Xinyang Jiang
Publications
A report-grounded vision-language foundation model for colonoscopy from 280000 routine reports
Vision-language models remain underused in colonoscopy despite the rich expert descriptions recorded in routine reports. These reports document lesion appearance, size and location but summarise entire procedures rather than caption individual frames, leaving clinical findings only weakly linked to the corresponding images. Here we develop EndoCLIP, a colonoscopy vision-language foundation model trained on 125,756 lesion-level image-text pairs progressively recovered from 280,476 routine colonoscopy records. Across lesion-level image-text retrieval, structured report generation and six multi-centre clinical classification tasks, EndoCLIP outperforms general-purpose and biomedical vision-language encoders in both zero-shot and linear-probe settings. On benign-versus-malignant classification, its linear probe approaches the performance of expert readers in a blinded study involving 12 endoscopists. These results suggest that recovering finding-to-frame correspondence can transform routine documentation into scalable supervision, enabling clinical targets to be specified in language rather than separately annotated for each task.
Reasoning-Driven Multimodal LLM for Domain Generalization
This paper addresses the domain generalization (DG) problem in deep learning. While most DG methods focus on enforcing visual feature invariance, we leverage the reasoning capability of multimodal large language models (MLLMs) and explore the potential of constructing reasoning chains that derives image categories to achieve more robust predictions under domain shift. To this end, we systematically study the role of reasoning in DG using DomainBed-Reasoning, a newly constructed extension of DomainBed dataset, in which each sample is paired with class-relevant reasoning chains. Our analysis reveals two key challenges: (i) fine-tuning MLLMs with reasoning chains for classification is more challenging than direct label supervision, since the model must optimize complex reasoning sequences before label prediction; and (ii) mismatches in reasoning patterns between supervision signals and fine-tuned MLLMs lead to a trade-off between semantic richness (informative but harder to optimize) and optimization efficiency (easier to optimize but less informative). To address these issues, we propose RD-MLDG (Reasoning-Driven Multimodal LLM for Domain Generalization), a framework with two components: (i) MTCT (Multi-Task Cross-Training), which introduces an additional direct classification pathway to guide reasoning supervision; and (ii) SARR (Self-Aligned Reasoning Regularization), which preserves the semantic richness of reasoning chains while mitigating reasoning-pattern mismatches via iterative self-labeling. Experiments on standard DomainBed datasets (PACS, VLCS, OfficeHome, TerraInc) demonstrate that RD-MLDG achieves state-of-the-art performances, highlighting reasoning as a promising complementary signal for robust out-of-domain generalization.