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SARAMIS: Simulation Assets for Robotic Assisted and Minimally Invasive Surgery

Neural Information Processing Systems

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MedReasoner: Reinforcement Learning Drives Reasoning Grounding from Clinical Thought to Pixel-Level Precision

Yan, Zhonghao, Diao, Muxi, Yang, Yuxuan, Jing, Ruoyan, Xu, Jiayuan, Zhang, Kaizhou, Yang, Lele, Liu, Yanxi, Liang, Kongming, Ma, Zhanyu

arXiv.org Artificial Intelligence

Accurately grounding regions of interest (ROIs) is critical for diagnosis and treatment planning in medical imaging. While multimodal large language models (MLLMs) combine visual perception with natural language, current medical-grounding pipelines still rely on supervised fine-tuning with explicit spatial hints, making them ill-equipped to handle the implicit queries common in clinical practice. This work makes three core contributions. We first define Unified Medical Reasoning Grounding (UMRG), a novel vision-language task that demands clinical reasoning and pixel-level grounding. Second, we release U-MRG-14K, a dataset of 14K samples featuring pixel-level masks alongside implicit clinical queries and reasoning traces, spanning 10 modalities, 15 super-categories, and 108 specific categories. Finally, we introduce MedReasoner, a modular framework that distinctly separates reasoning from segmentation: an MLLM reasoner is optimized with reinforcement learning, while a frozen segmentation expert converts spatial prompts into masks, with alignment achieved through format and accuracy rewards. MedReasoner achieves state-of-the-art performance on U-MRG-14K and demonstrates strong generalization to unseen clinical queries, underscoring the significant promise of reinforcement learning for interpretable medical grounding.


U-Mamba2: Scaling State Space Models for Dental Anatomy Segmentation in CBCT

Tan, Zhi Qin, Zhu, Xiatian, Addison, Owen, Li, Yunpeng

arXiv.org Artificial Intelligence

Cone-Beam Computed Tomography (CBCT) is a widely used 3D imaging technique in dentistry, providing volumetric information about the anatomical structures of jaws and teeth. Accurate segmentation of these anatomies is critical for clinical applications such as diagnosis and surgical planning, but remains time-consuming and challenging. In this paper, we present U-Mamba2, a new neural network architecture designed for multi-anatomy CBCT segmentation in the context of the ToothFairy3 challenge. U-Mamba2 integrates the Mamba2 state space models into the U-Net architecture, enforcing stronger structural constraints for higher efficiency without compromising performance. In addition, we integrate interactive click prompts with cross-attention blocks, pre-train U-Mamba2 using self-supervised learning, and incorporate dental domain knowledge into the model design to address key challenges of dental anatomy segmentation in CBCT. Extensive experiments, including independent tests, demonstrate that U-Mamba2 is both effective and efficient, securing first place in both tasks of the Toothfairy3 challenge. In Task 1, U-Mamba2 achieved a mean Dice of 0.84, HD95 of 38.17 with the held-out test data, with an average inference time of 40.58s. In Task 2, U-Mamba2 achieved the mean Dice of 0.87 and HD95 of 2.15 with the held-out test data. The code is publicly available at https://github.com/zhiqin1998/UMamba2.


NeuroABench: A Multimodal Evaluation Benchmark for Neurosurgical Anatomy Identification

Song, Ziyang, Zang, Zelin, Ye, Xiaofan, Xu, Boqiang, Bai, Long, Wu, Jinlin, Ren, Hongliang, Liu, Hongbin, Luo, Jiebo, Lei, Zhen

arXiv.org Artificial Intelligence

Multimodal Large Language Models (MLLMs) have shown significant potential in surgical video understanding. With improved zero-shot performance and more effective human-machine interaction, they provide a strong foundation for advancing surgical education and assistance. However, existing research and datasets primarily focus on understanding surgical procedures and workflows, while paying limited attention to the critical role of anatomical comprehension. In clinical practice, surgeons rely heavily on precise anatomical understanding to interpret, review, and learn from surgical videos. To fill this gap, we introduce the Neurosurgical Anatomy Benchmark (NeuroABench), the first multimodal benchmark explicitly created to evaluate anatomical understanding in the neurosurgical domain. NeuroABench consists of 9 hours of annotated neurosurgical videos covering 89 distinct procedures and is developed using a novel multimodal annotation pipeline with multiple review cycles. The benchmark evaluates the identification of 68 clinical anatomical structures, providing a rigorous and standardized framework for assessing model performance. Experiments on over 10 state-of-the-art MLLMs reveal significant limitations, with the best-performing model achieving only 40.87% accuracy in anatomical identification tasks. To further evaluate the benchmark, we extract a subset of the dataset and conduct an informative test with four neurosurgical trainees. The results show that the best-performing student achieves 56% accuracy, with the lowest scores of 28% and an average score of 46.5%. While the best MLLM performs comparably to the lowest-scoring student, it still lags significantly behind the group's average performance. This comparison underscores both the progress of MLLMs in anatomical understanding and the substantial gap that remains in achieving human-level performance.