The emergence of large multimodal models has unlocked remarkable potential in AI, particularly in pathology. However, the lack of specialized, high-quality benchmark impeded their development and precise evaluation. To address this, we introduce PathMMU, the largest and highest-quality expert-validated pathology benchmark for Large Multimodal Models (LMMs). It comprises 33,428 multimodal multi-choice questions and 24,067 images from various sources, each accompanied by an explanation for the correct answer. The construction of PathMMU harnesses GPT-4V's advanced capabilities, utilizing over 30,000 image-caption pairs to enrich captions and generate corresponding Q&As in a cascading process. Significantly, to maximize PathMMU's authority, we invite seven pathologists to scrutinize each question under strict standards in PathMMU's validation and test sets, while simultaneously setting an expert-level performance benchmark for PathMMU. We conduct extensive evaluations, including zero-shot assessments of 14 open-sourced and 4 closed-sourced LMMs and their robustness to image corruption. We also fine-tune representative LMMs to assess their adaptability to PathMMU. The empirical findings indicate that advanced LMMs struggle with the challenging PathMMU benchmark, with the top-performing LMM, GPT-4V, achieving only a 49.8% zero-shot performance, significantly lower than the 71.8% demonstrated by human pathologists. After fine-tuning, significantly smaller open-sourced LMMs can outperform GPT-4V but still fall short of the expertise shown by pathologists. We hope that the PathMMU will offer valuable insights and foster the development of more specialized, next-generation LMMs for pathology.

Due to the difficulty of collecting real paired data, most existing desmoking methods train the models by synthesizing smoke, generalizing poorly to real surgical scenarios. Although a few works have explored single-image real-world desmoking in unpaired learning manners, they still encounter challenges in handling dense smoke. In this work, we address these issues together by introducing the self-supervised surgery video desmoking (SelfSVD). On the one hand, we observe that the frame captured before the activation of high-energy devices is generally clear (named pre-smoke frame, PS frame), thus it can serve as supervision for other smoky frames, making real-world self-supervised video desmoking practically feasible. On the other hand, in order to enhance the desmoking performance, we further feed the valuable information from PS frame into models, where a masking strategy and a regularization term are presented to avoid trivial solutions. In addition, we construct a real surgery video dataset for desmoking, which covers a variety of smoky scenes. Extensive experiments on the dataset show that our SelfSVD can remove smoke more effectively and efficiently while recovering more photo-realistic details than the state-of-the-art methods. The dataset, codes, and pre-trained models will be publicly available.

Echocardiography plays a crucial role in analyzing cardiac function and diagnosing cardiac diseases. Current deep neural network methods primarily aim to enhance diagnosis accuracy by incorporating prior knowledge, such as segmenting cardiac structures or lesions annotated by human experts. However, diagnosing the inconsistent behaviours of the heart, which exist across both spatial and temporal dimensions, remains extremely challenging. For instance, the analysis of cardiac motion acquires both spatial and temporal information from the heartbeat cycle. To address this issue, we propose a novel reconstruction-based approach named CardiacNet to learn a better representation of local cardiac structures and motion abnormalities through echocardiogram videos. CardiacNet is accompanied by the Consistency Deformation Codebook (CDC) and the Consistency Deformed-Discriminator (CDD) to learn the commonalities across abnormal and normal samples by incorporating cardiac prior knowledge. In addition, we propose benchmark datasets named CardiacNet-PAH and CardiacNet-ASD for evaluating the effectiveness of cardiac disease assessment. In experiments, our CardiacNet can achieve state-of-the-art results in downstream tasks, i.e., classification and regression, on public datasets CAMUS, EchoNet, and our datasets. The codes and datasets will be publicly available.

Magnetic Resonance Imaging (MRI) is a widely used imaging modality for clinical diagnostics and the planning of surgical interventions. Accelerated MRI seeks to mitigate the inherent limitation of long scanning time by reducing the amount of raw $k$-space data required for image reconstruction. Recently, the deep unrolled model (DUM) has demonstrated significant effectiveness and improved interpretability for MRI reconstruction, by truncating and unrolling the conventional iterative reconstruction algorithms with deep neural networks. However, the potential of DUM for MRI reconstruction has not been fully exploited. In this paper, we first enhance the gradient and information flow within and across iteration stages of DUM, then we highlight the importance of using various adjacent information for accurate and memory-efficient sensitivity map estimation and improved multi-coil MRI reconstruction. Extensive experiments on several public MRI reconstruction datasets show that our method outperforms existing MRI reconstruction methods by a large margin. The code will be released publicly.

We propose an adaptive training scheme for unsupervised medical image registration. Existing methods rely on image reconstruction as the primary supervision signal. However, nuisance variables (e.g. noise and covisibility) often cause the loss of correspondence between medical images, violating the Lambertian assumption in physical waves (e.g. ultrasound) and consistent image acquisition. As the unsupervised learning scheme relies on intensity constancy between images to establish correspondence for reconstruction, this introduces spurious error residuals that are not modeled by the typical training objective. To mitigate this, we propose an adaptive framework that re-weights the error residuals with a correspondence scoring map during training, preventing the parametric displacement estimator from drifting away due to noisy gradients, which leads to performance degradation. To illustrate the versatility and effectiveness of our method, we tested our framework on three representative registration architectures across three medical image datasets along with other baselines. Our adaptive framework consistently outperforms other methods both quantitatively and qualitatively. Paired t-tests show that our improvements are statistically significant. Code available at: \url{https://anonymous.4open.science/r/AdaCS-E8B4/}.

Cellular nuclei recognition serves as a fundamental and essential step in the workflow of digital pathology. However, with disparate source organs and staining procedures among histology image clusters, the scanned tiles inherently conform to a non-uniform data distribution, which induces deteriorated promises for general cross-domain usages. Despite the latest efforts leveraging domain adaptation to mitigate distributional discrepancy, those methods are subjected to modeling the morphological characteristics of each cell individually, disregarding the hierarchical latent structure and intrinsic contextual correspondences across the tumor micro-environment. In this work, we identify the importance of implicit correspondences across biological contexts for exploiting domain-invariant pathological composition and thereby propose to explore the dependence over various biological structures for domain adaptive nuclei recognition. We discover those high-level correspondences via unsupervised contextual modeling and use them as bridges to facilitate adaptation at image and instance feature levels. In addition, to further exploit the rich spatial contexts embedded amongst nuclear communities, we propose self-adaptive dynamic distillation to secure instance-aware trade-offs across different model constituents. The proposed method is extensively evaluated on a broad spectrum of cross-domain settings under miscellaneous data distribution shifts and outperforms the state-of-the-art methods by a substantial margin.

Traditional fluorescence staining is phototoxic to live cells, slow, and expensive; thus, the subcellular structure prediction (SSP) from transmitted light (TL) images is emerging as a label-free, faster, low-cost alternative. However, existing approaches utilize 3D etworks for one-to-one voxel level dense prediction, which necessitates a frequent and time-consuming Z-axis imaging process. Moreover, 3D convolutions inevitably lead to significant computation and GPU memory overhead. Therefore, we propose an efficient framework, SparseSSP, predicting fluorescent intensities within the target voxel grid in an efficient paradigm instead of relying entirely on 3D topologies. In particular, SparseSSP makes two pivotal improvements to prior works. First, SparseSSP introduces a one-to-many voxel mapping paradigm, which permits the sparse TL slices to reconstruct the subcellular structure. Secondly, we propose a hybrid dimensions topology, which folds the Z-axis information into channel features, enabling the 2D network layers to tackle SSP under low computational cost. We conduct extensive experiments to validate the effectiveness and advantages of SparseSSP on diverse sparse imaging ratios, and our approach achieves a leading performance compared to pure 3D topologies. SparseSSP reduces imaging frequencies compared to previous dense-view SSP (i.e., the number of imaging is reduced up to 87.5% at most), which is significant in visualizing rapid biological dynamics on low-cost devices and samples.

In this paper, we consider the problem of visual representation learning for computational pathology, by exploiting large-scale image-text pairs gathered from public resources, along with the domain-specific knowledge in pathology. Specifically, we make the following contributions: (i) We curate a pathology knowledge tree that consists of 50,470 informative attributes for 4,718 diseases requiring pathology diagnosis from 32 human tissues. To our knowledge, this is the first comprehensive structured pathology knowledge base; (ii) We develop a knowledge-enhanced visual-language pretraining approach, where we first project pathology-specific knowledge into latent embedding space via language model, and use it to guide the learning of visual representation; (iii) We conduct thorough experiments to validate the effectiveness of our proposed components, demonstrating significant performance improvement on various downstream tasks, including cross-modal retrieval, zero-shot classification on pathology patches, and zero-shot tumor subtyping on whole slide images (WSIs). All codes, models and the pathology knowledge tree will be released to the research community.