#01Aug 20, 2026
cs.CV
Artificial Intelligence for Workflow Analysis in Colorectal Surgery: A Multicentric, Cross-Procedural Development and Generalization Study
Pietro Mascagni, Julia Alekseenko, Pooja P Jain and 10 more
Minimally invasive colorectal surgeries (MIS-CRS) are characterised by significant variability and inconsistent outcomes. ColoWorkflow, a tool for the video-based assessment (VBA) of MIS-CRS workflow, was recently validated. However, manual VBA is time-consuming, limiting implementation. This study presents AI-ColoWorkflow, a deep learning model for automated surgical workflow analysis across MIS-CRS. Operative videos of MIS-CRS were collected from 4 centres and a publicly available dataset. Phases and steps were manually annotated according to ColoWorkflow. A deep learning model combining a fine-tuned DINOv3 vision transformer for per-frame visual feature extraction with a hierarchical multi-stage temporal convolutional network was jointly optimized for phase and step recognition. The model trained on pooled multicentric data, namely AI-ColoWorkflow was compared against centre-specific and procedure-specific models on a held-out test set. The following metrics were used for evaluation: macro F1 score, balanced accuracy, precision, and recall. AI-ColoWorkflow achieved a macro F1 of 73.01% $\pm$ 10.27 (balanced accuracy 73.43%) for phase recognition and 39.82% $\pm$ 7.06 (balanced accuracy 38.65%) for step recognition. The global model outperformed centre- and procedure-specific models in most experiments except procedure-specific step recognition. In the generalization analysis, mean F1 was 48.42% for phase recognition. AI-ColoWorkflow can reliably recognize MIS-CRS phases. A single model trained on pooled, multicentric, multi-procedural data generalises at least as well as and often better than centre- or procedure-specific models for phase recognition in MIS-CRS, while procedure-specific step models retain advantages for certain procedure types, motivating hybrid training strategies for future surgical AI development.
#02Aug 20, 2026
cs.CL
G-CARL: Grounded Checklist-Aligned Reward Learning for Patient-Oriented Medical Report Interpretation
Shiao Xie, Siyu Chen, Jianwei Lv and 3 more
Personalized interpretation of medical reports has emerged as an increasingly important need among patients. Addressing this need requires both evidence-grounded medical factuality and context-dependent patient communication, yet existing medical vision-language tasks do not adequately capture these dual requirements. To bridge this gap, we introduce Patient-oriented Medical Report Interpretation (PMRI), a novel open-ended multimodal generation task that requires models to explain medical reports in accurate and accessible language based on a user's query and dialogue history. These two objectives differ fundamentally in their verifiability, yet remain tightly coupled, making them difficult to optimize jointly under conventional supervised fine-tuning and holistic reinforcement learning paradigms. To address this challenge, we propose G-CARL, a grounded, checklist-aligned reinforcement learning framework that combines multi-source retrieval for atomic claim verification with context-aware, instance-specific weighted checklists for response coverage, providing structured supervision for factuality, user-demand satisfaction, and expression quality without constraining response diversity. We further construct MMedReport, a real-world PMRI benchmark, along with a clinician-designed three-dimensional evaluation protocol. Extensive experiments demonstrate that G-CARL consistently outperforms existing post-training baselines in overall quality, claim-level precision, and checklist recall. Pairwise preference evaluation by clinicians further confirms that G-CARL produces interpretations that are more accurate and better aligned with patient needs.
#03Aug 20, 2026
cs.CV
Prompt-Conditioned Channel Attention for Hierarchical Feature Modulation toward Anatomy-Agnostic Segmentation
Mosharof Hossain, Md Rabiul Islam, Limon Halder and 2 more
Anatomically plausible segmentation remains challenging because of low contrast, ambiguous boundaries, and modality-specific artifacts. Interactive segmentation has emerged as a promising strategy to guide feature extraction and improve localization, particularly in structurally ambiguous regions. However, existing methods integrate prompts through late-stage fusion and lack explicit mechanisms for prompt-driven channel-wise modulation across hierarchical feature representations, limiting their ability to capture deeper contextual and modality-specific variations. To address these limitations, we introduce Prompt-Conditioned Channel Attention (PCCA), a novel modulation mechanism that enables deep, hierarchical integration of semantic prompts within encoder-decoder networks. PCCA extracts compact channel descriptors via pooling, projects them into a shared space, and fuses them through a gated excitation mechanism to compute prompt-aware channel attention weights. These weights adaptively recalibrate feature responses across multiple network stages, enabling prompt-conditioned, semantically enriched hierarchical representations. Building on this, we propose PROMISE-Net, instantiated in two network variants: a convolutional model (PROMISE-CNN) and a transformer-based model (PROMISE-Txformer). Across the ISIC-Lesion, Kvasir-Polyp, CAMUS-Cardiac, and Kvasir-Instrument benchmarks, integrating PCCA into PROMISE-CNN yielded relative IoU gains of 10.4%, 8.7%, 0.8%, and 3.4%, respectively, over the baseline U-Net, while PROMISE-Txformer achieved corresponding gains of 7.6%, 23.0%, 2.1%, and 1.1%, respectively, over the baseline UNETR. These results show consistent improvements across architectures, imaging modalities, and anatomical targets, establishing PCCA and PROMISE-Net as a scalable, generalizable framework for prompt-aware hierarchical feature modulation in medical image segmentation.
#04Aug 20, 2026
cs.CV
WithEveryone: Unified Planning and Identity Grounding for Group Image Generation
Hengyuan Xu, Qixun Wang, Yiji Cheng and 5 more
Identity-preserving image generation becomes increasingly unreliable when a scene must contain many specified people. Beyond retaining each identity, the model must bind every reference to a distinct person and location, while training-time identity losses must establish correspondence among several noisy predicted faces. We introduce WithEveryone, a unified framework for generating group images up to ten reference identities. WithEveryone injects each selected identity as an addressed token, predicts a structured identity--layout plan, and renders the plan as a visual condition. Its key objective, Layout-Grounded ID Loss, uses annotated face regions to supervise the intended identities directly, avoiding unstable embedding-based face matching; ID Representation Forcing additionally trains a prediction for each identity before image synthesis. On an identity-disjoint benchmark, WithEveryone achieves the highest target-context identity similarity, improving face similarity from 0.462 for GPT-Image-2 to 0.499, while reducing copy-paste artifacts from 0.169 to 0.055. It further covers 97.3\% of the requested identities with a duplicate rate of only 2.8\%. These results show that explicit identity--layout grounding enables identity-preserving generation to scale to larger groups without relying on direct reference-face copying.
#05Aug 20, 2026
cs.CV
V-REX: Efficient Specialist VLM Training for Veterinary X-Rays
Tim Elsner, Nicole McNally, Andre Dourson and 1 more
While generalist VLMs are expensive to train, creating domain experts is widely assumed to require fine-tuning increasingly large foundation models. We show that, in veterinary radiology, this assumption is misguided. By rethinking the entire VLM pipeline - from text tokenisation and pre-training to grounding and inference - we demonstrate that careful engineering can yield models that outperform much larger foundation models from scratch, without relying on any other data. Our approach introduces new strategies for generative pre-training and grounding that improve training efficiency, increasing data utilisation and downstream performance. Using only a fraction of the parameters, data, and compute of contemporary generalist models, we develop the first VLM capable of generating diagnostic reports for veterinary radiographs, surpassing open foundation models on this task by significant margin.