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版本更新 · v4arXiv:2607.24743

ClinFusion: A Vision-Centric Multimodal LLM System for Holistic Medical Understanding

Hangjie Yuan, Yichen Qian, Zhiwei Tang, Xianzhe Xu, Sicheng Yang, Lirong Wu, Jinwang Wang, Pengju Wang 等 25 位作者

原文摘要

Multimodal large language models (MLLMs) hold immense potential to revolutionize clinical practice, yet deploying them in the medical domain is fundamentally a vision-centric challenge: models must absorb knowledge from heterogeneous 2D and 3D medical images, and evaluation protocols must align with radiologists' clinical practice and provide an accurate, fine-grained and factualness-driven assessment. In this paper, we introduce ClinFusion, a vision-centric MLLM designed for holistic medical understanding that systematically addresses these limitations. We propose a compositional and cascaded vision encoder architecture featuring a Cascade Spatial-Aware Locality Fusion operator that unifies diverse 2D and native 3D medical image understanding within a fused encoder. We further introduce a vision-grounded evaluation framework, including MedIF-Bench for instruction-following assessment and a region-of-interest-grounded method for clinically aligned and factualness-driven report generation evaluation. We show that ClinFusion sets a new state-of-the-art across a comprehensive suite of 2D and 3D multimodal medical benchmarks---spanning visual question answering, report generation, and instruction following---as well as textual medical tasks, outperforming leading open-source medical MLLMs (\textit{e.g.}, Hulu-Med, Lingshu) on 20 out of 24 benchmarks and demonstrating multimodal capabilities better than powerful proprietary models such as GPT-5.2 and Gemini-3-Flash on 13 out of 16 benchmarks, and can be further augmented with agentic tool use for retrieval-augmented and tool-assisted clinical workflows. A blinded evaluation by board-certified radiologists confirms that ClinFusion produces the highest-ranked reports, and validates our RoI-grounded metric as achieving the strongest correlation with expert judgment among all automatic evaluation metrics examined.

cs.CV · cs.AI · cs.CL

版本更新 · v2arXiv:2606.18587

Dual Dimensionality for Local and Global Attention

Zhiyuan Wang, Xuan Luo, Sirui Zeng, Xifeng Yan

原文摘要

Decoder-only Transformers compute attention over the KV cache of preceding tokens. Keys and Values are typically represented with the same dimensionality, regardless of their distance from the prediction target. In natural language, however, the next word is most strongly influenced by the immediately preceding tokens. We hypothesize that local and distant tokens impose asymmetric demands on representational capacity: local tokens are more critical for predicting immediate outputs and thus require richer representations, whereas distant tokens primarily serve as long-range memory, for which lower-dimensional representations may suffice. We formalize this idea as Distance-Adaptive Representation (DAR), which preserves full-dimensional representations within a local context window while assigning reduced-dimensional representations (e.g. 1/2 or 1/4 of the original dimensionality) to tokens beyond that window. Across multiple pretraining scales (70M to 410M parameters), as well as continued supervised fine-tuning on a 1B-scale model, this approach closely matches the performance of full-dimensional baselines. In contrast, uniformly reducing dimensionality across all token positions leads to worse performance. These results challenge the common assumption that key and value dimensionality should be uniform across token positions. We further develop an efficient realization of DAR that achieves model quality comparable to the MLA baseline while reducing the average KV-cache size by 68.8\% at 8K context and achieving up to a $1.9\times$ decoding speedup at 128K context on the evaluated models. Our findings suggest a new direction for designing attention architectures that allocate representational capacity according to token distance to reduce KV-cache during inference.

cs.CL · cs.AI