Jiayu Qian
Publications
STAIL: Semantic Text-Anchored Incremental Learning for Medical Imaging via Large Language Models
Deep learning models applied to medical image analysis suffer from severe catastrophic forgetting when continually adapting to new clinical tasks in dynamic environments. Mainstream incremental learning methods typically mitigate this by rehearsing raw historical images. However, this pixel-level rehearsal incurs significant storage overhead, raises privacy concerns, and fails to adequately capture the true data distribution with sparse exemplars. Inspired by human cognitive mechanisms, we propose a novel framework termed Semantic Text-Anchored Incremental Learning (STAIL) for sequential clinical tasks. To overcome the rehearsal bottleneck, STAIL introduces an asymmetric semantic consolidation buffer (SCB). By incorporating a minimal set of image anchors and extensive textual descriptions, the SCB enables dense semantic reconstruction of old tasks at a minimal storage cost. Furthermore, we design an LLM-derived Semantic Anchoring Mechanism (LSAM) that leverages the stable semantic space of frozen large language models as developmental priors. This mechanism explicitly anchors evolving visual features to textual representations, guiding and constraining plasticity and stability at both macroscopic and microscopic levels. Extensive experiments across three heterogeneous medical datasets, covering fundus, ultrasound, and X-ray imaging, demonstrate that STAIL acts as a highly effective plug-and-play module. It comprehensively enhances the performance of various existing baselines, achieving average gains of 2.24\% in AAA-AUC for sustained performance and 3.55\% in BWT-AUC for reduced forgetting. Code is available.
CoT2-Meta: Budgeted Metacognitive Control for Test-Time Reasoning
Recent test-time reasoning methods improve performance by generating more candidate chains or searching over larger reasoning trees, but they typically lack explicit control over when to expand, what to prune, how to repair, and when to abstain. We introduce CoT2-Meta, a training-free metacognitive reasoning framework that combines object-level chain-of-thought generation with meta-level control over partial reasoning trajectories. The framework integrates four components: strategy-conditioned thought generation, tree-structured search, an online process oracle for step-level reasoning evaluation, and a meta-controller that allocates computation through expansion, pruning, repair, stopping, and fallback decisions. Under matched inference budgets, CoT2-Meta consistently outperforms strong single-path, sampling-based, and search-based baselines, including ReST-MCTS. On the default backbone, it achieves 92.8 EM on MATH, 90.4 accuracy on GPQA, 98.65 EM on GSM8K, 75.8 accuracy on BBEH, 85.6 accuracy on MMMU-Pro, and 48.8 accuracy on HLE, with gains over the strongest non-CoT2-Meta baseline of +3.6, +5.2, +1.15, +2.0, +4.3, and +4.3 points, respectively. Beyond these core results, the framework remains effective across a broader 15-benchmark suite spanning knowledge and QA, multi-hop reasoning, coding, and out-of-distribution evaluation. Additional analyses show better compute scaling, improved calibration, stronger selective prediction, targeted repair behavior, and consistent gains across backbone families. These results suggest that explicit metacognitive control is a practical design principle for reliable and compute-efficient test-time reasoning systems.
PathMem: Toward Cognition-Aligned Memory Transformation for Pathology MLLMs
Computational pathology demands both visual pattern recognition and dynamic integration of structured domain knowledge, including taxonomy, grading criteria, and clinical evidence. In practice, diagnostic reasoning requires linking morphological evidence with formal diagnostic and grading criteria. Although multimodal large language models (MLLMs) demonstrate strong vision language reasoning capabilities, they lack explicit mechanisms for structured knowledge integration and interpretable memory control. As a result, existing models struggle to consistently incorporate pathology-specific diagnostic standards during reasoning. Inspired by the hierarchical memory process of human pathologists, we propose PathMem, a memory-centric multimodal framework for pathology MLLMs. PathMem organizes structured pathology knowledge as a long-term memory (LTM) and introduces a Memory Transformer that models the dynamic transition from LTM to working memory (WM) through multimodal memory activation and context-aware knowledge grounding, enabling context-aware memory refinement for downstream reasoning. PathMem achieves SOTA performance across benchmarks, improving WSI-Bench report generation (12.8% WSI-Precision, 10.1% WSI-Relevance) and open-ended diagnosis by 9.7% and 8.9% over prior WSI-based models.