrained environments a feasible reality.

The visual projector serves as an essential bridge between the visual encoder and the Large Language Model (LLM) in a Multimodal LLM (MLLM). Typically, MLLMs adopt a simple MLP to preserve all visual contexts via one-to-one transformation. However, the visual tokens are redundant and can be considerably increased when dealing with high-resolution images, impairing the efficiency of MLLMs significantly. Some recent works have introduced resampler or abstractor to reduce the number of resulting visual tokens. Unfortunately, they fail to capture finer details and undermine the visual reasoning capabilities of MLLMs. In this work, we propose a novel visual projector, which adopts a coarse-to-fine scheme to inject the enriched characteristics to generate the condensed visual tokens. In specific, we first interpolate the visual features as a low-resolution point query, providing the overall visual representation as the foundation. Then, we introduce a region-to-point injection module that utilizes high-resolution, multi-level region-based cues as fine-grained reference keys and values, allowing them to be fully absorbed within the corresponding local context region. This step effectively updates the coarse point query, transforming it into an enriched one for the subsequent LLM reasoning. Extensive experiments demonstrate that our approach compresses the visual tokens by 75%~89%, while achieves comparable or even better performance across diverse benchmarks with significantly higher efficiency. The source codes can be found at https://github.com/CircleRadon/TokenPacker.

Diffusion models have exhibited impressive prowess in the text-to-image task. Recent methods add image-level structure controls, e.g., edge and depth maps, to manipulate the generation process together with text prompts to obtain desired images. This controlling process is globally operated on the entire image, which limits the flexibility of control regions. In this paper, we explore a novel and practical task setting: local control. It focuses on controlling specific local region according to user-defined image conditions, while the remaining regions are only conditioned by the original text prompt. However, it is non-trivial to achieve local conditional controlling. The naive manner of directly adding local conditions may lead to the local control dominance problem, which forces the model to focus on the controlled region and neglect object generation in other regions. To mitigate this problem, we propose Regional Discriminate Loss to update the noised latents, aiming at enhanced object generation in non-control regions. Furthermore, the proposed Focused Token Response suppresses weaker attention scores which lack the strongest response to enhance object distinction and reduce duplication. Lastly, we adopt Feature Mask Constraint to reduce quality degradation in images caused by information differences across the local control region. All proposed strategies are operated at the inference stage. Extensive experiments demonstrate that our method can synthesize high-quality images aligned with the text prompt under local control conditions.

We introduce Groma, a Multimodal Large Language Model (MLLM) with grounded and fine-grained visual perception ability. Beyond holistic image understanding, Groma is adept at region-level tasks such as region captioning and visual grounding. Such capabilities are built upon a localized visual tokenization mechanism, where an image input is decomposed into regions of interest and subsequently encoded into region tokens. By integrating region tokens into user instructions and model responses, we seamlessly enable Groma to understand user-specified region inputs and ground its textual output to images. Besides, to enhance the grounded chat ability of Groma, we curate a visually grounded instruction dataset by leveraging the powerful GPT-4V and visual prompting techniques. Compared with MLLMs that rely on the language model or external module for localization, Groma consistently demonstrates superior performances in standard referring and grounding benchmarks, highlighting the advantages of embedding localization into image tokenization. Project page: https://groma-mllm.github.io/.

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

Medical image segmentation poses challenges due to domain gaps, data modality variations, and dependency on domain knowledge or experts, especially for low- and middle-income countries (LMICs). Whereas for humans, given a few exemplars (with corresponding labels), we are able to segment different medical images even without exten-sive domain-specific clinical training. In addition, current SAM-based medical segmentation models use fine-grained visual prompts, such as the bounding rectangle generated from manually annotated target segmentation mask, as the bounding box (bbox) prompt during the testing phase. However, in actual clinical scenarios, no such precise prior knowledge is available. Our experimental results also reveal that previous models nearly fail to predict when given coarser bbox prompts. Considering these issues, in this paper, we introduce a domain-aware selective adaptation approach to adapt the general knowledge learned from a large model trained with natural images to the corresponding medical domains/modalities, with access to only a few (e.g. less than 5) exemplars. Our method mitigates the aforementioned limitations, providing an efficient and LMICs-friendly solution. Extensive experimental analysis showcases the effectiveness of our approach, offering potential advancements in healthcare diagnostics and clinical applications in LMICs.

We present GeoSynth, a model for synthesizing satellite images with global style and image-driven layout control. The global style control is via textual prompts or geographic location. These enable the specification of scene semantics or regional appearance respectively, and can be used together. We train our model on a large dataset of paired satellite imagery, with automatically generated captions, and OpenStreetMap data. We evaluate various combinations of control inputs, including different types of layout controls. Results demonstrate that our model can generate diverse, high-quality images and exhibits excellent zero-shot generalization. The code and model checkpoints are available at https://github.com/mvrl/GeoSynth.

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

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

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

Precision medicine, such as patient-adaptive treatments assisted by medical image analysis, poses new challenges for segmentation algorithms in adapting to new patients, due to the large variability across different patients and the limited availability of annotated data for each patient. In this work, we propose a data-efficient segmentation algorithm, namely Part-aware Prompted Segment Anything Model (P^2SAM). Without any model fine-tuning, P^2SAM enables seamless adaptation to any new patients relying only on one-shot patient-specific data. We introduce a novel part-aware prompt mechanism to select multiple-point prompts based on the part-level features of the one-shot data, which can be extensively integrated into different promptable segmentation models, such as SAM and SAM 2. Moreover, to determine the optimal number of parts for each specific case, we propose a distribution-guided retrieval approach that further enhances the robustness of the part-aware prompt mechanism. P^2SAM improves the performance by +8.0% and +2.0% mean Dice score for two different patient-adaptive segmentation applications, respectively. In addition, P^2SAM also exhibits impressive generalizability in other adaptive segmentation tasks in the natural image domain, e.g., +6.4% mIoU within personalized object segmentation task. The code is available at: https://github.com/Zch0414/p2sam

Ultrasound (US) is a widely used medical imaging modality due to its real-time capabilities, non-invasive nature, and cost-effectiveness. Robotic ultrasound can further enhance its utility by reducing operator dependence and improving access to complex anatomical regions. For this, while deep reinforcement learning (DRL) and imitation learning (IL) have shown potential for autonomous navigation, their use in complex surgical tasks such as anatomy reconstruction and surgical guidance remains limited -- largely due to the lack of realistic and efficient simulation environments tailored to these tasks. We introduce SonoGym, a scalable simulation platform for complex robotic ultrasound tasks that enables parallel simulation across tens to hundreds of environments. Our framework supports realistic and real-time simulation of US data from CT-derived 3D models of the anatomy through both a physics-based and a generative modeling approach. Sonogym enables the training of DRL and recent IL agents (vision transformers and diffusion policies) for relevant tasks in robotic orthopedic surgery by integrating common robotic platforms and orthopedic end effectors. We further incorporate submodular DRL -- a recent method that handles history-dependent rewards -- for anatomy reconstruction and safe reinforcement learning for surgery. Our results demonstrate successful policy learning across a range of scenarios, while also highlighting the limitations of current methods in clinically relevant environments. We believe our simulation can facilitate research in robot learning approaches for such challenging robotic surgery applications. Dataset, codes, and videos are publicly available at https://sonogym.github.io/.

Surgical simulation offers a promising addition to conventional surgical training. However, available simulation tools lack photorealism and rely on hardcoded behaviour. Denoising Diffusion Models are a promising alternative for high-fidelity image synthesis, but existing state-of-the-art conditioning methods fall short in providing precise control or interactivity over the generated scenes. We introduce SurGrID, a Scene Graph to Image Diffusion Model, allowing for controllable surgical scene synthesis by leveraging Scene Graphs. These graphs encode a surgical scene's components' spatial and semantic information, which are then translated into an intermediate representation using our novel pre-training step that explicitly captures local and global information. Our proposed method improves the fidelity of generated images and their coherence with the graph input over the state-of-the-art. Further, we demonstrate the simulation's realism and controllability in a user assessment study involving clinical experts. Scene Graphs can be effectively used for precise and interactive conditioning of Denoising Diffusion Models for simulating surgical scenes, enabling high fidelity and interactive control over the generated content.

Chain-of-thought reasoning has significantly improved the performance of Large Language Models (LLMs) across various domains. However, this reasoning process has been confined exclusively to textual space, limiting its effectiveness in visually intensive tasks. To address this limitation, we introduce the concept of reasoning in the pixel-space. Within this novel framework, Vision-Language Models (VLMs) are equipped with a suite of visual reasoning operations, such as zoom-in and select-frame. These operations enable VLMs to directly inspect, interrogate, and infer from visual evidences, thereby enhancing reasoning fidelity for visual tasks. Cultivating such pixel-space reasoning capabilities in VLMs presents notable challenges, including the model's initially imbalanced competence and its reluctance to adopt the newly introduced pixel-space operations. We address these challenges through a two-phase training approach. The first phase employs instruction tuning on synthesized reasoning traces to familiarize the model with the novel visual operations. Following this, a reinforcement learning (RL) phase leverages a curiosity-driven reward scheme to balance exploration between pixel-space reasoning and textual reasoning. With these visual operations, VLMs can interact with complex visual inputs, such as information-rich images or videos to proactively gather necessary information. We demonstrate that this approach significantly improves VLM performance across diverse visual reasoning benchmarks. Our 7B model, \model, achieves 84\% on V* bench, 74\% on TallyQA-Complex, and 84\% on InfographicsVQA, marking the highest accuracy achieved by any open-source model to date. These results highlight the importance of pixel-space reasoning and the effectiveness of our framework.

Contemporary diffusion models show remarkable capability in text-to-image generation, while still being limited to restricted resolutions (e.g., 1,024 X 1,024). Recent advances enable tuning-free higher-resolution image generation by recycling pre-trained diffusion models and extending them via regional denoising or dilated sampling/convolutions. However, these models struggle to simultaneously preserve global semantic structure and produce creative regional details in higher-resolution images. To address this, we present C-Upscale, a new recipe of tuning-free image upscaling that pivots on global-regional priors derived from given global prompt and estimated regional prompts via Multimodal LLM. Technically, the low-frequency component of low-resolution image is recognized as global structure prior to encourage global semantic consistency in high-resolution generation. Next, we perform regional attention control to screen cross-attention between global prompt and each region during regional denoising, leading to regional attention prior that alleviates object repetition issue. The estimated regional prompts containing rich descriptive details further act as regional semantic prior to fuel the creativity of regional detail generation. Both quantitative and qualitative evaluations demonstrate that our C-Upscale manages to generate ultra-high-resolution images (e.g., 4,096 X 4,096 and 8,192 X 8,192) with higher visual fidelity and more creative regional details.

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

Computer-assisted surgery has been developed to enhance surgery correctness and safety. However, researchers and engineers suffer from limited annotated data to develop and train better algorithms. Consequently, the development of fundamental algorithms such as Simultaneous Localization and Mapping (SLAM) is limited. This article elaborates on the efforts of preparing the dataset for semantic segmentation, which is the foundation of many computer-assisted surgery mechanisms. Based on the Cholec80 dataset [3], we extracted 8,080 laparoscopic cholecystectomy image frames from 17 video clips in Cholec80 and annotated the images. The dataset is named CholecSeg8K and its total size is 3GB. Each of these images is annotated at pixel-level for thirteen classes, which are commonly founded in laparoscopic cholecystectomy surgery. CholecSeg8k is released under the license CC BY- NC-SA 4.0.

We present a novel algorithm for transferring artistic styles of semantically meaningful local regions of an image onto local regions of a target video while preserving its photorealism. Local regions may be selected either fully automatically from an image, through using video segmentation algorithms, or from casual user guidance such as scribbles. Our method, based on a deep neural network architecture inspired by recent work in photorealistic style transfer, is real-time and works on arbitrary inputs without runtime optimization once trained on a diverse dataset of artistic styles. By augmenting our video dataset with noisy semantic labels and jointly optimizing over style, content, mask, and temporal losses, our method can cope with a variety of imperfections in the input and produce temporally coherent videos without visual artifacts. We demonstrate our method on a variety of style images and target videos, including the ability to transfer different styles onto multiple objects simultaneously, and smoothly transition between styles in time.

Medical image analysis is critical yet challenged by the need of jointly segmenting organs or tissues, and numerous instances for anatomical structures and tumor microenvironment analysis. Existing studies typically formulated different segmentation tasks in isolation, which overlooks the fundamental interdependencies between these tasks, leading to suboptimal segmentation performance and insufficient medical image understanding. To address this issue, we propose a Co-Seg++ framework for versatile medical segmentation. Specifically, we introduce a novel co-segmentation paradigm, allowing semantic and instance segmentation tasks to mutually enhance each other. We first devise a spatio-temporal prompt encoder (STP-Encoder) to capture long-range spatial and temporal relationships between segmentation regions and image embeddings as prior spatial constraints. Moreover, we devise a multi-task collaborative decoder (MTC-Decoder) that leverages cross-guidance to strengthen the contextual consistency of both tasks, jointly computing semantic and instance segmentation masks. Extensive experiments on diverse CT and histopathology datasets demonstrate that the proposed Co-Seg++ outperforms state-of-the-arts in the semantic, instance, and panoptic segmentation of dental anatomical structures, histopathology tissues, and nuclei instances. The source code is available at https://github.com/xq141839/Co-Seg-Plus.

Endoscopic procedures are essential for diagnosing and treating internal diseases, and multi-modal large language models (MLLMs) are increasingly applied to assist in endoscopy analysis. However, current benchmarks are limited, as they typically cover specific endoscopic scenarios and a small set of clinical tasks, failing to capture the real-world diversity of endoscopic scenarios and the full range of skills needed in clinical workflows. To address these issues, we introduce EndoBench, the first comprehensive benchmark specifically designed to assess MLLMs across the full spectrum of endoscopic practice with multi-dimensional capacities. EndoBench encompasses 4 distinct endoscopic scenarios, 12 specialized clinical tasks with 12 secondary subtasks, and 5 levels of visual prompting granularities, resulting in 6,832 rigorously validated VQA pairs from 21 diverse datasets. Our multi-dimensional evaluation framework mirrors the clinical workflow--spanning anatomical recognition, lesion analysis, spatial localization, and surgical operations--to holistically gauge the perceptual and diagnostic abilities of MLLMs in realistic scenarios. We benchmark 23 state-of-the-art models, including general-purpose, medical-specialized, and proprietary MLLMs, and establish human clinician performance as a reference standard. Our extensive experiments reveal: (1) proprietary MLLMs outperform open-source and medical-specialized models overall, but still trail human experts; (2) medical-domain supervised fine-tuning substantially boosts task-specific accuracy; and (3) model performance remains sensitive to prompt format and clinical task complexity. EndoBench establishes a new standard for evaluating and advancing MLLMs in endoscopy, highlighting both progress and persistent gaps between current models and expert clinical reasoning. We publicly release our benchmark and code.

Region proposal mechanisms are essential for existing deep learning approaches to object detection in images. Although they can generally achieve a good detection performance under normal circumstances, their recall in a scene with extreme cases is unacceptably low. This is mainly because bounding box annotations contain much environment noise information, and non-maximum suppression (NMS) is required to select target boxes. Therefore, in this paper, we propose the first anchor-free and NMS-free object detection model called weakly supervised multimodal annotation segmentation (WSMA-Seg), which utilizes segmentation models to achieve an accurate and robust object detection without NMS. In WSMA-Seg, multimodal annotations are proposed to achieve an instance-aware segmentation using weakly supervised bounding boxes; we also develop a run-data-based following algorithm to trace contours of objects. In addition, we propose a multi-scale pooling segmentation (MSP-Seg) as the underlying segmentation model of WSMA-Seg to achieve a more accurate segmentation and to enhance the detection accuracy of WSMA-Seg. Experimental results on multiple datasets show that the proposed WSMA-Seg approach outperforms the state-of-the-art detectors.

Recent advancements in Large Vision-Language Models (VLMs) have shown great promise in natural image domains, allowing users to hold a dialogue about given visual content. However, such general-domain VLMs perform poorly for Remote Sensing (RS) scenarios, leading to inaccurate or fabricated information when presented with RS domain-specific queries. Such a behavior emerges due to the unique challenges introduced by RS imagery. For example, to handle high-resolution RS imagery with diverse scale changes across categories and many small objects, region-level reasoning is necessary alongside holistic scene interpretation. Furthermore, the lack of domain-specific multimodal instruction following data as well as strong backbone models for RS make it hard for the models to align their behavior with user queries. To address these limitations, we propose GeoChat - the first versatile remote sensing VLM that offers multitask conversational capabilities with high-resolution RS images. Specifically, GeoChat can not only answer image-level queries but also accepts region inputs to hold region-specific dialogue. Furthermore, it can visually ground objects in its responses by referring to their spatial coordinates. To address the lack of domain-specific datasets, we generate a novel RS multimodal instruction-following dataset by extending image-text pairs from existing diverse RS datasets. We establish a comprehensive benchmark for RS multitask conversations and compare with a number of baseline methods. GeoChat demonstrates robust zero-shot performance on various RS tasks, e.g., image and region captioning, visual question answering, scene classification, visually grounded conversations and referring detection. Our code is available at https://github.com/mbzuai-oryx/geochat.

Recent advances in multimodal large language models (LLMs) have highlighted their potential for medical and surgical applications. However, existing surgical datasets predominantly adopt a Visual Question Answering (VQA) format with heterogeneous taxonomies and lack support for pixel-level segmentation, limiting consistent evaluation and applicability. We present SurgMLLMBench, a unified multimodal benchmark explicitly designed for developing and evaluating interactive multimodal LLMs for surgical scene understanding, including the newly collected Micro-surgical Artificial Vascular anastomosIS (MAVIS) dataset. It integrates pixel-level instrument segmentation masks and structured VQA annotations across laparoscopic, robot-assisted, and micro-surgical domains under a unified taxonomy, enabling comprehensive evaluation beyond traditional VQA tasks and richer visual-conversational interactions. Extensive baseline experiments show that a single model trained on SurgMLLMBench achieves consistent performance across domains and generalizes effectively to unseen datasets. SurgMLLMBench will be publicly released as a robust resource to advance multimodal surgical AI research, supporting reproducible evaluation and development of interactive surgical reasoning models.

Plain text has become a prevalent interface for text-to-image synthesis. However, its limited customization options hinder users from accurately describing desired outputs. For example, plain text makes it hard to specify continuous quantities, such as the precise RGB color value or importance of each word. Furthermore, creating detailed text prompts for complex scenes is tedious for humans to write and challenging for text encoders to interpret. To address these challenges, we propose using a rich-text editor supporting formats such as font style, size, color, and footnote. We extract each word's attributes from rich text to enable local style control, explicit token reweighting, precise color rendering, and detailed region synthesis. We achieve these capabilities through a region-based diffusion process. We first obtain each word's region based on attention maps of a diffusion process using plain text. For each region, we enforce its text attributes by creating region-specific detailed prompts and applying region-specific guidance, and maintain its fidelity against plain-text generation through region-based injections. We present various examples of image generation from rich text and demonstrate that our method outperforms strong baselines with quantitative evaluations.

Efficient processing of high-resolution images is crucial for real-world vision-language applications. However, existing Large Vision-Language Models (LVLMs) incur substantial computational overhead due to the large number of vision tokens. With the advent of "thinking with images" models, reasoning now extends beyond text to the visual domain. This capability motivates our two-stage "coarse-to-fine" reasoning pipeline: first, a downsampled image is analyzed to identify task-relevant regions; then, only these regions are cropped at full resolution and processed in a subsequent reasoning stage. This approach reduces computational cost while preserving fine-grained visual details where necessary. A major challenge lies in inferring which regions are truly relevant to a given query. Recent related methods often fail in the first stage after input-image downsampling, due to perception-driven reasoning, where clear visual information is required for effective reasoning. To address this issue, we propose ERGO (Efficient Reasoning & Guided Observation) that performs reasoning-driven perception-leveraging multimodal context to determine where to focus. Our model can account for perceptual uncertainty, expanding the cropped region to cover visually ambiguous areas for answering questions. To this end, we develop simple yet effective reward components in a reinforcement learning framework for coarse-to-fine perception. Across multiple datasets, our approach delivers higher accuracy than the original model and competitive methods, with greater efficiency. For instance, ERGO surpasses Qwen2.5-VL-7B on the V* benchmark by 4.7 points while using only 23% of the vision tokens, achieving a 3x inference speedup. The code and models can be found at: https://github.com/nota-github/ERGO.

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

Cell instance segmentation in cytology images has significant importance for biology analysis and cancer screening, while remains challenging due to 1) the extensive overlapping translucent cell clusters that cause the ambiguous boundaries, and 2) the confusion of mimics and debris as nuclei. In this work, we proposed a De-overlapping Network (DoNet) in a decompose-and-recombined strategy. A Dual-path Region Segmentation Module (DRM) explicitly decomposes the cell clusters into intersection and complement regions, followed by a Semantic Consistency-guided Recombination Module (CRM) for integration. To further introduce the containment relationship of the nucleus in the cytoplasm, we design a Mask-guided Region Proposal Strategy (MRP) that integrates the cell attention maps for inner-cell instance prediction. We validate the proposed approach on ISBI2014 and CPS datasets. Experiments show that our proposed DoNet significantly outperforms other state-of-the-art (SOTA) cell instance segmentation methods. The code is available at https://github.com/DeepDoNet/DoNet.

Remote sensing imagery presents vast, inherently unstructured spatial data, necessitating sophisticated reasoning to interpret complex user intents and contextual relationships beyond simple recognition tasks. In this paper, we aim to construct an Earth observation workflow to handle complex queries by reasoning about spatial context and user intent. As a reasoning workflow, it should autonomously explore and construct its own inference paths, rather than being confined to predefined ground-truth sequences. Ideally, its architecture ought to be unified yet generalized, possessing capabilities to perform diverse reasoning tasks through one model without requiring additional fine-tuning. Existing remote sensing approaches rely on supervised fine-tuning paradigms and task-specific heads, limiting both autonomous reasoning and unified generalization. To this end, we propose RemoteReasoner, a unified workflow for geospatial reasoning. The design of RemoteReasoner integrates a multi-modal large language model (MLLM) for interpreting user instructions and localizing targets, together with task transformation strategies that enable multi-granularity tasks, including object-, region-, and pixel-level. In contrast to existing methods, our framework is trained with reinforcement learning (RL) to endow the MLLM sufficient reasoning autonomy. At the inference stage, our transformation strategies enable diverse task output formats without requiring task-specific decoders or further fine-tuning. Experiments demonstrated that RemoteReasoner achieves state-of-the-art (SOTA) performance across multi-granularity reasoning tasks. Furthermore, it retains the MLLM's inherent generalization capability, demonstrating robust performance on unseen tasks and out-of-distribution categories.

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

Recently, many methods to interpret and visualize deep neural network predictions have been proposed and significant progress has been made. However, a more class-discriminative and visually pleasing explanation is required. Thus, this paper proposes a region-based approach that estimates feature importance in terms of appropriately segmented regions. By fusing the saliency maps generated from multi-scale segmentations, a more class-discriminative and visually pleasing map is obtained. We incorporate this regional multi-scale concept into a prediction difference method that is model-agnostic. An input image is segmented in several scales using the super-pixel method, and exclusion of a region is simulated by sampling a normal distribution constructed using the boundary prior. The experimental results demonstrate that the regional multi-scale method produces much more class-discriminative and visually pleasing saliency maps.

Background: We evaluate SAM 2 for surgical scene understanding by examining its semantic segmentation capabilities for organs/tissues both in zero-shot scenarios and after fine-tuning. Methods: We utilized five public datasets to evaluate and fine-tune SAM 2 for segmenting anatomical tissues in surgical videos/images. Fine-tuning was applied to the image encoder and mask decoder. We limited training subsets from 50 to 400 samples per class to better model real-world constraints with data acquisition. The impact of dataset size on fine-tuning performance was evaluated with weighted mean Dice coefficient (WMDC), and the results were also compared against previously reported state-of-the-art (SOTA) results. Results: SurgiSAM 2, a fine-tuned SAM 2 model, demonstrated significant improvements in segmentation performance, achieving a 17.9% relative WMDC gain compared to the baseline SAM 2. Increasing prompt points from 1 to 10 and training data scale from 50/class to 400/class enhanced performance; the best WMDC of 0.92 on the validation subset was achieved with 10 prompt points and 400 samples per class. On the test subset, this model outperformed prior SOTA methods in 24/30 (80%) of the classes with a WMDC of 0.91 using 10-point prompts. Notably, SurgiSAM 2 generalized effectively to unseen organ classes, achieving SOTA on 7/9 (77.8%) of them. Conclusion: SAM 2 achieves remarkable zero-shot and fine-tuned performance for surgical scene segmentation, surpassing prior SOTA models across several organ classes of diverse datasets. This suggests immense potential for enabling automated/semi-automated annotation pipelines, thereby decreasing the burden of annotations facilitating several surgical applications.

Natural language often struggles to accurately associate positional and attribute information with multiple instances, which limits current text-based visual generation models to simpler compositions featuring only a few dominant instances. To address this limitation, this work enhances diffusion models by introducing regional instance control, where each instance is governed by a bounding box paired with a free-form caption. Previous methods in this area typically rely on implicit position encoding or explicit attention masks to separate regions of interest (ROIs), resulting in either inaccurate coordinate injection or large computational overhead. Inspired by ROI-Align in object detection, we introduce a complementary operation called ROI-Unpool. Together, ROI-Align and ROI-Unpool enable explicit, efficient, and accurate ROI manipulation on high-resolution feature maps for visual generation. Building on ROI-Unpool, we propose ROICtrl, an adapter for pretrained diffusion models that enables precise regional instance control. ROICtrl is compatible with community-finetuned diffusion models, as well as with existing spatial-based add-ons (\eg, ControlNet, T2I-Adapter) and embedding-based add-ons (\eg, IP-Adapter, ED-LoRA), extending their applications to multi-instance generation. Experiments show that ROICtrl achieves superior performance in regional instance control while significantly reducing computational costs.

End-to-end region-based object detectors like Sparse R-CNN usually have multiple cascade bounding box decoding stages, which refine the current predictions according to their previous results. Model parameters within each stage are independent, evolving a huge cost. In this paper, we find the general setting of decoding stages is actually redundant. By simply sharing parameters and making a recursive decoder, the detector already obtains a significant improvement. The recursive decoder can be further enhanced by positional encoding (PE) of the proposal box, which makes it aware of the exact locations and sizes of input bounding boxes, thus becoming adaptive to proposals from different stages during the recursion. Moreover, we also design centerness-based PE to distinguish the RoI feature element and dynamic convolution kernels at different positions within the bounding box. To validate the effectiveness of the proposed method, we conduct intensive ablations and build the full model on three recent mainstream region-based detectors. The RecusiveDet is able to achieve obvious performance boosts with even fewer model parameters and slightly increased computation cost. Codes are available at https://github.com/bravezzzzzz/RecursiveDet.

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

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

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

We introduce Geo-R1, a reasoning-centric post-training framework that unlocks geospatial reasoning in vision-language models by combining thinking scaffolding and elevating. In the scaffolding stage, Geo-R1 instills a ``geospatial thinking paradigm" via supervised fine-tuning on synthetic chain-of-thought exemplars, enabling models to connect visual cues with geographic priors without costly human reasoning annotations. In the elevating stage, it uses GRPO-based reinforcement learning on a weakly-supervised cross-view pairing proxy. This design supplies a verifiable and scalable reward signal: teaching models to capture and reconcile features across modalities, and harnessing reasoning for accurate prediction. Geo-R1 extends geospatial modeling from domain pretraining / supervised finetuning to reasoning-first post-training, and achieves state-of-the-art performance across various geospatial reasoning benchmarks. Our model is available at https://huggingface.co/miniHui/Geo-R1.

Image segmentation plays an essential role in medicine for both diagnostic and interventional tasks. Segmentation approaches are either manual, semi-automated or fully-automated. Manual segmentation offers full control over the quality of the results, but is tedious, time consuming and prone to operator bias. Fully automated methods require no human effort, but often deliver sub-optimal results without providing users with the means to make corrections. Semi-automated approaches keep users in control of the results by providing means for interaction, but the main challenge is to offer a good trade-off between precision and required interaction. In this paper we present a deep learning (DL) based semi-automated segmentation approach that aims to be a "smart" interactive tool for region of interest delineation in medical images. We demonstrate its use for segmenting multiple organs on computed tomography (CT) of the abdomen. Our approach solves some of the most pressing clinical challenges: (i) it requires only one to a few user clicks to deliver excellent 2D segmentations in a fast and reliable fashion; (ii) it can generalize to previously unseen structures and "corner cases"; (iii) it delivers results that can be corrected quickly in a smart and intuitive way up to an arbitrary degree of precision chosen by the user and (iv) ensures high accuracy. We present our approach and compare it to other techniques and previous work to show the advantages brought by our method.

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

The Segment Anything Model 2 (SAM 2) is the latest generation foundation model for image and video segmentation. Trained on the expansive Segment Anything Video (SA-V) dataset, which comprises 35.5 million masks across 50.9K videos, SAM 2 advances its predecessor's capabilities by supporting zero-shot segmentation through various prompts (e.g., points, boxes, and masks). Its robust zero-shot performance and efficient memory usage make SAM 2 particularly appealing for surgical tool segmentation in videos, especially given the scarcity of labeled data and the diversity of surgical procedures. In this study, we evaluate the zero-shot video segmentation performance of the SAM 2 model across different types of surgeries, including endoscopy and microscopy. We also assess its performance on videos featuring single and multiple tools of varying lengths to demonstrate SAM 2's applicability and effectiveness in the surgical domain. We found that: 1) SAM 2 demonstrates a strong capability for segmenting various surgical videos; 2) When new tools enter the scene, additional prompts are necessary to maintain segmentation accuracy; and 3) Specific challenges inherent to surgical videos can impact the robustness of SAM 2.

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

Precise lesion resection depends on accurately identifying fine-grained anatomical structures. While many coarse-grained segmentation (CGS) methods have been successful in large-scale segmentation (e.g., organs), they fall short in clinical scenarios requiring fine-grained segmentation (FGS), which remains challenging due to frequent individual variations in small-scale anatomical structures. Although recent Mamba-based models have advanced medical image segmentation, they often rely on fixed manually-defined scanning orders, which limit their adaptability to individual variations in FGS. To address this, we propose ASM-UNet, a novel Mamba-based architecture for FGS. It introduces adaptive scan scores to dynamically guide the scanning order, generated by combining group-level commonalities and individual-level variations. Experiments on two public datasets (ACDC and Synapse) and a newly proposed challenging biliary tract FGS dataset, namely BTMS, demonstrate that ASM-UNet achieves superior performance in both CGS and FGS tasks. Our code and dataset are available at https://github.com/YqunYang/ASM-UNet.

The ability to automatically detect and track surgical instruments in endoscopic videos can enable transformational interventions. Assessing surgical performance and efficiency, identifying skilled tool use and choreography, and planning operational and logistical aspects of OR resources are just a few of the applications that could benefit. Unfortunately, obtaining the annotations needed to train machine learning models to identify and localize surgical tools is a difficult task. Annotating bounding boxes frame-by-frame is tedious and time-consuming, yet large amounts of data with a wide variety of surgical tools and surgeries must be captured for robust training. Moreover, ongoing annotator training is needed to stay up to date with surgical instrument innovation. In robotic-assisted surgery, however, potentially informative data like timestamps of instrument installation and removal can be programmatically harvested. The ability to rely on tool installation data alone would significantly reduce the workload to train robust tool-tracking models. With this motivation in mind we invited the surgical data science community to participate in the challenge, SurgToolLoc 2022. The goal was to leverage tool presence data as weak labels for machine learning models trained to detect tools and localize them in video frames with bounding boxes. We present the results of this challenge along with many of the team's efforts. We conclude by discussing these results in the broader context of machine learning and surgical data science. The training data used for this challenge consisting of 24,695 video clips with tool presence labels is also being released publicly and can be accessed at https://console.cloud.google.com/storage/browser/isi-surgtoolloc-2022.

Semi-supervised learning has become a compelling approach for 3D tooth segmentation from CBCT scans, where labeled data is minimal. However, existing methods still face two persistent challenges: limited corrective supervision in structurally ambiguous or mislabeled regions during supervised training and performance degradation caused by unreliable pseudo-labels on unlabeled data. To address these problems, we propose Region-Aware Instructive Learning (RAIL), a dual-group dual-student, semi-supervised framework. Each group contains two student models guided by a shared teacher network. By alternating training between the two groups, RAIL promotes intergroup knowledge transfer and collaborative region-aware instruction while reducing overfitting to the characteristics of any single model. Specifically, RAIL introduces two instructive mechanisms. Disagreement-Focused Supervision (DFS) Controller improves supervised learning by instructing predictions only within areas where student outputs diverge from both ground truth and the best student, thereby concentrating supervision on structurally ambiguous or mislabeled areas. In the unsupervised phase, Confidence-Aware Learning (CAL) Modulator reinforces agreement in regions with high model certainty while reducing the effect of low-confidence predictions during training. This helps prevent our model from learning unstable patterns and improves the overall reliability of pseudo-labels. Extensive experiments on four CBCT tooth segmentation datasets show that RAIL surpasses state-of-the-art methods under limited annotation. Our code will be available at https://github.com/Tournesol-Saturday/RAIL.

Current text-driven image editing methods typically follow one of two directions: relying on large-scale, high-quality editing pair datasets to improve editing precision and diversity, or exploring alternative dataset-free techniques. However, constructing large-scale editing datasets requires carefully designed pipelines, is time-consuming, and often results in unrealistic samples or unwanted artifacts. Meanwhile, dataset-free methods may suffer from limited instruction comprehension and restricted editing capabilities. Faced with these challenges, the present work develops a novel paradigm for instruction-driven image editing that leverages widely available and enormous text-image pairs, instead of relying on editing pair datasets. Our approach introduces a multi-scale learnable region to localize and guide the editing process. By treating the alignment between images and their textual descriptions as supervision and learning to generate task-specific editing regions, our method achieves high-fidelity, precise, and instruction-consistent image editing. Extensive experiments demonstrate that the proposed approach attains state-of-the-art performance across various tasks and benchmarks, while exhibiting strong adaptability to various types of generative models.

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

Drag-Based Image Editing (DBIE), which allows users to manipulate images by directly dragging objects within them, has recently attracted much attention from the community. However, it faces two key challenges: (\textcolor{magenta{i}}) point-based drag is often highly ambiguous and difficult to align with users' intentions; (\textcolor{magenta{ii}}) current DBIE methods primarily rely on alternating between motion supervision and point tracking, which is not only cumbersome but also fails to produce high-quality results. These limitations motivate us to explore DBIE from a new perspective -- redefining it as deformation, rotation, and translation of user-specified handle regions. Thereby, by requiring users to explicitly specify both drag areas and types, we can effectively address the ambiguity issue. Furthermore, we propose a simple-yet-effective editing framework, dubbed SkyBlue{DragNeXt}. It unifies DBIE as a Latent Region Optimization (LRO) problem and solves it through Progressive Backward Self-Intervention (PBSI), simplifying the overall procedure of DBIE while further enhancing quality by fully leveraging region-level structure information and progressive guidance from intermediate drag states. We validate SkyBlue{DragNeXt} on our NextBench, and extensive experiments demonstrate that our proposed method can significantly outperform existing approaches. Code will be released on github.

Recent progress in VLMs has demonstrated impressive capabilities across a variety of tasks in the natural image domain. Motivated by these advancements, the remote sensing community has begun to adopt VLMs for remote sensing vision-language tasks, including scene understanding, image captioning, and visual question answering. However, existing remote sensing VLMs typically rely on closed-set scene understanding and focus on generic scene descriptions, yet lack the ability to incorporate external knowledge. This limitation hinders their capacity for semantic reasoning over complex or context-dependent queries that involve domain-specific or world knowledge. To address these challenges, we first introduced a multimodal Remote Sensing World Knowledge (RSWK) dataset, which comprises high-resolution satellite imagery and detailed textual descriptions for 14,141 well-known landmarks from 175 countries, integrating both remote sensing domain knowledge and broader world knowledge. Building upon this dataset, we proposed a novel Remote Sensing Retrieval-Augmented Generation (RS-RAG) framework, which consists of two key components. The Multi-Modal Knowledge Vector Database Construction module encodes remote sensing imagery and associated textual knowledge into a unified vector space. The Knowledge Retrieval and Response Generation module retrieves and re-ranks relevant knowledge based on image and/or text queries, and incorporates the retrieved content into a knowledge-augmented prompt to guide the VLM in producing contextually grounded responses. We validated the effectiveness of our approach on three representative vision-language tasks, including image captioning, image classification, and visual question answering, where RS-RAG significantly outperformed state-of-the-art baselines.

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

Efficient vision-language understanding of large Remote Sensing Images (RSIs) is meaningful but challenging. Current Large Vision-Language Models (LVLMs) typically employ limited pre-defined grids to process images, leading to information loss when handling gigapixel RSIs. Conversely, using unlimited grids significantly increases computational costs. To preserve image details while reducing computational complexity, we propose a text-guided token pruning method with Dynamic Image Pyramid (DIP) integration. Our method introduces: (i) a Region Focus Module (RFM) that leverages text-aware region localization capability to identify critical vision tokens, and (ii) a coarse-to-fine image tile selection and vision token pruning strategy based on DIP, which is guided by RFM outputs and avoids directly processing the entire large imagery. Additionally, existing benchmarks for evaluating LVLMs' perception ability on large RSI suffer from limited question diversity and constrained image sizes. We construct a new benchmark named LRS-VQA, which contains 7,333 QA pairs across 8 categories, with image length up to 27,328 pixels. Our method outperforms existing high-resolution strategies on four datasets using the same data. Moreover, compared to existing token reduction methods, our approach demonstrates higher efficiency under high-resolution settings. Dataset and code are in https://github.com/VisionXLab/LRS-VQA.

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

In the realm of robot-assisted minimally invasive surgery, dynamic scene reconstruction can significantly enhance downstream tasks and improve surgical outcomes. Neural Radiance Fields (NeRF)-based methods have recently risen to prominence for their exceptional ability to reconstruct scenes but are hampered by slow inference speed, prolonged training, and inconsistent depth estimation. Some previous work utilizes ground truth depth for optimization but is hard to acquire in the surgical domain. To overcome these obstacles, we present Endo-4DGS, a real-time endoscopic dynamic reconstruction approach that utilizes 3D Gaussian Splatting (GS) for 3D representation. Specifically, we propose lightweight MLPs to capture temporal dynamics with Gaussian deformation fields. To obtain a satisfactory Gaussian Initialization, we exploit a powerful depth estimation foundation model, Depth-Anything, to generate pseudo-depth maps as a geometry prior. We additionally propose confidence-guided learning to tackle the ill-pose problems in monocular depth estimation and enhance the depth-guided reconstruction with surface normal constraints and depth regularization. Our approach has been validated on two surgical datasets, where it can effectively render in real-time, compute efficiently, and reconstruct with remarkable accuracy.

Currently, instruction-based image editing methods have made significant progress by leveraging the powerful cross-modal understanding capabilities of vision language models (VLMs). However, they still face challenges in three key areas: 1) complex scenarios; 2) semantic consistency; and 3) fine-grained editing. To address these issues, we propose FireEdit, an innovative Fine-grained Instruction-based image editing framework that exploits a REgion-aware VLM. FireEdit is designed to accurately comprehend user instructions and ensure effective control over the editing process. Specifically, we enhance the fine-grained visual perception capabilities of the VLM by introducing additional region tokens. Relying solely on the output of the LLM to guide the diffusion model may lead to suboptimal editing results. Therefore, we propose a Time-Aware Target Injection module and a Hybrid Visual Cross Attention module. The former dynamically adjusts the guidance strength at various denoising stages by integrating timestep embeddings with the text embeddings. The latter enhances visual details for image editing, thereby preserving semantic consistency between the edited result and the source image. By combining the VLM enhanced with fine-grained region tokens and the time-dependent diffusion model, FireEdit demonstrates significant advantages in comprehending editing instructions and maintaining high semantic consistency. Extensive experiments indicate that our approach surpasses the state-of-the-art instruction-based image editing methods. Our project is available at https://zjgans.github.io/fireedit.github.io.