Daily Papers

Large-language-model (LLM)-based text-to-speech (TTS) systems can generate natural speech, but most are not designed for low-latency dual-streaming synthesis. High-quality dual-streaming TTS depends on accurate text--speech alignment and well-designed training sequences that balance synthesis quality and latency. Prior work often relies on GMM-HMM based forced-alignment toolkits (e.g., MFA), which are pipeline-heavy and less flexible than neural aligners; fixed-ratio interleaving of text and speech tokens struggles to capture text--speech alignment regularities. We propose CTC-TTS, which replaces MFA with a CTC based aligner and introduces a bi-word based interleaving strategy. Two variants are designed: CTC-TTS-L (token concatenation along the sequence length) for higher quality and CTC-TTS-F (embedding stacking along the feature dimension) for lower latency. Experiments show that CTC-TTS outperforms fixed-ratio interleaving and MFA-based baselines on streaming synthesis and zero-shot tasks. Speech samples are available at https://ctctts.github.io/.

Connectionist Temporal Classification (CTC) is a widely used criterion for training supervised sequence-to-sequence (seq2seq) models. It enables learning the relations between input and output sequences, termed alignments, by marginalizing over perfect alignments (that yield the ground truth), at the expense of imperfect alignments. This binary differentiation of perfect and imperfect alignments falls short of capturing other essential alignment properties that hold significance in other real-world applications. Here we propose Align With Purpose, a general Plug-and-Play framework for enhancing a desired property in models trained with the CTC criterion. We do that by complementing the CTC with an additional loss term that prioritizes alignments according to a desired property. Our method does not require any intervention in the CTC loss function, enables easy optimization of a variety of properties, and allows differentiation between both perfect and imperfect alignments. We apply our framework in the domain of Automatic Speech Recognition (ASR) and show its generality in terms of property selection, architectural choice, and scale of training dataset (up to 280,000 hours). To demonstrate the effectiveness of our framework, we apply it to two unrelated properties: emission time and word error rate (WER). For the former, we report an improvement of up to 570ms in latency optimization with a minor reduction in WER, and for the latter, we report a relative improvement of 4.5% WER over the baseline models. To the best of our knowledge, these applications have never been demonstrated to work on a scale of data as large as ours. Notably, our method can be implemented using only a few lines of code, and can be extended to other alignment-free loss functions and to domains other than ASR.

Non-autoregressive translation (NAT) models are typically trained with the cross-entropy loss, which forces the model outputs to be aligned verbatim with the target sentence and will highly penalize small shifts in word positions. Latent alignment models relax the explicit alignment by marginalizing out all monotonic latent alignments with the CTC loss. However, they cannot handle non-monotonic alignments, which is non-negligible as there is typically global word reordering in machine translation. In this work, we explore non-monotonic latent alignments for NAT. We extend the alignment space to non-monotonic alignments to allow for the global word reordering and further consider all alignments that overlap with the target sentence. We non-monotonically match the alignments to the target sentence and train the latent alignment model to maximize the F1 score of non-monotonic matching. Extensive experiments on major WMT benchmarks show that our method substantially improves the translation performance of CTC-based models. Our best model achieves 30.06 BLEU on WMT14 En-De with only one-iteration decoding, closing the gap between non-autoregressive and autoregressive models.

Connectionist temporal classification (CTC)-based scene text recognition (STR) methods, e.g., SVTR, are widely employed in OCR applications, mainly due to their simple architecture, which only contains a visual model and a CTC-aligned linear classifier, and therefore fast inference. However, they generally exhibit worse accuracy than encoder-decoder-based methods (EDTRs) due to struggling with text irregularity and linguistic missing. To address these challenges, we propose SVTRv2, a CTC model endowed with the ability to handle text irregularities and model linguistic context. First, a multi-size resizing strategy is proposed to resize text instances to appropriate predefined sizes, effectively avoiding severe text distortion. Meanwhile, we introduce a feature rearrangement module to ensure that visual features accommodate the requirement of CTC, thus alleviating the alignment puzzle. Second, we propose a semantic guidance module. It integrates linguistic context into the visual features, allowing CTC model to leverage language information for accuracy improvement. This module can be omitted at the inference stage and would not increase the time cost. We extensively evaluate SVTRv2 in both standard and recent challenging benchmarks, where SVTRv2 is fairly compared to popular STR models across multiple scenarios, including different types of text irregularity, languages, long text, and whether employing pretraining. SVTRv2 surpasses most EDTRs across the scenarios in terms of accuracy and inference speed. Code: https://github.com/Topdu/OpenOCR.

Connectionist Temporal Classification (CTC) and attention mechanism are two main approaches used in recent scene text recognition works. Compared with attention-based methods, CTC decoder has a much shorter inference time, yet a lower accuracy. To design an efficient and effective model, we propose the guided training of CTC (GTC), where CTC model learns a better alignment and feature representations from a more powerful attentional guidance. With the benefit of guided training, CTC model achieves robust and accurate prediction for both regular and irregular scene text while maintaining a fast inference speed. Moreover, to further leverage the potential of CTC decoder, a graph convolutional network (GCN) is proposed to learn the local correlations of extracted features. Extensive experiments on standard benchmarks demonstrate that our end-to-end model achieves a new state-of-the-art for regular and irregular scene text recognition and needs 6 times shorter inference time than attentionbased methods.

Forced aligners locate each word of a known transcript in the audio, and many speech pipelines depend on them. In our own data, a widely used CTC aligner inserts a pause at nearly every word boundary, and we found almost no aligner evaluated on telephone audio. We compare nine aligner configurations against human word boundaries on read, conversational and telephone English. The Montreal Forced Aligner (MFA) is the most precise, while CTC aligners consistently start words late, because most frames inside a word go to the blank token. We then fine-tune Whisper with LoRA to predict each word's start and end as timestamp tokens, training only on boundaries placed by people: 47 hours in 87 languages. The resulting aligner is more precise than MFA on every English test condition, and than MFA's own Korean and Dutch models. With FA-Bench's protocol and code on TIMIT, its word-boundary error is 11.6 ms, against 18.2 ms for the best published system. Two choices matter most on telephone conversations: placing the timestamp slots after the word they time, and training on noisy transcripts, which also makes the aligner nearly insensitive to errors in the transcript. The released model reaches 16.0 ms on real landline calls, against 36.5 ms for MFA. The models are available at https://huggingface.co/collections/Scicom-intl/force-alignment

We participated in the SynthRAD2025 challenge (Tasks 1 and 2) with a unified pipeline for synthetic CT (sCT) generation from MRI and CBCT, implemented using the KonfAI framework. Our model is a 2.5D U-Net++ with a ResNet-34 encoder, trained jointly across anatomical regions and fine-tuned per region. The loss function combined pixel-wise L1 loss with IMPACT-Synth, a perceptual loss derived from SAM and TotalSegmentator to enhance structural fidelity. Training was performed using AdamW (initial learning rate = 0.001, halved every 25k steps) on patch-based, normalized, body-masked inputs (320x320 for MRI, 256x256 for CBCT), with random flipping as the only augmentation. No post-processing was applied. Final predictions leveraged test-time augmentation and five-fold ensembling. The best model was selected based on validation MAE. Two registration strategies were evaluated: (i) Elastix with mutual information, consistent with the challenge pipeline, and (ii) IMPACT, a feature-based similarity metric leveraging pretrained segmentation networks. On the local test sets, IMPACT-based registration achieved more accurate and anatomically consistent alignments than mutual-information-based registration, resulting in improved sCT synthesis with lower MAE and more realistic anatomical structures. On the public validation set, however, models trained with Elastix-aligned data achieved higher scores, reflecting a registration bias favoring alignment strategies consistent with the evaluation pipeline. This highlights how registration errors can propagate into supervised learning, influencing both training and evaluation, and potentially inflating performance metrics at the expense of anatomical fidelity. By promoting anatomically consistent alignment, IMPACT helps mitigate this bias and supports the development of more robust and generalizable sCT synthesis models.

Because of predicting all the target tokens in parallel, the non-autoregressive models greatly improve the decoding efficiency of speech recognition compared with traditional autoregressive models. In this work, we present dynamic alignment Mask CTC, introducing two methods: (1) Aligned Cross Entropy (AXE), finding the monotonic alignment that minimizes the cross-entropy loss through dynamic programming, (2) Dynamic Rectification, creating new training samples by replacing some masks with model predicted tokens. The AXE ignores the absolute position alignment between prediction and ground truth sentence and focuses on tokens matching in relative order. The dynamic rectification method makes the model capable of simulating the non-mask but possible wrong tokens, even if they have high confidence. Our experiments on WSJ dataset demonstrated that not only AXE loss but also the rectification method could improve the WER performance of Mask CTC.

Connectionist temporal classification (CTC) models are known to have peaky output distributions. Such behavior is not a problem for automatic speech recognition (ASR), but it can cause inaccurate forced alignments (FA), especially at finer granularity, e.g., phoneme level. This paper aims at alleviating the peaky behavior for CTC and improve its suitability for forced alignment generation, by leveraging label priors, so that the scores of alignment paths containing fewer blanks are boosted and maximized during training. As a result, our CTC model produces less peaky posteriors and is able to more accurately predict the offset of the tokens besides their onset. It outperforms the standard CTC model and a heuristics-based approach for obtaining CTC's token offset timestamps by 12-40% in phoneme and word boundary errors (PBE and WBE) measured on the Buckeye and TIMIT data. Compared with the most widely used FA toolkit Montreal Forced Aligner (MFA), our method performs similarly on PBE/WBE on Buckeye, yet falls behind MFA on TIMIT. Nevertheless, our method has a much simpler training pipeline and better runtime efficiency. Our training recipe and pretrained model are released in TorchAudio.

Connectionist temporal classification (CTC) naturally supports offline and streaming speech recognition with utterance-level supervision, but conventional implementations materialize frame-by-vocabulary activations in memory, making CTC training with native LLM vocabularies prohibitively memory-intensive. A key observation is that every valid CTC alignment uses only target tokens and blank, and their union across a batch typically forms a small subset of the full vocabulary. We introduce Pruned CTC, which restricts alignment computation to this subset while retaining full-vocabulary normalization. We prove that this vocabulary reduction is exactly equivalent to full-vocabulary CTC in loss and gradients. Head-and-loss activation memory no longer scales linearly with vocabulary size. We further apply finite-beam alignment pruning. Building on Pruned CTC, we develop LLM-CTC, which adapts pretrained LLMs for non-autoregressive ASR while retaining causal attention and native vocabularies, and extend it to bounded-history streaming, avoiding chunk-level speech--text alignments. Experiments show that, with Zipformer-M encoder and 180K vocabulary, Pruned CTC reduces full-step memory by 5.1times with only 17% step-time overhead. Across three corpora, it matches standard CTC accuracy. On GigaSpeech, across six Qwen3 model sizes from 0.6B to 32B, LLM-CTC remains within 7% relative WER of LLM-CE with 7 to 10times faster recognition; when fine-tuning Qwen3-ASR for bounded-history streaming, LLM-CTC remains within 3% relative WER of matched offline models on the test set. Together, these results establish Pruned CTC as a scalable sequence objective for native-vocabulary LLM ASR across offline and streaming settings.

In contrast to Connectionist Temporal Classification (CTC) approaches, Sequence-To-Sequence (S2S) models for Handwritten Text Recognition (HTR) suffer from errors such as skipped or repeated words which often occur at the end of a sequence. In this paper, to combine the best of both approaches, we propose to use the CTC-Prefix-Score during S2S decoding. Hereby, during beam search, paths that are invalid according to the CTC confidence matrix are penalised. Our network architecture is composed of a Convolutional Neural Network (CNN) as visual backbone, bidirectional Long-Short-Term-Memory-Cells (LSTMs) as encoder, and a decoder which is a Transformer with inserted mutual attention layers. The CTC confidences are computed on the encoder while the Transformer is only used for character-wise S2S decoding. We evaluate this setup on three HTR data sets: IAM, Rimes, and StAZH. On IAM, we achieve a competitive Character Error Rate (CER) of 2.95% when pretraining our model on synthetic data and including a character-based language model for contemporary English. Compared to other state-of-the-art approaches, our model requires about 10-20 times less parameters. Access our shared implementations via this link to GitHub: https://github.com/Planet-AI-GmbH/tfaip-hybrid-ctc-s2s.

Accurate sequence-to-sequence (seq2seq) alignment is critical for applications like medical speech analysis and language learning tools relying on automatic speech recognition (ASR). State-of-the-art end-to-end (E2E) ASR systems, such as the Connectionist Temporal Classification (CTC) and transducer-based models, suffer from peaky behavior and alignment inaccuracies. In this paper, we propose a novel differentiable alignment framework based on one-dimensional optimal transport, enabling the model to learn a single alignment and perform ASR in an E2E manner. We introduce a pseudo-metric, called Sequence Optimal Transport Distance (SOTD), over the sequence space and discuss its theoretical properties. Based on the SOTD, we propose Optimal Temporal Transport Classification (OTTC) loss for ASR and contrast its behavior with CTC. Experimental results on the TIMIT, AMI, and LibriSpeech datasets show that our method considerably improves alignment performance compared to CTC and the more recently proposed Consistency-Regularized CTC, though with a trade-off in ASR performance. We believe this work opens new avenues for seq2seq alignment research, providing a solid foundation for further exploration and development within the community. Our code is publicly available at: https://github.com/idiap/OTTC

Supervised synthetic CT generation from CBCT requires registered training pairs, yet perfect registration between separately acquired scans remains unattainable. This registration bias propagates into trained models and corrupts standard evaluation metrics. This may suggest that superior benchmark performance indicates better reproduction of registration artifacts rather than anatomical fidelity. We propose physics-based CBCT simulation to provide geometrically aligned training pairs by construction, combined with evaluation using geometric alignment metrics against input CBCT rather than biased ground truth. On two independent pelvic datasets, models trained on synthetic data achieved superior geometric alignment (Normalized Mutual Information: 0.31 vs 0.22) despite lower conventional intensity scores. Intensity metrics showed inverted correlations with clinical assessment for deformably registered data, while Normalized Mutual Information consistently predicted observer preference across registration methodologies (rho = 0.31, p < 0.001). Clinical observers preferred synthetic-trained outputs in 87% of cases, demonstrating that geometric fidelity, not intensity agreement with biased ground truth, aligns with clinical requirements.

Supervised synthetic CT (sCT) generation is commonly trained and evaluated as voxel-wise regression against registered reference CT images. In practice, MRI-CT and CBCT-CT pairs are aligned through registration procedures that leave residual misalignments. These residuals are not independent intensity noise but spatially coherent geometric discrepancies that act as structured label noise. We investigate how this registration-induced bias affects supervised MRI-to-CT and CBCT-to-CT synthesis on 1,784 paired patients covering five anatomical regions. Voxel-wise scores strongly depend on the consistency between the registration used to build the training targets and the one used for evaluation: models score best when both conventions match, showing that networks partly learn the geometric convention of the registration pipeline and that standard metrics reward it. Training on more anatomically consistent registrations reduces prediction variability and improves out-of-distribution robustness, and CT-only controls show that registration alone produces metric errors in the range of top challenge submissions. To mitigate the limits of voxel-wise supervision, we introduce a perceptual loss computed in the feature space of a pretrained Segment Anything encoder. Compared with MAE-only and VGG-based objectives, it improves downstream segmentation and yields sharper, more structurally coherent sCT. Perceptual and voxel-wise metrics disagree under imperfect alignment and agree when the evaluation geometry is reliable. These results identify registration-induced bias as a central confounder in supervised sCT generation and argue for complementing voxel-wise agreement with anatomy-oriented evaluation criteria.

Connectionist Temporal Classification (CTC) is a widely used method for automatic speech recognition (ASR), renowned for its simplicity and computational efficiency. However, it often falls short in recognition performance. In this work, we propose the Consistency-Regularized CTC (CR-CTC), which enforces consistency between two CTC distributions obtained from different augmented views of the input speech mel-spectrogram. We provide in-depth insights into its essential behaviors from three perspectives: 1) it conducts self-distillation between random pairs of sub-models that process different augmented views; 2) it learns contextual representation through masked prediction for positions within time-masked regions, especially when we increase the amount of time masking; 3) it suppresses the extremely peaky CTC distributions, thereby reducing overfitting and improving the generalization ability. Extensive experiments on LibriSpeech, Aishell-1, and GigaSpeech datasets demonstrate the effectiveness of our CR-CTC. It significantly improves the CTC performance, achieving state-of-the-art results comparable to those attained by transducer or systems combining CTC and attention-based encoder-decoder (CTC/AED). We release our code at https://github.com/k2-fsa/icefall.

Accurate recognition of rare and new words remains a pressing problem for contextualized Automatic Speech Recognition (ASR) systems. Most context-biasing methods involve modification of the ASR model or the beam-search decoding algorithm, complicating model reuse and slowing down inference. This work presents a new approach to fast context-biasing with CTC-based Word Spotter (CTC-WS) for CTC and Transducer (RNN-T) ASR models. The proposed method matches CTC log-probabilities against a compact context graph to detect potential context-biasing candidates. The valid candidates then replace their greedy recognition counterparts in corresponding frame intervals. A Hybrid Transducer-CTC model enables the CTC-WS application for the Transducer model. The results demonstrate a significant acceleration of the context-biasing recognition with a simultaneous improvement in F-score and WER compared to baseline methods. The proposed method is publicly available in the NVIDIA NeMo toolkit.

The recently proposed Conformer architecture has shown state-of-the-art performances in Automatic Speech Recognition by combining convolution with attention to model both local and global dependencies. In this paper, we study how to reduce the Conformer architecture complexity with a limited computing budget, leading to a more efficient architecture design that we call Efficient Conformer. We introduce progressive downsampling to the Conformer encoder and propose a novel attention mechanism named grouped attention, allowing us to reduce attention complexity from O(n^{2}d) to O(n^{2}d / g) for sequence length n, hidden dimension d and group size parameter g. We also experiment the use of strided multi-head self-attention as a global downsampling operation. Our experiments are performed on the LibriSpeech dataset with CTC and RNN-Transducer losses. We show that within the same computing budget, the proposed architecture achieves better performances with faster training and decoding compared to the Conformer. Our 13M parameters CTC model achieves competitive WERs of 3.6%/9.0% without using a language model and 2.7%/6.7% with an external n-gram language model on the test-clean/test-other sets while being 29% faster than our CTC Conformer baseline at inference and 36% faster to train.

Connectionist Temporal Classification (CTC) suffers from the latency problem when applied to streaming models. We argue that in CTC lattice, the alignments that can access more future context are preferred during training, thereby leading to higher symbol delay. In this work we propose the delay-penalized CTC which is augmented with latency penalty regularization. We devise a flexible and efficient implementation based on the differentiable Finite State Transducer (FST). Specifically, by attaching a binary attribute to CTC topology, we can locate the frames that firstly emit non-blank tokens on the resulting CTC lattice, and add the frame offsets to the log-probabilities. Experimental results demonstrate the effectiveness of our proposed delay-penalized CTC, which is able to balance the delay-accuracy trade-off. Furthermore, combining the delay-penalized transducer enables the CTC model to achieve better performance and lower latency. Our work is open-sourced and publicly available https://github.com/k2-fsa/k2.

Generating synthetic Computed Tomography (CT) images from Cone Beam Computed Tomography (CBCT) is desirable for improving the image quality of CBCT. Existing synthetic CT (sCT) generation methods using Convolutional Neural Networks (CNN) and Transformers often face difficulties in effectively capturing both global and local features and contrasts for high-quality sCT generation. In this work, we propose a Global-Local Feature and Contrast learning (GLFC) framework for sCT generation. First, a Mamba-Enhanced UNet (MEUNet) is introduced by integrating Mamba blocks into the skip connections of a high-resolution UNet for effective global and local feature learning. Second, we propose a Multiple Contrast Loss (MCL) that calculates synthetic loss at different intensity windows to improve quality for both soft tissues and bone regions. Experiments on the SynthRAD2023 dataset demonstrate that GLFC improved the SSIM of sCT from 77.91% to 91.50% compared with the original CBCT, and significantly outperformed several existing methods for sCT generation. The code is available at https://github.com/HiLab-git/GLFC

Large Language Models (LLMs) are expected to produce safe, helpful, and honest content during interaction with human users, but they frequently fail to align with such values when given flawed instructions, e.g., missing context, ambiguous directives, or inappropriate tone, leaving substantial room for improvement along multiple dimensions. A cost-effective yet high-impact way is to pre-align instructions before the model begins decoding. Existing approaches either rely on prohibitive test-time search costs or end-to-end model rewrite, which is powered by a customized training corpus with unclear objectives. In this work, we demonstrate that the goal of efficient and effective preference alignment can be achieved by P-Aligner, a lightweight module generating instructions that preserve the original intents while being expressed in a more human-preferred form. P-Aligner is trained on UltraPrompt, a new dataset synthesized via a proposed principle-guided pipeline using Monte-Carlo Tree Search, which systematically explores the space of candidate instructions that are closely tied to human preference. Experiments across different methods show that P-Aligner generally outperforms strong baselines across various models and benchmarks, including average win-rate gains of 28.35% and 8.69% on GPT-4-turbo and Gemma-2-SimPO, respectively. Further analyses validate its effectiveness and efficiency through multiple perspectives, including data quality, search strategies, iterative deployment, and time overhead.

Text to image latent diffusion models have recently advanced medical image synthesis, but applications to 3D CT generation remain limited. Existing approaches rely on simplified prompts, neglecting the rich semantic detail in full radiology reports, which reduces text image alignment and clinical fidelity. We propose Report2CT, a radiology report conditional latent diffusion framework for synthesizing 3D chest CT volumes directly from free text radiology reports, incorporating both findings and impression sections using multiple text encoder. Report2CT integrates three pretrained medical text encoders (BiomedVLP CXR BERT, MedEmbed, and ClinicalBERT) to capture nuanced clinical context. Radiology reports and voxel spacing information condition a 3D latent diffusion model trained on 20000 CT volumes from the CT RATE dataset. Model performance was evaluated using Frechet Inception Distance (FID) for real synthetic distributional similarity and CLIP based metrics for semantic alignment, with additional qualitative and quantitative comparisons against GenerateCT model. Report2CT generated anatomically consistent CT volumes with excellent visual quality and text image alignment. Multi encoder conditioning improved CLIP scores, indicating stronger preservation of fine grained clinical details in the free text radiology reports. Classifier free guidance further enhanced alignment with only a minor trade off in FID. We ranked first in the VLM3D Challenge at MICCAI 2025 on Text Conditional CT Generation and achieved state of the art performance across all evaluation metrics. By leveraging complete radiology reports and multi encoder text conditioning, Report2CT advances 3D CT synthesis, producing clinically faithful and high quality synthetic data.

Recent work has witnessed a paradigm shift from Seq2Seq to Seq2Edit in the field of text editing, with the aim of addressing the slow autoregressive inference problem posed by the former. Despite promising results, Seq2Edit approaches still face several challenges such as inflexibility in generation and difficulty in generalizing to other languages. In this work, we propose a novel non-autoregressive text editing method to circumvent the above issues, by modeling the edit process with latent CTC alignments. We make a crucial extension to CTC by introducing the copy operation into the edit space, thus enabling more efficient management of textual overlap in editing. We conduct extensive experiments on GEC and sentence fusion tasks, showing that our proposed method significantly outperforms existing Seq2Edit models and achieves similar or even better results than Seq2Seq with over 4times speedup. Moreover, it demonstrates good generalizability on German and Russian. In-depth analyses reveal the strengths of our method in terms of the robustness under various scenarios and generating fluent and flexible outputs.

Lyrics alignment gained considerable attention in recent years. State-of-the-art systems either re-use established speech recognition toolkits, or design end-to-end solutions involving a Connectionist Temporal Classification (CTC) loss. However, both approaches suffer from specific weaknesses: toolkits are known for their complexity, and CTC systems use a loss designed for transcription which can limit alignment accuracy. In this paper, we use instead a contrastive learning procedure that derives cross-modal embeddings linking the audio and text domains. This way, we obtain a novel system that is simple to train end-to-end, can make use of weakly annotated training data, jointly learns a powerful text model, and is tailored to alignment. The system is not only the first to yield an average absolute error below 0.2 seconds on the standard Jamendo dataset but it is also robust to other languages, even when trained on English data only. Finally, we release word-level alignments for the JamendoLyrics Multi-Lang dataset.

We present a state-of-the-art end-to-end Automatic Speech Recognition (ASR) model. We learn to listen and write characters with a joint Connectionist Temporal Classification (CTC) and attention-based encoder-decoder network. The encoder is a deep Convolutional Neural Network (CNN) based on the VGG network. The CTC network sits on top of the encoder and is jointly trained with the attention-based decoder. During the beam search process, we combine the CTC predictions, the attention-based decoder predictions and a separately trained LSTM language model. We achieve a 5-10\% error reduction compared to prior systems on spontaneous Japanese and Chinese speech, and our end-to-end model beats out traditional hybrid ASR systems.

We introduce Aligner, a novel Parameter-Efficient Fine-Tuning (PEFT) method for aligning multi-billion-parameter-sized Large Language Models (LLMs). Aligner employs a unique design that constructs a globally shared set of tunable tokens that modify the attention of every layer. Remarkably with this method, even when using one token accounting for a mere 5,000 parameters, Aligner can still perform comparably well to state-of-the-art LLM adaptation methods like LoRA that require millions of parameters. This capacity is substantiated in both instruction following and value alignment tasks. Besides the multiple order-of-magnitude improvement in parameter efficiency, the insight Aligner provides into the internal mechanisms of LLMs is also valuable. The architectural features and efficacy of our method, in addition to our experiments demonstrate that an LLM separates its internal handling of "form" and "knowledge" in a somewhat orthogonal manner. This finding promises to motivate new research into LLM mechanism understanding and value alignment.

High-quality data labeling from specific domains is costly and human time-consuming. In this work, we propose a self-supervised domain adaptation method, based upon an iterative pseudo-forced alignment algorithm. The produced alignments are employed to customize an end-to-end Automatic Speech Recognition (ASR) and iteratively refined. The algorithm is fed with frame-wise character posteriors produced by a seed ASR, trained with out-of-domain data, and optimized throughout a Connectionist Temporal Classification (CTC) loss. The alignments are computed iteratively upon a corpus of broadcast TV. The process is repeated by reducing the quantity of text to be aligned or expanding the alignment window until finding the best possible audio-text alignment. The starting timestamps, or temporal anchors, are produced uniquely based on the confidence score of the last aligned utterance. This score is computed with the paths of the CTC-alignment matrix. With this methodology, no human-revised text references are required. Alignments from long audio files with low-quality transcriptions, like TV captions, are filtered out by confidence score and ready for further ASR adaptation. The obtained results, on both the Spanish RTVE2022 and CommonVoice databases, underpin the feasibility of using CTC-based systems to perform: highly accurate audio-text alignments, domain adaptation and semi-supervised training of end-to-end ASR.

Word alignment has traditionally been studied between sentences, but many cross-lingual tasks increasingly require correspondences across full documents. While recent multilingual embedding models can encode long inputs, we show that applying algorithms designed for sentences directly to documents leads to performance degradation. To address this, we introduce CTFAlign, a lightweight, training-free approach for document-level word alignment. CTFAlign applies a coarse-to-fine refinement strategy that restricts the alignment search space to semantically similar regions. Additionally, we introduce MDPAlign, a simpler alternative that constrains alignments by position with a main diagonal prior. Both approaches operate directly on full documents without relying on sentence segmentation or sentence alignment. We evaluate these methods across six language pairs varying in typological distance, resourcedness, and document length. Averaged over three models, CTFAlign reduces word alignment error rate from 0.412 to 0.326. These gains transfer downstream, leading to improvements in document-level translation coverage evaluation and recognition of semantic differences. We release CTFAlign as a Python package and make the code and data to reproduce our experiments publicly available.

Objective. Deformable image registration remains challenging because corresponding anatomy may exhibit different intensity relationships. Hand-crafted modality-robust descriptors such as Modality-Independent Neighborhood Descriptor with Self-Similarity Context (MIND-SSC) and features from pretrained vision encoders provide distinct representations for correspondence estimation, but how they should be combined remains unclear. We investigate whether tighter integration improves registration over a sequential, scale-separated design. Approach. We introduce FlexiMIND, a training-free and label-free two-stage framework in which frozen FlexiCT-2D encoder features establish contextual correspondence and MIND-SSC refines the deformation within ConvexAdam. Five alternative feature-coupling strategies were evaluated under a protocol across CT-CT (DIR-Lab 4DCT 4DCT, 10 cases), MR-MR (ACDC, 50 patients), and MR-CT (Learn2Reg Abdomen MR-CT, 8 pairs) registration. Performance was assessed using target registration error (TRE), Dice similarity coefficient (Dice), SDlogJ, and local folding. Main results. FlexiMIND achieved a TRE of 1.27 mm on DIR-Lab 4DCT, a DSC of 0.807 on ACDC, and an organ-averaged DSC of 0.825 on Abdomen MR-CT. Across 15 coupling-strategy dataset comparisons, only four outperformed the reference method, with a maximum absolute improvement of 0.0043 in Dice, whereas degradation reached 20.6 % in TRE and 37.9 % in Dice. Changes in registration accuracy were closely associated with changes in deformation-field regularity, and strategies that better preserved regularity generally remained closest to the reference performance. Landmark-level analysis showed that the pretrained encoder stage primarily reduced large correspondence errors rather than uniformly improving local precision. Code is available upon acceptance at https://github.com/mosaf/FlexiMIND.

Deep learning models have demonstrated exceptional performance across a wide range of computer vision tasks. However, their performance often degrades significantly when faced with distribution shifts, such as domain or dataset changes. Test-Time Training (TTT) has emerged as an effective method to enhance model robustness by incorporating an auxiliary unsupervised task during training and leveraging it for model updates at test time. In this work, we introduce CTA (Cross-Task Alignment), a novel approach for improving TTT. Unlike existing TTT methods, CTA does not require a specialized model architecture and instead takes inspiration from the success of multi-modal contrastive learning to align a supervised encoder with a self-supervised one. This process enforces alignment between the learned representations of both models, thereby mitigating the risk of gradient interference, preserving the intrinsic robustness of self-supervised learning and enabling more semantically meaningful updates at test-time. Experimental results demonstrate substantial improvements in robustness and generalization over the state-of-the-art on several benchmark datasets.

Unlocking medieval archives at scale is bottlenecked by the cost of line-level diplomatic transcriptions and manual abbreviation expansion. Focusing on the registers of Pope Honorius III (1216-1227) over 5,000 letters surviving in full only as manuscript images - we show that existing, line-break-free expert transcriptions (edition drafts) suffice to train end-to-end hand-written text recognition (HTR) that jointly transcribes and expands heavily abbreviated Latin. Using forced alignment on 860 unaligned edition entries across 394 pages of Reg. Vat. 9, we automatically bootstrap 13,122 training lines without manual alignment of segmented lines. While the generic CATMuS baseline struggles on this domain (18.9% CER) and a modular space-free HTR + word-segmentation pipeline (cf. Camps et al. 2021) plateaus at 15.6% WER, our from-scratch hybrid Conformer - combining CTC with bidirectional subword attention decoders, iterative self-realignment and n-best LM rescoring - achieves 4.7% CER and 8.7% WER (8.4% WER with ROVER system combination), nearly halving errors on clause-final words (22.7% to 12.2% WER). These figures are measured on the test lines that align with the transcription (86% of all test lines for the best hybrid). Furthermore, we address a tension between paleographic fidelity and editorial normalization: training on targets that preserve scribal name initials reduces the WER against the manuscript text on the 31 affected test lines from 13.3% to 9.2%, at a small cost against the expanded transcription (WER +0.3 points, CER +0.4). Finally, extensive ablations show that none of an auxiliary diplomatic CTC head, a copy mechanism, a permutation decoder or masked-image pretraining improves on direct end-to-end supervision, while strict padding-mask propagation and per-line beam termination make inference batch-invariant.

We present a simple and efficient auxiliary loss function for automatic speech recognition (ASR) based on the connectionist temporal classification (CTC) objective. The proposed objective, an intermediate CTC loss, is attached to an intermediate layer in the CTC encoder network. This intermediate CTC loss well regularizes CTC training and improves the performance requiring only small modification of the code and small and no overhead during training and inference, respectively. In addition, we propose to combine this intermediate CTC loss with stochastic depth training, and apply this combination to a recently proposed Conformer network. We evaluate the proposed method on various corpora, reaching word error rate (WER) 9.9% on the WSJ corpus and character error rate (CER) 5.2% on the AISHELL-1 corpus respectively, based on CTC greedy search without a language model. Especially, the AISHELL-1 task is comparable to other state-of-the-art ASR systems based on auto-regressive decoder with beam search.

Intraoperative Cone Beam Computed Tomography (CBCT) provides a reliable 3D anatomical context essential for interventional planning. However, its static nature fails to provide continuous monitoring of soft-tissue deformations induced by respiration, probe pressure, and surgical manipulation, leading to navigation discrepancies. We propose a deformation-aware CBCT updating framework that leverages robotic ultrasound as a dynamic proxy to infer tissue motion and update static CBCT slices in real time. Starting from calibration-initialized alignment with linear correlation of linear combination (LC2)-based rigid refinement, our method establishes accurate multimodal correspondence. To capture intraoperative dynamics, we introduce the ultrasound correlation UNet (USCorUNet), a lightweight network trained with optical flow-guided supervision to learn deformation-aware correlation representations, enabling accurate, real-time dense deformation field estimation from ultrasound streams. The inferred deformation is spatially regularized and transferred to the CBCT reference to produce deformation-consistent visualizations without repeated radiation exposure. We validate the proposed approach through deformation estimation and ultrasound-guided CBCT updating experiments. Results demonstrate real-time end-to-end CBCT slice updating and physically plausible deformation estimation, enabling dynamic refinement of static CBCT guidance during robotic ultrasound-assisted interventions. The source code is publicly available at https://github.com/anonymous-codebase/us-cbct-demo.

Medical image segmenters often get worse when sites, scanner vendors, or protocols change. Continual test-time adaptation (CTTA) addresses this problem without target labels, but it can be impossible to update a model on a non-stationary stream and can lead to a lot of errors. We examine a more reasonable and meaningful alternative: parameter-frozen inference enhancement(PIE). We use a source-trained segmenter that learns about anatomy-preserving scale and flip views, maps their predictions back to the native location, and averages the probabilities. We do not modify the weights of the model or the normalization statistics. On a cardiac MRI stream from M\&Ms, which is trained on vendor A and evaluated sequentially on vendors B, C, and D, PIE has 0.7786 mean Dice, compared to 0.7680 for source-only inference and 0.7388--0.7416 for five other online-adaptation baselines. The controlled ablations show that performance saturates at 28 views, and confidence weighting, class-prior correction, connected-component filtering, morphological refinement, and inter-slice smoothing have no effect or cause negative transfer. Qualitative results on cardiac MRI and fundus images are also consistent with the frozen ensemble keeping thinner and nested anatomical structures. These results provide a strong, stable baseline for medical CTTA and expose an important failure mode: adaptation and handcrafted refinement can be less reliable than carefully designed inference.

Root canal (RC) treatment is a highly delicate and technically complex procedure in clinical practice, heavily influenced by the clinicians' experience and subjective judgment. Deep learning has made significant advancements in the field of computer-aided diagnosis (CAD) because it can provide more objective and accurate diagnostic results. However, its application in RC treatment is still relatively rare, mainly due to the lack of public datasets in this field. To address this issue, in this paper, we established a First Molar Root Canal segmentation dataset called FMRC-2025. Additionally, to alleviate the workload of manual annotation for dentists and fully leverage the unlabeled data, we designed a Cross-Frequency Collaborative training semi-supervised learning (SSL) Network called CFC-Net. It consists of two components: (1) Cross-Frequency Collaborative Mean Teacher (CFC-MT), which introduces two specialized students (SS) and one comprehensive teacher (CT) for collaborative multi-frequency training. The CT and SS are trained on different frequency components while fully integrating multi-frequency knowledge through cross and full frequency consistency supervisions. (2) Uncertainty-guided Cross-Frequency Mix (UCF-Mix) mechanism enables the network to generate high-confidence pseudo-labels while learning to integrate multi-frequency information and maintaining the structural integrity of the targets. Extensive experiments on FMRC-2025 and three public dental datasets demonstrate that CFC-MT is effective for RC segmentation and can also exhibit strong generalizability on other dental segmentation tasks, outperforming state-of-the-art SSL medical image segmentation methods. Codes and dataset will be released.

CAD-to-image alignment aims to estimate an object's 9D pose (rotation, translation, and anisotropic scale) from a single RGB image, enabling applications in robotics and augmented reality. Recent zero-shot methods use visual foundation models to match image regions to CAD models, yet typically their correspondences are appearance-driven and degrade under occlusion or sim-to-real domain shift. To address these limitations, we introduce SUFLECA (Scaling Up Feature LEarning for CAD Alignment), a weakly-supervised framework for zero-shot CAD alignment with two key contributions. First, SUFLECA scales up geometry-grounded feature learning from pretrained visual representations through Normalized Object Coordinates (NOCs) supervision on 674K images spanning 12 real and synthetic datasets, learning compact geometry-aware features that generalize across domains. Second, we propose a geometrically consistent matching algorithm that establishes reliable one-to-one CAD-to-image correspondences. Together, these contributions enable accurate, sub-second alignment per object instance without iterative pose refinement. On ScanNet25k, SUFLECA achieves 33.4%/42.3% category/instance accuracy, outperforming, with a smaller computational footprint, the strongest zero-shot baseline by 10.3/12.2 percentage points and, for the first time on this benchmark, even surpassing fully supervised methods. Code is available at: https://github.com/snt-arg/SUFLECA

Computed tomography (CT) is a central to three-dimensional medical imaging, yet CT-based artificial intelligence remains fragmented across task-specific models for segmentation, classification, registration, and report analysis. Here we present FlexiCT, a family of CT foundation models trained by agglomerative continual pretraining on 266,227 CT volumes from 56 publicly available datasets, forming a large-scale public resource for CT representation learning. FlexiCT uses agglomerative pretraining across three stages: two-dimensional axial pretraining, three-dimensional anatomical pretraining and report-guided semantic alignment. This training strategy supports slice-level, volume-level and vision-language analysis. Across five downstream task families (segmentation, classification, registration, vision-language understanding and clinical retrieval), FlexiCT matches or exceeds prior task-specific approaches on multiple benchmarks. Its embeddings further organize CT scans along gradients associated with various tumor stages, suggesting that CT foundation models can capture imaging features relevant to disease phenotype characterization. Code is available at https://github.com/ricklisz/FlexiCT

Generative modelling of entire CT volumes conditioned on clinical reports has the potential to accelerate research through data augmentation, privacy-preserving synthesis and reducing regulator-constraints on patient data while preserving diagnostic signals. With the recent release of CT-RATE, a large-scale collection of 3D CT volumes paired with their respective clinical reports, training large text-conditioned CT volume generation models has become achievable. In this work, we introduce CTFlow, a 0.5B latent flow matching transformer model, conditioned on clinical reports. We leverage the A-VAE from FLUX to define our latent space, and rely on the CT-Clip text encoder to encode the clinical reports. To generate consistent whole CT volumes while keeping the memory constraints tractable, we rely on a custom autoregressive approach, where the model predicts the first sequence of slices of the volume from text-only, and then relies on the previously generated sequence of slices and the text, to predict the following sequence. We evaluate our results against state-of-the-art generative CT model, and demonstrate the superiority of our approach in terms of temporal coherence, image diversity and text-image alignment, with FID, FVD, IS scores and CLIP score.

Recent 3D CT vision-language models align volumes with reports via contrastive pretraining, but typically rely on limited public data and provide only coarse global supervision. We train a 3D CT vision-language model on 98k report-volume pairs (50k patients) collected at a single hospital, combined with public datasets, using SigLIP-style contrastive pretraining together with prompt-based disease supervision in the shared vision-text embedding space. On CT-RATE, our model achieves state-of-the-art text-to-image retrieval (R@10 31.5 vs. 22.2) and competitive disease classification (AUC 83.8 vs. 83.8), with consistent results on Rad-ChestCT (AUC 77.0 vs. 77.3). We further observe that radiologists routinely reference specific images within their reports (e.g., ``series X, image Y''), linking textual descriptions to precise axial locations. We automatically mine 262k such snippet-slice pairs and introduce the task of intra-scan snippet localization -- predicting the axial depth referred to by a text snippet -- reducing mean absolute error to 36.3 mm at 12 mm feature resolution, compared with 67.0 mm for the best baseline. Adding this localization objective leaves retrieval and classification broadly unchanged within confidence bounds, yielding a single unified model for retrieval, classification, and intra-scan grounding.

Continual Test-Time Adaptation (CTTA) aims to maintain model performance under evolving target domains by adapting online without labeled data. However, practical deployments often cannot retain the source dataset due to privacy or licensing constraints, and purely source-free CTTA methods tend to become unstable under long-term distribution shift, suffering from compounding self-training errors and catastrophic forgetting. We introduce DO-ALL (Distill Once, Adapt Life-Long), a plug-and-play framework that revisits source information in a compact and privacy-conscious form via Dataset Distillation (DD). Before deployment, DO-ALL performs DD to produce a small set of synthetic distilled anchors that summarize the source distribution. During adaptation, each target sample is matched with its most semantically aligned anchor, which provides a stable reference for various CTTA via source replay, representation alignment, and manifold-smoothing regularization. DO-ALL can be seamlessly integrated into existing CTTA algorithms, consistently improving long-term robustness across CIFAR100-C, ImageNet-C, and the CCC benchmark. This demonstrates the potential of leveraging DD to enable stable and continuous adaptation without retaining raw source data. The code is available at https://github.com/blue-531/DOALL.

Neural Transducer and connectionist temporal classification (CTC) are popular end-to-end automatic speech recognition systems. Due to their frame-synchronous design, blank symbols are introduced to address the length mismatch between acoustic frames and output tokens, which might bring redundant computation. Previous studies managed to accelerate the training and inference of neural Transducers by discarding frames based on the blank symbols predicted by a co-trained CTC. However, there is no guarantee that the co-trained CTC can maximize the ratio of blank symbols. This paper proposes two novel regularization methods to explicitly encourage more blanks by constraining the self-loop of non-blank symbols in the CTC. It is interesting to find that the frame reduction ratio of the neural Transducer can approach the theoretical boundary. Experiments on LibriSpeech corpus show that our proposed method accelerates the inference of neural Transducer by 4 times without sacrificing performance. Our work is open-sourced and publicly available https://github.com/k2-fsa/icefall.

Large Language Models prompting, such as using in-context demonstrations, is a mainstream technique for invoking LLMs to perform high-performance and solid complex reasoning (e.g., mathematical reasoning, commonsense reasoning), and has the potential for further human-machine collaborative scientific findings. However, current LLMs are delicate and elusive in prompt words and styles. And there is an unseen gap between LLM understanding and human-written prompts. This paper introduces Alignedcot, an LLM-acquainted prompting technique that includes proficient ``native-speaking'' in in-context learning for the LLMs. Specifically, it achieves consistent and correct step-wise prompts in zero-shot scenarios by progressively probing, refining, and formatting the LLM chain of thoughts so that free from handcrafted few-shot demonstrations while maintaining the prompt quality. We conduct experiments on mathematical reasoning and commonsense reasoning. We find that LLMs with Alignedcot perform significantly superior to them with human-crafted demonstrations. We further apply Alignedcot for rewriting the GSM8K training set, resulting in a GSM8K-Align dataset. We observe its benefits for retrieval augmented generation. The code and data can be found at https://github.com/yangzhch6/AlignedCoT.

Efforts to align Large Language Models (LLMs) are mainly conducted via Reinforcement Learning from Human Feedback (RLHF) methods. However, RLHF encounters major challenges including training reward models, actor-critic engineering, and importantly, it requires access to LLM parameters. Here we introduce Aligner, a new efficient alignment paradigm that bypasses the whole RLHF process by learning the correctional residuals between the aligned and the unaligned answers. Our Aligner offers several key advantages. Firstly, it is an autoregressive seq2seq model that is trained on the query-answer-correction dataset via supervised learning; this offers a parameter-efficient alignment solution with minimal resources. Secondly, the Aligner facilitates weak-to-strong generalization; finetuning large pretrained models by Aligner's supervisory signals demonstrates strong performance boost. Thirdly, Aligner functions as a model-agnostic plug-and-play module, allowing for its direct application on different open-source and API-based models. Remarkably, Aligner-7B improves 11 different LLMs by 21.9% in helpfulness and 23.8% in harmlessness on average (GPT-4 by 17.5% and 26.9%). When finetuning (strong) Llama2-70B with (weak) Aligner-13B's supervision, we can improve Llama2 by 8.2% in helpfulness and 61.6% in harmlessness. See our dataset and code at https://aligner2024.github.io

Time accurate speech transcription is essential in critical appli- cations, such as medical conversation transcription, reading as- sessment, and atypical speech recognition. Encoder-decoder auto- matic speech recognition models, such as Whisper, do not produce word-level timestamps out-of-the-box for all languages. Existing approaches to word-level time stamp estimation either use an exter- nal CTC model capable of frame level phoneme/character prediction which is computationally expensive, or use the cross attention scores internal to the model which gives coarse time stamps. We consider timestamped speech transcription for Hindi in this paper. We pro- pose a CTC-based approach, in which we train a low-complexity character level CTC head directly on the Whisper encoder output, to address the complexity and granularity limitations of existing works. We evaluate the system using manually-annotated word-level times- tamps. Experiments show that the proposed internal-CTC based approach performs similar to using an external CTC model and better than the cross attention score-based approaches. Further, we study the usage of CTC-head output to detect and mitigate hallu- cinations in conversational speech. Our results show that a simple token length criterion derived from the CTC output can improve the transcription quality for short segments where hallucinations are more probable.

CTC compressor can be an effective approach to integrate audio encoders to decoder-only models, which has gained growing interest for different speech applications. In this work, we propose a novel CTC compressor based joint speech and text training (CJST) framework for decoder-only ASR. CJST matches speech and text modalities from both directions by exploring a simple modality adaptor and several features of the CTC compressor, including sequence compression, on-the-fly forced peaky alignment and CTC class embeddings. Experimental results on the Librispeech and TED-LIUM2 corpora show that the proposed CJST achieves an effective text injection without the need of duration handling, leading to the best performance for both in-domain and cross-domain scenarios. We also provide a comprehensive study on CTC compressor, covering various compression modes, edge case handling and behavior under both clean and noisy data conditions, which reveals the most robust setting to use CTC compressor for decoder-only models.

Weakly-Supervised Semantic Segmentation (WSSS) using image-level labels typically utilizes Class Activation Map (CAM) to generate the pseudo labels. Limited by the local structure perception of CNN, CAM usually cannot identify the integral object regions. Though the recent Vision Transformer (ViT) can remedy this flaw, we observe it also brings the over-smoothing issue, \ie, the final patch tokens incline to be uniform. In this work, we propose Token Contrast (ToCo) to address this issue and further explore the virtue of ViT for WSSS. Firstly, motivated by the observation that intermediate layers in ViT can still retain semantic diversity, we designed a Patch Token Contrast module (PTC). PTC supervises the final patch tokens with the pseudo token relations derived from intermediate layers, allowing them to align the semantic regions and thus yield more accurate CAM. Secondly, to further differentiate the low-confidence regions in CAM, we devised a Class Token Contrast module (CTC) inspired by the fact that class tokens in ViT can capture high-level semantics. CTC facilitates the representation consistency between uncertain local regions and global objects by contrasting their class tokens. Experiments on the PASCAL VOC and MS COCO datasets show the proposed ToCo can remarkably surpass other single-stage competitors and achieve comparable performance with state-of-the-art multi-stage methods. Code is available at https://github.com/rulixiang/ToCo.

Efficient, reliable and reproducible target volume delineation is a key step in the effective planning of breast radiotherapy. However, post-operative breast target delineation is challenging as the contrast between the tumor bed volume (TBV) and normal breast tissue is relatively low in CT images. In this study, we propose to mimic the marker-guidance procedure in manual target delineation. We developed a saliency-based deep learning segmentation (SDL-Seg) algorithm for accurate TBV segmentation in post-operative breast irradiation. The SDL-Seg algorithm incorporates saliency information in the form of markers' location cues into a U-Net model. The design forces the model to encode the location-related features, which underscores regions with high saliency levels and suppresses low saliency regions. The saliency maps were generated by identifying markers on CT images. Markers' locations were then converted to probability maps using a distance-transformation coupled with a Gaussian filter. Subsequently, the CT images and the corresponding saliency maps formed a multi-channel input for the SDL-Seg network. Our in-house dataset was comprised of 145 prone CT images from 29 post-operative breast cancer patients, who received 5-fraction partial breast irradiation (PBI) regimen on GammaPod. The performance of the proposed method was compared against basic U-Net. Our model achieved mean (standard deviation) of 76.4 %, 6.76 mm, and 1.9 mm for DSC, HD95, and ASD respectively on the test set with computation time of below 11 seconds per one CT volume. SDL-Seg showed superior performance relative to basic U-Net for all the evaluation metrics while preserving low computation cost. The findings demonstrate that SDL-Seg is a promising approach for improving the efficiency and accuracy of the on-line treatment planning procedure of PBI, such as GammaPod based PBI.

A 3D CT scan entering a vision-language model produces a long sequence of visual tokens, often thousands to tens of thousands per volume, and this sequence must be compressed before a language model can consume it. Token compression is well studied in general vision, but little of it targets 3D CT specifically. A common baseline is grid average, which pools regular grid cells and can blend distinct anatomy, lesion, and air into one token. We present ORCA (ORgan-Centroid Aggregation), a token compressor for 3D CT. It merges adjacent tokens with organ guidance and adds a sinusoidal encoding of each region's centroid to preserve spatial layout. This preserves the anatomical information a downstream model needs. ORCA is training-free and plug-and-play, producing an adjustable token set without any model change or text query. We evaluate it across two datasets (CT-RATE and Merlin) and five encoders. The evaluation spans two task types: attribute prediction over five families (size, density, location, texture, and disease) and text generation (visual question answering and report generation). At matched token budgets, ORCA improves consistently over existing compression methods. It shrinks the visual context 64times and its KV-cache 50times, and is 31times faster to process each volume. Code released at https://github.com/renjie-liang/ORCA-3DCT.

Objective: While recent advances in text-conditioned generative models have enabled the synthesis of realistic medical images, progress has been largely confined to 2D modalities such as chest X-rays. Extending text-to-image generation to volumetric Computed Tomography (CT) remains a significant challenge, due to its high dimensionality, anatomical complexity, and the absence of robust frameworks that align vision-language data in 3D medical imaging. Methods: We introduce a novel architecture for Text-to-CT generation that combines a latent diffusion model with a 3D contrastive vision-language pretraining scheme. Our approach leverages a dual-encoder CLIP-style model trained on paired CT volumes and radiology reports to establish a shared embedding space, which serves as the conditioning input for generation. CT volumes are compressed into a low-dimensional latent space via a pretrained volumetric VAE, enabling efficient 3D denoising diffusion without requiring external super-resolution stages. Results: We evaluate our method on the CT-RATE dataset and conduct a comprehensive assessment of image fidelity, clinical relevance, and semantic alignment. Our model achieves competitive performance across all tasks, significantly outperforming prior baselines for text-to-CT generation. Moreover, we demonstrate that CT scans synthesized by our framework can effectively augment real data, improving downstream diagnostic performance. Conclusion: Our results show that modality-specific vision-language alignment is a key component for high-quality 3D medical image generation. By integrating contrastive pretraining and volumetric diffusion, our method offers a scalable and controllable solution for synthesizing clinically meaningful CT volumes from text, paving the way for new applications in data augmentation, medical education, and automated clinical simulation.

Recurrent neural network (RNN) and connectionist temporal classification (CTC) have showed successes in many sequence labeling tasks with the strong ability of dealing with the problems where the alignment between the inputs and the target labels is unknown. Residual network is a new structure of convolutional neural network and works well in various computer vision tasks. In this paper, we take advantage of the architectures mentioned above to create a new network for handwritten digit string recognition. First we design a residual network to extract features from input images, then we employ a RNN to model the contextual information within feature sequences and predict recognition results. At the top of this network, a standard CTC is applied to calculate the loss and yield the final results. These three parts compose an end-to-end trainable network. The proposed new architecture achieves the highest performances on ORAND-CAR-A and ORAND-CAR-B with recognition rates 89.75% and 91.14%, respectively. In addition, the experiments on a generated captcha dataset which has much longer string length show the potential of the proposed network to handle long strings.

Recently, end-to-end models have been widely used in automatic speech recognition (ASR) systems. Two of the most representative approaches are connectionist temporal classification (CTC) and attention-based encoder-decoder (AED) models. Autoregressive transformers, variants of AED, adopt an autoregressive mechanism for token generation and thus are relatively slow during inference. In this paper, we present a comprehensive study of a CTC Alignment-based Single-Step Non-Autoregressive Transformer (CASS-NAT) for end-to-end ASR. In CASS-NAT, word embeddings in the autoregressive transformer (AT) are substituted with token-level acoustic embeddings (TAE) that are extracted from encoder outputs with the acoustical boundary information offered by the CTC alignment. TAE can be obtained in parallel, resulting in a parallel generation of output tokens. During training, Viterbi-alignment is used for TAE generation, and multiple training strategies are further explored to improve the word error rate (WER) performance. During inference, an error-based alignment sampling method is investigated in depth to reduce the alignment mismatch in the training and testing processes. Experimental results show that the CASS-NAT has a WER that is close to AT on various ASR tasks, while providing a ~24x inference speedup. With and without self-supervised learning, we achieve new state-of-the-art results for non-autoregressive models on several datasets. We also analyze the behavior of the CASS-NAT decoder to explain why it can perform similarly to AT. We find that TAEs have similar functionality to word embeddings for grammatical structures, which might indicate the possibility of learning some semantic information from TAEs without a language model.

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

Contrastive vision-language learning uses paired chest CT volumes and radiology reports to learn abnormality classifiers without manually annotated labels. However, two characteristics of chest CT challenge conventional global contrastive learning. First, many critical abnormalities are small or anatomically localized, and pooling an en- tire volume into a single embedding may dilute their visual evidence. Second, the standard contrastive objective treats every other scan in a batch as a negative. Because many chest CTs share abnormalities, this objective incorrectly pushes co-positive pairs apart. We propose Anatomy-Routed Contrastive Learning for 3D Chest CT (ARC-CT), a region-aware framework that addresses these limitations using only la- bels extracted from reports by an LLM, with no manual annotations or bounding boxes. ARC-CT combines three components: (1) an Anato- myQFormer localizing evidence via queries constrained by automatically generated organ masks; (2) a label-Jaccard soft InfoNCE objective in- tegrating the standard one-hot target with the label-set overlap of each pair, which reduces false-negative penalties between studies that share clinical findings; and (3) an organ-level alignment loss connecting mask- pooled visual features to organ-specific report text extracted offline with a large language model. ARC-CT achieves a 0.86 mask-free macro AUC across 18 abnormalities using a compact 3D ResNet-18 backbone. Over- all, ARC-CT outperforms both comparable efficient baselines and sev- eral larger transformer models. Our code and weights are available at https://github.com/arc-ct/arc-ct.

Medical vision-language pre-training shows great potential in learning representative features from massive paired radiographs and reports. However, in computed tomography (CT) scans, the distribution of lesions which contain intricate structures is characterized by spatial sparsity. Besides, the complex and implicit relationships between different pathological descriptions in each sentence of the report and their corresponding sub-regions in radiographs pose additional challenges. In this paper, we propose a Similarity-Driven Cross-Granularity Pre-training (SimCroP) framework on chest CTs, which combines similarity-driven alignment and cross-granularity fusion to improve radiograph interpretation. We first leverage multi-modal masked modeling to optimize the encoder for understanding precise low-level semantics from radiographs. Then, similarity-driven alignment is designed to pre-train the encoder to adaptively select and align the correct patches corresponding to each sentence in reports. The cross-granularity fusion module integrates multimodal information across instance level and word-patch level, which helps the model better capture key pathology structures in sparse radiographs, resulting in improved performance for multi-scale downstream tasks. SimCroP is pre-trained on a large-scale paired CT-reports dataset and validated on image classification and segmentation tasks across five public datasets. Experimental results demonstrate that SimCroP outperforms both cutting-edge medical self-supervised learning methods and medical vision-language pre-training methods. Codes and models are available at https://github.com/ToniChopp/SimCroP.

Purpose : To develop and evaluate CAPTOR, a deep-learning vision-language foundation model for oncologic chest-abdomen-pelvis (CAP) CT interpretation. Materials & Methods : CAPTOR (Chest-Abdomen-Pelvis foundaTion model for Oncologic Radiology) is a contrastive vision-language model, trained using a pretraining strategy for oncologic CAP CT (in single- or multiple-series acquisitions), on a multicenter retrospective dataset from North America, Europe and Asia, predominantly from tumor lesion examinations. CAPTOR was compared with state-of-the-art CT foundation models on three downstream tasks: disease detection, survival prediction using TumorImagingBench and image retrieval. Classification and retrieval were both evaluated on held-out internal and public test sets, stratified by anatomical coverage and indication. Bootstrap resampling was used to estimate confidence intervals, and pairwise comparisons were performed using permutation tests. Results : CAPTOR was trained and tested on 25,512 and 10,794 CT-report pairs respectively. TumorImagingBench datasets comprised between 134 and 421 studies each. CAPTOR outperformed all baseline models, on the classification task, on the CAP subset (AUC 0.767, 95%CI: 0.734-0.793, vs. 0.695, 95%CI: 0.645-0.736 for the next-best, p<0.001) and oncologic subset (AUC 0.784, 95%CI: 0.759-0.805, vs. 0.734, 95%CI: 0.703-0.767 p<0.001), ranked first on three of the four oncologic prognostic benchmarks, and achieved superior retrieval performance on CAP and oncologic subsets. Conclusion : A foundation model trained on oncology-enriched CAP CT data outperformed relevant state-of-the-art models in its target clinical context, underscoring the importance of clinically aligned pretraining. We release our preprocessing, training and inference code : https://github.com/Guerbet-AI/CAPTOR and model weights : https://huggingface.co/Guerbet-AI/CAPTOR

Recent alignment-free non-autoregressive (NAR) text-to-speech (TTS) models formulate synthesis as a conditional infilling task, bypassing explicit duration predictors and external aligners. When speech is represented with neural codec tokens, the infilling problem becomes discrete, making Discrete Flow Matching (DFM), a Continuous-Time Markov Chain (CTMC) framework for discrete generation, a natural fit. However, inference-time control for stable low-step conditional infilling remains underexplored. We propose Mask, Sample, Revise, an inference-time CTMC stack for alignment-free DFM-TTS. The stack combines predictor-free guidance to strengthen text conditioning, prompt-matched conditional coupling to align the probability path with the acoustic prompt, and SC-ReMask, a schedule-constrained remasking mechanism that introduces token-to-mask transitions so early de-masking decisions can be revised. These components require no post-hoc fine-tuning and operate in a single tau-leaping sampler. Controlled ablations show that this stack improves intelligibility and robustness in the low-NFE prompted setting, outperforming unguided and guidance-only samplers with substantially more steps.

Vision-language models offer a promising path toward automating radiology report generation, but applying them to full 3D CT volumes poses substantial computational challenges. Modern foundation vision encoders (VEs) can produce tens of thousands of vision tokens per scan, making the visual sequence passed to the large language model (LLM) a primary computational bottleneck. Vision-to-language projectors can compress this sequence to reduce computation, but may discard clinically relevant detail; conversely, effective compression can accommodate higher-resolution inputs while keeping the downstream token count fixed. How this vision-token budget should be allocated across input field of view, spatial resolution, and vision-to-language projection therefore remains an open design question. We systematically evaluate four heterogeneous VEs (CNN- and ViT-based), five token-reducing projectors at up to 64x compression alongside a non-reducing MLP projector baseline, and five instruction-tuned LLMs (1.7B--4B) on two large-scale CT report datasets (CT-RATE and Merlin). At matched LLM token budgets, anatomy-guided region of interest cropping is the most consistent strategy, improving clinical macro F1 in 19 of 20 settings by +3.7 points on average for the 3D ViT Primus encoder and +1.1 for the slice-based 2D ViT Curia encoder. Increasing input resolution further is strongly projector-dependent: the PerceiverResampler, paired with higher-resolution Curia features, yields the strongest configuration in the resolution study on both datasets. Our best configurations achieve state-of-the-art clinical macro F1 on the test sets, reaching 49.5 on CT-RATE and 49.0 on Merlin. Code and models will be published upon publication.

In this study, we introduce CT-LLM, a 2B large language model (LLM) that illustrates a pivotal shift towards prioritizing the Chinese language in developing LLMs. Uniquely initiated from scratch, CT-LLM diverges from the conventional methodology by primarily incorporating Chinese textual data, utilizing an extensive corpus of 1,200 billion tokens, including 800 billion Chinese tokens, 300 billion English tokens, and 100 billion code tokens. This strategic composition facilitates the model's exceptional proficiency in understanding and processing Chinese, a capability further enhanced through alignment techniques. Demonstrating remarkable performance on the CHC-Bench, CT-LLM excels in Chinese language tasks, and showcases its adeptness in English through SFT. This research challenges the prevailing paradigm of training LLMs predominantly on English corpora and then adapting them to other languages, broadening the horizons for LLM training methodologies. By open-sourcing the full process of training a Chinese LLM, including a detailed data processing procedure with the obtained Massive Appropriate Pretraining Chinese Corpus (MAP-CC), a well-chosen multidisciplinary Chinese Hard Case Benchmark (CHC-Bench), and the 2B-size Chinese Tiny LLM (CT-LLM), we aim to foster further exploration and innovation in both academia and industry, paving the way for more inclusive and versatile language models.

Vision-language models (VLMs) for radiology have emerged as a scalable paradigm by leveraging image-report pairs naturally produced in clinical workflows. However, this pairing reveals a mismatch in scale: each finding occupies only a small region of the image, yet supervision is provided only at the global image-report level. This poses a central challenge: prior approaches spread weight densely across all patches rather than concentrating on the sparse subset relevant to a given query. To address this, we present GLINT (Gated Language-Image alignmeNT), a framework that explicitly models this sparse correspondence. On the alignment side, we introduce Sparsely Gated Alignment, a novel architecture in which a sigmoid gate over a separate gate embedding space activates only the patches relevant to each textual query, enforcing explicit sparsity. On the representation side, we add Dense Feature Regularization, which anchors the trainable encoder's intermediate features to a frozen self-supervised learning (SSL) teacher, preserving the fine-grained patch features that the gate relies on. The same recipe applies to both 2D chest X-ray (CXR) and 3D chest computed tomography (CT), built with DINOv3 and V-JEPA 2.1, respectively. GLINT enables zero-shot classification, grounding, and segmentation from free-text queries, and to our knowledge is the first to demonstrate zero-shot segmentation on 3D CT volumes without mask supervision. Notably, the most pronounced gains arise on zero-shot grounding and segmentation, where sparse, query-specific localization is required, consistent with our design intent. In downstream evaluation, GLINT outperforms both SSL encoders and medical VLMs on classification, report generation, and segmentation.

We propose self-speculative decoding for speech-aware LLMs by using the CTC encoder as a draft model to accelerate auto-regressive (AR) inference and improve ASR accuracy. Our three-step procedure works as follows: (1) if the frame entropies of the CTC output distributions are below a threshold, the greedy CTC hypothesis is accepted as final; (2) otherwise, the CTC hypothesis is verified in a single LLM forward pass using a relaxed acceptance criterion based on token likelihoods; (3) if verification fails, AR decoding resumes from the accepted CTC prefix. Experiments on nine corpora and five languages show that this approach can simultaneously accelerate decoding and reduce WER. On the HuggingFace Open ASR benchmark with a 1B parameter LLM and 440M parameter CTC encoder, we achieve a record 5.58% WER and improve the inverse real time factor by a factor of 4.4 with only a 12% relative WER increase over AR search. Code and model weights are publicly available under a permissive license.

Zero-shot Image Captioning (ZIC) increasingly utilizes synthetic datasets generated by text-to-image (T2I) models to mitigate the need for costly manual annotation. However, these T2I models often produce images that exhibit semantic misalignments with their corresponding input captions (e.g., missing objects, incorrect attributes), resulting in noisy synthetic image-caption pairs that can hinder model training. Existing dataset pruning techniques are largely designed for removing noisy text in web-crawled data. However, these methods are ill-suited for the distinct challenges of synthetic data, where captions are typically well-formed, but images may be inaccurate representations. To address this gap, we introduce SynC, a novel framework specifically designed to refine synthetic image-caption datasets for ZIC. Instead of conventional filtering or regeneration, SynC focuses on reassigning captions to the most semantically aligned images already present within the synthetic image pool. Our approach employs a one-to-many mapping strategy by initially retrieving multiple relevant candidate images for each caption. We then apply a cycle-consistency-inspired alignment scorer that selects the best image by verifying its ability to retrieve the original caption via image-to-text retrieval. Extensive evaluations demonstrate that SynC consistently and significantly improves performance across various ZIC models on standard benchmarks (MS-COCO, Flickr30k, NoCaps), achieving state-of-the-art results in several scenarios. SynC offers an effective strategy for curating refined synthetic data to enhance ZIC.

Recent advances in zero-shot referring image segmentation (RIS), driven by models such as the Segment Anything Model (SAM) and CLIP, have made substantial progress in aligning visual and textual information. Despite these successes, the extraction of precise and high-quality mask region representations remains a critical challenge, limiting the full potential of RIS tasks. In this paper, we introduce a training-free, hybrid global-local feature extraction approach that integrates detailed mask-specific features with contextual information from the surrounding area, enhancing mask region representation. To further strengthen alignment between mask regions and referring expressions, we propose a spatial guidance augmentation strategy that improves spatial coherence, which is essential for accurately localizing described areas. By incorporating multiple spatial cues, this approach facilitates more robust and precise referring segmentation. Extensive experiments on standard RIS benchmarks demonstrate that our method significantly outperforms existing zero-shot RIS models, achieving substantial performance gains. We believe our approach advances RIS tasks and establishes a versatile framework for region-text alignment, offering broader implications for cross-modal understanding and interaction. Code is available at https://github.com/fhgyuanshen/HybridGL .

Computer-aided design (CAD) tools are increasingly popular in modern dental practice, particularly for treatment planning or comprehensive prognosis evaluation. In particular, the 2D panoramic X-ray image efficiently detects invisible caries, impacted teeth and supernumerary teeth in children, while the 3D dental cone beam computed tomography (CBCT) is widely used in orthodontics and endodontics due to its low radiation dose. However, there is no open-access 2D public dataset for children's teeth and no open 3D dental CBCT dataset, which limits the development of automatic algorithms for segmenting teeth and analyzing diseases. The Semi-supervised Teeth Segmentation (STS) Challenge, a pioneering event in tooth segmentation, was held as a part of the MICCAI 2023 ToothFairy Workshop on the Alibaba Tianchi platform. This challenge aims to investigate effective semi-supervised tooth segmentation algorithms to advance the field of dentistry. In this challenge, we provide two modalities including the 2D panoramic X-ray images and the 3D CBCT tooth volumes. In Task 1, the goal was to segment tooth regions in panoramic X-ray images of both adult and pediatric teeth. Task 2 involved segmenting tooth sections using CBCT volumes. Limited labelled images with mostly unlabelled ones were provided in this challenge prompt using semi-supervised algorithms for training. In the preliminary round, the challenge received registration and result submission by 434 teams, with 64 advancing to the final round. This paper summarizes the diverse methods employed by the top-ranking teams in the STS MICCAI 2023 Challenge.

Image registration is important for medical imaging, the estimation of the spatial transformation between different images. Many previous studies have used learning-based methods for coarse-to-fine registration to efficiently perform 3D image registration. The coarse-to-fine approach, however, is limited when dealing with the different motions of nearby objects. Here we propose a novel Motion-Aware (MA) structure that captures the different motions in a region. The MA structure incorporates a novel Residual Aligner (RA) module which predicts the multi-head displacement field used to disentangle the different motions of multiple neighbouring objects. Compared with other deep learning methods, the network based on the MA structure and RA module achieve one of the most accurate unsupervised inter-subject registration on the 9 organs of assorted sizes in abdominal CT scans, with the highest-ranked registration of the veins (Dice Similarity Coefficient / Average surface distance: 62\%/4.9mm for the vena cava and 34\%/7.9mm for the portal and splenic vein), with a half-sized structure and more efficient computation. Applied to the segmentation of lungs in chest CT scans, the new network achieves results which were indistinguishable from the best-ranked networks (94\%/3.0mm). Additionally, the theorem on predicted motion pattern and the design of MA structure are validated by further analysis.

Bone density prediction via CT scans to estimate T-scores is crucial, providing a more precise assessment of bone health compared to traditional methods like X-ray bone density tests, which lack spatial resolution and the ability to detect localized changes. However, CT-based prediction faces two major challenges: the high computational complexity of transformer-based architectures, which limits their deployment in portable and clinical settings, and the imbalanced, long-tailed distribution of real-world hospital data that skews predictions. To address these issues, we introduce MedConv, a convolutional model for bone density prediction that outperforms transformer models with lower computational demands. We also adapt Bal-CE loss and post-hoc logit adjustment to improve class balance. Extensive experiments on our AustinSpine dataset shows that our approach achieves up to 21% improvement in accuracy and 20% in ROC AUC over previous state-of-the-art methods.

While beam search improves speech recognition quality over greedy decoding, standard implementations are slow, often sequential, and CPU-bound. To fully leverage modern hardware capabilities, we present a novel open-source FlexCTC toolkit for fully GPU-based beam decoding, designed for Connectionist Temporal Classification (CTC) models. Developed entirely in Python and PyTorch, it offers a fast, user-friendly, and extensible alternative to traditional C++, CUDA, or WFST-based decoders. The toolkit features a high-performance, fully batched GPU implementation with eliminated CPU-GPU synchronization and minimized kernel launch overhead via CUDA Graphs. It also supports advanced contextualization techniques, including GPU-powered N-gram language model fusion and phrase-level boosting. These features enable accurate and efficient decoding, making them suitable for both research and production use.

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

Although deep neural networks have achieved reasonable accuracy in solving face alignment, it is still a challenging task, specifically when we deal with facial images, under occlusion, or extreme head poses. Heatmap-based Regression (HBR) and Coordinate-based Regression (CBR) are among the two mainly used methods for face alignment. CBR methods require less computer memory, though their performance is less than HBR methods. In this paper, we propose an Adaptive Coordinate-based Regression (ACR) loss to improve the accuracy of CBR for face alignment. Inspired by the Active Shape Model (ASM), we generate Smooth-Face objects, a set of facial landmark points with less variations compared to the ground truth landmark points. We then introduce a method to estimate the level of difficulty in predicting each landmark point for the network by comparing the distribution of the ground truth landmark points and the corresponding Smooth-Face objects. Our proposed ACR Loss can adaptively modify its curvature and the influence of the loss based on the difficulty level of predicting each landmark point in a face. Accordingly, the ACR Loss guides the network toward challenging points than easier points, which improves the accuracy of the face alignment task. Our extensive evaluation shows the capabilities of the proposed ACR Loss in predicting facial landmark points in various facial images.

Large Language Models (LLMs) need to be aligned with human expectations to ensure their safety and utility in most applications. Alignment is challenging, costly, and needs to be repeated for every LLM and alignment criterion. We propose to decouple LLMs and alignment by training aligner models that can be used to align any LLM for a given criteria on an as-needed basis, thus also reducing the potential negative impacts of alignment on performance. Our recipe for training the aligner models solely relies on synthetic data generated with a (prompted) LLM and can be easily adjusted for a variety of alignment criteria. We illustrate our method by training an "ethical" aligner and verify its efficacy empirically.

This paper proposes a method to relax the conditional independence assumption of connectionist temporal classification (CTC)-based automatic speech recognition (ASR) models. We train a CTC-based ASR model with auxiliary CTC losses in intermediate layers in addition to the original CTC loss in the last layer. During both training and inference, each generated prediction in the intermediate layers is summed to the input of the next layer to condition the prediction of the last layer on those intermediate predictions. Our method is easy to implement and retains the merits of CTC-based ASR: a simple model architecture and fast decoding speed. We conduct experiments on three different ASR corpora. Our proposed method improves a standard CTC model significantly (e.g., more than 20 % relative word error rate reduction on the WSJ corpus) with a little computational overhead. Moreover, for the TEDLIUM2 corpus and the AISHELL-1 corpus, it achieves a comparable performance to a strong autoregressive model with beam search, but the decoding speed is at least 30 times faster.

Existing methods for text-to-CAD generation either operate in a single pass with no geometric verification or rely on lossy visual feedback that cannot resolve dimensional errors. We present CADSmith, a multi-agent pipeline that generates CadQuery code from natural language. It then undergoes an iterative refinement process through two nested correction loops: an inner loop that resolves execution errors and an outer loop grounded in programmatic geometric validation. The outer loop combines exact measurements from the OpenCASCADE kernel (bounding box dimensions, volume, solid validity) with holistic visual assessment from an independent vision-language model Judge. This provides both the numerical precision and the high-level shape awareness needed to converge on the correct geometry. The system uses retrieval-augmented generation over API documentation rather than fine-tuning, maintaining a current database as the underlying CAD library evolves. We evaluate on a custom benchmark of 100 prompts in three difficulty tiers (T1 through T3) with three ablation configurations. Against a zero-shot baseline, CADSmith achieves a 100% execution rate (up from 95%), improves the median F1 score from 0.9707 to 0.9846, the median IoU from 0.8085 to 0.9629, and reduces the mean Chamfer Distance from 28.37 to 0.74, demonstrating that closed-loop refinement with programmatic geometric feedback substantially improves the quality and reliability of LLM-generated CAD models.

Image-Text Matching (ITM) task, a fundamental vision-language (VL) task, suffers from the inherent ambiguity arising from multiplicity and imperfect annotations. Deterministic functions are not sufficiently powerful to capture ambiguity, prompting the exploration of probabilistic embeddings to tackle the challenge. However, the existing probabilistic ITM approach encounters two key shortcomings; the burden of heavy computations due to the Monte Carlo approximation, and the loss saturation issue in the face of abundant false negatives. To overcome the issues, this paper presents an improved Probabilistic Cross-Modal Embeddings (named PCME++) by introducing a new probabilistic distance with a closed-form solution. In addition, two optimization techniques are proposed to enhance PCME++ further: first, the incorporation of pseudo-positives to prevent the loss saturation problem under massive false negatives; second, mixed sample data augmentation for probabilistic matching. Experimental results on MS-COCO Caption and two extended benchmarks, CxC and ECCV Caption, demonstrate the effectiveness of PCME++ compared to state-of-the-art ITM methods. The robustness of PCME++ is also evaluated under noisy image-text correspondences. In addition, the potential applicability of PCME++ in automatic prompt tuning for zero-shot classification is shown. The code is available at https://github.com/naver-ai/pcmepp.

Template-based segmentation, a widely used paradigm in medical imaging, propagates anatomical labels via deformable registration from a labeled atlas to a target image, and is often used to compute volumetric biomarkers for downstream decision-making. While conformal prediction (CP) provides finite-sample valid intervals for scalar metrics, existing segmentation-based uncertainty quantification (UQ) approaches either rely on learned model features, often unavailable in classic template-based pipelines, or treat the registration process as a black box, resulting in overly conservative intervals when applied directly in output space. We introduce ConVOLT, a CP framework that achieves efficient volumetric UQ by conditioning calibration on properties of the estimated deformation field from template-based segmentation. ConVOLT calibrates a learned volumetric scaling factor from deformation space features. We evaluate ConVOLT on template-based segmentation tasks involving global, regional, and label volumetry across multiple datasets and registration methods. ConVOLT achieves target coverage while producing substantially tighter intervals than output-space conformal baselines. Our work paves way to exploit the registration process for efficient UQ in medical imaging pipelines.

Learning medical visual representations directly from paired radiology reports has become an emerging topic in representation learning. However, existing medical image-text joint learning methods are limited by instance or local supervision analysis, ignoring disease-level semantic correspondences. In this paper, we present a novel Multi-Granularity Cross-modal Alignment (MGCA) framework for generalized medical visual representation learning by harnessing the naturally exhibited semantic correspondences between medical image and radiology reports at three different levels, i.e., pathological region-level, instance-level, and disease-level. Specifically, we first incorporate the instance-wise alignment module by maximizing the agreement between image-report pairs. Further, for token-wise alignment, we introduce a bidirectional cross-attention strategy to explicitly learn the matching between fine-grained visual tokens and text tokens, followed by contrastive learning to align them. More important, to leverage the high-level inter-subject relationship semantic (e.g., disease) correspondences, we design a novel cross-modal disease-level alignment paradigm to enforce the cross-modal cluster assignment consistency. Extensive experimental results on seven downstream medical image datasets covering image classification, object detection, and semantic segmentation tasks demonstrate the stable and superior performance of our framework.

Vision-language models (VLMs) pretrained on large-scale image-text pairs demonstrate strong image-level understanding, but are primarily optimized for global alignment and do not explicitly encode fine-grained anatomical structure, limiting their suitability for spatially precise tasks such as segmentation. We introduce CheXanatomy, a framework that integrates explicit anatomical knowledge into a pretrained VLM through autoregressive token-space supervision. Instead of adding task-specific decoder heads, the model is trained to generate anatomical segmentation masks via next-token prediction. To enable scalable supervision, we synthesize realistic chest radiographs from CT volumes and forward-project CT segmentation labels to obtain anatomically consistent 2D masks. We evaluate the approach on synthetic and real chest radiographs against a U-Net baseline, including ablations on model scale, input resolution, and vision encoder fine-tuning. Autoregressive anatomical supervision achieves performance comparable to specialized convolutional models in-distribution and demonstrates improved geometric robustness under domain shift to real CXR data. In addition, anatomy-pretrained models exhibit improved sample efficiency when adapting to novel localization tasks under limited supervision. Larger models and higher input image resolution improve performance, while vision encoder fine-tuning has limited effect. These results show that embedding anatomical structure directly into the generative objective promotes spatially grounded representations and supports anatomy-aware medical vision-language modeling.

Accurate and reliable C-arm positioning is essential for fluoroscopy-guided interventions. However, clinical workflows rely on manual alignment that increases radiation exposure and procedural delays. In this work, we present a pipeline that autonomously navigates the C-arm to predefined anatomical landmarks utilizing X-ray images. Given an input X-ray image from an arbitrary starting location on the operating table, the model predicts a 3D displacement vector toward each target landmark along the body. To ensure reliable deployment, we capture both aleatoric and epistemic uncertainties in the model's predictions and further calibrate them using conformal prediction. The derived prediction regions are interpreted as 3D confidence regions around the predicted landmark locations. The training framework combines a probabilistic loss with skeletal pose regularization to encourage anatomically plausible outputs. We validate our approach on a synthetic X-ray dataset generated from DeepDRR. Results show not only strong localization accuracy across multiple architectures but also well-calibrated prediction bounds. These findings highlight the pipeline's potential as a component in safe and reliable autonomous C-arm systems. Code is available at https://github.com/AhmadArrabi/C_arm_guidance_APAH

Recent advances in AI foundation models have significant potential for lightening the clinical workload by mimicking the comprehensive and multi-faceted approaches used by medical professionals. In the field of radiation oncology, the integration of multiple modalities holds great importance, so the opportunity of foundational model is abundant. Inspired by this, here we present RO-LMM, a multi-purpose, comprehensive large multimodal model (LMM) tailored for the field of radiation oncology. This model effectively manages a series of tasks within the clinical workflow, including clinical context summarization, radiation treatment plan suggestion, and plan-guided target volume segmentation by leveraging the capabilities of LMM. In particular, to perform consecutive clinical tasks without error accumulation, we present a novel Consistency Embedding Fine-Tuning (CEFTune) technique, which boosts LMM's robustness to noisy inputs while preserving the consistency of handling clean inputs. We further extend this concept to LMM-driven segmentation framework, leading to a novel Consistency Embedding Segmentation~(CESEG) techniques. Experimental results including multi-centre validation confirm that our RO-LMM with CEFTune and CESEG results in promising performance for multiple clinical tasks with generalization capabilities.

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

This study proposes a deep learning framework and annotation methodology for the automatic detection of periodontal bone loss landmarks, associated conditions, and staging. 192 periapical radiographs were collected and annotated with a stage agnostic methodology, labelling clinically relevant landmarks regardless of disease presence or extent. We propose a heuristic post-processing module that aligns predicted keypoints to tooth boundaries using an auxiliary instance segmentation model. An evaluation metric, Percentage of Relative Correct Keypoints (PRCK), is proposed to capture keypoint performance in dental imaging domains. Four donor pose estimation models were adapted with fine-tuning for our keypoint problem. Post-processing improved fine-grained localisation, raising average PRCK^{0.05} by +0.028, but reduced coarse performance for PRCK^{0.25} by -0.0523 and PRCK^{0.5} by -0.0345. Orientation estimation shows excellent performance for auxiliary segmentation when filtered with either stage 1 object detection model. Periodontal staging was detected sufficiently, with the best mesial and distal Dice scores of 0.508 and 0.489, while furcation involvement and widened periodontal ligament space tasks remained challenging due to scarce positive samples. Scalability is implied with similar validation and external set performance. The annotation methodology enables stage agnostic training with balanced representation across disease severities for some detection tasks. The PRCK metric provides a domain-specific alternative to generic pose metrics, while the heuristic post-processing module consistently corrected implausible predictions with occasional catastrophic failures. The proposed framework demonstrates the feasibility of clinically interpretable periodontal bone loss assessment, with potential to reduce diagnostic variability and clinician workload.

Referring 3D Segmentation is a visual-language task that segments all points of the specified object from a 3D point cloud described by a sentence of query. Previous works perform a two-stage paradigm, first conducting language-agnostic instance segmentation then matching with given text query. However, the semantic concepts from text query and visual cues are separately interacted during the training, and both instance and semantic labels for each object are required, which is time consuming and human-labor intensive. To mitigate these issues, we propose a novel Referring 3D Segmentation pipeline, Label-Efficient and Single-Stage, dubbed LESS, which is only under the supervision of efficient binary mask. Specifically, we design a Point-Word Cross-Modal Alignment module for aligning the fine-grained features of points and textual embedding. Query Mask Predictor module and Query-Sentence Alignment module are introduced for coarse-grained alignment between masks and query. Furthermore, we propose an area regularization loss, which coarsely reduces irrelevant background predictions on a large scale. Besides, a point-to-point contrastive loss is proposed concentrating on distinguishing points with subtly similar features. Through extensive experiments, we achieve state-of-the-art performance on ScanRefer dataset by surpassing the previous methods about 3.7% mIoU using only binary labels. Code is available at https://github.com/mellody11/LESS.

Automated radiology report generation from 3D computed tomography (CT) volumes is challenging due to extreme sequence lengths, severe class imbalance, and the tendency of large language models (LLMs) to ignore visual tokens in favor of linguistic priors. We present Ker-VLJEPA-3B, a four-phase curriculum learning framework for free-text report generation from thoracic CT volumes. A phased training curriculum progressively adapts a Llama 3.2 3B decoder to ground its output in visual features from a frozen, self-supervised encoder. Our visual backbone (LeJEPA ViT-Large) is trained via self-supervised joint-embedding prediction on unlabeled CTs, without text supervision. Unlike contrastive models (CLIP, BiomedCLIP), this language-free backbone yields modality-pure representations. Vision-language alignment is deferred to the curriculum's bridge and generation phases. This modality-agnostic design can integrate any self-supervised encoder into an LLM without paired text during foundation training. Methodological innovations include: (1) zone-constrained cross-attention compressing slice embeddings into 32 spatially-grounded visual tokens; (2) PCA whitening of anisotropic LLM embeddings; (3) a positive-findings-only strategy eliminating posterior collapse; (4) warm bridge initialization transferring projection weights; and (5) selective cross-attention freezing with elastic weight consolidation to prevent catastrophic forgetting. Evaluated on the CT-RATE benchmark (2,984 validation volumes, 18 classes), Ker-VLJEPA-3B achieves a macro F1 of 0.429, surpassing the state-of-the-art (U-VLM, macro F1 = 0.414) by 3.6%, and reaching 0.448 (+8.2%) with threshold optimization. Ablation studies confirm 56.6% of generation quality derives from patient-specific visual content. Code and weights are available.

We present ToothCraft, a diffusion-based model for the contextual generation of tooth crowns, trained on artificially created incomplete teeth. Building upon recent advancements in conditioned diffusion models for 3D shapes, we developed a model capable of an automated tooth crown completion conditioned on local anatomical context. To address the lack of training data for this task, we designed an augmentation pipeline that generates incomplete tooth geometries from a publicly available dataset of complete dental arches (3DS, ODD). By synthesising a diverse set of training examples, our approach enables robust learning across a wide spectrum of tooth defects. Experimental results demonstrate the strong capability of our model to reconstruct complete tooth crowns, achieving an intersection over union (IoU) of 81.8% and a Chamfer Distance (CD) of 0.00034 on synthetically damaged testing restorations. Our experiments demonstrate that the model can be applied directly to real-world cases, effectively filling in incomplete teeth, while generated crowns show minimal intersection with the opposing dentition, thus reducing the risk of occlusal interference. Access to the code, model weights, and dataset information will be available at: https://github.com/ikarus1211/VISAPP_ToothCraft

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

Uncertainty estimation is essential for the safe clinical deployment of medical image segmentation systems, enabling the identification of unreliable predictions and supporting human oversight. While prior work has largely focused on pixel-level uncertainty, landmark-based segmentation offers inherent topological guarantees yet remains underexplored from an uncertainty perspective. In this work, we study uncertainty estimation for anatomical landmark-based segmentation on chest X-rays. Inspired by hybrid neural network architectures that combine standard image convolutional encoders with graph-based generative decoders, and leveraging their variational latent space, we derive two complementary measures: (i) latent uncertainty, captured directly from the learned distribution parameters, and (ii) predictive uncertainty, obtained by generating multiple stochastic output predictions from latent samples. Through controlled corruption experiments we show that both uncertainty measures increase with perturbation severity, reflecting both global and local degradation. We demonstrate that these uncertainty signals can identify unreliable predictions by comparing with manual ground-truth, and support out-of-distribution detection on the CheXmask dataset. More importantly, we release CheXmask-U (huggingface.co/datasets/mcosarinsky/CheXmask-U), a large scale dataset of 657,566 chest X-ray landmark segmentations with per-node uncertainty estimates, enabling researchers to account for spatial variations in segmentation quality when using these anatomical masks. Our findings establish uncertainty estimation as a promising direction to enhance robustness and safe deployment of landmark-based anatomical segmentation methods in chest X-ray. A fully working interactive demo of the method is available at huggingface.co/spaces/matiasky/CheXmask-U and the source code at github.com/mcosarinsky/CheXmask-U.

Generative modeling has experienced substantial progress in recent years, particularly in text-to-image and text-to-video synthesis. However, the medical field has not yet fully exploited the potential of large-scale foundational models for synthetic data generation. In this paper, we introduce GenerateCT, the first method for text-conditional computed tomography (CT) generation, addressing the limitations in 3D medical imaging research and making our entire framework open-source. GenerateCT consists of a pre-trained large language model, a transformer-based text-conditional 3D chest CT generation architecture, and a text-conditional spatial super-resolution diffusion model. We also propose CT-ViT, which efficiently compresses CT volumes while preserving auto-regressiveness in-depth, enabling the generation of 3D CT volumes with variable numbers of axial slices. Our experiments demonstrate that GenerateCT can produce realistic, high-resolution, and high-fidelity 3D chest CT volumes consistent with medical language text prompts. We further investigate the potential of GenerateCT by training a model using generated CT volumes for multi-abnormality classification of chest CT volumes. Our contributions provide a valuable foundation for future research in text-conditional 3D medical image generation and have the potential to accelerate advancements in medical imaging research. Our code, pre-trained models, and generated data are available at https://github.com/ibrahimethemhamamci/GenerateCT.

Image registration is fundamental in medical imaging, enabling precise alignment of anatomical structures for diagnosis, treatment planning, image-guided treatment or longitudinal monitoring. This work introduces IMPACT (Image Metric with Pretrained model-Agnostic Comparison for Transmodality registration), a generic semantic similarity metric designed for seamless integration into diverse image registration frameworks (such as Elastix and Voxelmorph). It compares deep learning-based features extracted from medical images without requiring task-specific training, ensuring broad applicability across various modalities. By leveraging the features of the large-scale pretrained TotalSegmentator models and the ability to integrate Segment Anything Model (SAM) and other large-scale segmentation networks, this approach offers significant advantages. It provides robust, scalable, and efficient solutions for multimodal image registration. The IMPACT loss was evaluated on five challenging registration tasks involving thoracic CT/CBCT, and pelvic MR/CT datasets. Quantitative metrics, such as Target Registration Error and Dice Similarity Coefficient, demonstrated significant improvements in anatomical alignment compared to baseline methods. Qualitative analyses further confirmed the increased robustness of the proposed metric in the face of noise, artifacts, and modality variations. IMPACT's versatility and efficiency make it a valuable tool for advancing registration performance in clinical and research applications, addressing critical challenges in multimodal medical imaging.

In this work, we investigate two popular end-to-end automatic speech recognition (ASR) models, namely Connectionist Temporal Classification (CTC) and RNN-Transducer (RNN-T), for offline recognition of voice search queries, with up to 2B model parameters. The encoders of our models use the neural architecture of Google's universal speech model (USM), with additional funnel pooling layers to significantly reduce the frame rate and speed up training and inference. We perform extensive studies on vocabulary size, time reduction strategy, and its generalization performance on long-form test sets. Despite the speculation that, as the model size increases, CTC can be as good as RNN-T which builds label dependency into the prediction, we observe that a 900M RNN-T clearly outperforms a 1.8B CTC and is more tolerant to severe time reduction, although the WER gap can be largely removed by LM shallow fusion.

In this work, we present a hybrid CTC/Attention model based on a ResNet-18 and Convolution-augmented transformer (Conformer), that can be trained in an end-to-end manner. In particular, the audio and visual encoders learn to extract features directly from raw pixels and audio waveforms, respectively, which are then fed to conformers and then fusion takes place via a Multi-Layer Perceptron (MLP). The model learns to recognise characters using a combination of CTC and an attention mechanism. We show that end-to-end training, instead of using pre-computed visual features which is common in the literature, the use of a conformer, instead of a recurrent network, and the use of a transformer-based language model, significantly improve the performance of our model. We present results on the largest publicly available datasets for sentence-level speech recognition, Lip Reading Sentences 2 (LRS2) and Lip Reading Sentences 3 (LRS3), respectively. The results show that our proposed models raise the state-of-the-art performance by a large margin in audio-only, visual-only, and audio-visual experiments.

We present a complete software pipeline for revealing the hidden texts of the Herculaneum papyri using X-ray CT images. This enhanced virtual unwrapping pipeline combines machine learning with a novel geometric framework linking 3D and 2D images. We also present EduceLab-Scrolls, a comprehensive open dataset representing two decades of research effort on this problem. EduceLab-Scrolls contains a set of volumetric X-ray CT images of both small fragments and intact, rolled scrolls. The dataset also contains 2D image labels that are used in the supervised training of an ink detection model. Labeling is enabled by aligning spectral photography of scroll fragments with X-ray CT images of the same fragments, thus creating a machine-learnable mapping between image spaces and modalities. This alignment permits supervised learning for the detection of "invisible" carbon ink in X-ray CT, a task that is "impossible" even for human expert labelers. To our knowledge, this is the first aligned dataset of its kind and is the largest dataset ever released in the heritage domain. Our method is capable of revealing accurate lines of text on scroll fragments with known ground truth. Revealed text is verified using visual confirmation, quantitative image metrics, and scholarly review. EduceLab-Scrolls has also enabled the discovery, for the first time, of hidden texts from the Herculaneum papyri, which we present here. We anticipate that the EduceLab-Scrolls dataset will generate more textual discovery as research continues.

Multimodal Large Language Models (MLLMs) demonstrate impressive cross-modal capabilities, yet their substantial size poses significant deployment challenges. Knowledge distillation (KD) is a promising solution for compressing these models, but existing methods primarily rely on static next-token alignment, neglecting the dynamic token interactions, which embed essential capabilities for multimodal understanding and generation. To this end, we introduce Align-TI, a novel KD framework designed from the perspective of Token Interactions. Our approach is motivated by the insight that MLLMs rely on two primary interactions: vision-instruction token interactions to extract relevant visual information, and intra-response token interactions for coherent generation. Accordingly, Align-TI introduces two components: IVA enables the student model to imitate the teacher's instruction-relevant visual information extract capability by aligning on salient visual regions. TPA captures the teacher's dynamic generative logic by aligning the sequential token-to-token transition probabilities. Extensive experiments demonstrate Align-TI's superiority. Notably, our approach achieves 2.6% relative improvement over Vanilla KD, and our distilled Align-TI-2B even outperforms LLaVA-1.5-7B (a much larger MLLM) by 7.0%, establishing a new state-of-the-art distillation framework for training parameter-efficient MLLMs. Code is available at https://github.com/lchen1019/Align-TI.

We suggest a new multi-modal algorithm for joint inference of paired structurally aligned samples with Rectified Flow models. While some existing methods propose a codependent generation process, they do not view the problem of joint generation from a structural alignment perspective. Recent work uses Score Distillation Sampling to generate aligned 3D models, but SDS is known to be time-consuming, prone to mode collapse, and often provides cartoonish results. By contrast, our suggested approach relies on the joint transport of a segment in the sample space, yielding faster computation at inference time. Our approach can be built on top of an arbitrary Rectified Flow model operating on the structured latent space. We show the applicability of our method to the domains of image, video, and 3D shape generation using state-of-the-art baselines and evaluate it against both editing-based and joint inference-based competing approaches. We demonstrate a high degree of structural alignment for the sample pairs obtained with our method and a high visual quality of the samples. Our method improves the state-of-the-art for image and video generation pipelines. For 3D generation, it is able to show comparable quality while working orders of magnitude faster.

Aligning Large Language Models (LLMs) with human values and preferences is essential for making them helpful and safe. However, building efficient tools to perform alignment can be challenging, especially for the largest and most competent LLMs which often contain tens or hundreds of billions of parameters. We create NeMo-Aligner, a toolkit for model alignment that can efficiently scale to using hundreds of GPUs for training. NeMo-Aligner comes with highly optimized and scalable implementations for major paradigms of model alignment such as: Reinforcement Learning from Human Feedback (RLHF), Direct Preference Optimization (DPO), SteerLM, and Self-Play Fine-Tuning (SPIN). Additionally, our toolkit supports running most of the alignment techniques in a Parameter Efficient Fine-Tuning (PEFT) setting. NeMo-Aligner is designed for extensibility, allowing support for other alignment techniques with minimal effort. It is open-sourced with Apache 2.0 License and we invite community contributions at https://github.com/NVIDIA/NeMo-Aligner

Formula recognition presents significant challenges due to the complicated structure and varied notation of mathematical expressions. Despite continuous advancements in formula recognition models, the evaluation metrics employed by these models, such as BLEU and Edit Distance, still exhibit notable limitations. They overlook the fact that the same formula has diverse representations and is highly sensitive to the distribution of training data, thereby causing the unfairness in formula recognition evaluation. To this end, we propose a Character Detection Matching (CDM) metric, ensuring the evaluation objectivity by designing a image-level rather than LaTex-level metric score. Specifically, CDM renders both the model-predicted LaTeX and the ground-truth LaTeX formulas into image-formatted formulas, then employs visual feature extraction and localization techniques for precise character-level matching, incorporating spatial position information. Such a spatially-aware and character-matching method offers a more accurate and equitable evaluation compared with previous BLEU and Edit Distance metrics that rely solely on text-based character matching. Experimentally, we evaluated various formula recognition models using CDM, BLEU, and ExpRate metrics. Their results demonstrate that the CDM aligns more closely with human evaluation standards and provides a fairer comparison across different models by eliminating discrepancies caused by diverse formula representations.

Training deep neural networks for 3D segmentation tasks can be challenging, often requiring efficient and effective strategies to improve model performance. In this study, we introduce a novel approach, DeCode, that utilizes label-derived features for model conditioning to support the decoder in the reconstruction process dynamically, aiming to enhance the efficiency of the training process. DeCode focuses on improving 3D segmentation performance through the incorporation of conditioning embedding with learned numerical representation of 3D-label shape features. Specifically, we develop an approach, where conditioning is applied during the training phase to guide the network toward robust segmentation. When labels are not available during inference, our model infers the necessary conditioning embedding directly from the input data, thanks to a feed-forward network learned during the training phase. This approach is tested using synthetic data and cone-beam computed tomography (CBCT) images of teeth. For CBCT, three datasets are used: one publicly available and two in-house. Our results show that DeCode significantly outperforms traditional, unconditioned models in terms of generalization to unseen data, achieving higher accuracy at a reduced computational cost. This work represents the first of its kind to explore conditioning strategies in 3D data segmentation, offering a novel and more efficient method for leveraging annotated data. Our code, pre-trained models are publicly available at https://github.com/SanoScience/DeCode .

Developing an interpretable system for generating reports in chest X-ray (CXR) analysis is becoming increasingly crucial in Computer-aided Diagnosis (CAD) systems, enabling radiologists to comprehend the decisions made by these systems. Despite the growth of diverse datasets and methods focusing on report generation, there remains a notable gap in how closely these models' generated reports align with the interpretations of real radiologists. In this study, we tackle this challenge by initially introducing Fine-Grained CXR (FG-CXR) dataset, which provides fine-grained paired information between the captions generated by radiologists and the corresponding gaze attention heatmaps for each anatomy. Unlike existing datasets that include a raw sequence of gaze alongside a report, with significant misalignment between gaze location and report content, our FG-CXR dataset offers a more grained alignment between gaze attention and diagnosis transcript. Furthermore, our analysis reveals that simply applying black-box image captioning methods to generate reports cannot adequately explain which information in CXR is utilized and how long needs to attend to accurately generate reports. Consequently, we propose a novel explainable radiologist's attention generator network (Gen-XAI) that mimics the diagnosis process of radiologists, explicitly constraining its output to closely align with both radiologist's gaze attention and transcript. Finally, we perform extensive experiments to illustrate the effectiveness of our method. Our datasets and checkpoint is available at https://github.com/UARK-AICV/FG-CXR.

Vision-language pretraining has advanced image-text alignment, yet progress in radiology remains constrained by the heterogeneity of clinical reports, including abbreviations, impression-only notes, and stylistic variability. Unlike general-domain settings where more data often leads to better performance, naively scaling to large collections of noisy reports can plateau or even degrade model learning. We ask whether large language model (LLM) encoders can provide robust clinical representations that transfer across diverse styles and better guide image-text alignment. We introduce LLM2VEC4CXR, a domain-adapted LLM encoder for chest X-ray reports, and LLM2CLIP4CXR, a dual-tower framework that couples this encoder with a vision backbone. LLM2VEC4CXR improves clinical text understanding over BERT-based baselines, handles abbreviations and style variation, and achieves strong clinical alignment on report-level metrics. LLM2CLIP4CXR leverages these embeddings to boost retrieval accuracy and clinically oriented scores, with stronger cross-dataset generalization than prior medical CLIP variants. Trained on 1.6M CXR studies from public and private sources with heterogeneous and noisy reports, our models demonstrate that robustness -- not scale alone -- is the key to effective multimodal learning. We release models to support further research in medical image-text representation learning.

Four-dimensional cone-beam computed tomography (4D CBCT) provides respiration-resolved images and can be used for image-guided radiation therapy. However, the ability to reveal respiratory motion comes at the cost of image artifacts. As raw projection data are sorted into multiple respiratory phases, the cone-beam projections become much sparser and the reconstructed 4D CBCT images will be covered by severe streak artifacts. Although several deep learning-based methods have been proposed to address this issue, most algorithms employ 2D network models as backbones, neglecting the intrinsic structural priors within 4D CBCT images. In this paper, we first explore the origin and appearance of streak artifacts in 4D CBCT images. We find that streak artifacts exhibit a unique rotational motion along with the patient's respiration, distinguishable from diaphragm-driven respiratory motion in the spatiotemporal domain. Therefore, we propose a novel 4D neural network model, RSTAR4D-Net, designed to address Rotational STreak Artifact Reduction by integrating the spatial and temporal information within 4D CBCT images. Specifically, we overcome the computational and training difficulties of a 4D neural network. The specially designed model adopts an efficient implementation of 4D convolutions to reduce computational costs and thus can process the whole 4D image in one pass. Additionally, a Tetris training strategy pertinent to the separable 4D convolutions is proposed to effectively train the model using limited 4D training samples. Extensive experiments substantiate the effectiveness of our proposed method, and the RSTAR4D-Net shows superior performance compared to other methods. The source code and dynamic demos are available at https://github.com/ivy9092111111/RSTAR.

As the capabilities of large language models (LLMs) have expanded dramatically, aligning these models with human values presents a significant challenge. Traditional alignment strategies rely heavily on human intervention, such as Supervised Fine-Tuning (SFT) and Reinforcement Learning from Human Feedback (RLHF), or on the self-alignment capacities of LLMs, which usually require a strong LLM's emergent ability to improve its original bad answer. To address these challenges, we propose a novel self-alignment method that utilizes a Chain of Thought (CoT) approach, termed AlignCoT. This method encompasses stages of Question Analysis, Answer Guidance, and Safe Answer production. It is designed to enable LLMs to generate high-quality, safe responses throughout various stages of their development. Furthermore, we introduce the Mixture of insighTful Experts (MoTE) architecture, which applies mixture of experts to enhance each component of the AlignCoT process, markedly increasing alignment efficiency. The MoTE approach not only outperforms existing methods in aligning LLMs with human values but also highlights the benefits of using self-generated data, revealing the dual benefits of improved alignment and training efficiency.

Recent end-to-end Automatic Speech Recognition (ASR) systems demonstrated the ability to outperform conventional hybrid DNN/ HMM ASR. Aside from architectural improvements in those systems, those models grew in terms of depth, parameters and model capacity. However, these models also require more training data to achieve comparable performance. In this work, we combine freely available corpora for German speech recognition, including yet unlabeled speech data, to a big dataset of over 1700h of speech data. For data preparation, we propose a two-stage approach that uses an ASR model pre-trained with Connectionist Temporal Classification (CTC) to boot-strap more training data from unsegmented or unlabeled training data. Utterances are then extracted from label probabilities obtained from the network trained with CTC to determine segment alignments. With this training data, we trained a hybrid CTC/attention Transformer model that achieves 12.8% WER on the Tuda-DE test set, surpassing the previous baseline of 14.4% of conventional hybrid DNN/HMM ASR.

Vision-language pre-training (VLP) has great potential for developing multifunctional and general medical diagnostic capabilities. However, aligning medical images with a low signal-to-noise ratio (SNR) to reports with a high SNR presents a semantic density gap, leading to visual alignment bias. In this paper, we propose boosting vision semantic density to improve alignment effectiveness. On one hand, we enhance visual semantics through disease-level vision contrastive learning, which strengthens the model's ability to differentiate between normal and abnormal samples for each anatomical structure. On the other hand, we introduce an anatomical normality modeling method to model the distribution of normal samples for each anatomy, leveraging VQ-VAE for reconstructing normal vision embeddings in the latent space. This process amplifies abnormal signals by leveraging distribution shifts in abnormal samples, enhancing the model's perception and discrimination of abnormal attributes. The enhanced visual representation effectively captures the diagnostic-relevant semantics, facilitating more efficient and accurate alignment with the diagnostic report. We conduct extensive experiments on two chest CT datasets, CT-RATE and Rad-ChestCT, and an abdominal CT dataset, MedVL-CT69K, and comprehensively evaluate the diagnosis performance across multiple tasks in the chest and abdominal CT scenarios, achieving state-of-the-art zero-shot performance. Notably, our method achieved an average AUC of 84.9% across 54 diseases in 15 organs, significantly surpassing existing methods. Additionally, we demonstrate the superior transfer learning capabilities of our pre-trained model. Code is available at https://github.com/alibaba-damo-academy/ViSD-Boost.

Our approach, which we call Embeddings for Language/Image-aligned X-Rays, or ELIXR, leverages a language-aligned image encoder combined or grafted onto a fixed LLM, PaLM 2, to perform a broad range of tasks. We train this lightweight adapter architecture using images paired with corresponding free-text radiology reports from the MIMIC-CXR dataset. ELIXR achieved state-of-the-art performance on zero-shot chest X-ray (CXR) classification (mean AUC of 0.850 across 13 findings), data-efficient CXR classification (mean AUCs of 0.893 and 0.898 across five findings (atelectasis, cardiomegaly, consolidation, pleural effusion, and pulmonary edema) for 1% (~2,200 images) and 10% (~22,000 images) training data), and semantic search (0.76 normalized discounted cumulative gain (NDCG) across nineteen queries, including perfect retrieval on twelve of them). Compared to existing data-efficient methods including supervised contrastive learning (SupCon), ELIXR required two orders of magnitude less data to reach similar performance. ELIXR also showed promise on CXR vision-language tasks, demonstrating overall accuracies of 58.7% and 62.5% on visual question answering and report quality assurance tasks, respectively. These results suggest that ELIXR is a robust and versatile approach to CXR AI.

Medical imaging plays a significant role in clinical practice of medical diagnosis, where the text reports of the images are essential in understanding them and facilitating later treatments. By generating the reports automatically, it is beneficial to help lighten the burden of radiologists and significantly promote clinical automation, which already attracts much attention in applying artificial intelligence to medical domain. Previous studies mainly follow the encoder-decoder paradigm and focus on the aspect of text generation, with few studies considering the importance of cross-modal mappings and explicitly exploit such mappings to facilitate radiology report generation. In this paper, we propose a cross-modal memory networks (CMN) to enhance the encoder-decoder framework for radiology report generation, where a shared memory is designed to record the alignment between images and texts so as to facilitate the interaction and generation across modalities. Experimental results illustrate the effectiveness of our proposed model, where state-of-the-art performance is achieved on two widely used benchmark datasets, i.e., IU X-Ray and MIMIC-CXR. Further analyses also prove that our model is able to better align information from radiology images and texts so as to help generating more accurate reports in terms of clinical indicators.

Text-conditioned generative models for volumetric medical imaging provide semantic control but lack explicit anatomical guidance, often resulting in outputs that are spatially ambiguous or anatomically inconsistent. In contrast, structure-driven methods ensure strong anatomical consistency but typically assume access to ground-truth annotations, which are unavailable when the target image is to be synthesized. We propose a retrieval-augmented approach for Text-to-CT generation that integrates semantic and anatomical information under a realistic inference setting. Given a radiology report, our method retrieves a semantically related clinical case using a 3D vision-language encoder and leverages its associated anatomical annotation as a structural proxy. This proxy is injected into a text-conditioned latent diffusion model via a ControlNet branch, providing coarse anatomical guidance while maintaining semantic flexibility. Experiments on the CT-RATE dataset show that retrieval-augmented generation improves image fidelity and clinical consistency compared to text-only baselines, while additionally enabling explicit spatial controllability, a capability inherently absent in such approaches. Further analysis highlights the importance of retrieval quality, with semantically aligned proxies yielding consistent gains across all evaluation axes. This work introduces a principled and scalable mechanism to bridge semantic conditioning and anatomical plausibility in volumetric medical image synthesis. Code will be released.

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

End-to-end (E2E) automatic speech recognition (ASR) systems have revolutionized the field by integrating all components into a single neural network, with attention-based encoder-decoder models achieving state-of-the-art performance. However, their autoregressive decoding process limits inference speed, making them unsuitable for real-time applications. In contrast, CTC-based models offer faster, non-autoregressive decoding but struggle to model linguistic dependencies effectively. Addressing this challenge, we propose a novel auxiliary loss framework called Language-Aware Intermediate Loss (LAIL) to enhance CTC-based ASR using the linguistic knowledge of large language models (LLMs). By attaching connector layers to intermediate encoder layers, LAIL maps outputs to the embedding space of an LLM and computes a causal language modeling loss during training. This approach enhances linguistic modeling while preserving the computational efficiency of CTC decoding. Using the Conformer architecture and various LLaMA models, we demonstrate significant improvements in Word Error Rate (WER) on the LibriSpeech, TEDLIUM2, and WSJ corpora, achieving state-of-the-art performance for CTC-based ASR with minimal computational overhead.

3D medical image segmentation methods have been successful, but their dependence on large amounts of voxel-level annotated data is a disadvantage that needs to be addressed given the high cost to obtain such annotation. Semi-supervised learning (SSL) solve this issue by training models with a large unlabelled and a small labelled dataset. The most successful SSL approaches are based on consistency learning that minimises the distance between model responses obtained from perturbed views of the unlabelled data. These perturbations usually keep the spatial input context between views fairly consistent, which may cause the model to learn segmentation patterns from the spatial input contexts instead of the segmented objects. In this paper, we introduce the Translation Consistent Co-training (TraCoCo) which is a consistency learning SSL method that perturbs the input data views by varying their spatial input context, allowing the model to learn segmentation patterns from visual objects. Furthermore, we propose the replacement of the commonly used mean squared error (MSE) semi-supervised loss by a new Cross-model confident Binary Cross entropy (CBC) loss, which improves training convergence and keeps the robustness to co-training pseudo-labelling mistakes. We also extend CutMix augmentation to 3D SSL to further improve generalisation. Our TraCoCo shows state-of-the-art results for the Left Atrium (LA) and Brain Tumor Segmentation (BRaTS19) datasets with different backbones. Our code is available at https://github.com/yyliu01/TraCoCo.

Non-contrast chest CTs offer a rich opportunity for both conventional pulmonary and opportunistic extra-pulmonary screening. While Multi-Task Learning (MTL) can unify these diverse tasks, standard hard-parameter sharing approaches are often suboptimal for modeling distinct pathologies. We propose HyperCT, a framework that dynamically adapts a Vision Transformer backbone via a Hypernetwork. To ensure computational efficiency, we integrate Low-Rank Adaptation (LoRA), allowing the model to regress task-specific low-rank weight updates rather than full parameters. Validated on a large-scale dataset of radiological and cardiological tasks, outperforms various strong baselines, offering a unified, parameter-efficient solution for holistic patient assessment. Our code is available at https://github.com/lfb-1/HyperCT.

Ensuring precise multimodal alignment between diffusion-generated images and input prompts has been a long-standing challenge. Earlier works finetune diffusion weight using high-quality preference data, which tends to be limited and difficult to scale up. Recent editing-based methods further refine local regions of generated images but may compromise overall image quality. In this work, we propose Implicit Multimodal Guidance (IMG), a novel re-generation-based multimodal alignment framework that requires no extra data or editing operations. Specifically, given a generated image and its prompt, IMG a) utilizes a multimodal large language model (MLLM) to identify misalignments; b) introduces an Implicit Aligner that manipulates diffusion conditioning features to reduce misalignments and enable re-generation; and c) formulates the re-alignment goal into a trainable objective, namely Iteratively Updated Preference Objective. Extensive qualitative and quantitative evaluations on SDXL, SDXL-DPO, and FLUX show that IMG outperforms existing alignment methods. Furthermore, IMG acts as a flexible plug-and-play adapter, seamlessly enhancing prior finetuning-based alignment methods. Our code will be available at https://github.com/SHI-Labs/IMG-Multimodal-Diffusion-Alignment.

Reliable spatial understanding is an important prerequisite for future medical vision-language systems that aim to support radiological report generation and structured image understanding. While modern vision-language models (VLMs) show promising performance on many medical imaging tasks, recent evidence suggests they remain weak in controlled spatial reasoning and often fail to reliably ground spatial relations in image evidence. Given that radiological reasoning hinges on understanding the relative positions of anatomical structures and findings, this spatial weakness poses risks to diagnostic accuracy. We present a modular medical imaging agent for binary spatial relation verification in axial CT slices. Instead of directly predicting spatial answers end-to-end, the system decomposes the task into explicit stages: language parsing, anatomical localization, and deterministic geometric verification. Natural-language queries are converted into structured relation tuples, queried organs are localized with a YOLO-based detector, and the final spatial decision is computed from object centers using deterministic geometric rules. We evaluate the approach on the held-out MIRP spatial QA benchmark and compare it against representative end-to-end VLM baselines. The best-performing hybrid configuration reaches 94.1% accuracy and 94.2% F1, outperforming direct Qwen2-VL prompting by 42.5 percentage points in accuracy, while preserving interpretable intermediate representations and auditable reasoning stages. The results suggest that explicit modular spatial verification can serve as a promising building block for future report-oriented medical imaging agents.

Multimodal alignment between language and vision is the fundamental topic in current vision-language model research. Contrastive Captioners (CoCa), as a representative method, integrates Contrastive Language-Image Pretraining (CLIP) and Image Caption (IC) into a unified framework, resulting in impressive results. CLIP imposes a bidirectional constraints on global representation of entire images and sentences. Although IC conducts an unidirectional image-to-text generation on local representation, it lacks any constraint on local text-to-image reconstruction, which limits the ability to understand images at a fine-grained level when aligned with texts. To achieve multimodal alignment from both global and local perspectives, this paper proposes Symmetrizing Contrastive Captioners (SyCoCa), which introduces bidirectional interactions on images and texts across the global and local representation levels. Specifically, we expand a Text-Guided Masked Image Modeling (TG-MIM) head based on ITC and IC heads. The improved SyCoCa can further leverage textual cues to reconstruct contextual images and visual cues to predict textual contents. When implementing bidirectional local interactions, the local contents of images tend to be cluttered or unrelated to their textual descriptions. Thus, we employ an attentive masking strategy to select effective image patches for interaction. Extensive experiments on five vision-language tasks, including image-text retrieval, image-captioning, visual question answering, and zero-shot/finetuned image classification, validate the effectiveness of our proposed method.

Prompt-based methods, which encode medical priors through descriptive text, have been only minimally explored for CT Image Quality Assessment (IQA). While such prompts can embed prior knowledge about diagnostic quality, they often introduce bias by reflecting idealized definitions that may not hold under real-world degradations such as noise, motion artifacts, or scanner variability. To address this, we propose the Context-Aware Prompt-guided Image Quality Assessment (CAP-IQA) framework, which integrates text-level priors with instance-level context prompts and applies causal debiasing to separate idealized knowledge from factual, image-specific degradations. Our framework combines a CNN-based visual encoder with a domain-specific text encoder to assess diagnostic visibility, anatomical clarity, and noise perception in abdominal CT images. The model leverages radiology-style prompts and context-aware fusion to align semantic and perceptual representations. On the 2023 LDCTIQA challenge benchmark, CAP-IQA achieves an overall correlation score of 2.8590 (sum of PLCC, SROCC, and KROCC), surpassing the top-ranked leaderboard team (2.7427) by 4.24%. Moreover, our comprehensive ablation experiments confirm that prompt-guided fusion and the simplified encoder-only design jointly enhance feature alignment and interpretability. Furthermore, evaluation on an in-house dataset of 91,514 pediatric CT images demonstrates the true generalizability of CAP-IQA in assessing perceptual fidelity in a different patient population.

Understanding radiologists' eye movement during Computed Tomography (CT) reading is crucial for developing effective interpretable computer-aided diagnosis systems. However, CT research in this area has been limited by the lack of publicly available eye-tracking datasets and the three-dimensional complexity of CT volumes. To address these challenges, we present the first publicly available eye gaze dataset on CT, called CT-ScanGaze. Then, we introduce CT-Searcher, a novel 3D scanpath predictor designed specifically to process CT volumes and generate radiologist-like 3D fixation sequences, overcoming the limitations of current scanpath predictors that only handle 2D inputs. Since deep learning models benefit from a pretraining step, we develop a pipeline that converts existing 2D gaze datasets into 3D gaze data to pretrain CT-Searcher. Through both qualitative and quantitative evaluations on CT-ScanGaze, we demonstrate the effectiveness of our approach and provide a comprehensive assessment framework for 3D scanpath prediction in medical imaging.

Reliable pelvic bone segmentation (PBS) from CT is essential for robot-assisted pelvic trauma surgery, yet deploying a source-trained model to a new hospital suffers from severe performance degradation due to cross-center domain shifts. While test-time adaptation (TTA) enables online model adaptation without accessing source data, existing methods show limited effectiveness for PBS, facing challenges including boundary degradation, anatomical inconsistency under domain shifts, and voxel-level class imbalance. To address these challenges, we propose a novel closed-loop dynamic Reliability-Guided TTA framework (ReGA) for PBS. Specifically, we introduce a pseudo-label reliability criterion termed Segmentation Inference Consistency Evaluation (SICE), which jointly measures region overlap and boundary deviation via dropout-based ensemble predictions. Based on SICE, a trust-weighted refinement module adaptively updates features to mitigate boundary errors in pseudo-labels. Furthermore, a confidence-weighted region-level contrastive learning strategy is proposed to enforce anatomical consistency. Finally, ReGA follows the teacher-student (TS) scheme to alleviate voxel-level class imbalance. Experiments on three heterogeneous 3D pelvic CT datasets demonstrate that ReGA consistently outperforms state-of-the-art TTA methods, enabling effective adaptation of the source-trained PBS model to unseen clinical domains. The code is available at https://github.com/Ren-ling/ReGA.

We present MInDI-3D (Medical Inversion by Direct Iteration in 3D), the first 3D conditional diffusion-based model for real-world sparse-view Cone Beam Computed Tomography (CBCT) artefact removal, aiming to reduce imaging radiation exposure. A key contribution is extending the "InDI" concept from 2D to a full 3D volumetric approach for medical images, implementing an iterative denoising process that refines the CBCT volume directly from sparse-view input. A further contribution is the generation of a large pseudo-CBCT dataset (16,182) from chest CT volumes of the CT-RATE public dataset to robustly train MInDI-3D. We performed a comprehensive evaluation, including quantitative metrics, scalability analysis, generalisation tests, and a clinical assessment by 11 clinicians. Our results show MInDI-3D's effectiveness, achieving a 12.96 (6.10) dB PSNR gain over uncorrected scans with only 50 projections on the CT-RATE pseudo-CBCT (independent real-world) test set and enabling an 8x reduction in imaging radiation exposure. We demonstrate its scalability by showing that performance improves with more training data. Importantly, MInDI-3D matches the performance of a 3D U-Net on real-world scans from 16 cancer patients across distortion and task-based metrics. It also generalises to new CBCT scanner geometries. Clinicians rated our model as sufficient for patient positioning across all anatomical sites and found it preserved lung tumour boundaries well.

Purpose: To develop and evaluate TotalSynth, a reusable pretrained framework for whole-body synthetic CT (sCT) generation from MRI and cone-beam CT (CBCT) images. Materials and Methods: In this retrospective technical study, the dataset was assembled between 2020 and 2026 from SynthRAD challenge data, four prostate cohorts, and BIC-MAC. After registration quality control, 1450 of 1800 public challenge pairs were retained; 350 were excluded for insufficient registration quality or major source/CT mismatch. The corpus also included 84 additional prostate MRI/CT and 60 external BIC-MAC MRI/CT cases. Three 5-fold model families were evaluated with image-domain, anatomy-aware, registration-based, and uncertainty metrics. Age and sex were not consistently available across public datasets. Results: The released MRI-to-CT model achieved an overall MAE of 67.49 HU, SSIM of 0.920, and PSNR of 29.28 dB. The CBCT-to-CT model achieved an overall MAE of 53.55 HU, SSIM of 0.939, and PSNR of 32.09 dB. The unified model maintained similar performance on MRI inputs (MAE, 67.68 HU) and CBCT inputs (MAE, 54.22 HU). On external BIC-MAC data, MRI-to-CT MAE was 100.91 HU without fine-tuning and 62.21 HU after fine-tuning. Conclusion: TotalSynth provides reusable MRI- and CBCT-based CT synthesis models with broad anatomical coverage, while external evaluation highlights the need for local validation and optional fine-tuning under domain shift.

Accurate delineation of anatomical structures in volumetric CT scans is crucial for diagnosis and treatment planning. While AI has advanced automated segmentation, current approaches typically target individual structures, creating a fragmented landscape of incompatible models with varying performance and disparate evaluation protocols. Foundational segmentation models address these limitations by providing a holistic anatomical view through a single model. Yet, robust clinical deployment demands comprehensive training data, which is lacking in existing whole-body approaches, both in terms of data heterogeneity and, more importantly, anatomical coverage. In this work, rather than pursuing incremental optimizations in model architecture, we present CADS, an open-source framework that prioritizes the systematic integration, standardization, and labeling of heterogeneous data sources for whole-body CT segmentation. At its core is a large-scale dataset of 22,022 CT volumes with complete annotations for 167 anatomical structures, representing a significant advancement in both scale and coverage, with 18 times more scans than existing collections and 60% more distinct anatomical targets. Building on this diverse dataset, we develop the CADS-model using established architectures for accessible and automated full-body CT segmentation. Through comprehensive evaluation across 18 public datasets and an independent real-world hospital cohort, we demonstrate advantages over SoTA approaches. Notably, thorough testing of the model's performance in segmentation tasks from radiation oncology validates its direct utility for clinical interventions. By making our large-scale dataset, our segmentation models, and our clinical software tool publicly available, we aim to advance robust AI solutions in radiology and make comprehensive anatomical analysis accessible to clinicians and researchers alike.

The development of large-scale image-text pair datasets has significantly advanced self-supervised learning in Vision-Language Processing (VLP). However, directly applying general-domain architectures such as CLIP to medical data presents challenges, particularly in handling negations and addressing the inherent data imbalance of medical datasets. To address these issues, we propose a novel approach that integrates clinically-enhanced dynamic soft labels and medical graphical alignment, thereby improving clinical comprehension and the applicability of contrastive loss in medical contexts. Furthermore, we introduce negation-based hard negatives to deepen the model's understanding of the complexities of clinical language. Our approach is easily integrated into the medical CLIP training pipeline and achieves state-of-the-art performance across multiple tasks, including zero-shot, fine-tuned classification, and report retrieval. To comprehensively evaluate our model's capacity for understanding clinical language, we introduce CXR-Align, a benchmark uniquely designed to evaluate the understanding of negation and clinical information within chest X-ray (CXR) datasets. Experimental results demonstrate that our proposed methods are straightforward to implement and generalize effectively across contrastive learning frameworks, enhancing medical VLP capabilities and advancing clinical language understanding in medical imaging.

Large Language Model (LLM) based text-to-speech (TTS) systems have demonstrated remarkable capabilities in handling large speech datasets and generating natural speech for new speakers. However, LLM-based TTS models are not robust as the generated output can contain repeating words, missing words and mis-aligned speech (referred to as hallucinations or attention errors), especially when the text contains multiple occurrences of the same token. We examine these challenges in an encoder-decoder transformer model and find that certain cross-attention heads in such models implicitly learn the text and speech alignment when trained for predicting speech tokens for a given text. To make the alignment more robust, we propose techniques utilizing CTC loss and attention priors that encourage monotonic cross-attention over the text tokens. Our guided attention training technique does not introduce any new learnable parameters and significantly improves robustness of LLM-based TTS models.

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

Existing deep-learning approaches to semantic column type annotation (CTA) have important shortcomings: they rely on semantic types which are fixed at training time; require a large number of training samples per type and incur large run-time inference costs; and their performance can degrade when evaluated on novel datasets, even when types remain constant. Large language models have exhibited strong zero-shot classification performance on a wide range of tasks and in this paper we explore their use for CTA. We introduce ArcheType, a simple, practical method for context sampling, prompt serialization, model querying, and label remapping, which enables large language models to solve CTA problems in a fully zero-shot manner. We ablate each component of our method separately, and establish that improvements to context sampling and label remapping provide the most consistent gains. ArcheType establishes a new state-of-the-art performance on zero-shot CTA benchmarks (including three new domain-specific benchmarks which we release along with this paper), and when used in conjunction with classical CTA techniques, it outperforms a SOTA DoDuo model on the fine-tuned SOTAB benchmark. Our code is available at https://github.com/penfever/ArcheType.

Post-training alignment has increasingly become a crucial factor in enhancing the usability of language models (LMs). However, the strength of alignment varies depending on individual preferences. This paper proposes a method to incorporate alignment control into a single model, referred to as CLM. This approach adds one identity layer preceding the initial layers and performs preference learning only on this layer to map unaligned input token embeddings into the aligned space. Experimental results demonstrate that this efficient fine-tuning method performs comparable to full fine-tuning. During inference, the input embeddings are processed through the aligned and unaligned layers, which are then merged through the interpolation coefficient. By controlling this parameter, the alignment exhibits a clear interpolation and extrapolation phenomenon.