Daily Papers

The recent emergence of Medical Large Vision Language Models (Med-LVLMs) has enhanced medical diagnosis. However, current Med-LVLMs frequently encounter factual issues, often generating responses that do not align with established medical facts. Retrieval-Augmented Generation (RAG), which utilizes external knowledge, can improve the factual accuracy of these models but introduces two major challenges. First, limited retrieved contexts might not cover all necessary information, while excessive retrieval can introduce irrelevant and inaccurate references, interfering with the model's generation. Second, in cases where the model originally responds correctly, applying RAG can lead to an over-reliance on retrieved contexts, resulting in incorrect answers. To address these issues, we propose RULE, which consists of two components. First, we introduce a provably effective strategy for controlling factuality risk through the calibrated selection of the number of retrieved contexts. Second, based on samples where over-reliance on retrieved contexts led to errors, we curate a preference dataset to fine-tune the model, balancing its dependence on inherent knowledge and retrieved contexts for generation. We demonstrate the effectiveness of RULE on three medical VQA datasets, achieving an average improvement of 20.8% in factual accuracy. We publicly release our benchmark and code in https://github.com/richard-peng-xia/RULE.

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

Artificial intelligence has significantly impacted medical applications, particularly with the advent of Medical Large Vision Language Models (Med-LVLMs), sparking optimism for the future of automated and personalized healthcare. However, the trustworthiness of Med-LVLMs remains unverified, posing significant risks for future model deployment. In this paper, we introduce CARES and aim to comprehensively evaluate the Trustworthiness of Med-LVLMs across the medical domain. We assess the trustworthiness of Med-LVLMs across five dimensions, including trustfulness, fairness, safety, privacy, and robustness. CARES comprises about 41K question-answer pairs in both closed and open-ended formats, covering 16 medical image modalities and 27 anatomical regions. Our analysis reveals that the models consistently exhibit concerns regarding trustworthiness, often displaying factual inaccuracies and failing to maintain fairness across different demographic groups. Furthermore, they are vulnerable to attacks and demonstrate a lack of privacy awareness. We publicly release our benchmark and code in https://github.com/richard-peng-xia/CARES.

Medical Large Vision-Language Models (Med-LVLMs) have shown strong potential in multimodal diagnostic tasks. However, existing single-agent models struggle to generalize across diverse medical specialties, limiting their performance. Recent efforts introduce multi-agent collaboration frameworks inspired by clinical workflows, where general practitioners (GPs) and specialists interact in a fixed sequence. Despite improvements, these static pipelines lack flexibility and adaptability in reasoning. To address this, we propose MMedAgent-RL, a reinforcement learning (RL)-based multi-agent framework that enables dynamic, optimized collaboration among medical agents. Specifically, we train two GP agents based on Qwen2.5-VL via RL: the triage doctor learns to assign patients to appropriate specialties, while the attending physician integrates the judgments from multi-specialists and its own knowledge to make final decisions. To address the inconsistency in specialist outputs, we introduce a curriculum learning (CL)-guided RL strategy that progressively teaches the attending physician to balance between imitating specialists and correcting their mistakes. Experiments on five medical VQA benchmarks demonstrate that MMedAgent-RL not only outperforms both open-source and proprietary Med-LVLMs, but also exhibits human-like reasoning patterns. Notably, it achieves an average performance gain of 20.7% over supervised fine-tuning baselines.

Medical visual question answering (VQA) is a challenging multimodal task, where Vision-Language Pre-training (VLP) models can effectively improve the generalization performance. However, most methods in the medical field treat VQA as an answer classification task which is difficult to transfer to practical application scenarios. Additionally, due to the privacy of medical images and the expensive annotation process, large-scale medical image-text pairs datasets for pretraining are severely lacking. In this paper, we propose a large-scale MultI-task Self-Supervised learning based framework (MISS) for medical VQA tasks. Unlike existing methods, we treat medical VQA as a generative task. We unify the text encoder and multimodal encoder and align image-text features through multi-task learning. Furthermore, we propose a Transfer-and-Caption method that extends the feature space of single-modal image datasets using large language models (LLMs), enabling those traditional medical vision field task data to be applied to VLP. Experiments show that our method achieves excellent results with fewer multimodal datasets and demonstrates the advantages of generative VQA models. The code and model weights will be released upon the paper's acceptance.

We present HealthGPT, a powerful Medical Large Vision-Language Model (Med-LVLM) that integrates medical visual comprehension and generation capabilities within a unified autoregressive paradigm. Our bootstrapping philosophy is to progressively adapt heterogeneous comprehension and generation knowledge to pre-trained large language models (LLMs). This is achieved through a novel heterogeneous low-rank adaptation (H-LoRA) technique, which is complemented by a tailored hierarchical visual perception approach and a three-stage learning strategy. To effectively learn the HealthGPT, we devise a comprehensive medical domain-specific comprehension and generation dataset called VL-Health. Experimental results demonstrate exceptional performance and scalability of HealthGPT in medical visual unified tasks. Our project can be accessed at https://github.com/DCDmllm/HealthGPT.

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

Large Vision-Language Models (LVLMs) are capable of handling diverse data types such as imaging, text, and physiological signals, and can be applied in various fields. In the medical field, LVLMs have a high potential to offer substantial assistance for diagnosis and treatment. Before that, it is crucial to develop benchmarks to evaluate LVLMs' effectiveness in various medical applications. Current benchmarks are often built upon specific academic literature, mainly focusing on a single domain, and lacking varying perceptual granularities. Thus, they face specific challenges, including limited clinical relevance, incomplete evaluations, and insufficient guidance for interactive LVLMs. To address these limitations, we developed the GMAI-MMBench, the most comprehensive general medical AI benchmark with well-categorized data structure and multi-perceptual granularity to date. It is constructed from 285 datasets across 39 medical image modalities, 18 clinical-related tasks, 18 departments, and 4 perceptual granularities in a Visual Question Answering (VQA) format. Additionally, we implemented a lexical tree structure that allows users to customize evaluation tasks, accommodating various assessment needs and substantially supporting medical AI research and applications. We evaluated 50 LVLMs, and the results show that even the advanced GPT-4o only achieves an accuracy of 52%, indicating significant room for improvement. Moreover, we identified five key insufficiencies in current cutting-edge LVLMs that need to be addressed to advance the development of better medical applications. We believe that GMAI-MMBench will stimulate the community to build the next generation of LVLMs toward GMAI. Project Page: https://uni-medical.github.io/GMAI-MMBench.github.io/

Large vision-language models (LVLMs) have shown great promise in medical applications, particularly in visual question answering (MedVQA) and diagnosis from medical images. However, existing datasets and models often fail to consider critical aspects of medical diagnostics, such as the integration of historical records and the analysis of disease progression over time. In this paper, we introduce MMXU (Multimodal and MultiX-ray Understanding), a novel dataset for MedVQA that focuses on identifying changes in specific regions between two patient visits. Unlike previous datasets that primarily address single-image questions, MMXU enables multi-image questions, incorporating both current and historical patient data. We demonstrate the limitations of current LVLMs in identifying disease progression on MMXU-test, even those that perform well on traditional benchmarks. To address this, we propose a MedRecord-Augmented Generation (MAG) approach, incorporating both global and regional historical records. Our experiments show that integrating historical records significantly enhances diagnostic accuracy by at least 20\%, bridging the gap between current LVLMs and human expert performance. Additionally, we fine-tune models with MAG on MMXU-dev, which demonstrates notable improvements. We hope this work could illuminate the avenue of advancing the use of LVLMs in medical diagnostics by emphasizing the importance of historical context in interpreting medical images. Our dataset is released at https://github.com/linjiemu/MMXU{https://github.com/linjiemu/MMXU}.

Multimodal Large Language Models (MLLMs) inherit the superior text understanding capabilities of LLMs and extend these capabilities to multimodal scenarios. These models achieve excellent results in the general domain of multimodal tasks. However, in the medical domain, the substantial training costs and the requirement for extensive medical data pose challenges to the development of medical MLLMs. Furthermore, due to the free-text form of answers, tasks such as visual grounding that need to produce output in a prescribed form become difficult for MLLMs. So far, there have been no medical MLLMs works in medical visual grounding area. For the medical vision grounding task, which involves identifying locations in medical images based on short text descriptions, we propose Parameter-efficient Fine-tuning medical multimodal large language models for Medcial Visual Grounding (PFMVG). To validate the performance of the model, we evaluate it on a public benchmark dataset for medical visual grounding, where it achieves competitive results, and significantly outperforming GPT-4v. Our code will be open sourced after peer review.

Large Vision-Language Models (LVLMs) are an extension of Large Language Models (LLMs) that facilitate processing both image and text inputs, expanding AI capabilities. However, LVLMs struggle with object hallucinations due to their reliance on text cues and learned object co-occurrence biases. While most research quantifies these hallucinations, mitigation strategies are still lacking. Our study introduces a Language Contrastive Decoding (LCD) algorithm that adjusts LVLM outputs based on LLM distribution confidence levels, effectively reducing object hallucinations. We demonstrate the advantages of LCD in leading LVLMs, showing up to %4 improvement in POPE F1 scores and up to %36 reduction in CHAIR scores on the COCO validation set, while also improving captioning quality scores. Our method effectively improves LVLMs without needing complex post-processing or retraining, and is easily applicable to different models. Our findings highlight the potential of further exploration of LVLM-specific decoding algorithms.

Medical vision-and-language models (MVLMs) have attracted substantial interest due to their capability to offer a natural language interface for interpreting complex medical data. Their applications are versatile and have the potential to improve diagnostic accuracy and decision-making for individual patients while also contributing to enhanced public health monitoring, disease surveillance, and policy-making through more efficient analysis of large data sets. MVLMS integrate natural language processing with medical images to enable a more comprehensive and contextual understanding of medical images alongside their corresponding textual information. Unlike general vision-and-language models trained on diverse, non-specialized datasets, MVLMs are purpose-built for the medical domain, automatically extracting and interpreting critical information from medical images and textual reports to support clinical decision-making. Popular clinical applications of MVLMs include automated medical report generation, medical visual question answering, medical multimodal segmentation, diagnosis and prognosis and medical image-text retrieval. Here, we provide a comprehensive overview of MVLMs and the various medical tasks to which they have been applied. We conduct a detailed analysis of various vision-and-language model architectures, focusing on their distinct strategies for cross-modal integration/exploitation of medical visual and textual features. We also examine the datasets used for these tasks and compare the performance of different models based on standardized evaluation metrics. Furthermore, we highlight potential challenges and summarize future research trends and directions. The full collection of papers and codes is available at: https://github.com/YtongXie/Medical-Vision-and-Language-Tasks-and-Methodologies-A-Survey.

Multimodal Large Language Models (MLLMs) have shown significant potential in medical image analysis. However, their capabilities in interpreting fundus images, a critical skill for ophthalmology, remain under-evaluated. Existing benchmarks lack fine-grained task divisions and fail to provide modular analysis of its two key modules, i.e., large language model (LLM) and vision encoder (VE). This paper introduces FunBench, a novel visual question answering (VQA) benchmark designed to comprehensively evaluate MLLMs' fundus reading skills. FunBench features a hierarchical task organization across four levels (modality perception, anatomy perception, lesion analysis, and disease diagnosis). It also offers three targeted evaluation modes: linear-probe based VE evaluation, knowledge-prompted LLM evaluation, and holistic evaluation. Experiments on nine open-source MLLMs plus GPT-4o reveal significant deficiencies in fundus reading skills, particularly in basic tasks such as laterality recognition. The results highlight the limitations of current MLLMs and emphasize the need for domain-specific training and improved LLMs and VEs.

Vision-Language Models (VLMs) trained via contrastive learning have achieved notable success in natural image tasks. However, their application in the medical domain remains limited due to the scarcity of openly accessible, large-scale medical image-text datasets. Existing medical VLMs either train on closed-source proprietary or relatively small open-source datasets that do not generalize well. Similarly, most models remain specific to a single or limited number of medical imaging domains, again restricting their applicability to other modalities. To address this gap, we introduce UniMed, a large-scale, open-source multi-modal medical dataset comprising over 5.3 million image-text pairs across six diverse imaging modalities: X-ray, CT, MRI, Ultrasound, Pathology, and Fundus. UniMed is developed using a data-collection framework that leverages Large Language Models (LLMs) to transform modality-specific classification datasets into image-text formats while incorporating existing image-text data from the medical domain, facilitating scalable VLM pretraining. Using UniMed, we trained UniMed-CLIP, a unified VLM for six modalities that significantly outperforms existing generalist VLMs and matches modality-specific medical VLMs, achieving notable gains in zero-shot evaluations. For instance, UniMed-CLIP improves over BiomedCLIP (trained on proprietary data) by an absolute gain of +12.61, averaged over 21 datasets, while using 3x less training data. To facilitate future research, we release UniMed dataset, training codes, and models at https://github.com/mbzuai-oryx/UniMed-CLIP.

The rapid development of multimodal large language models (MLLMs), such as GPT-4V, has led to significant advancements. However, these models still face challenges in medical multimodal capabilities due to limitations in the quantity and quality of medical vision-text data, stemming from data privacy concerns and high annotation costs. While pioneering approaches utilize PubMed's large-scale, de-identified medical image-text pairs to address these limitations, they still fall short due to inherent data noise. To tackle this, we refined medical image-text pairs from PubMed and employed MLLMs (GPT-4V) in an 'unblinded' capacity to denoise and reformat the data, resulting in the creation of the PubMedVision dataset with 1.3 million medical VQA samples. Our validation demonstrates that: (1) PubMedVision can significantly enhance the medical multimodal capabilities of current MLLMs, showing significant improvement in benchmarks including the MMMU Health & Medicine track; (2) manual checks by medical experts and empirical results validate the superior data quality of our dataset compared to other data construction methods. Using PubMedVision, we train a 34B medical MLLM HuatuoGPT-Vision, which shows superior performance in medical multimodal scenarios among open-source MLLMs.

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.

Multimodal large language models (MLLMs) represent an evolutionary expansion in the capabilities of traditional large language models, enabling them to tackle challenges that surpass the scope of purely text-based applications. It leverages the knowledge previously encoded within these language models, thereby enhancing their applicability and functionality in the reign of multimodal contexts. Recent works investigate the adaptation of MLLMs to predict free-form answers as a generative task to solve medical visual question answering (Med-VQA) tasks. In this paper, we propose a parameter efficient framework for fine-tuning MLLM specifically tailored to Med-VQA applications, and empirically validate it on a public benchmark dataset. To accurately measure the performance, we employ human evaluation and the results reveal that our model achieves an overall accuracy of 81.9%, and outperforms the GPT-4v model by a significant margin of 26% absolute accuracy on closed-ended questions. The code will be available here: https://github.com/jinlHe/PeFoMed.

Vision Large Language Models (VLMs) combine visual understanding with natural language processing, enabling tasks like image captioning, visual question answering, and video analysis. While VLMs show impressive capabilities across domains such as autonomous vehicles, smart surveillance, and healthcare, their deployment on resource-constrained edge devices remains challenging due to processing power, memory, and energy limitations. This survey explores recent advancements in optimizing VLMs for edge environments, focusing on model compression techniques, including pruning, quantization, knowledge distillation, and specialized hardware solutions that enhance efficiency. We provide a detailed discussion of efficient training and fine-tuning methods, edge deployment challenges, and privacy considerations. Additionally, we discuss the diverse applications of lightweight VLMs across healthcare, environmental monitoring, and autonomous systems, illustrating their growing impact. By highlighting key design strategies, current challenges, and offering recommendations for future directions, this survey aims to inspire further research into the practical deployment of VLMs, ultimately making advanced AI accessible in resource-limited settings.

Multimodal Large Language Models (MLLMs) have tremendous potential to improve the accuracy, availability, and cost-effectiveness of healthcare by providing automated solutions or serving as aids to medical professionals. Despite promising first steps in developing medical MLLMs in the past few years, their capabilities and limitations are not well-understood. Recently, many benchmark datasets have been proposed that test the general medical knowledge of such models across a variety of medical areas. However, the systematic failure modes and vulnerabilities of such models are severely underexplored with most medical benchmarks failing to expose the shortcomings of existing models in this safety-critical domain. In this paper, we introduce MediConfusion, a challenging medical Visual Question Answering (VQA) benchmark dataset, that probes the failure modes of medical MLLMs from a vision perspective. We reveal that state-of-the-art models are easily confused by image pairs that are otherwise visually dissimilar and clearly distinct for medical experts. Strikingly, all available models (open-source or proprietary) achieve performance below random guessing on MediConfusion, raising serious concerns about the reliability of existing medical MLLMs for healthcare deployment. We also extract common patterns of model failure that may help the design of a new generation of more trustworthy and reliable MLLMs in healthcare.

Multimodal large language models (MLLMs) have made significant strides, yet they face challenges in the medical domain due to limited specialized knowledge. While recent medical MLLMs demonstrate strong performance in lab settings, they often struggle in real-world applications, highlighting a substantial gap between research and practice. In this paper, we seek to address this gap at various stages of the end-to-end learning pipeline, including data collection, model fine-tuning, and evaluation. At the data collection stage, we introduce SemiHVision, a dataset that combines human annotations with automated augmentation techniques to improve both medical knowledge representation and diagnostic reasoning. For model fine-tuning, we trained PMC-Cambrian-8B-AN over 2400 H100 GPU hours, resulting in performance that surpasses public medical models like HuatuoGPT-Vision-34B (79.0% vs. 66.7%) and private general models like Claude3-Opus (55.7%) on traditional benchmarks such as SLAKE and VQA-RAD. In the evaluation phase, we observed that traditional benchmarks cannot accurately reflect realistic clinical task capabilities. To overcome this limitation and provide more targeted guidance for model evaluation, we introduce the JAMA Clinical Challenge, a novel benchmark specifically designed to evaluate diagnostic reasoning. On this benchmark, PMC-Cambrian-AN achieves state-of-the-art performance with a GPT-4 score of 1.29, significantly outperforming HuatuoGPT-Vision-34B (1.13) and Claude3-Opus (1.17), demonstrating its superior diagnostic reasoning abilities.

Large vision-language models (LVLMs) have been regarded as a breakthrough advance in an astoundingly variety of tasks, from content generation to virtual assistants and multimodal search or retrieval. However, for many of these applications, the performance of these methods has been widely criticized, particularly when compared with state-of-the-art methods and technologies in each specific domain. In this work, we compare the performance of the leading large vision-language models in the human re-identification task, using as baseline the performance attained by state-of-the-art AI models specifically designed for this problem. We compare the results due to ChatGPT-4o, Gemini-2.0-Flash, Claude 3.5 Sonnet, and Qwen-VL-Max to a baseline ReID PersonViT model, using the well-known Market1501 dataset. Our evaluation pipeline includes the dataset curation, prompt engineering, and metric selection to assess the models' performance. Results are analyzed from many different perspectives: similarity scores, classification accuracy, and classification metrics, including precision, recall, F1 score, and area under curve (AUC). Our results confirm the strengths of LVLMs, but also their severe limitations that often lead to catastrophic answers and should be the scope of further research. As a concluding remark, we speculate about some further research that should fuse traditional and LVLMs to combine the strengths from both families of techniques and achieve solid improvements in performance.

Large Vision-Language Models (LVLMs) represent a significant advancement toward achieving superior multimodal capabilities by enabling powerful Large Language Models (LLMs) to understand visual input. Typically, LVLMs utilize visual encoders, such as CLIP, to transform images into visual tokens, which are then aligned with textual tokens through projection layers before being input into the LLM for inference. Although existing LVLMs have achieved significant success, their inference efficiency is still limited by the substantial number of visual tokens and the potential redundancy among them. To mitigate this issue, we propose Focal Pruning (FoPru), a training-free method that prunes visual tokens based on the attention-based token significance derived from the vision encoder. Specifically, we introduce two alternative pruning strategies: 1) the rank strategy, which leverages all token significance scores to retain more critical tokens in a global view; 2) the row strategy, which focuses on preserving continuous key information in images from a local perspective. Finally, the selected tokens are reordered to maintain their original positional relationships. Extensive experiments across various LVLMs and multimodal datasets demonstrate that our method can prune a large number of redundant tokens while maintaining high accuracy, leading to significant improvements in inference efficiency.

Large Language Models (LLMs) have introduced a new era of proficiency in comprehending complex healthcare and biomedical topics. However, there is a noticeable lack of models in languages other than English and models that can interpret multi-modal input, which is crucial for global healthcare accessibility. In response, this study introduces Qilin-Med-VL, the first Chinese large vision-language model designed to integrate the analysis of textual and visual data. Qilin-Med-VL combines a pre-trained Vision Transformer (ViT) with a foundational LLM. It undergoes a thorough two-stage curriculum training process that includes feature alignment and instruction tuning. This method enhances the model's ability to generate medical captions and answer complex medical queries. We also release ChiMed-VL, a dataset consisting of more than 1M image-text pairs. This dataset has been carefully curated to enable detailed and comprehensive interpretation of medical data using various types of images.

Large Vision-Language Models (LVLMs) have demonstrated remarkable capabilities in various multimodal tasks. However, their potential in the medical domain remains largely unexplored. A significant challenge arises from the scarcity of diverse medical images spanning various modalities and anatomical regions, which is essential in real-world medical applications. To solve this problem, in this paper, we introduce OmniMedVQA, a novel comprehensive medical Visual Question Answering (VQA) benchmark. This benchmark is collected from 75 different medical datasets, including 12 different modalities and covering more than 20 distinct anatomical regions. Importantly, all images in this benchmark are sourced from authentic medical scenarios, ensuring alignment with the requirements of the medical field and suitability for evaluating LVLMs. Through our extensive experiments, we have found that existing LVLMs struggle to address these medical VQA problems effectively. Moreover, what surprises us is that medical-specialized LVLMs even exhibit inferior performance to those general-domain models, calling for a more versatile and robust LVLM in the biomedical field. The evaluation results not only reveal the current limitations of LVLM in understanding real medical images but also highlight our dataset's significance. Our dataset will be made publicly available.

This paper explores the advancements and applications of large-scale models in the medical field, with a particular focus on Medical Large Models (MedLMs). These models, encompassing Large Language Models (LLMs), Vision Models, 3D Large Models, and Multimodal Models, are revolutionizing healthcare by enhancing disease prediction, diagnostic assistance, personalized treatment planning, and drug discovery. The integration of graph neural networks in medical knowledge graphs and drug discovery highlights the potential of Large Graph Models (LGMs) in understanding complex biomedical relationships. The study also emphasizes the transformative role of Vision-Language Models (VLMs) and 3D Large Models in medical image analysis, anatomical modeling, and prosthetic design. Despite the challenges, these technologies are setting new benchmarks in medical innovation, improving diagnostic accuracy, and paving the way for personalized healthcare solutions. This paper aims to provide a comprehensive overview of the current state and future directions of large models in medicine, underscoring their significance in advancing global health.

Multimodal large language models (MLLMs) demonstrate significant potential in the field of medical diagnosis. However, they face critical challenges in specialized domains such as ophthalmology, particularly the fragmentation of annotation granularity and inconsistencies in clinical reasoning logic, which hinder precise cross-modal understanding. This paper introduces FundusExpert, an ophthalmology-specific MLLM with integrated positioning-diagnosis reasoning capabilities, along with FundusGen, a dataset constructed through the intelligent Fundus-Engine system. Fundus-Engine automates localization and leverages MLLM-based semantic expansion to integrate global disease classification, local object detection, and fine-grained feature analysis within a single fundus image. Additionally, by constructing a clinically aligned cognitive chain, it guides the model to generate interpretable reasoning paths. FundusExpert, fine-tuned with instruction data from FundusGen, achieves the best performance in ophthalmic question-answering tasks, surpassing the average accuracy of the 40B MedRegA by 26.6%. It also excels in zero-shot report generation tasks, achieving a clinical consistency of 77.0%, significantly outperforming GPT-4o's 47.6%. Furthermore, we reveal a scaling law between data quality and model capability (L propto N^{0.068}), demonstrating that the cognitive alignment annotations in FundusGen enhance data utilization efficiency. By integrating region-level localization with diagnostic reasoning chains, our work develops a scalable, clinically-aligned MLLM and explores a pathway toward bridging the visual-language gap in specific MLLMs. Our project can be found at https://github.com/MeteorElf/FundusExpert.

Medicine, by its nature, is a multifaceted domain that requires the synthesis of information across various modalities. Medical generative vision-language models (VLMs) make a first step in this direction and promise many exciting clinical applications. However, existing models typically have to be fine-tuned on sizeable down-stream datasets, which poses a significant limitation as in many medical applications data is scarce, necessitating models that are capable of learning from few examples in real-time. Here we propose Med-Flamingo, a multimodal few-shot learner adapted to the medical domain. Based on OpenFlamingo-9B, we continue pre-training on paired and interleaved medical image-text data from publications and textbooks. Med-Flamingo unlocks few-shot generative medical visual question answering (VQA) abilities, which we evaluate on several datasets including a novel challenging open-ended VQA dataset of visual USMLE-style problems. Furthermore, we conduct the first human evaluation for generative medical VQA where physicians review the problems and blinded generations in an interactive app. Med-Flamingo improves performance in generative medical VQA by up to 20\% in clinician's rating and firstly enables multimodal medical few-shot adaptations, such as rationale generation. We release our model, code, and evaluation app under https://github.com/snap-stanford/med-flamingo.

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

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

With the advent of Vision-Language Models (VLMs), medical artificial intelligence (AI) has experienced significant technological progress and paradigm shifts. This survey provides an extensive review of recent advancements in Medical Vision-Language Models (Med-VLMs), which integrate visual and textual data to enhance healthcare outcomes. We discuss the foundational technology behind Med-VLMs, illustrating how general models are adapted for complex medical tasks, and examine their applications in healthcare. The transformative impact of Med-VLMs on clinical practice, education, and patient care is highlighted, alongside challenges such as data scarcity, narrow task generalization, interpretability issues, and ethical concerns like fairness, accountability, and privacy. These limitations are exacerbated by uneven dataset distribution, computational demands, and regulatory hurdles. Rigorous evaluation methods and robust regulatory frameworks are essential for safe integration into healthcare workflows. Future directions include leveraging large-scale, diverse datasets, improving cross-modal generalization, and enhancing interpretability. Innovations like federated learning, lightweight architectures, and Electronic Health Record (EHR) integration are explored as pathways to democratize access and improve clinical relevance. This review aims to provide a comprehensive understanding of Med-VLMs' strengths and limitations, fostering their ethical and balanced adoption in healthcare.

In recent years, Multimodal Large Language Models (MLLM) have achieved notable advancements, demonstrating the feasibility of developing an intelligent biomedical assistant. However, current biomedical MLLMs predominantly focus on image-level understanding and restrict interactions to textual commands, thus limiting their capability boundaries and the flexibility of usage. In this paper, we introduce a novel end-to-end multimodal large language model for the biomedical domain, named MedPLIB, which possesses pixel-level understanding. Excitingly, it supports visual question answering (VQA), arbitrary pixel-level prompts (points, bounding boxes, and free-form shapes), and pixel-level grounding. We propose a novel Mixture-of-Experts (MoE) multi-stage training strategy, which divides MoE into separate training phases for a visual-language expert model and a pixel-grounding expert model, followed by fine-tuning using MoE. This strategy effectively coordinates multitask learning while maintaining the computational cost at inference equivalent to that of a single expert model. To advance the research of biomedical MLLMs, we introduce the Medical Complex Vision Question Answering Dataset (MeCoVQA), which comprises an array of 8 modalities for complex medical imaging question answering and image region understanding. Experimental results indicate that MedPLIB has achieved state-of-the-art outcomes across multiple medical visual language tasks. More importantly, in zero-shot evaluations for the pixel grounding task, MedPLIB leads the best small and large models by margins of 19.7 and 15.6 respectively on the mDice metric. The codes, data, and model checkpoints will be made publicly available at https://github.com/ShawnHuang497/MedPLIB.

In recent years, multimodal large language models (MLLMs) have shown strong potential in real-world applications. They are developing rapidly due to their remarkable ability to comprehend multimodal information and their inherent powerful cognitive and reasoning capabilities. Among MLLMs, vision language models (VLM) stand out for their ability to understand vision information. However, the scaling trend of VLMs under the current mainstream paradigm has not been extensively studied. Whether we can achieve better performance by training even larger models is still unclear. To address this issue, we conducted experiments on the pretraining stage of MLLMs. We conduct our experiment using different encoder sizes and large language model (LLM) sizes. Our findings indicate that merely increasing the size of encoders does not necessarily enhance the performance of VLMs. Moreover, we analyzed the effects of LLM backbone parameter size and data quality on the pretraining outcomes. Additionally, we explored the differences in scaling laws between LLMs and VLMs.

Multimodal large language models (MLLMs) hold significant potential in medical applications, including disease diagnosis and clinical decision-making. However, these tasks require highly accurate, context-sensitive, and professionally aligned responses, making reliable reward models and judges critical. Despite their importance, medical reward models (MRMs) and judges remain underexplored, with no dedicated benchmarks addressing clinical requirements. Existing benchmarks focus on general MLLM capabilities or evaluate models as solvers, neglecting essential evaluation dimensions like diagnostic accuracy and clinical relevance. To address this, we introduce Med-RewardBench, the first benchmark specifically designed to evaluate MRMs and judges in medical scenarios. Med-RewardBench features a multimodal dataset spanning 13 organ systems and 8 clinical departments, with 1,026 expert-annotated cases. A rigorous three-step process ensures high-quality evaluation data across six clinically critical dimensions. We evaluate 32 state-of-the-art MLLMs, including open-source, proprietary, and medical-specific models, revealing substantial challenges in aligning outputs with expert judgment. Additionally, we develop baseline models that demonstrate substantial performance improvements through fine-tuning.

Multimodal large language models (MLLMs) have demonstrated promising prospects in healthcare, particularly for addressing complex medical tasks, supporting multidisciplinary treatment (MDT), and enabling personalized precision medicine. However, their practical deployment faces critical challenges in resource efficiency, diagnostic accuracy, clinical considerations, and ethical privacy. To address these limitations, we propose Infi-Med, a comprehensive framework for medical MLLMs that introduces three key innovations: (1) a resource-efficient approach through curating and constructing high-quality supervised fine-tuning (SFT) datasets with minimal sample requirements, with a forward-looking design that extends to both pretraining and posttraining phases; (2) enhanced multimodal reasoning capabilities for cross-modal integration and clinical task understanding; and (3) a systematic evaluation system that assesses model performance across medical modalities and task types. Our experiments demonstrate that Infi-Med achieves state-of-the-art (SOTA) performance in general medical reasoning while maintaining rapid adaptability to clinical scenarios. The framework establishes a solid foundation for deploying MLLMs in real-world healthcare settings by balancing model effectiveness with operational constraints.

Medical Vision-Language Models (MVLMs) have achieved par excellence generalization in medical image analysis, yet their performance under noisy, corrupted conditions remains largely untested. Clinical imaging is inherently susceptible to acquisition artifacts and noise; however, existing evaluations predominantly assess generally clean datasets, overlooking robustness -- i.e., the model's ability to perform under real-world distortions. To address this gap, we first introduce MediMeta-C, a corruption benchmark that systematically applies several perturbations across multiple medical imaging datasets. Combined with MedMNIST-C, this establishes a comprehensive robustness evaluation framework for MVLMs. We further propose RobustMedCLIP, a visual encoder adaptation of a pretrained MVLM that incorporates few-shot tuning to enhance resilience against corruptions. Through extensive experiments, we benchmark 5 major MVLMs across 5 medical imaging modalities, revealing that existing models exhibit severe degradation under corruption and struggle with domain-modality tradeoffs. Our findings highlight the necessity of diverse training and robust adaptation strategies, demonstrating that efficient low-rank adaptation when paired with few-shot tuning, improves robustness while preserving generalization across modalities.

Large vision language models (LVLMs) integrate large language models (LLMs) with pre-trained vision encoders, thereby activating the perception capability of the model to understand image inputs for different queries and conduct subsequent reasoning. Improving this capability requires high-quality vision-language data, which is costly and labor-intensive to acquire. Self-training approaches have been effective in single-modal settings to alleviate the need for labeled data by leveraging model's own generation. However, effective self-training remains a challenge regarding the unique visual perception and reasoning capability of LVLMs. To address this, we introduce Self-Training on Image Comprehension (STIC), which emphasizes a self-training approach specifically for image comprehension. First, the model self-constructs a preference dataset for image descriptions using unlabeled images. Preferred responses are generated through a step-by-step prompt, while dis-preferred responses are generated from either corrupted images or misleading prompts. To further self-improve reasoning on the extracted visual information, we let the model reuse a small portion of existing instruction-tuning data and append its self-generated image descriptions to the prompts. We validate the effectiveness of STIC across seven different benchmarks, demonstrating substantial performance gains of 4.0% on average while using 70% less supervised fine-tuning data than the current method. Further studies investigate various components of STIC and highlight its potential to leverage vast quantities of unlabeled images for self-training. Code and data are made publicly available.

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

Multimodal large language models (MLLMs) have demonstrated impressive performance in vision-language tasks across a broad spectrum of domains. However, the large model scale and associated high computational costs pose significant challenges for training and deploying MLLMs on consumer-grade GPUs or edge devices, thereby hindering their widespread application. In this work, we introduce Mini-InternVL, a series of MLLMs with parameters ranging from 1B to 4B, which achieves 90% of the performance with only 5% of the parameters. This significant improvement in efficiency and effectiveness makes our models more accessible and applicable in various real-world scenarios. To further promote the adoption of our models, we develop a unified adaptation framework for Mini-InternVL, which enables our models to transfer and outperform specialized models in downstream tasks, including autonomous driving, medical images, and remote sensing. We believe that our study can provide valuable insights and resources to advance the development of efficient and effective MLLMs. Code is available at https://github.com/OpenGVLab/InternVL.

Conversation agents powered by large language models are revolutionizing the way we interact with visual data. Recently, large vision-language models (LVLMs) have been extensively studied for both images and videos. However, these studies typically focus on common scenarios. In this work, we introduce an LVLM specifically designed for surgical scenarios. We integrate visual representations of surgical images and videos into the language feature space. Consequently, we establish a LVLM model, Surgical-LLaVA, fine-tuned on instruction following data of surgical scenarios. Our experiments demonstrate that Surgical-LLaVA exhibits impressive multi-modal chat abilities in surgical contexts, occasionally displaying multi-modal behaviors on unseen instructions. We conduct a quantitative evaluation of visual question-answering datasets for surgical scenarios. The results show superior performance compared to previous works, indicating the potential of our model to tackle more complex surgery scenarios.

Large Vision-Language Models (LVLMs) have demonstrated outstanding performance in various general multimodal applications such as image recognition and visual reasoning, and have also shown promising potential in specialized domains. However, the application potential of LVLMs in the insurance domain-characterized by rich application scenarios and abundant multimodal data-has not been effectively explored. There is no systematic review of multimodal tasks in the insurance domain, nor a benchmark specifically designed to evaluate the capabilities of LVLMs in insurance. This gap hinders the development of LVLMs within the insurance domain. In this paper, we systematically review and distill multimodal tasks for four representative types of insurance: auto insurance, property insurance, health insurance, and agricultural insurance. We propose INS-MMBench, the first comprehensive LVLMs benchmark tailored for the insurance domain. INS-MMBench comprises a total of 2.2K thoroughly designed multiple-choice questions, covering 12 meta-tasks and 22 fundamental tasks. Furthermore, we evaluate multiple representative LVLMs, including closed-source models such as GPT-4o and open-source models like BLIP-2. This evaluation not only validates the effectiveness of our benchmark but also provides an in-depth performance analysis of current LVLMs on various multimodal tasks in the insurance domain. We hope that INS-MMBench will facilitate the further application of LVLMs in the insurance domain and inspire interdisciplinary development. Our dataset and evaluation code are available at https://github.com/FDU-INS/INS-MMBench.

Multimodal Large Language Models (MLLMs) have demonstrated remarkable effectiveness in various general-domain scenarios, such as visual question answering and image captioning. Recently, researchers have increasingly focused on empowering MLLMs with medical conversational abilities, which hold significant promise for clinical applications. However, medical data presents unique challenges due to its heterogeneous nature -- encompassing diverse modalities including 2D images, 3D volumetric scans, and temporal video sequences. The substantial domain gap and data format inconsistencies across these modalities have hindered the development of unified medical MLLMs. To address these challenges, we propose Fleming-VL, a unified end-to-end framework for comprehensive medical visual understanding across heterogeneous modalities. Fleming-VL tackles this problem from a data-centric perspective through three key strategies: (1) scaling up pretraining by integrating long-context data from both natural and medical-specific domains; (2) complementing fine-tuning with rare medical data, including holistic video analysis and underrepresented 2D modalities such as ultrasound and dermoscopy images; (3) extending existing evaluation frameworks to incorporate 3D volumetric and video understanding benchmarks. Through supervised fine-tuning (SFT) and group relative policy optimization (GRPO), we develop Fleming-VL in multiple model scales. Extensive experiments demonstrate that Fleming-VL achieves state-of-the-art performance across multiple benchmarks, including medical VQA, video QA, and 3D medical image understanding. We publicly release Fleming-VL to promote transparent, reproducible, and auditable progress in medical AI.

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

Large Vision-Language Models (LVLMs) process multimodal inputs consisting of text tokens and vision tokens extracted from images or videos. Due to the rich visual information, a single image can generate thousands of vision tokens, leading to high computational costs during the prefilling stage and significant memory overhead during decoding. Existing methods attempt to prune redundant vision tokens, revealing substantial redundancy in visual representations. However, these methods often struggle in shallow layers due to the lack of sufficient contextual information. We argue that many visual tokens are inherently redundant even in shallow layers and can be safely and effectively pruned with appropriate contextual signals. In this work, we propose CoViPAL, a layer-wise contextualized visual token pruning method that employs a Plug-and-Play Pruning Module (PPM) to predict and remove redundant vision tokens before they are processed by the LVLM. The PPM is lightweight, model-agnostic, and operates independently of the LVLM architecture, ensuring seamless integration with various models. Extensive experiments on multiple benchmarks demonstrate that CoViPAL outperforms training-free pruning methods under equal token budgets and surpasses training-based methods with comparable supervision. CoViPAL offers a scalable and efficient solution to improve inference efficiency in LVLMs without compromising accuracy.

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

Large Vision-Language Models (LVLMs) have achieved remarkable performance in many vision-language tasks, yet their capabilities in fine-grained visual understanding remain insufficiently evaluated. Existing benchmarks either contain limited fine-grained evaluation samples that are mixed with other data, or are confined to object-level assessments in natural images. To holistically assess LVLMs' fine-grained visual understanding capabilities, we propose using document images with multi-granularity and multi-modal information to supplement natural images. In this light, we construct MMDocBench, a benchmark with various OCR-free document understanding tasks for the evaluation of fine-grained visual perception and reasoning abilities. MMDocBench defines 15 main tasks with 4,338 QA pairs and 11,353 supporting regions, covering various document images such as research papers, receipts, financial reports, Wikipedia tables, charts, and infographics. Based on MMDocBench, we conduct extensive experiments using 13 open-source and 3 proprietary advanced LVLMs, assessing their strengths and weaknesses across different tasks and document image types. The benchmark, task instructions, and evaluation code will be made publicly available.

Large language models (LLMs) have proven their remarkable versatility in handling a comprehensive range of language-centric applications. To expand LLMs' capabilities to a broader spectrum of modal inputs, multimodal large language models (MLLMs) have attracted growing interest. This work delves into enabling LLMs to tackle more vision-language-related tasks, particularly image captioning, visual question answering (VQA,) and visual grounding. To this end, we implemented a three-stage training scheme: starting with lightweight alignment pretraining, then moderate-weight multitask hybrid training, and finally, LLM fine-tuning to improve instruction following capability. Throughout the training process, the requirements on GPU memory gradually increase. To effectively manage the number of visual embeddings passed to the LLM while preserving their positional information, we introduce a straightforward visual adapter module dubbed pool-adapter. Our experiments demonstrate that preserving the positional information of visual embeddings through the pool-adapter is particularly beneficial for tasks like visual grounding. We name our proposed approach InfMLLM and have evaluated it extensively on various benchmark datasets. Our results demonstrate that InfMLLM achieves either state-of-the-art (SOTA) performance or performance comparable to recent MLLMs. The code and model will be made open-source at: https://github.com/mightyzau/InfMLLM.

Current vision-language models (VLMs) in medicine are primarily designed for categorical question answering (e.g., "Is this normal or abnormal?") or qualitative descriptive tasks. However, clinical decision-making often relies on quantitative assessments, such as measuring the size of a tumor or the angle of a joint, from which physicians draw their own diagnostic conclusions. This quantitative reasoning capability remains underexplored and poorly supported in existing VLMs. In this work, we introduce MedVision, a large-scale dataset and benchmark specifically designed to evaluate and improve VLMs on quantitative medical image analysis. MedVision spans 22 public datasets covering diverse anatomies and modalities, with 30.8 million image-annotation pairs. We focus on three representative quantitative tasks: (1) detection of anatomical structures and abnormalities, (2) tumor/lesion (T/L) size estimation, and (3) angle/distance (A/D) measurement. Our benchmarks show that current off-the-shelf VLMs perform poorly on these tasks. However, with supervised fine-tuning on MedVision, we significantly enhance their performance across detection, T/L estimation, and A/D measurement, demonstrating reduced error rates and improved precision. This work provides a foundation for developing VLMs with robust quantitative reasoning capabilities in medical imaging. Code and data are available at https://medvision-vlm.github.io.

The application of Large Vision-Language Models (LVLMs) for analyzing images and videos is an exciting and rapidly evolving field. In recent years, we've seen significant growth in high-quality image-text datasets for fine-tuning image understanding, but there is still a lack of comparable datasets for videos. Additionally, many VideoLLMs are extensions of single-image VLMs, which may not efficiently handle the complexities of longer videos. In this study, we introduce a large-scale synthetic dataset created from proprietary models, using carefully designed prompts to tackle a wide range of questions. We also explore a dynamic visual token compression architecture that strikes a balance between computational efficiency and performance. Our proposed achieves state-of-the-art results across various video tasks and shows impressive generalization, setting new baselines in multi-image understanding. Notably, delivers an absolute improvement of 2.7\% over LLaVA-OneVision on VideoMME and 10.7\% on MuirBench. Codes are available at https://github.com/Hon-Wong/ByteVideoLLM

The success of large language models (LLMs) has fostered a new research trend of multi-modality large language models (MLLMs), which changes the paradigm of various fields in computer vision. Though MLLMs have shown promising results in numerous high-level vision and vision-language tasks such as VQA and text-to-image, no works have demonstrated how low-level vision tasks can benefit from MLLMs. We find that most current MLLMs are blind to low-level features due to their design of vision modules, thus are inherently incapable for solving low-level vision tasks. In this work, we purpose LM4LV, a framework that enables a FROZEN LLM to solve a range of low-level vision tasks without any multi-modal data or prior. This showcases the LLM's strong potential in low-level vision and bridges the gap between MLLMs and low-level vision tasks. We hope this work can inspire new perspectives on LLMs and deeper understanding of their mechanisms.

The Large Vision-Language Model (LVLM) has enhanced the performance of various downstream tasks in visual-language understanding. Most existing approaches encode images and videos into separate feature spaces, which are then fed as inputs to large language models. However, due to the lack of unified tokenization for images and videos, namely misalignment before projection, it becomes challenging for a Large Language Model (LLM) to learn multi-modal interactions from several poor projection layers. In this work, we unify visual representation into the language feature space to advance the foundational LLM towards a unified LVLM. As a result, we establish a simple but robust LVLM baseline, Video-LLaVA, which learns from a mixed dataset of images and videos, mutually enhancing each other. Video-LLaVA achieves superior performances on a broad range of 9 image benchmarks across 5 image question-answering datasets and 4 image benchmark toolkits. Additionally, our Video-LLaVA also outperforms Video-ChatGPT by 5.8%, 9.9%, 18.6%, and 10.1% on MSRVTT, MSVD, TGIF, and ActivityNet, respectively. Notably, extensive experiments demonstrate that Video-LLaVA mutually benefits images and videos within a unified visual representation, outperforming models designed specifically for images or videos.

Visual-language models (VLM) have emerged as a powerful tool for learning a unified embedding space for vision and language. Inspired by large language models, which have demonstrated strong reasoning and multi-task capabilities, visual large language models (VLLMs) are gaining increasing attention for building general-purpose VLMs. Despite the significant progress made in VLLMs, the related literature remains limited, particularly from a comprehensive application perspective, encompassing generalized and specialized applications across vision (image, video, depth), action, and language modalities. In this survey, we focus on the diverse applications of VLLMs, examining their using scenarios, identifying ethics consideration and challenges, and discussing future directions for their development. By synthesizing these contents, we aim to provide a comprehensive guide that will pave the way for future innovations and broader applications of VLLMs. The paper list repository is available: https://github.com/JackYFL/awesome-VLLMs.

Multimodal Large Language Models (MLLMs) have demonstrated profound capabilities in understanding multimodal information, covering from Image LLMs to the more complex Video LLMs. Numerous studies have illustrated their exceptional cross-modal comprehension. Recently, integrating video foundation models with large language models to build a comprehensive video understanding system has been proposed to overcome the limitations of specific pre-defined vision tasks. However, the current advancements in Video LLMs tend to overlook the foundational contributions of Image LLMs, often opting for more complicated structures and a wide variety of multimodal data for pre-training. This approach significantly increases the costs associated with these methods.In response to these challenges, this work introduces an efficient method that strategically leverages the priors of Image LLMs, facilitating a resource-efficient transition from Image to Video LLMs. We propose RED-VILLM, a Resource-Efficient Development pipeline for Video LLMs from Image LLMs, which utilizes a temporal adaptation plug-and-play structure within the image fusion module of Image LLMs. This adaptation extends their understanding capabilities to include temporal information, enabling the development of Video LLMs that not only surpass baseline performances but also do so with minimal instructional data and training resources. Our approach highlights the potential for a more cost-effective and scalable advancement in multimodal models, effectively building upon the foundational work of Image LLMs.

Large vision-language models (LVLMs) have recently achieved rapid progress, sparking numerous studies to evaluate their multi-modal capabilities. However, we dig into current evaluation works and identify two primary issues: 1) Visual content is unnecessary for many samples. The answers can be directly inferred from the questions and options, or the world knowledge embedded in LLMs. This phenomenon is prevalent across current benchmarks. For instance, GeminiPro achieves 42.9% on the MMMU benchmark without any visual input, and outperforms the random choice baseline across six benchmarks over 20% on average. 2) Unintentional data leakage exists in LLM and LVLM training. LLM and LVLM could still answer some visual-necessary questions without visual content, indicating the memorizing of these samples within large-scale training data. For example, Sphinx-X-MoE gets 43.6% on MMMU without accessing images, surpassing its LLM backbone with 17.9%. Both problems lead to misjudgments of actual multi-modal gains and potentially misguide the study of LVLM. To this end, we present MMStar, an elite vision-indispensable multi-modal benchmark comprising 1,500 samples meticulously selected by humans. MMStar benchmarks 6 core capabilities and 18 detailed axes, aiming to evaluate LVLMs' multi-modal capacities with carefully balanced and purified samples. These samples are first roughly selected from current benchmarks with an automated pipeline, human review is then involved to ensure each curated sample exhibits visual dependency, minimal data leakage, and requires advanced multi-modal capabilities. Moreover, two metrics are developed to measure data leakage and actual performance gain in multi-modal training. We evaluate 16 leading LVLMs on MMStar to assess their multi-modal capabilities, and on 7 benchmarks with the proposed metrics to investigate their data leakage and actual multi-modal gain.

With the bloom of Large Language Models (LLMs), Multimodal Large Language Models (MLLMs) that incorporate LLMs with pre-trained vision models have recently demonstrated impressive performance across diverse vision-language tasks. However, they fall short to comprehend context involving multiple images. A primary reason for this shortcoming is that the visual features for each images are encoded individually by frozen encoders before feeding into the LLM backbone, lacking awareness of other images and the multimodal instructions. We term this issue as prior-LLM modality isolation and propose a two phase paradigm, browse-and-concentrate, to enable in-depth multimodal context fusion prior to feeding the features into LLMs. This paradigm initially "browses" through the inputs for essential insights, and then revisits the inputs to "concentrate" on crucial details, guided by these insights, to achieve a more comprehensive understanding of the multimodal inputs. Additionally, we develop training strategies specifically to enhance the understanding of multi-image inputs. Our method markedly boosts the performance on 7 multi-image scenarios, contributing to increments on average accuracy by 2.13% and 7.60% against strong MLLMs baselines with 3B and 11B LLMs, respectively.

Recent advancements in Multimodal Large Language Models (MLLMs) have revolutionized the field of vision-language understanding by integrating visual perception capabilities into Large Language Models (LLMs). The prevailing trend in this field involves the utilization of a vision encoder derived from vision-language contrastive learning (CL), showing expertise in capturing overall representations while facing difficulties in capturing detailed local patterns. In this work, we focus on enhancing the visual representations for MLLMs by combining high-frequency and detailed visual representations, obtained through masked image modeling (MIM), with semantically-enriched low-frequency representations captured by CL. To achieve this goal, we introduce X-Former which is a lightweight transformer module designed to exploit the complementary strengths of CL and MIM through an innovative interaction mechanism. Specifically, X-Former first bootstraps vision-language representation learning and multimodal-to-multimodal generative learning from two frozen vision encoders, i.e., CLIP-ViT (CL-based) and MAE-ViT (MIM-based). It further bootstraps vision-to-language generative learning from a frozen LLM to ensure visual features from X-Former can be interpreted by the LLM. To demonstrate the effectiveness of our approach, we assess its performance on tasks demanding detailed visual understanding. Extensive evaluations indicate that X-Former excels in visual reasoning tasks involving both structural and semantic categories in the GQA dataset. Assessment on fine-grained visual perception benchmark further confirms its superior capabilities in visual understanding.

Multimodal large language models (MLLMs) have shown remarkable potential in various domains, yet their application in the medical field is hindered by several challenges. General-purpose MLLMs often lack the specialized knowledge required for medical tasks, leading to uncertain or hallucinatory responses. Knowledge distillation from advanced models struggles to capture domain-specific expertise in radiology and pharmacology. Additionally, the computational cost of continual pretraining with large-scale medical data poses significant efficiency challenges. To address these issues, we propose InfiMed-Foundation-1.7B and InfiMed-Foundation-4B, two medical-specific MLLMs designed to deliver state-of-the-art performance in medical applications. We combined high-quality general-purpose and medical multimodal data and proposed a novel five-dimensional quality assessment framework to curate high-quality multimodal medical datasets. We employ low-to-high image resolution and multimodal sequence packing to enhance training efficiency, enabling the integration of extensive medical data. Furthermore, a three-stage supervised fine-tuning process ensures effective knowledge extraction for complex medical tasks. Evaluated on the MedEvalKit framework, InfiMed-Foundation-1.7B outperforms Qwen2.5VL-3B, while InfiMed-Foundation-4B surpasses HuatuoGPT-V-7B and MedGemma-27B-IT, demonstrating superior performance in medical visual question answering and diagnostic tasks. By addressing key challenges in data quality, training efficiency, and domain-specific knowledge extraction, our work paves the way for more reliable and effective AI-driven solutions in healthcare. InfiMed-Foundation-4B model is available at https://huggingface.co/InfiX-ai/InfiMed-Foundation-4B{InfiMed-Foundation-4B}.

The development of vision-language models (VLMs) is driven by large-scale and diverse multimodal datasets. However, progress toward generalist biomedical VLMs is limited by the lack of annotated, publicly accessible datasets across biology and medicine. Existing efforts are restricted to narrow domains, missing the full diversity of biomedical knowledge encoded in scientific literature. To address this gap, we introduce BIOMEDICA, a scalable, open-source framework to extract, annotate, and serialize the entirety of the PubMed Central Open Access subset into an easy-to-use, publicly accessible dataset.Our framework produces a comprehensive archive with over 24 million unique image-text pairs from over 6 million articles. Metadata and expert-guided annotations are also provided. We demonstrate the utility and accessibility of our resource by releasing BMCA-CLIP, a suite of CLIP-style models continuously pre-trained on the BIOMEDICA dataset via streaming, eliminating the need to download 27 TB of data locally.On average, our models achieve state-of-the-art performance across 40 tasks - spanning pathology, radiology, ophthalmology, dermatology, surgery, molecular biology, parasitology, and cell biology - excelling in zero-shot classification with a 6.56% average improvement (as high as 29.8% and 17.5% in dermatology and ophthalmology, respectively), and stronger image-text retrieval, all while using 10x less compute. To foster reproducibility and collaboration, we release our codebase and dataset for the broader research community.

Vision-Language Models (VLM) can support clinicians by analyzing medical images and engaging in natural language interactions to assist in diagnostic and treatment tasks. However, VLMs often exhibit "hallucinogenic" behavior, generating textual outputs not grounded in contextual multimodal information. This challenge is particularly pronounced in the medical domain, where we do not only require VLM outputs to be accurate in single interactions but also to be consistent with clinical reasoning and diagnostic pathways throughout multi-turn conversations. For this purpose, we propose a new alignment algorithm that uses symbolic representations of clinical reasoning to ground VLMs in medical knowledge. These representations are utilized to (i) generate GPT-4-guided visual instruction tuning data at scale, simulating clinician-VLM conversations with demonstrations of clinical reasoning, and (ii) create an automatic reward function that evaluates the clinical validity of VLM generations throughout clinician-VLM interactions. Our algorithm eliminates the need for human involvement in training data generation or reward model construction, reducing costs compared to standard reinforcement learning with human feedback (RLHF). We apply our alignment algorithm to develop Dr-LLaVA, a conversational VLM finetuned for analyzing bone marrow pathology slides, demonstrating strong performance in multi-turn medical conversations.

Recent advances in microscopy have enabled the rapid generation of terabytes of image data in cell biology and biomedical research. Vision-language models (VLMs) offer a promising solution for large-scale biological image analysis, enhancing researchers' efficiency, identifying new image biomarkers, and accelerating hypothesis generation and scientific discovery. However, there is a lack of standardized, diverse, and large-scale vision-language benchmarks to evaluate VLMs' perception and cognition capabilities in biological image understanding. To address this gap, we introduce {\mu}-Bench, an expert-curated benchmark encompassing 22 biomedical tasks across various scientific disciplines (biology, pathology), microscopy modalities (electron, fluorescence, light), scales (subcellular, cellular, tissue), and organisms in both normal and abnormal states. We evaluate state-of-the-art biomedical, pathology, and general VLMs on {\mu}-Bench and find that: i) current models struggle on all categories, even for basic tasks such as distinguishing microscopy modalities; ii) current specialist models fine-tuned on biomedical data often perform worse than generalist models; iii) fine-tuning in specific microscopy domains can cause catastrophic forgetting, eroding prior biomedical knowledge encoded in their base model. iv) weight interpolation between fine-tuned and pre-trained models offers one solution to forgetting and improves general performance across biomedical tasks. We release {\mu}-Bench under a permissive license to accelerate the research and development of microscopy foundation models.

Large Vision-Language Models (LVLMs) have achieved significant progress in combining visual comprehension with language generation. Despite this success, the training data of LVLMs still suffers from Long-Tail (LT) problems, where the data distribution is highly imbalanced. Previous works have mainly focused on traditional VLM architectures, i.e., CLIP or ViT, and specific tasks such as recognition and classification. Nevertheless, the exploration of LVLM (e.g. LLaVA) and more general tasks (e.g. Visual Question Answering and Visual Reasoning) remains under-explored. In this paper, we first conduct an in-depth analysis of the LT issues in LVLMs and identify two core causes: the overrepresentation of head concepts and the underrepresentation of tail concepts. Based on the above observation, we propose an Adaptive Data Refinement Framework (ADR), which consists of two stages: Data Rebalancing (DR) and Data Synthesis (DS). In the DR stage, we adaptively rebalance the redundant data based on entity distributions, while in the DS stage, we leverage Denoising Diffusion Probabilistic Models (DDPMs) and scarce images to supplement underrepresented portions. Through comprehensive evaluations across eleven benchmarks, our proposed ADR effectively mitigates the long-tail problem in the training data, improving the average performance of LLaVA 1.5 relatively by 4.36%, without increasing the training data volume.

While Large Language Models (LLMs) excel in world knowledge understanding, adapting them to specific subfields requires precise adjustments. Due to the model's vast scale, traditional global fine-tuning methods for large models can be computationally expensive and impact generalization. To address this challenge, a range of innovative Parameters-Efficient Fine-Tuning (PEFT) methods have emerged and achieved remarkable success in both LLMs and Large Vision-Language Models (LVLMs). In the medical domain, fine-tuning a medical Vision-Language Pretrained (VLP) model is essential for adapting it to specific tasks. Can the fine-tuning methods for large models be transferred to the medical field to enhance transfer learning efficiency? In this paper, we delve into the fine-tuning methods of LLMs and conduct extensive experiments to investigate the impact of fine-tuning methods for large models on the existing multimodal model in the medical domain from the training data level and the model structure level. We show the different impacts of fine-tuning methods for large models on medical VLMs and develop the most efficient ways to fine-tune medical VLP models. We hope this research can guide medical domain researchers in optimizing VLMs' training costs, fostering the broader application of VLMs in healthcare fields. The code and dataset have been released at https://github.com/TIMMY-CHAN/MILE.

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

Recent advancements in Large Vision-Language Models (LVLMs) have enabled processing of multimodal inputs in language models but require significant computational resources for deployment, especially in edge devices. This study aims to bridge the performance gap between traditional-scale LVLMs and resource-friendly lite versions by adopting high-quality training data. To do this, a synthetic dataset is created by leveraging GPT-4V's ability to generate detailed captions, complex reasoning instructions and detailed answers from images. The resulted model trained with our data, ALLaVA, achieves competitive performance on 12 benchmarks up to 3B LVLMs. This work highlights the feasibility of adopting high-quality data in crafting more efficient LVLMs. Our online demo is available at https://allava.freedomai.cn.

The Large Vision-Language Model (LVLM) integrates computer vision and natural language processing techniques, offering substantial application potential. However, these models demand extensive resources during inference. Adaptive attention techniques can dynamically reduce computational redundancy and thus improve efficiency. Although current adaptive attention methods significantly reduce the memory requirements of Transformer-based language models, they are not tailored for LVLMs. We observe that LVLMs generate responses from both remote image tokens and local text tokens, and different modalities have different attention patterns. This observation inspires us to manage the attention for each modality separately. Specifically, for visual input, we store the cache of potentially useful information but only compute the most critical parts. For language input, we care more about local information. Based on our observation and analysis of vision-language attention patterns, we develop A-VL, a plug-and-play adaptive attention tailored for LVLM inference. Extensive evaluations on three vision-language tasks and five datasets show the effectiveness of our designs. Our approach A-VL outperforms existing adaptive attention methods in reducing memory usage and computational load without compromising performance.

Multimodal large language models (MLLMs) hold significant potential in the medical field, but their capabilities are often limited by insufficient data in certain medical domains, highlighting the need for understanding what kinds of images can be used by MLLMs for generalization. Current research suggests that multi-task training outperforms single-task as different tasks can benefit each other, but they often overlook the internal relationships within these tasks, providing limited guidance on selecting datasets to enhance specific tasks. To analyze this phenomenon, we attempted to employ compositional generalization (CG)-the ability of models to understand novel combinations by recombining learned elements-as a guiding framework. Since medical images can be precisely defined by Modality, Anatomical area, and Task, naturally providing an environment for exploring CG. Therefore, we assembled 106 medical datasets to create Med-MAT for comprehensive experiments. The experiments confirmed that MLLMs can use CG to understand unseen medical images and identified CG as one of the main drivers of the generalization observed in multi-task training. Additionally, further studies demonstrated that CG effectively supports datasets with limited data and delivers consistent performance across different backbones, highlighting its versatility and broad applicability. Med-MAT is publicly available at https://github.com/FreedomIntelligence/Med-MAT.

Large Language Models (LLMs) and Vision-Language Large Models (LVLMs) have achieved remarkable progress in natural language processing and multimodal understanding. Despite their impressive generalization capabilities, current LVLMs often exhibit insufficient robustness, proneness to hallucination, and reasoning errors in complex real-world scenarios, particularly when precise image region localization and fine-grained visual reasoning are required. To address these limitations, we propose the Hierarchical Contextual Grounding LVLM (HCG-LVLM), a novel architecture that mimics human coarse-to-fine cognitive processing. HCG-LVLM employs a two-layered approach: a Global Contextual Perception layer for initial broad understanding and a Fine-grained Local Grounding layer. The latter incorporates a Local Detail Enhancement Module to extract high-resolution features and a Semantic Consistency Validator to ensure accurate, hallucination-free visual-language alignment. Through an adaptive fusion mechanism, information from both layers is integrated for robust and precise outputs. Extensive experiments on challenging datasets, including GQA, A-OKVQA for fine-grained VQA, and RefCOCO/+/g for Referring Expression Comprehension, demonstrate that HCG-LVLM consistently outperforms state-of-the-art models such as Flamingo, BLIP-2, and MiniGPT-4. Our model achieves superior accuracy and significantly reduces hallucination, validating the effectiveness of its hierarchical design in enhancing fine-grained visual-language understanding and precise grounding capabilities.

Recent advancements in vision-language models (VLMs) have leveraged large language models (LLMs) to achieve performance on par with closed-source systems like GPT-4V. However, deploying these models in real-world scenarios, particularly on resource-constrained devices, remains challenging due to their substantial computational demands. This has spurred interest in distilling knowledge from large VLMs into smaller, more efficient counterparts. A key challenge arises here from the diversity of VLM architectures, which are built on different LLMs and employ varying token types-differing in vocabulary size, token splits, and token index ordering. To address this challenge of limitation to a specific VLM type, we present Generation after Recalibration (GenRecal), a novel, general-purpose distillation framework for VLMs. GenRecal incorporates a Recalibrator that aligns and adapts feature representations between heterogeneous VLMs, enabling effective knowledge transfer across different types of VLMs. Through extensive experiments on multiple challenging benchmarks, we demonstrate that GenRecal significantly improves baseline performances, eventually outperforming large-scale open- and closed-source VLMs.

Vision-language models (VLMs) integrate visual and textual information, enabling a wide range of applications such as image captioning and visual question answering, making them crucial for modern AI systems. However, their high computational demands pose challenges for real-time applications. This has led to a growing focus on developing efficient vision language models. In this survey, we review key techniques for optimizing VLMs on edge and resource-constrained devices. We also explore compact VLM architectures, frameworks and provide detailed insights into the performance-memory trade-offs of efficient VLMs. Furthermore, we establish a GitHub repository at https://github.com/MPSCUMBC/Efficient-Vision-Language-Models-A-Survey to compile all surveyed papers, which we will actively update. Our objective is to foster deeper research in this area.

Large Vision-Language Models (LVLMs) have demonstrated remarkable performance across multi-modal tasks by scaling model size and training data. However, these dense LVLMs incur significant computational costs and motivate the exploration of sparse Mixture of Experts (MoE) architectures. While MoE improve parameter efficiency, effectively applying MoE to simultaneously model modality-specific features and cross-modal associations in LVLMs remains challenging. In this work, we propose to incorporate Mixture of Intra- and Inter-Modality Experts (MoIIE) to LVLMs. For each token, expert routing is guided by its modality, directing tokens to their respective intra-modality experts as well as a shared pool of inter-modality experts, enabling the model to jointly learn rich intra-modal features and cross-modal interactions. We further introduce an effective and straightforward two-stage training strategy, which facilitates the direct activation of both MoE and multi-modal capabilities. Extensive experiments across different data scales and LLM backbone demonstrate the effectiveness, efficiency and generality of our approach. Notably, our MoIIE models with 5.5B and 11.3B activated parameters match or even surpass the performance of existing advanced open-source MoE-LLMs based multi-modal models that involve more activated parameters. The code is available at https://github.com/AlenjandroWang/MoIIE.

Multimodal Large Language Models (MLLMs) have shown promise in a broad range of vision-language tasks with their strong reasoning and generalization capabilities. However, they heavily depend on high-quality data in the Supervised Fine-Tuning (SFT) phase. The existing approaches aim to curate high-quality data via GPT-4V, but they are not scalable due to the commercial nature of GPT-4V and the simplicity of the prompts used to instruct the model. To this end, we devised the FullAnno system, which is a data engine that can generate large-scale, high-quality, and fine-grained image annotations consisting of the category and position of objects, region descriptions, text information, as well as image dense captions. This engine is characterized by its cascade annotation process, which involves multiple expert models and employs rich prompts to instruct LLMs in generating dense image captions. We re-annotated the COCO and Visual Genome datasets using our FullAnno system, tripling the number of object annotations and increasing the length of the original image captions by a factor of 15. Experiments show that the regenerated annotation can significantly enhance the capabilities of LLaVA-v1.5 on several benchmarks. The re-annotated data are available at: https://arcana-project-page.github.io

Large Vision-Language Models (LVLMs) have shown promising performance in vision-language understanding and reasoning tasks. However, their visual understanding behaviors remain underexplored. A fundamental question arises: to what extent do LVLMs rely on visual input, and which image regions contribute to their responses? It is non-trivial to interpret the free-form generation of LVLMs due to their complicated visual architecture (e.g., multiple encoders and multi-resolution) and variable-length outputs. In this paper, we extend existing heatmap visualization methods (e.g., iGOS++) to support LVLMs for open-ended visual question answering. We propose a method to select visually relevant tokens that reflect the relevance between generated answers and input image. Furthermore, we conduct a comprehensive analysis of state-of-the-art LVLMs on benchmarks designed to require visual information to answer. Our findings offer several insights into LVLM behavior, including the relationship between focus region and answer correctness, differences in visual attention across architectures, and the impact of LLM scale on visual understanding. The code and data are available at https://github.com/bytedance/LVLM_Interpretation.

Existing Multimodal Large Language Models (MLLMs) follow the paradigm that perceives visual information by aligning visual features with the input space of Large Language Models (LLMs), and concatenating visual tokens with text tokens to form a unified sequence input for LLMs. These methods demonstrate promising results on various vision-language tasks but are limited by the high computational effort due to the extended input sequence resulting from the involvement of visual tokens. In this paper, instead of input space alignment, we propose a novel parameter space alignment paradigm that represents visual information as model weights. For each input image, we use a vision encoder to extract visual features, convert features into perceptual weights, and merge the perceptual weights with LLM's weights. In this way, the input of LLM does not require visual tokens, which reduces the length of the input sequence and greatly improves efficiency. Following this paradigm, we propose VLoRA with the perceptual weights generator. The perceptual weights generator is designed to convert visual features to perceptual weights with low-rank property, exhibiting a form similar to LoRA. The experimental results show that our VLoRA achieves comparable performance on various benchmarks for MLLMs, while significantly reducing the computational costs for both training and inference. The code and models will be made open-source.

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

Multimodal Large Language Models (MLLMs) have recently demonstrated remarkable perceptual and reasoning abilities, typically comprising a Vision Encoder, an Adapter, and a Large Language Model (LLM). The adapter serves as the critical bridge between the visual and language components. However, training adapters with image-level supervision often results in significant misalignment, undermining the LLMs' capabilities and limiting the potential of Multimodal LLMs. To address this, we introduce Supervised Embedding Alignment (SEA), a token-level alignment method that leverages vision-language pre-trained models, such as CLIP, to align visual tokens with the LLM's embedding space through contrastive learning. This approach ensures a more coherent integration of visual and language representations, enhancing the performance and interpretability of multimodal LLMs while preserving their inherent capabilities. Extensive experiments show that SEA effectively improves MLLMs, particularly for smaller models, without adding extra data or inference computation. SEA also lays the groundwork for developing more general and adaptable solutions to enhance multimodal systems.

Multimodal/vision language models (VLMs) are increasingly being deployed in healthcare settings worldwide, necessitating robust benchmarks to ensure their safety, efficacy, and fairness. Multiple-choice question and answer (QA) datasets derived from national medical examinations have long served as valuable evaluation tools, but existing datasets are largely text-only and available in a limited subset of languages and countries. To address these challenges, we present WorldMedQA-V, an updated multilingual, multimodal benchmarking dataset designed to evaluate VLMs in healthcare. WorldMedQA-V includes 568 labeled multiple-choice QAs paired with 568 medical images from four countries (Brazil, Israel, Japan, and Spain), covering original languages and validated English translations by native clinicians, respectively. Baseline performance for common open- and closed-source models are provided in the local language and English translations, and with and without images provided to the model. The WorldMedQA-V benchmark aims to better match AI systems to the diverse healthcare environments in which they are deployed, fostering more equitable, effective, and representative applications.

Large Vision-Language Models (LVLMs) are gaining traction for their remarkable ability to process and integrate visual and textual data. Despite their popularity, the capacity of LVLMs to generate precise, fine-grained textual descriptions has not been fully explored. This study addresses this gap by focusing on distinctiveness and fidelity, assessing how models like Open-Flamingo, IDEFICS, and MiniGPT-4 can distinguish between similar objects and accurately describe visual features. We proposed the Textual Retrieval-Augmented Classification (TRAC) framework, which, by leveraging its generative capabilities, allows us to delve deeper into analyzing fine-grained visual description generation. This research provides valuable insights into the generation quality of LVLMs, enhancing the understanding of multimodal language models. Notably, MiniGPT-4 stands out for its better ability to generate fine-grained descriptions, outperforming the other two models in this aspect. The code is provided at https://anonymous.4open.science/r/Explore_FGVDs-E277.

Recent Multimodal Large Language Models (MLLMs) have demonstrated significant progress in perceiving and reasoning over multimodal inquiries, ushering in a new research era for foundation models. However, vision-language misalignment in MLLMs has emerged as a critical challenge, where the textual responses generated by these models are not factually aligned with the given text-image inputs. Existing efforts to address vision-language misalignment have focused on developing specialized vision-language connectors or leveraging visual instruction tuning from diverse domains. In this paper, we tackle this issue from a fundamental yet unexplored perspective by revisiting the core architecture of MLLMs. Most MLLMs are typically built on decoder-only LLMs consisting of a causal attention mechanism, which limits the ability of earlier modalities (e.g., images) to incorporate information from later modalities (e.g., text). To address this problem, we propose AKI, a novel MLLM that unlocks causal attention into modality-mutual attention (MMA) to enable image tokens to attend to text tokens. This simple yet effective design allows AKI to achieve superior performance in 12 multimodal understanding benchmarks (+7.2% on average) without introducing additional parameters and increasing training time. Our MMA design is intended to be generic, allowing for application across various modalities, and scalable to accommodate diverse multimodal scenarios. The code is publicly available at https://github.com/sony/aki, and we will release our AKI-4B model to encourage further advancements in MLLMs across various directions.

Clinicians spend a significant amount of time reviewing medical images and transcribing their findings regarding patient diagnosis, referral and treatment in text form. Vision-language models (VLMs), which automatically interpret images and summarize their findings as text, have enormous potential to alleviate clinical workloads and increase patient access to high-quality medical care. While foundational models have stirred considerable interest in the medical community, it is unclear whether their general capabilities translate to real-world clinical utility. In this work, we show that foundation VLMs markedly underperform compared to practicing ophthalmologists on specialist tasks crucial to the care of patients with age-related macular degeneration (AMD). To address this, we initially identified the essential capabilities required for image-based clinical decision-making, and then developed a curriculum to selectively train VLMs in these skills. The resulting model, RetinaVLM, can be instructed to write reports that significantly outperform those written by leading foundation medical VLMs in disease staging (F1 score of 0.63 vs. 0.11) and patient referral (0.67 vs. 0.39), and approaches the diagnostic performance of junior ophthalmologists (who achieve 0.77 and 0.78 on the respective tasks). Furthermore, in a reader study involving two senior ophthalmologists with up to 32 years of experience, RetinaVLM's reports were found to be similarly correct (78.6% vs. 82.1%) and complete (both 78.6%) as reports written by junior ophthalmologists with up to 10 years of experience. These results demonstrate that our curriculum-based approach provides a blueprint for specializing generalist foundation medical VLMs to handle real-world clinical tasks.

Large Vision-Language Models (LVLMs) have demonstrated remarkable capabilities across multimodal tasks such as visual perception and reasoning, leading to good performance on various multimodal evaluation benchmarks. However, these benchmarks keep a static nature and overlap with the pre-training data, resulting in fixed complexity constraints and data contamination issues. This raises the concern regarding the validity of the evaluation. To address these two challenges, we introduce a dynamic multimodal evaluation protocol called Vision-Language Bootstrapping (VLB). VLB provides a robust and comprehensive assessment for LVLMs with reduced data contamination and flexible complexity. To this end, VLB dynamically generates new visual question-answering samples through a multimodal bootstrapping module that modifies both images and language, while ensuring that newly generated samples remain consistent with the original ones by a judge module. By composing various bootstrapping strategies, VLB offers dynamic variants of existing benchmarks with diverse complexities, enabling the evaluation to co-evolve with the ever-evolving capabilities of LVLMs. Extensive experimental results across multiple benchmarks, including SEEDBench, MMBench, and MME, show that VLB significantly reduces data contamination and exposes performance limitations of LVLMs.

The architecture of multimodal large language models (MLLMs) commonly connects a vision encoder, often based on CLIP-ViT, to a large language model. While CLIP-ViT works well for capturing global image features, it struggles to model local relationships between adjacent patches, leading to weaker visual representation, which in turn affects the detailed understanding ability of MLLMs. To solve this, we propose LLaVA-SP, which only adds six spatial visual tokens to the original visual tokens to enhance the visual representation. Our approach offers three key advantages: 1)We propose a novel Projector, which uses convolutional kernels to derive visual spatial tokens from ViT patch features, simulating two visual spatial ordering approaches: ``from central region to global" and ``from abstract to specific". Then, a cross-attention mechanism is applied to fuse fine-grained visual information, enriching the overall visual representation. 2) We present two model variants: LLaVA-SP-Cropping, which focuses on detail features through progressive cropping, and LLaVA-SP-Pooling, which captures global semantics through adaptive pooling, enabling the model to handle diverse visual understanding tasks. 3) Extensive experiments show that LLaVA-SP, fine-tuned with LoRA, achieves significant performance improvements across various multimodal benchmarks, outperforming the state-of-the-art LLaVA-1.5 model in multiple tasks with nearly identical inference latency. The code and models are available at https://github.com/CnFaker/LLaVA-SP.

Accurate segmentation of regions of interest in biomedical images holds substantial value in image analysis. Although several foundation models for biomedical segmentation have currently achieved excellent performance on certain datasets, they typically demonstrate sub-optimal performance on unseen domain data. We owe the deficiency to lack of vision-language knowledge before segmentation. Multimodal Large Language Models (MLLMs) bring outstanding understanding and reasoning capabilities to multimodal tasks, which inspires us to leverage MLLMs to inject Vision-Language Knowledge (VLK), thereby enabling vision models to demonstrate superior generalization capabilities on cross-domain datasets. In this paper, we propose using MLLMs to guide SAM in learning microscopy crose-domain data, unifying Segment Anything in Microscopy, named uLLSAM. Specifically, we propose the Vision-Language Semantic Alignment (VLSA) module, which injects VLK into Segment Anything Model (SAM). We find that after SAM receives global VLK prompts, its performance improves significantly, but there are deficiencies in boundary contour perception. Therefore, we further propose Semantic Boundary Regularization (SBR) to prompt SAM. Our method achieves performance improvements of 7.71% in Dice and 12.10% in SA across 9 in-domain microscopy datasets, achieving state-of-the-art performance. Our method also demonstrates improvements of 6.79% in Dice and 10.08% in SA across 10 out-ofdomain datasets, exhibiting strong generalization capabilities. Code is available at https://github.com/ieellee/uLLSAM.

Multimodal large language models (MLLMs) integrate image features from visual encoders with LLMs, demonstrating advanced comprehension capabilities. However, mainstream MLLMs are solely supervised by the next-token prediction of textual tokens, neglecting critical vision-centric information essential for analytical abilities. To track this dilemma, we introduce VaCo, which optimizes MLLM representations through Vision-Centric activation and Coordination from multiple vision foundation models (VFMs). VaCo introduces visual discriminative alignment to integrate task-aware perceptual features extracted from VFMs, thereby unifying the optimization of both textual and visual outputs in MLLMs. Specifically, we incorporate the learnable Modular Task Queries (MTQs) and Visual Alignment Layers (VALs) into MLLMs, activating specific visual signals under the supervision of diverse VFMs. To coordinate representation conflicts across VFMs, the crafted Token Gateway Mask (TGM) restricts the information flow among multiple groups of MTQs. Extensive experiments demonstrate that VaCo significantly improves the performance of different MLLMs on various benchmarks, showcasing its superior capabilities in visual comprehension.

Large Vision-Language Models (LVLMs) have recently played a dominant role in multimodal vision-language learning. Despite the great success, it lacks a holistic evaluation of their efficacy. This paper presents a comprehensive evaluation of publicly available large multimodal models by building a LVLM evaluation Hub (LVLM-eHub). Our LVLM-eHub consists of 8 representative LVLMs such as InstructBLIP and MiniGPT-4, which are thoroughly evaluated by a quantitative capability evaluation and an online arena platform. The former evaluates 6 categories of multimodal capabilities of LVLMs such as visual question answering and embodied artificial intelligence on 47 standard text-related visual benchmarks, while the latter provides the user-level evaluation of LVLMs in an open-world question-answering scenario. The study reveals several innovative findings. First, instruction-tuned LVLM with massive in-domain data such as InstructBLIP heavily overfits many existing tasks, generalizing poorly in the open-world scenario. Second, instruction-tuned LVLM with moderate instruction-following data may result in object hallucination issues (i.e., generate objects that are inconsistent with target images in the descriptions). It either makes the current evaluation metric such as CIDEr for image captioning ineffective or generates wrong answers. Third, employing a multi-turn reasoning evaluation framework can mitigate the issue of object hallucination, shedding light on developing an effective pipeline for LVLM evaluation. The findings provide a foundational framework for the conception and assessment of innovative strategies aimed at enhancing zero-shot multimodal techniques. Our LVLM-eHub will be available at https://github.com/OpenGVLab/Multi-Modality-Arena

Real-world clinical decision-making grapples with integrating information from diverse data modalities, including medical text, 2D/3D images, and video, leading to inefficiencies and potential diagnostic oversights. While generalist vision-language models (VLMs) offer promise, their medical development faces challenges of opaque pipelines, data scarcity, and architectural inflexibility. Here we present Hulu-Med, a transparent medical VLM that unifies understanding across all these modalities. Built upon a unified patch-based vision encoder and an LLM decoder, Hulu-Med was progressively trained on 16.7 million (M) samples to scale from 2D to 3D and video comprehension. The medical-aware token reduction enables efficient training, requiring only 4,000 to 40,000 GPU hours for 7B to 32B parameter variants. Extensive evaluation across 30 benchmarks exhibits state-of-the-art performance, surpassing leading open-source models and competing with proprietary systems in tasks spanning visual question-answering, medical report generation, and complex reasoning in multilingual and rare disease scenarios. By open-sourcing our complete pipeline, we establish that high-performance medical VLM can be achieved transparently, providing a foundational tool for accessible and impactful clinical AI. Code is released on https://github.com/ZJUI-AI4H/Hulu-Med{https://github.com/ZJUI-AI4H/Hulu-Med}.

Vision-language models (VLMs) extend the conventional large language models by integrating visual data, enabling richer multimodal reasoning and significantly broadens the practical applications of AI. However, including visual inputs also brings new challenges in maintaining data quality. Empirical evidence consistently shows that carefully curated and representative training examples often yield superior results compared to simply increasing the quantity of data. Inspired by this observation, we introduce a streamlined data filtration framework that employs a compact VLM, fine-tuned on a high-quality image-caption annotated dataset. This model effectively evaluates and filters potential training samples based on caption and image quality and alignment. Unlike previous approaches, which typically add auxiliary filtration modules on top of existing full-scale VLMs, our method exclusively utilizes the inherent evaluative capability of a purpose-built small VLM. This strategy eliminates the need for extra modules and reduces training overhead. Our lightweight model efficiently filters out inaccurate, noisy web data, improving image-text alignment and caption linguistic fluency. Experimental results show that datasets underwent high-precision filtration using our compact VLM perform on par with, or even surpass, larger and noisier datasets gathered through high-volume web crawling. Thus, our method provides a lightweight yet robust solution for building high-quality vision-language training corpora. \\ Availability and implementation: Our compact VLM filtration model, training data, utility scripts, and Supplementary data (Appendices) are freely available at https://github.com/daulettoibazar/Compact_VLM_Filter.

Large Language Models (LLMs) hold great promise to revolutionize current clinical systems for their superior capacities on medical text processing tasks and medical licensing exams. Meanwhile, traditional ML models such as SVM and XGBoost have still been mainly adopted in clinical prediction tasks. An emerging question is Can LLMs beat traditional ML models in clinical prediction? Thus, we build a new benchmark ClinicalBench to comprehensively study the clinical predictive modeling capacities of both general-purpose and medical LLMs, and compare them with traditional ML models. ClinicalBench embraces three common clinical prediction tasks, two databases, 14 general-purpose LLMs, 8 medical LLMs, and 11 traditional ML models. Through extensive empirical investigation, we discover that both general-purpose and medical LLMs, even with different model scales, diverse prompting or fine-tuning strategies, still cannot beat traditional ML models in clinical prediction yet, shedding light on their potential deficiency in clinical reasoning and decision-making. We call for caution when practitioners adopt LLMs in clinical applications. ClinicalBench can be utilized to bridge the gap between LLMs' development for healthcare and real-world clinical practice.

Multimodal Large Language Models (MLLMs) have demonstrated notable capabilities in general visual understanding and reasoning tasks. However, their deployment is hindered by substantial computational costs in both training and inference, limiting accessibility to the broader research and user communities. A straightforward solution is to leverage smaller pre-trained vision and language models, which inevitably causes significant performance drop. In this paper, we demonstrate the possibility to beat the scaling law and train a smaller but better MLLM by exploring more informative training data. Specifically, we introduce Bunny, a family of lightweight MLLMs with flexible vision and language backbones for efficient multimodal learning from condensed training data. Remarkably, our Bunny-3B outperforms the state-of-the-art large MLLMs, especially LLaVA-v1.5-13B, on multiple benchmarks. The code, models and data can be found in https://github.com/BAAI-DCAI/Bunny.

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

Large Vision-Language Models (LVLMs) are pivotal for real-world AI tasks like embodied intelligence due to their strong vision-language reasoning abilities. However, current LVLMs process entire images at the token level, which is inefficient compared to humans who analyze information and generate content at the conceptual level, extracting relevant visual concepts with minimal effort. This inefficiency, stemming from the lack of a visual concept model, limits LVLMs' usability in real-world applications. To address this, we propose VCM, an end-to-end self-supervised visual concept modeling framework. VCM leverages implicit contrastive learning across multiple sampled instances and vision-language fine-tuning to construct a visual concept model without requiring costly concept-level annotations. Our results show that VCM significantly reduces computational costs (e.g., 85\% fewer FLOPs for LLaVA-1.5-7B) while maintaining strong performance across diverse image understanding tasks. Moreover, VCM enhances visual encoders' capabilities in classic visual concept perception tasks. Extensive quantitative and qualitative experiments validate the effectiveness and efficiency of VCM.

Following the recent popularity of Large Language Models (LLMs), several attempts have been made to extend them to the visual domain. From having a visual assistant that could guide us through unfamiliar environments to generative models that produce images using only a high-level text description, the vision-language model (VLM) applications will significantly impact our relationship with technology. However, there are many challenges that need to be addressed to improve the reliability of those models. While language is discrete, vision evolves in a much higher dimensional space in which concepts cannot always be easily discretized. To better understand the mechanics behind mapping vision to language, we present this introduction to VLMs which we hope will help anyone who would like to enter the field. First, we introduce what VLMs are, how they work, and how to train them. Then, we present and discuss approaches to evaluate VLMs. Although this work primarily focuses on mapping images to language, we also discuss extending VLMs to videos.

Large Vision-Language Models (LVLMs) typically learn visual capacity through visual instruction tuning, involving updates to both a projector and their LLM backbones. Drawing inspiration from the concept of visual region in the human brain, we investigate the existence of an analogous visual region within LLMs that functions as a cognitive core, and explore the possibility of efficient training of LVLMs via selective layers tuning. We use Bunny-Llama-3-8B-V for detailed experiments and LLaVA-1.5-7B and LLaVA-1.5-13B for validation across a range of visual and textual tasks. Our findings reveal that selectively updating 25\% of LLMs layers, when sparsely and uniformly distributed, can preserve nearly 99\% of visual performance while maintaining or enhancing textual task results, and also effectively reducing training time. Based on this targeted training approach, we further propose a novel visual region-based pruning paradigm, removing non-critical layers outside the visual region, which can achieve minimal performance loss. This study offers an effective and efficient strategy for LVLM training and inference by activating a layer-wise visual region within LLMs, which is consistently effective across different models and parameter scales.

Large Multimodal Models (LMMs) are increasingly capable of answering medical questions that require joint reasoning over images and text, yet training general medical VQA systems is impeded by the lack of large, openly usable, high-quality corpora. We present MedVLSynther, a rubric-guided generator-verifier framework that synthesizes high-quality multiple-choice VQA items directly from open biomedical literature by conditioning on figures, captions, and in-text references. The generator produces self-contained stems and parallel, mutually exclusive options under a machine-checkable JSON schema; a multi-stage verifier enforces essential gates (self-containment, single correct answer, clinical validity, image-text consistency), awards fine-grained positive points, and penalizes common failure modes before acceptance. Applying this pipeline to PubMed Central yields MedSynVQA: 13,087 audited questions over 14,803 images spanning 13 imaging modalities and 28 anatomical regions. Training open-weight LMMs with reinforcement learning using verifiable rewards improves accuracy across six medical VQA benchmarks, achieving averages of 55.85 (3B) and 58.15 (7B), with up to 77.57 on VQA-RAD and 67.76 on PathVQA, outperforming strong medical LMMs. A Ablations verify that both generation and verification are necessary and that more verified data consistently helps, and a targeted contamination analysis detects no leakage from evaluation suites. By operating entirely on open literature and open-weight models, MedVLSynther offers an auditable, reproducible, and privacy-preserving path to scalable medical VQA training data.

Current ophthalmology clinical workflows are plagued by over-referrals, long waits, and complex and heterogeneous medical records. Large language models (LLMs) present a promising solution to automate various procedures such as triaging, preliminary tests like visual acuity assessment, and report summaries. However, LLMs have demonstrated significantly varied performance across different languages in natural language question-answering tasks, potentially exacerbating healthcare disparities in Low and Middle-Income Countries (LMICs). This study introduces the first multilingual ophthalmological question-answering benchmark with manually curated questions parallel across languages, allowing for direct cross-lingual comparisons. Our evaluation of 6 popular LLMs across 7 different languages reveals substantial bias across different languages, highlighting risks for clinical deployment of LLMs in LMICs. Existing debiasing methods such as Translation Chain-of-Thought or Retrieval-augmented generation (RAG) by themselves fall short of closing this performance gap, often failing to improve performance across all languages and lacking specificity for the medical domain. To address this issue, We propose CLARA (Cross-Lingual Reflective Agentic system), a novel inference time de-biasing method leveraging retrieval augmented generation and self-verification. Our approach not only improves performance across all languages but also significantly reduces the multilingual bias gap, facilitating equitable LLM application across the globe.

Vision-Language Models (VLMs), such as GPT-4V and Llama 3.2 vision, have garnered significant research attention for their ability to leverage Large Language Models (LLMs) in multimodal tasks. However, their potential is constrained by inherent challenges, including proprietary restrictions, substantial computational demands, and limited accessibility. Smaller models, such as GIT and BLIP, exhibit marked limitations, often failing to generate coherent and consistent text beyond a few tokens, even with extensive training. This underscores a pivotal inquiry: how small can a VLM be and still produce fluent and consistent text? Drawing inspiration from the exceptional learning process of 3-4 year old children, who rely heavily on visual cues for understanding and communication, we introduce two novel datasets: ShortDesc (featuring concise image descriptions) and LongDesc (containing more detailed image descriptions). These datasets consist of image-text pairs where the text is restricted to the simple vocabulary and syntax typically used by young children, generated with a scaled- down model, GPT-4o. Using these datasets, we demonstrate that it is possible to train VLMs that are significantly smaller, up to 10 times smaller than state of the art(SOTA) small VLMs while maintaining architectural simplicity. To evaluate the outputs, we leverage GPT-4o to grade the text, as if stories written by students, on creativity, meaningfulness, and consistency, assigning scores out of 10. This method addresses limitations of standard benchmarks by accommodating unstructured outputs and providing a multidimensional evaluation of the model capabilities. Our findings contribute to the development of lightweight, accessible multimodal models for resource constrained environments.

Starting from the resurgence of deep learning, vision-language models (VLMs) benefiting from large language models (LLMs) have never been so popular. However, while LLMs can utilize extensive background knowledge and task information with in-context learning, most VLMs still struggle with understanding complex multi-modal prompts with multiple images. The issue can traced back to the architectural design of VLMs or pre-training data. Specifically, the current VLMs primarily emphasize utilizing multi-modal data with a single image some, rather than multi-modal prompts with interleaved multiple images and text. Even though some newly proposed VLMs could handle user prompts with multiple images, pre-training data does not provide more sophisticated multi-modal prompts than interleaved image and text crawled from the web. We propose MMICL to address the issue by considering both the model and data perspectives. We introduce a well-designed architecture capable of seamlessly integrating visual and textual context in an interleaved manner and MIC dataset to reduce the gap between the training data and the complex user prompts in real-world applications, including: 1) multi-modal context with interleaved images and text, 2) textual references for each image, and 3) multi-image data with spatial, logical, or temporal relationships. Our experiments confirm that MMICL achieves new stat-of-the-art zero-shot and few-shot performance on a wide range of general vision-language tasks, especially for complex reasoning benchmarks including MME and MMBench. Our analysis demonstrates that MMICL effectively deals with the challenge of complex multi-modal prompt understanding. The experiments on ScienceQA-IMG also show that MMICL successfully alleviates the issue of language bias in VLMs, which we believe is the reason behind the advanced performance of MMICL.

Open-source, multilingual medical large language models (LLMs) have the potential to serve linguistically diverse populations across different regions. Adapting generic LLMs for healthcare often requires continual pretraining, but this approach is computationally expensive and sometimes impractical. Instruction fine-tuning on a specific task may not always guarantee optimal performance due to the lack of broader domain knowledge that the model needs to understand and reason effectively in diverse scenarios. To address these challenges, we introduce two multilingual instruction fine-tuning datasets, MMed-IFT and MMed-IFT-MC, containing over 200k high-quality medical samples in six languages. We propose a two-stage training paradigm: the first stage injects general medical knowledge using MMed-IFT, while the second stage fine-tunes task-specific multiple-choice questions with MMed-IFT-MC. Our method achieves competitive results on both English and multilingual benchmarks, striking a balance between computational efficiency and performance. We plan to make our dataset and model weights public at https://github.com/SpassMed/Med-Llama3 in the future.

Multimodal Large Language Models (MLLMs) have showcased impressive skills in tasks related to visual understanding and reasoning. Yet, their widespread application faces obstacles due to the high computational demands during both the training and inference phases, restricting their use to a limited audience within the research and user communities. In this paper, we investigate the design aspects of Multimodal Small Language Models (MSLMs) and propose an efficient multimodal assistant named Mipha, which is designed to create synergy among various aspects: visual representation, language models, and optimization strategies. We show that without increasing the volume of training data, our Mipha-3B outperforms the state-of-the-art large MLLMs, especially LLaVA-1.5-13B, on multiple benchmarks. Through detailed discussion, we provide insights and guidelines for developing strong MSLMs that rival the capabilities of MLLMs. Our code is available at https://github.com/zhuyiche/llava-phi.

Visual Language Models (VLMs) have demonstrated impressive capabilities in visual grounding tasks. However, their effectiveness in the medical domain, particularly for abnormality detection and localization within medical images, remains underexplored. A major challenge is the complex and abstract nature of medical terminology, which makes it difficult to directly associate pathological anomaly terms with their corresponding visual features. In this work, we introduce a novel approach to enhance VLM performance in medical abnormality detection and localization by leveraging decomposed medical knowledge. Instead of directly prompting models to recognize specific abnormalities, we focus on breaking down medical concepts into fundamental attributes and common visual patterns. This strategy promotes a stronger alignment between textual descriptions and visual features, improving both the recognition and localization of abnormalities in medical images.We evaluate our method on the 0.23B Florence-2 base model and demonstrate that it achieves comparable performance in abnormality grounding to significantly larger 7B LLaVA-based medical VLMs, despite being trained on only 1.5% of the data used for such models. Experimental results also demonstrate the effectiveness of our approach in both known and previously unseen abnormalities, suggesting its strong generalization capabilities.

Multimodal Large Language Model (MLLMs) leverages Large Language Models as a cognitive framework for diverse visual-language tasks. Recent efforts have been made to equip MLLMs with visual perceiving and grounding capabilities. However, there still remains a gap in providing fine-grained pixel-level perceptions and extending interactions beyond text-specific inputs. In this work, we propose {AnyRef}, a general MLLM model that can generate pixel-wise object perceptions and natural language descriptions from multi-modality references, such as texts, boxes, images, or audio. This innovation empowers users with greater flexibility to engage with the model beyond textual and regional prompts, without modality-specific designs. Through our proposed refocusing mechanism, the generated grounding output is guided to better focus on the referenced object, implicitly incorporating additional pixel-level supervision. This simple modification utilizes attention scores generated during the inference of LLM, eliminating the need for extra computations while exhibiting performance enhancements in both grounding masks and referring expressions. With only publicly available training data, our model achieves state-of-the-art results across multiple benchmarks, including diverse modality referring segmentation and region-level referring expression generation.

Large language models (LLMs) can potentially democratize access to medical knowledge. While many efforts have been made to harness and improve LLMs' medical knowledge and reasoning capacities, the resulting models are either closed-source (e.g., PaLM, GPT-4) or limited in scale (<= 13B parameters), which restricts their abilities. In this work, we improve access to large-scale medical LLMs by releasing MEDITRON: a suite of open-source LLMs with 7B and 70B parameters adapted to the medical domain. MEDITRON builds on Llama-2 (through our adaptation of Nvidia's Megatron-LM distributed trainer), and extends pretraining on a comprehensively curated medical corpus, including selected PubMed articles, abstracts, and internationally-recognized medical guidelines. Evaluations using four major medical benchmarks show significant performance gains over several state-of-the-art baselines before and after task-specific finetuning. Overall, MEDITRON achieves a 6% absolute performance gain over the best public baseline in its parameter class and 3% over the strongest baseline we finetuned from Llama-2. Compared to closed-source LLMs, MEDITRON-70B outperforms GPT-3.5 and Med-PaLM and is within 5% of GPT-4 and 10% of Med-PaLM-2. We release our code for curating the medical pretraining corpus and the MEDITRON model weights to drive open-source development of more capable medical LLMs.

Multimodal large language models (MLLMs) have recently achieved remarkable progress in radiology by integrating visual perception with natural language understanding. However, they often generate clinically unsupported descriptions, known as medical hallucinations, which pose serious risks in medical applications that demand accuracy and image-grounded outputs. Through empirical analysis, we find that prompt-induced hallucinations remain prevalent in radiology MLLMs, largely due to over-sensitivity to clinical sections. To address this, we introduce Clinical Contrastive Cecoding (CCD), a training-free and retrieval-free inference framework that integrates structured clinical signals from task-specific radiology expert models. CCD introduces a dual-stage contrastive mechanism to refine token-level logits during generation, thereby enhancing clinical fidelity without modifying the base MLLM. Experiments on three datasets and multiple models demonstrate that CCD consistently improves overall performance on radiology report generation (RRG). On the MIMIC-CXR dataset, it yields up to a 17% improvement in RadGraph-F1 when applied to state-of-the-art RRG models. Our approach provides a lightweight and generalisable solution for mitigating medical hallucinations, effectively bridging expert models and MLLMs in radiology.

Do we fully leverage the potential of visual encoder in Multimodal Large Language Models (MLLMs)? The recent outstanding performance of MLLMs in multimodal understanding has garnered broad attention from both academia and industry. In the current MLLM rat race, the focus seems to be predominantly on the linguistic side. We witness the rise of larger and higher-quality instruction datasets, as well as the involvement of larger-sized LLMs. Yet, scant attention has been directed towards the visual signals utilized by MLLMs, often assumed to be the final high-level features extracted by a frozen visual encoder. In this paper, we introduce the Dense Connector - a simple, effective, and plug-and-play vision-language connector that significantly enhances existing MLLMs by leveraging multi-layer visual features, with minimal additional computational overhead. Furthermore, our model, trained solely on images, showcases remarkable zero-shot capabilities in video understanding as well. Experimental results across various vision encoders, image resolutions, training dataset scales, varying sizes of LLMs (2.7B->70B), and diverse architectures of MLLMs (e.g., LLaVA and Mini-Gemini) validate the versatility and scalability of our approach, achieving state-of-the-art performance on across 19 image and video benchmarks. We hope that this work will provide valuable experience and serve as a basic module for future MLLM development.

Foundation Vision-Language Models (VLMs) trained using large-scale open-domain images and text pairs have recently been adapted to develop Vision-Language Segmentation Models (VLSMs) that allow providing text prompts during inference to guide image segmentation. If robust and powerful VLSMs can be built for medical images, it could aid medical professionals in many clinical tasks where they must spend substantial time delineating the target structure of interest. VLSMs for medical images resort to fine-tuning base VLM or VLSM pretrained on open-domain natural image datasets due to fewer annotated medical image datasets; this fine-tuning is resource-consuming and expensive as it usually requires updating all or a significant fraction of the pretrained parameters. Recently, lightweight blocks called adapters have been proposed in VLMs that keep the pretrained model frozen and only train adapters during fine-tuning, substantially reducing the computing resources required. We introduce a novel adapter, VLSM-Adapter, that can fine-tune pretrained vision-language segmentation models using transformer encoders. Our experiments in widely used CLIP-based segmentation models show that with only 3 million trainable parameters, the VLSM-Adapter outperforms state-of-the-art and is comparable to the upper bound end-to-end fine-tuning. The source code is available at: https://github.com/naamiinepal/vlsm-adapter.

The Large Vision-Language Model (LVLM) field has seen significant advancements, yet its progression has been hindered by challenges in comprehending fine-grained visual content due to limited resolution. Recent efforts have aimed to enhance the high-resolution understanding capabilities of LVLMs, yet they remain capped at approximately 1500 x 1500 pixels and constrained to a relatively narrow resolution range. This paper represents InternLM-XComposer2-4KHD, a groundbreaking exploration into elevating LVLM resolution capabilities up to 4K HD (3840 x 1600) and beyond. Concurrently, considering the ultra-high resolution may not be necessary in all scenarios, it supports a wide range of diverse resolutions from 336 pixels to 4K standard, significantly broadening its scope of applicability. Specifically, this research advances the patch division paradigm by introducing a novel extension: dynamic resolution with automatic patch configuration. It maintains the training image aspect ratios while automatically varying patch counts and configuring layouts based on a pre-trained Vision Transformer (ViT) (336 x 336), leading to dynamic training resolution from 336 pixels to 4K standard. Our research demonstrates that scaling training resolution up to 4K HD leads to consistent performance enhancements without hitting the ceiling of potential improvements. InternLM-XComposer2-4KHD shows superb capability that matches or even surpasses GPT-4V and Gemini Pro in 10 of the 16 benchmarks. The InternLM-XComposer2-4KHD model series with 7B parameters are publicly available at https://github.com/InternLM/InternLM-XComposer.

Large vision-language models (LVLMs) have achieved impressive results in various vision-language tasks. However, despite showing promising performance, LVLMs suffer from hallucinations caused by language bias, leading to diminished focus on images and ineffective visual comprehension. We identify two primary reasons for this bias: 1. Different scales of training data between the pretraining stage of LLM and multimodal alignment stage. 2. The learned inference bias due to short-term dependency of text data. Therefore, we propose LACING, a systemic framework designed to address the language bias of LVLMs with muLtimodal duAl-attention meChanIsm (MDA) aNd soft-image Guidance (IFG). Specifically, MDA introduces a parallel dual-attention mechanism that enhances the integration of visual inputs across the model. IFG introduces a learnable soft visual prompt during training and inference to replace visual inputs, designed to compel LVLMs to prioritize text inputs. Then, IFG further proposes a novel decoding strategy using the soft visual prompt to mitigate the model's over-reliance on adjacent text inputs. Comprehensive experiments demonstrate that our method effectively debiases LVLMs from their language bias, enhancing visual comprehension and reducing hallucinations without requiring additional training resources or data. The code and model are available at [lacing-lvlm.github.io](https://lacing-lvlm.github.io).

Large Vision-Language Models (LVLMs) have recently achieved remarkable success. However, LVLMs are still plagued by the hallucination problem, which limits the practicality in many scenarios. Hallucination refers to the information of LVLMs' responses that does not exist in the visual input, which poses potential risks of substantial consequences. There has been limited work studying hallucination evaluation in LVLMs. In this paper, we propose Hallucination Evaluation based on Large Language Models (HaELM), an LLM-based hallucination evaluation framework. HaELM achieves an approximate 95% performance comparable to ChatGPT and has additional advantages including low cost, reproducibility, privacy preservation and local deployment. Leveraging the HaELM, we evaluate the hallucination in current LVLMs. Furthermore, we analyze the factors contributing to hallucination in LVLMs and offer helpful suggestions to mitigate the hallucination problem. Our training data and human annotation hallucination data will be made public soon.

Multi-Modal Large Language Models (MLLMs), despite being successful, exhibit limited generality and often fall short when compared to specialized models. Recently, LLM-based agents have been developed to address these challenges by selecting appropriate specialized models as tools based on user inputs. However, such advancements have not been extensively explored within the medical domain. To bridge this gap, this paper introduces the first agent explicitly designed for the medical field, named Multi-modal Medical Agent (MMedAgent). We curate an instruction-tuning dataset comprising six medical tools solving seven tasks across five modalities, enabling the agent to choose the most suitable tools for a given task. Comprehensive experiments demonstrate that MMedAgent achieves superior performance across a variety of medical tasks compared to state-of-the-art open-source methods and even the closed-source model, GPT-4o. Furthermore, MMedAgent exhibits efficiency in updating and integrating new medical tools. Codes and models are all available.

Accurate disease interpretation from radiology remains challenging due to imaging heterogeneity. Achieving expert-level diagnostic decisions requires integration of subtle image features with clinical knowledge. Yet major vision-language models (VLMs) treat images as holistic entities and overlook fine-grained image details that are vital for disease diagnosis. Clinicians analyze images by utilizing their prior medical knowledge and identify anatomical structures as important region of interests (ROIs). Inspired from this human-centric workflow, we introduce Anatomy-VLM, a fine-grained, vision-language model that incorporates multi-scale information. First, we design a model encoder to localize key anatomical features from entire medical images. Second, these regions are enriched with structured knowledge for contextually-aware interpretation. Finally, the model encoder aligns multi-scale medical information to generate clinically-interpretable disease prediction. Anatomy-VLM achieves outstanding performance on both in- and out-of-distribution datasets. We also validate the performance of Anatomy-VLM on downstream image segmentation tasks, suggesting that its fine-grained alignment captures anatomical and pathology-related knowledge. Furthermore, the Anatomy-VLM's encoder facilitates zero-shot anatomy-wise interpretation, providing its strong expert-level clinical interpretation capabilities.

We introduce NVLM 1.0, a family of frontier-class multimodal large language models (LLMs) that achieve state-of-the-art results on vision-language tasks, rivaling the leading proprietary models (e.g., GPT-4o) and open-access models (e.g., Llama 3-V 405B and InternVL 2). Remarkably, NVLM 1.0 shows improved text-only performance over its LLM backbone after multimodal training. In terms of model design, we perform a comprehensive comparison between decoder-only multimodal LLMs (e.g., LLaVA) and cross-attention-based models (e.g., Flamingo). Based on the strengths and weaknesses of both approaches, we propose a novel architecture that enhances both training efficiency and multimodal reasoning capabilities. Furthermore, we introduce a 1-D tile-tagging design for tile-based dynamic high-resolution images, which significantly boosts performance on multimodal reasoning and OCR-related tasks. Regarding training data, we meticulously curate and provide detailed information on our multimodal pretraining and supervised fine-tuning datasets. Our findings indicate that dataset quality and task diversity are more important than scale, even during the pretraining phase, across all architectures. Notably, we develop production-grade multimodality for the NVLM-1.0 models, enabling them to excel in vision-language tasks while maintaining and even improving text-only performance compared to their LLM backbones. To achieve this, we craft and integrate a high-quality text-only dataset into multimodal training, alongside a substantial amount of multimodal math and reasoning data, leading to enhanced math and coding capabilities across modalities. To advance research in the field, we are releasing the model weights and will open-source the code for the community: https://nvlm-project.github.io/.

Existing Multimodal Large Language Models (MLLMs) increasingly emphasize complex understanding of various visual elements, including multiple objects, text information, and spatial relations. Their development for comprehensive visual perception hinges on the availability of high-quality image-text datasets that offer diverse visual elements and throughout image descriptions. However, the scarcity of such hyper-detailed datasets currently hinders progress within the MLLM community. The bottleneck stems from the limited perceptual capabilities of current caption engines, which fall short in providing complete and accurate annotations. To facilitate the cutting-edge research of MLLMs on comprehensive vision perception, we thereby propose Perceptual Fusion, using a low-budget but highly effective caption engine for complete and accurate image descriptions. Specifically, Perceptual Fusion integrates diverse perception experts as image priors to provide explicit information on visual elements and adopts an efficient MLLM as a centric pivot to mimic advanced MLLMs' perception abilities. We carefully select 1M highly representative images from uncurated LAION dataset and generate dense descriptions using our engine, dubbed DenseFusion-1M. Extensive experiments validate that our engine outperforms its counterparts, where the resulting dataset significantly improves the perception and cognition abilities of existing MLLMs across diverse vision-language benchmarks, especially with high-resolution images as inputs. The dataset and code are publicly available at https://github.com/baaivision/DenseFusion.

In this work, we address the problem of grounding abnormalities in medical images, where the goal is to localize clinical findings based on textual descriptions. While generalist Vision-Language Models (VLMs) excel in natural grounding tasks, they often struggle in the medical domain due to rare, compositional, and domain-specific terms that are poorly aligned with visual patterns. Specialized medical VLMs address this challenge via large-scale domain pretraining, but at the cost of substantial annotation and computational resources. To overcome these limitations, we propose Knowledge to Sight (K2Sight), a framework that introduces structured semantic supervision by decomposing clinical concepts into interpretable visual attributes, such as shape, density, and anatomical location. These attributes are distilled from domain ontologies and encoded into concise instruction-style prompts, which guide region-text alignment during training. Unlike conventional report-level supervision, our approach explicitly bridges domain knowledge and spatial structure, enabling data-efficient training of compact models. We train compact models with 0.23B and 2B parameters using only 1.5\% of the data required by state-of-the-art medical VLMs. Despite their small size and limited training data, these models achieve performance on par with or better than 7B+ medical VLMs, with up to 9.82\% improvement in mAP_{50}. Code and models: https://lijunrio.github.io/K2Sight/{SOTAPink{https://lijunrio.github.io/K2Sight/}}.

Recent Large Vision-Language Models (LVLMs) have advanced multi-modal understanding by incorporating finer-grained visual perception and encoding. However, such methods incur significant computational costs due to longer visual token sequences, posing challenges for real-time deployment. To mitigate this, prior studies have explored pruning unimportant visual tokens either at the output layer of the visual encoder or at the early layers of the language model. In this work, we revisit these design choices and reassess their effectiveness through comprehensive empirical studies of how visual tokens are processed throughout the visual encoding and language decoding stages. Guided by these insights, we propose VScan, a two-stage visual token reduction framework that addresses token redundancy by: (1) integrating complementary global and local scans with token merging during visual encoding, and (2) introducing pruning at intermediate layers of the language model. Extensive experimental results across four LVLMs validate the effectiveness of VScan in accelerating inference and demonstrate its superior performance over current state-of-the-arts on sixteen benchmarks. Notably, when applied to LLaVA-NeXT-7B, VScan achieves a 2.91times speedup in prefilling and a 10times reduction in FLOPs, while retaining 95.4% of the original performance.

Multimodal Large Language Models (MLLMs) are experiencing rapid growth, yielding a plethora of noteworthy contributions in recent months. The prevailing trend involves adopting data-driven methodologies, wherein diverse instruction-following datasets are collected. However, a prevailing challenge persists in these approaches, specifically in relation to the limited visual perception ability, as CLIP-like encoders employed for extracting visual information from inputs. Though these encoders are pre-trained on billions of image-text pairs, they still grapple with the information loss dilemma, given that textual captions only partially capture the contents depicted in images. To address this limitation, this paper proposes to improve the visual perception ability of MLLMs through a mixture-of-experts knowledge enhancement mechanism. Specifically, we introduce a novel method that incorporates multi-task encoders and visual tools into the existing MLLMs training and inference pipeline, aiming to provide a more comprehensive and accurate summarization of visual inputs. Extensive experiments have evaluated its effectiveness of advancing MLLMs, showcasing improved visual perception achieved through the integration of visual experts.

Multi-modal Large Language Models (MLLMs) have made significant strides in expanding the capabilities of Large Language Models (LLMs) through the incorporation of visual perception interfaces. Despite the emergence of exciting applications and the availability of diverse instruction tuning data, existing approaches often rely on CLIP or its variants as the visual branch, and merely extract features from the deep layers. However, these methods lack a comprehensive analysis of the visual encoders in MLLMs. In this paper, we conduct an extensive investigation into the effectiveness of different vision encoders within MLLMs. Our findings reveal that the shallow layer features of CLIP offer particular advantages for fine-grained tasks such as grounding and region understanding. Surprisingly, the vision-only model DINO, which is not pretrained with text-image alignment, demonstrates promising performance as a visual branch within MLLMs. By simply equipping it with an MLP layer for alignment, DINO surpasses CLIP in fine-grained related perception tasks. Building upon these observations, we propose a simple yet effective feature merging strategy, named COMM, that integrates CLIP and DINO with Multi-level features Merging, to enhance the visual capabilities of MLLMs. We evaluate COMM through comprehensive experiments on a wide range of benchmarks, including image captioning, visual question answering, visual grounding, and object hallucination. Experimental results demonstrate the superior performance of COMM compared to existing methods, showcasing its enhanced visual capabilities within MLLMs. Code will be made available at https://github.com/YuchenLiu98/COMM.

Multimodal Large Language Models (MLLMs) have exhibited immense potential across numerous medical specialties; yet, dentistry remains underexplored, in part due to limited domain-specific data, scarce dental expert annotations, insufficient modality-specific modeling, and challenges in reliability. In this paper, we present OralGPT-Omni, the first dental-specialized MLLM designed for comprehensive and trustworthy analysis across diverse dental imaging modalities and clinical tasks. To explicitly capture dentists' diagnostic reasoning, we construct TRACE-CoT, a clinically grounded chain-of-thought dataset that mirrors dental radiologists' decision-making processes. This reasoning supervision, combined with our proposed four-stage training paradigm, substantially strengthens the model's capacity for dental image understanding and analysis. In parallel, we introduce MMOral-Uni, the first unified multimodal benchmark for dental image analysis. It comprises 2,809 open-ended question-answer pairs spanning five modalities and five tasks, offering a comprehensive evaluation suite to date for MLLMs in digital dentistry. OralGPT-Omni achieves an overall score of 51.84 on the MMOral-Uni benchmark and 45.31 on the MMOral-OPG benchmark, dramatically outperforming the scores of GPT-5. Our work promotes intelligent dentistry and paves the way for future advances in dental image analysis. All code, benchmark, and models will be made publicly available.

We introduce Xmodel-VLM, a cutting-edge multimodal vision language model. It is designed for efficient deployment on consumer GPU servers. Our work directly confronts a pivotal industry issue by grappling with the prohibitive service costs that hinder the broad adoption of large-scale multimodal systems. Through rigorous training, we have developed a 1B-scale language model from the ground up, employing the LLaVA paradigm for modal alignment. The result, which we call Xmodel-VLM, is a lightweight yet powerful multimodal vision language model. Extensive testing across numerous classic multimodal benchmarks has revealed that despite its smaller size and faster execution, Xmodel-VLM delivers performance comparable to that of larger models. Our model checkpoints and code are publicly available on GitHub at https://github.com/XiaoduoAILab/XmodelVLM.

Multimodal Large Language Models (MLLMs) are commonly derived by extending pre-trained Large Language Models (LLMs) with visual capabilities. In this work, we investigate how MLLMs process visual inputs by analyzing their attention mechanisms. We reveal a surprising sparsity phenomenon: only a small subset (approximately less than 5%) of attention heads in LLMs actively contribute to visual understanding, termed visual heads. To identify these heads efficiently, we design a training-free framework that quantifies head-level visual relevance through targeted response analysis. Building on this discovery, we introduce SparseMM, a KV-Cache optimization strategy that allocates asymmetric computation budgets to heads in LLMs based on their visual scores, leveraging the sparity of visual heads for accelerating the inference of MLLMs. Compared with prior KV-Cache acceleration methods that ignore the particularity of visual, SparseMM prioritizes stress and retaining visual semantics during decoding. Extensive evaluations across mainstream multimodal benchmarks demonstrate that SparseMM achieves superior accuracy-efficiency trade-offs. Notably, SparseMM delivers 1.38x real-time acceleration and 52% memory reduction during generation while maintaining performance parity on efficiency test. Our project is open sourced at https://github.com/CR400AF-A/SparseMM.

Vision-language models (VLMs) are highly effective but often underperform on specialized tasks; for example, Llava-1.5 struggles with chart and diagram understanding due to scarce task-specific training data. Existing training data, sourced from general-purpose datasets, fails to capture the nuanced details needed for these tasks. We introduce MM-Gen, a scalable method that generates task-specific, high-quality synthetic text for candidate images by leveraging stronger models. MM-Gen employs a three-stage targeted process: partitioning data into subgroups, generating targeted text based on task descriptions, and filtering out redundant and outlier data. Fine-tuning VLMs with data generated by MM-Gen leads to significant performance gains, including 29% on spatial reasoning and 15% on diagram understanding for Llava-1.5 (7B). Compared to human-curated caption data, MM-Gen achieves up to 1.6x better improvements for the original models, proving its effectiveness in enhancing task-specific VLM performance and bridging the gap between general-purpose datasets and specialized requirements. Code available at https://github.com/sjoshi804/MM-Gen.

Multimodal Large Language Models (MLLMs) excel in vision--language tasks by pre-training solely on coarse-grained concept annotations (e.g., image captions). We hypothesize that integrating fine-grained concept annotations (e.g., object labels and object regions) will further improve performance, as both data granularities complement each other in terms of breadth and depth in concept representation. We introduce a new dataset featuring Multimodal Multi-Grained Concept annotations (MMGiC) for MLLMs. In constructing MMGiC, we explore the impact of different data recipes on multimodal comprehension and generation. Our analyses reveal that multi-grained concept annotations integrate and complement each other, under our structured template and a general MLLM framework. We clearly explore and demonstrate the potential of MMGiC to help MLLMs better locate and learn concepts, aligning vision and language at multiple granularities. We further validate our hypothesis by investigating the fair comparison and effective collaboration between MMGiC and image--caption data on 12 multimodal comprehension and generation benchmarks, e.g., their appropriate combination achieve 3.95% and 2.34% absolute improvements over image--caption data alone on POPE and SEED-Bench. Code, data and models will be available at https://github.com/LooperXX/MMGiC.

Obtaining large pre-trained models that can be fine-tuned to new tasks with limited annotated samples has remained an open challenge for medical imaging data. While pre-trained deep networks on ImageNet and vision-language foundation models trained on web-scale data are prevailing approaches, their effectiveness on medical tasks is limited due to the significant domain shift between natural and medical images. To bridge this gap, we introduce LVM-Med, the first family of deep networks trained on large-scale medical datasets. We have collected approximately 1.3 million medical images from 55 publicly available datasets, covering a large number of organs and modalities such as CT, MRI, X-ray, and Ultrasound. We benchmark several state-of-the-art self-supervised algorithms on this dataset and propose a novel self-supervised contrastive learning algorithm using a graph-matching formulation. The proposed approach makes three contributions: (i) it integrates prior pair-wise image similarity metrics based on local and global information; (ii) it captures the structural constraints of feature embeddings through a loss function constructed via a combinatorial graph-matching objective; and (iii) it can be trained efficiently end-to-end using modern gradient-estimation techniques for black-box solvers. We thoroughly evaluate the proposed LVM-Med on 15 downstream medical tasks ranging from segmentation and classification to object detection, and both for the in and out-of-distribution settings. LVM-Med empirically outperforms a number of state-of-the-art supervised, self-supervised, and foundation models. For challenging tasks such as Brain Tumor Classification or Diabetic Retinopathy Grading, LVM-Med improves previous vision-language models trained on 1 billion masks by 6-7% while using only a ResNet-50.