Tianyu Luan
Publications
FairLLaVA: Fairness-Aware Parameter-Efficient Fine-Tuning for Large Vision-Language Assistants
While powerful in image-conditioned generation, multimodal large language models (MLLMs) can display uneven performance across demographic groups, highlighting fairness risks. In safety-critical clinical settings, such disparities risk producing unequal diagnostic narratives and eroding trust in AI-assisted decision-making. While fairness has been studied extensively in vision-only and language-only models, its impact on MLLMs remains largely underexplored. To address these biases, we introduce FairLLaVA, a parameter-efficient fine-tuning method that mitigates group disparities in visual instruction tuning without compromising overall performance. By minimizing the mutual information between target attributes, FairLLaVA regularizes the model's representations to be demographic-invariant. The method can be incorporated as a lightweight plug-in, maintaining efficiency with low-rank adapter fine-tuning, and provides an architecture-agnostic approach to fair visual instruction following. Extensive experiments on large-scale chest radiology report generation and dermoscopy visual question answering benchmarks show that FairLLaVA consistently reduces inter-group disparities while improving both equity-scaled clinical performance and natural language generation quality across diverse medical imaging modalities. Code can be accessed at https://github.com/bhosalems/FairLLaVA.
VLM-Guided Iterative Refinement for Surgical Image Segmentation with Foundation Models
Surgical image segmentation is essential for robot-assisted surgery and intraoperative guidance. However, existing methods are constrained to predefined categories, produce one-shot predictions without adaptive refinement, and lack mechanisms for clinician interaction. We propose IR-SIS, an iterative refinement system for surgical image segmentation that accepts natural language descriptions. IR-SIS leverages a fine-tuned SAM3 for initial segmentation, employs a Vision-Language Model to detect instruments and assess segmentation quality, and applies an agentic workflow that adaptively selects refinement strategies. The system supports clinician-in-the-loop interaction through natural language feedback. We also construct a multi-granularity language-annotated dataset from EndoVis2017 and EndoVis2018 benchmarks. Experiments demonstrate state-of-the-art performance on both in-domain and out-of-distribution data, with clinician interaction providing additional improvements. Our work establishes the first language-based surgical segmentation framework with adaptive self-refinement capabilities.