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    This study introduces MedPLIB, a novel multimodal large language model (MLLM) for advanced biomedical AI. MedPLIB achieves state-of-the-art pixel-level visual understanding and reasoning for medical imaging tasks.

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    Area of Science:

    • Biomedical Artificial Intelligence
    • Computer Vision
    • Natural Language Processing

    Background:

    • Current multimodal large language models (MLLMs) in biomedicine lack fine-grained reasoning capabilities for clinical applications.
    • Existing models are limited to basic image understanding and textual queries, hindering clinical utility.

    Purpose of the Study:

    • To develop a comprehensive solution for pixel-level multimodal intelligence in biomedicine.
    • To introduce MedPLIB, an end-to-end biomedical MLLM with enhanced visual understanding.
    • To create a new benchmark, MeCoVQA, for evaluating spatially-grounded reasoning and diagnostic comprehension.

    Main Methods:

    • Construction of MeCoVQA, a visual-language benchmark across eight medical imaging modalities and four tasks.
    • Introduction of MedPLIB, a biomedical MLLM featuring pixel-level visual understanding and unified modeling for diverse tasks (VQA, querying, grounding, segmentation).
    • Design of a task-specialized Mixture-of-Experts (MoE) architecture for MedPLIB, optimized via unified fine-tuning, incorporating retrieval-augmented generation (RAG) and in-context learning (ICL).

    Main Results:

    • MedPLIB achieves state-of-the-art performance on biomedical vision-language tasks.
    • Outperforms existing models by 19.7 and 15.6 mDice in zero-shot pixel-level grounding.
    • Demonstrates strong generalization on out-of-distribution medical image segmentation.

    Conclusions:

    • MedPLIB represents a significant advancement in pixel-level multimodal intelligence for biomedicine.
    • The model's performance highlights its clinical utility and strong generalization capabilities.
    • Publicly available code and data facilitate further research and development in biomedical AI.