Medical phrase grounding (MPG) maps textual descriptions of radiological findings to corresponding image regions. These grounded reports are easier to interpret, especially for non-experts. Existing MPG systems mostly follow the referring expression comprehension (REC) paradigm and return exactly one bounding box per phrase. Real reports often violate this assumption. They contain multi-region findings, non-diagnostic text, and non-groundable phrases, such as negations or descriptions of normal anatomy. Motivated by this, we reformulate the task as generalised medical phrase grounding (GMPG), where each sentence is mapped to zero, one, or multiple scored regions. To realise this formulation, we introduce the first GMPG model: MedGrounder. We adopted a two-stage training regime: pre-training on report sentence--anatomy box alignment datasets and fine-tuning on report sentence--human annotated box datasets. Experiments on PadChest-GR and MS-CXR show that MedGrounder achieves strong zero-shot transfer and outperforms REC-style and grounded report generation baselines on multi-region and non-groundable phrases, while using far fewer human box annotations. Finally, we show that MedGrounder can be composed with existing report generators to produce grounded reports without retraining the generator.

Accurate estimation of three-dimensional ground reaction forces and moments (GRFs/GRMs) is crucial for both biomechanics research and clinical rehabilitation evaluation. In this study, we focus on insole-based GRF/GRM estimation and further validate our approach on a public walking dataset. We propose a Dual-Path Region-Guided Attention Network that integrates anatomy-inspired spatial priors and temporal priors into a region-level attention mechanism, while a complementary path captures context from the full sensor field. The two paths are trained jointly and their outputs are combined to produce the final GRF/GRM predictions. Conclusions: Our model outperforms strong baseline models, including CNN and CNN-LSTM architectures on two datasets, achieving the lowest six-component average NRMSE of 5.78% on the insole dataset and 1.42% for the vertical ground reaction force on the public dataset. This demonstrates robust performance for ground reaction force and moment estimation.

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

The emergence of foundation models in neuroimaging is driven by the increasing availability of large-scale and heterogeneous brain imaging datasets. Recent advances in self-supervised learning, particularly reconstruction-based objectives, have demonstrated strong potential for pretraining models that generalize effectively across diverse downstream functional MRI (fMRI) tasks. In this study, we explore region-aware reconstruction strategies for a foundation model in resting-state fMRI, moving beyond approaches that rely on random region masking. Specifically, we introduce an ROI-guided masking strategy using the Automated Anatomical Labelling Atlas (AAL3), applied directly to full 4D fMRI volumes to selectively mask semantically coherent brain regions during self-supervised pretraining. Using the ADHD-200 dataset comprising 973 subjects with resting-state fMRI scans, we show that our method achieves a 4.23% improvement in classification accuracy for distinguishing healthy controls from individuals diagnosed with ADHD, compared to conventional random masking. Region-level attribution analysis reveals that brain volumes within the limbic region and cerebellum contribute most significantly to reconstruction fidelity and model representation. Our results demonstrate that masking anatomical regions during model pretraining not only enhances interpretability but also yields more robust and discriminative representations. In future work, we plan to extend this approach by evaluating it on additional neuroimaging datasets, and developing new loss functions explicitly derived from region-aware reconstruction objectives. These directions aim to further improve the robustness and interpretability of foundation models for functional neuroimaging.

Current Vision-Language Models (VLMs) struggle to ground anatomical regions in 3D medical images and reason about them in a step-by-step manner, a key requirement of real-world diagnostic assessment. This ability is essential for aligning model outputs with the diagnostic workflows clinicians use in practice, enabling trustworthy clinician-AI collaboration. Existing 3D datasets provide localization labels, but none support this "grounded reasoning" ability. To address this gap, we introduce 3DReasonKnee, the first 3D grounded reasoning dataset for medical images, which provides 494k high-quality quintuples derived from 7,970 3D knee MRI volumes. Each quintuple includes: (1) the 3D MRI volume, (2) a diagnostic question targeting a specific anatomical region (3) a 3D bounding box localizing the relevant anatomical structures, (4) clinician-generated diagnostic reasoning steps that explicitly detail the 3D reasoning process, and (5) structured severity assessments for the relevant anatomical region. The creation and validation of 3DReasonKnee, involving over 450 hours of expert clinician time for manually segmenting MRIs and generating reasoning chains, ensures its superior quality and clinical relevance. We establish ReasonKnee-Bench to evaluate localization and diagnostic accuracy, providing insight into VLM ability to perform grounding and severity assessment across anatomical regions and diagnostic inquiries. We benchmark five state-of-the-art VLMs, providing baseline performance for ReasonKnee-Bench. By providing this unique resource of expert-annotated 3D reasoning pathways, 3DReasonKnee serves as a repository of orthopedic surgeons' diagnostic expertise and offers a vital testbed for advancing multimodal medical AI systems towards 3D, clinically aligned, localized decision-making capabilities. The dataset can be found in: https://huggingface.co/datasets/rajpurkarlab/3DReasonKnee

However, the trustworthiness of Med-L VLMs remains unverified, posing significant risks for future model deployment.

Aortic aneurysm disease ranks consistently in the top 20 causes of death in the U.S. population. Thoracic aortic aneurysm is manifested as an abnormal bulging of thoracic aortic wall and it is a leading cause of death in adults. From the perspective of biomechanics, rupture occurs when the stress acting on the aortic wall exceeds the wall strength. Wall stress distribution can be obtained by computational biomechanical analyses, especially structural Finite Element Analysis. For risk assessment, probabilistic rupture risk of TAA can be calculated by comparing stress with material strength using a material failure model. Although these engineering tools are currently available for TAA rupture risk assessment on patient specific level, clinical adoption has been limited due to two major barriers: labor intensive 3D reconstruction current patient specific anatomical modeling still relies on manual segmentation, making it time consuming and difficult to scale to a large patient population, and computational burden traditional FEA simulations are resource intensive and incompatible with time sensitive clinical workflows. The second barrier was successfully overcome by our team through the development of the PyTorch FEA library and the FEA DNN integration framework. By incorporating the FEA functionalities within PyTorch FEA and applying the principle of static determinacy, we reduced the FEA based stress computation time to approximately three minutes per case. Moreover, by integrating DNN and FEA through the PyTorch FEA library, our approach further decreases the computation time to only a few seconds per case. This work focuses on overcoming the first barrier through the development of an end to end deep neural network capable of generating patient specific finite element meshes of the aorta directly from 3D CT images.

Text-guided image editing has seen significant progress in natural image domains, but its application in medical imaging remains limited and lacks standardized evaluation frameworks. Such editing could revolutionize clinical practices by enabling personalized surgical planning, enhancing medical education, and improving patient communication. To bridge this gap, we introduce MedEBench1, a robust benchmark designed to diagnose reliability in text-guided medical image editing. MedEBench consists of 1,182 clinically curated image-prompt pairs covering 70 distinct editing tasks and 13 anatomical regions. It contributes in three key areas: (1) a clinically grounded evaluation framework that measures Editing Accuracy, Context Preservation, and Visual Quality, complemented by detailed descriptions of intended edits and corresponding Region-of-Interest (ROI) masks; (2) a comprehensive comparison of seven state-of-theart models, revealing consistent patterns of failure; and (3) a diagnostic error analysis technique that leverages attention alignment, using Intersection-over-Union (IoU) between model attention maps and ROI masks to identify mislocalization issues, where models erroneously focus on incorrect anatomical regions. MedEBench sets the stage for developing more reliable and clinically effective text-guided medical image editing tools.

Magnetic Resonance Imaging (MRI) is a critical medical imaging modality in clinical diagnosis and research, yet its complexity and heterogeneity pose challenges for automated analysis, particularly in scalable and generalizable machine learning applications. While foundation models have revolutionized natural language and vision tasks, their application to MRI remains limited due to data scarcity and narrow anatomical focus. In this work, we present Decipher-MR, a 3D MRI-specific vision-language foundation model trained on a large-scale dataset comprising 200,000 MRI series from over 22,000 studies spanning diverse anatomical regions, sequences, and pathologies. Decipher-MR integrates self-supervised vision learning with report-guided text supervision to build robust, generalizable representations, enabling effective adaptation across broad applications. To enable robust and diverse clinical tasks with minimal computational overhead, Decipher-MR supports a modular design that enables tuning of lightweight, task-specific decoders attached to a frozen pretrained encoder. Following this setting, we evaluate Decipher-MR across diverse benchmarks including disease classification, demographic prediction, anatomical localization, and cross-modal retrieval, demonstrating consistent performance gains over existing foundation models and task-specific approaches. Our results establish Decipher-MR as a scalable and versatile foundation for MRI-based AI, facilitating efficient development across clinical and research domains.