arXiv subjects

Hongming Shan

Publications and source records attributed to Hongming Shan.

At least 19 recordsLinked to original sources

arXiv2026

SparseTokenGS: Gaussian-based Sparse-View CBCT Reconstruction via Reusable Token Pool

Sparse-view cone-beam computed tomography is widely used for fast, low-dose volumetric imaging and lesion localization in dentistry and image-guided interventions, but it introduces severe artifacts. Feed-forward Gaussian methods transfer the reconstruction cost to training and decode each coordinate from projection-aligned features and neighboring anchors. However, information from the whole scan is written only when the field is constructed and cannot be retrieved during coordinate decoding, leaving the volume inconsistent within the scan. This is a common limitation of such methods: once the field is fixed, decoding uses only local features and reconstruction quality drops substantially. We propose SparseTokenGS, a Gaussian-based method for sparse-view cone-beam computed tomography reconstruction via a reusable token pool. Anchor Token Fusion and Point-Token Attention query this shared pool at the anchors and at the query coordinates, respectively. The local Gaussian prior is retained, and the volume is reconstructed in one forward pass, without per-scan optimization or a projection-domain loss. On three public chest and dental datasets, SparseTokenGS achieves the highest reconstruction performance among the compared methods. On clinical dental scans, reconstruction from only six projections reaches 29.51 decibels in peak signal-to-noise ratio and a structural similarity of 0.842 against the full-view reference, and off-the-shelf tooth-and-pulp segmentation keeps these structures separable for root-canal localization. Experiments on volcanic rock and chicken show performance after same-object adaptation. A reusable token pool gives feed-forward reconstruction a mechanism that keeps scan-wide context available through decoding and can benefit future rapid clinical lesion localization and analysis. The code is available at: https://github.com/FrankDengAI/SparseTokenGS.

cs.CV↗

arXiv2026

MedVTok: A General-Purpose Medical Visual Tokenizer

Multimodal medical AI requires a common visual interface for encoding heterogeneous imaging evidence for patient condition modeling. However, existing medical visual tokenizers are often tied to a specific dimension and imaging modality, forcing multimodal systems to rely on fragmented and poorly reusable representations. We introduce MedVTok, a general-purpose visual tokenizer that maps 2D images and 3D volumes from diverse imaging modalities into a unified token space. Building such a tokenizer poses two key challenges: preserving anatomical structure across dimensions and capturing clinical semantics across modalities. To this end, MedVTok introduces (i) slice differential regularization, which explicitly models inter-slice anatomical coherence missing in previous per-pixel/per-voxel supervision, and (ii) multi-expert representation alignment, which integrates knowledge from multiple medical expert encoders while retaining modality-specific complementary knowledge. Trained on 28M images and 70K volumes across 9 imaging modalities, MedVTok supports classification, retrieval, segmentation, synthesis, visual question answering, and medical report generation through a single tokenizer. Across 24 benchmarks, MedVTok achieves state-of-the-art performance, demonstrating a scalable token interface that unifies medical image dimension, modality, and task usage.

eess.IV↗

arXiv2026

Noise2Match: Self-Supervised Low-Dose CT Denoising via Adaptive Inter-Slice Matching

With the rapid development of deep learning, supervised convolutional neural network methods have greatly improved the performance of low-dose computed tomography (CT) denoising. However, they require paired noisy-clean training data, which is difficult to obtain in practice. Some classic self-supervised denoising methods rely on the assumption of pixel-wise independent noise, making them ineffective for correlated noise in low-dose CT (LDCT) images. Considering the high similarity and weaker noise correlation between adjacent CT slices, several recently proposed self-supervised methods use adjacent LDCT slices for training. Nevertheless, these approaches fail to effectively account for the non-rigid misalignment between slices caused by anatomical variation, hindering them from satisfying the equal-mean condition required by the classic Noise2Noise framework. In this paper, we propose Noise2Match, a self-supervised LDCT denoising method based on adaptive inter-slice matching. Noise2Match introduces an inter-slice matching network to model the label transition process between adjacent slices, and then applies correction to the denoiser's outputs to better satisfy the equal-mean condition. We theoretically prove that, under idealized conditions, training Noise2Match using adjacent LDCT slices is equivalent to supervised training with paired noisy-clean images. We further find that Noise2Match can also effectively perform low-dose conebeam CT (CBCT) denoising, which could be attributed to its correction operation that reduces inter-slice noise correlation. To the best of our knowledge, Noise2Match is the first effective image-domain self-supervised method for low-dose CBCT. Extensive experiments demonstrate that Noise2Match outperforms existing image-domain selfsupervised methods, offering broader applicability and higher practical value.

cs.CV↗

arXiv2026

Gaussian Material Fields for Volumetric Multi-Energy CT Decomposition

Volumetric material decomposition in multi-energy computed tomography requires a representation that organizes multiple three-dimensional material fields in a common spatial domain while retaining differences in composition and local structure. We observe that spatial primitives can be shared across materials without tying their coefficients, but their local capacity must respond to material-specific reconstruction needs. We introduce Gaussian material fields, which represent multiple material distributions with shared anisotropic 3D Gaussian primitives and independent nonnegative material coefficients. The shared geometry defines a continuous spatial basis, while the coefficients determine each primitive's contribution to the individual material fields. To reconstruct this representation from multi-energy projections, a differentiable spectral forward model combines Gaussian material path integrals with a calibrated basis matrix, enabling joint optimization of spatial geometry and material composition. Material-aware adaptive density control retains material-specific refinement evidence before aggregation and adjusts local representation capacity to accommodate both spatially extensive components and sparse details. Experiments use synthesized multi-energy projections generated from pseudo-reference material maps constructed by conventional methods from publicly available CT data. Across 15 cases, our approach improves average PSNR by 4.03 dB and SSIM by 4.96% over the strongest baseline, while reducing NRMSE by 33.45%. Material-wise comparisons and component ablations support improved recovery of localized structures, while runtime and memory measurements show favorable computational scaling. These results establish Gaussian material fields as an explicit, adaptive representation for volumetric multi-material reconstruction.

cs.CV↗

arXiv2026

Skill-Evolving Grounded Reasoning for Free-Text Promptable 3D Medical Image Segmentation

Free-text promptable 3D medical image segmentation offers an intuitive and clinically flexible interaction paradigm. However, current methods are highly sensitive to linguistic variability: minor changes in phrasing can cause substantial performance degradation despite identical clinical intent. Existing approaches attempt to improve robustness through stronger vision-language fusion or larger vocabularies, yet they lack mechanisms to consistently align ambiguous free-form expressions with anatomically grounded representations. We propose Skill-Evolving grounded Reasoning (SEER), a novel framework for free-text promptable 3D medical image segmentation that explicitly bridges linguistic variability and anatomical precision through a reasoning-driven design. First, we curate the SEER-Trace dataset, which pairs raw clinical requests with image-grounded, skill-tagged reasoning traces, establishing a reproducible benchmark. Second, SEER constructs an evidence-aligned target representation via a vision-language reasoning chain that verifies clinical intent against image-derived anatomical evidence, thereby enforcing semantic consistency before voxel-level decoding. Third, we introduce SEER-Loop, a dynamic skill-evolving strategy that distills high-reward reasoning trajectories into reusable skill artifacts and progressively integrates them into subsequent inference, enabling structured self-refinement and improved robustness to diverse linguistic expressions. Extensive experiments demonstrate superior performance of SEER over state-of-the-art baselines. Under linguistic perturbations, SEER reduces performance variance by 81.94% and improves worst-case Dice by 18.60%. Project page: https://seer-medseg.github.io.

eess.IV↗

arXiv2026

Interpreting Object-Dependent Concept Brittleness in Text-to-Image Diffusion Models

Although text-to-image diffusion models generally exhibit strong prompt-following ability, we identify a persistent and previously underexplored failure pattern in which a small subset of prompts differing only in the object consistently fails to realize the same target concept under identical generation settings. We term this phenomenon object-dependent concept brittleness. Such cases suggest systematic internal blind spots rather than random sampling noise. In this paper, we present an interpretability-oriented framework to audit and minimally correct these failures. Our key idea is to analyze denoising trajectories in a step-wise sparse autoencoder (SAE) space, where abstract style and attribute concepts become more separable than in the raw denoising representation. This sparse space enables us to compare successful and failed generations, identify concept dimensions whose evidence is missing, weakened, or temporally delayed, and construct class-level concept prototypes from reliable class-consistent samples. Based on this audit process, we introduce a lightweight inference-time correction strategy that interpolates denoising features toward the corresponding prototype in SAE space. Rather than serving as a task-specific retraining method, this intervention acts as a validation of the diagnosed concept deficiency. We evaluate the proposed framework on style and attribute failure cases across multiple diffusion backbones, with significant improvements in concept consistency, text fidelity, and repair success. Further analyses show that deeper denoising representations provide clearer concept structure, while early-stage intervention offers the strongest correction leverage. Code is available at https://github.com/Metecade/Object-Dependent-Concept-Brittleness.

cs.CV↗

arXiv2026

FoundDiff: Foundational Diffusion Model for Generalizable Low-Dose CT Denoising

Low-dose computed tomography (CT) denoising is crucial for reduced radiation exposure while ensuring diagnostically acceptable image quality. Despite significant advancements driven by deep learning (DL) in recent years, existing DL-based methods, typically trained on a specific dose level and anatomical region, struggle to handle diverse noise characteristics and anatomical heterogeneity during varied scanning conditions, limiting their generalizability and robustness in clinical scenarios. In this paper, we propose FoundDiff, a foundational diffusion model for unified and generalizable LDCT denoising across various dose levels and anatomical regions. FoundDiff employs a two-stage strategy: (i) dose-anatomy perception and (ii) adaptive denoising. First, we develop a dose- and anatomy-aware contrastive language-image pre-training model (DA-CLIP) to achieve robust dose and anatomy perception by leveraging specialized contrastive learning strategies to learn continuous representations that quantify ordinal dose variations and identify salient anatomical regions. Second, we design a dose- and anatomy-aware diffusion model (DA-Diff) to perform adaptive and generalizable denoising by synergistically integrating the learned dose and anatomy embeddings from DA-CLIP into diffusion process via a novel dose and anatomy conditional block (DACB) based on Mamba. Extensive experiments on a large simulated multi-dose CT dataset spanning three anatomical regions, together with cross-dataset evaluations on Mayo-2016, CQ500, and piglet datasets, demonstrate superior denoising performance and strong generalization to unseen dose levels and anatomical regions. The codes and models are available at https: //github.com/hao1635/FoundDiff.

cs.CV↗

arXiv2026

Volumetric Radiology AI in the Era of Multimodal Large Language Models

Advances in multimodal large language models (MLLMs) are extending radiological artificial intelligence (AI) beyond task-specific image analysis toward multimodal understanding and reasoning. Volumetric radiology, however, presents a fundamental representational mismatch: clinical interpretation often requires full-volume spatial context and acquisition-dependent quantitative information, whereas current MLLMs are commonly conditioned on selected two-dimensional (2D) images, compressed visual representations, or report-derived text. Reliable volumetric radiology AI therefore requires representations that preserve task-relevant three-dimensional (3D) information and systems that can access, verify, and integrate this information across clinical workflows. In this Review, we examine more than 200 publications through July 2026. We organize the literature around volumetric representation and multimodal understanding at the model level, agentic orchestration at the system level, and their links to clinical applications and evaluation. We review volumetric foundation models, language alignment and compression strategies, and agentic systems that extend MLLMs through planning, tools, memory, and workflow interaction. We distinguish settings in which selected 2D views or report-mediated reasoning may suffice from those that warrant native volumetric modeling. We also introduce a Claim-Design-Validation framework to assess whether technical, workflow, and clinical claims are matched by appropriate design and validation. Across the literature, native volumetric modeling and agentic capabilities depend on the spatial, quantitative, contextual, and workflow requirements of the intended task. Clinical credibility requires faithful volumetric representation, traceable system behavior, claim-aligned validation, and clearly defined human oversight in realistic workflows.

cs.AI↗

arXiv2026

MSAVBench: Towards Comprehensive and Reliable Evaluation of Multi-Shot Audio-Video Generation

Video generation is rapidly evolving from single-shot synthesis to complex multi-shot audio-video (MSAV) narratives to meet real-world demands. However, evaluating such frontier models remains a fundamental challenge. Existing benchmarks are limited in scope and data diversity, and rely on rigid evaluation pipelines, preventing systematic and reliable assessment of modern MSAV models. To bridge these gaps, we introduce MSAVBench, the first comprehensive benchmark and adaptive hybrid evaluation framework for multi-shot audio-video generation. Our benchmark spans four key dimensions, video, audio, shot, and reference, covering diverse task settings, varying shot counts of up to 15, and challenging non-realistic scenarios. Our evaluation framework improves robustness through an adaptive self-correction mechanism for shot segmentation, instance-wise rubrics for subjective metrics, and tool-grounded evidence extraction for complex judgments. Furthermore, MSAVBench achieves high alignment with human judgments, reaching a Spearman rank correlation of 91.5%. Our systematic evaluation of 19 state-of-the-art closed- and open-source models shows that current systems still struggle with director-level control and fine-grained audio-visual synchronization, while modular or agentic generation pipelines offer a promising path toward narrowing the gap between open- and closed-source models. The benchmark data and evaluation code are publicly available at https://github.com/ali-vilab/MSAVBench.

cs.CV↗

arXiv2026

GraphMAR: Geometry-Aware Graph Learning Framework for Spatially Adaptive CT Metal Artifact Reduction

Computed tomography (CT) metal artifact reduction (MAR) aims to reduce the severe streaking artifacts induced by metallic implants and other high-density objects. Effective MAR generally requires both accurate artifact localization and artifact removal. Sinogram-domain methods can exploit explicit geometric cues, such as metal traces, to identify metal-corrupted measurements, while requiring raw projection data, which is often unavailable in clinical and practical scenarios. Image-domain methods are more flexible and widely applicable, yet they usually lack comparable geometric guidance, limiting their ability to localize artifacts and leading to suboptimal results. To address this limitation, we propose GraphMAR, a geometry-aware learning framework for explicit artifact identification and spatially adaptive MAR in the image domain. The key idea is to introduce graph-based geometric modeling as an image-domain analogue of sinogram metal traces. Specifically, we first construct a geometric graph from the metal mask and derive a geometric density graph that coarsely localizes artifact-prone regions according to inter-implant geometry. We then design GraphMoE, a graph-routed mixture-of-experts module that builds a polar-coordinate artifact graph in feature space and adaptively routes different experts to different spatial regions for MAR. By aligning the learned routing maps with the geometric density graph, GraphMAR provides explicit and interpretable artifact localization while enabling region-adaptive artifact reduction. Experiments on both simulated and real-world datasets demonstrate that GraphMAR achieves superior MAR performance compared with existing methods. To the best of our knowledge, this is the first work to introduce graph-based modeling for CT MAR and to enable explicit artifact identification in the image domain, improving both restoration quality and interpretability.

cs.CV↗

arXiv2026

Bridging Brain and Semantics: A Hierarchical Framework for Semantically Enhanced fMRI-to-Video Reconstruction

Reconstructing dynamic visual experiences as videos from functional magnetic resonance imaging (fMRI) is pivotal for advancing the understanding of neural processes. However, current fMRI-to-video reconstruction methods are hindered by a semantic gap between noisy fMRI signals and the rich content of videos, stemming from a reliance on incomplete semantic embeddings that neither capture video-specific cues (e.g., actions) nor integrate prior knowledge. To this end, we draw inspiration from the dual-pathway processing mechanism in human brain and introduce CineNeuron, a novel hierarchical framework for semantically enhanced video reconstruction from fMRI signals with two synergistic stages. First, a bottom-up semantic enrichment stage maps fMRI signals to a rich embedding space that comprehensively captures textual semantics, image contents, action concepts, and object categories. Second, a top-down memory integration stage utilizes the proposed Mixture-of-Memories method to dynamically select relevant "memories" from previously seen data and fuse them with the fMRI embedding to refine the video reconstruction. Extensive experimental results on two fMRI-to-video benchmarks demonstrate that CineNeuron surpasses state-of-the-art methods across various metrics.

cs.CV↗

arXiv2026

Hierarchical Codec Diffusion for Video-to-Speech Generation

Video-to-Speech (VTS) generation aims to synthesize speech from a silent video without auditory signals. However, existing VTS methods disregard the hierarchical nature of speech, which spans coarse speaker-aware semantics to fine-grained prosodic details. This oversight hinders direct alignment between visual and speech features at specific hierarchical levels during property matching. In this paper, leveraging the hierarchical structure of Residual Vector Quantization (RVQ)-based codec, we propose HiCoDiT, a novel Hierarchical Codec Diffusion Transformer that exploits the inherent hierarchy of discrete speech tokens to achieve strong audio-visual alignment. Specifically, since lower-level tokens encode coarse speaker-aware semantics and higher-level tokens capture fine-grained prosody, HiCoDiT employs low-level and high-level blocks to generate tokens at different levels. The low-level blocks condition on lip-synchronized motion and facial identity to capture speaker-aware content, while the high-level blocks use facial expression to modulate prosodic dynamics. Finally, to enable more effective coarse-to-fine conditioning, we propose a dual-scale adaptive instance layer normalization that jointly captures global vocal style through channel-wise normalization and local prosody dynamics through temporal-wise normalization. Extensive experiments demonstrate that HiCoDiT outperforms baselines in fidelity and expressiveness, highlighting the potential of discrete modelling for VTS. The code and speech demo are both available at https://github.com/Jiaxin-Ye/HiCoDiT.

cs.SD↗

arXiv2026

CoSyncDiT: Cognitive Synchronous Diffusion Transformer for Movie Dubbing

Movie dubbing aims to synthesize speech that preserves the vocal identity of a reference audio while synchronizing with the lip movements in a target video. Existing methods fail to achieve precise lip-sync and lack naturalness due to explicit alignment at the duration level. While implicit alignment solutions have emerged, they remain susceptible to interference from the reference audio, triggering timbre and pronunciation degradation in in-the-wild scenarios. In this paper, we propose a novel flow matching-based movie dubbing framework driven by the Cognitive Synchronous Diffusion Transformer (CoSync-DiT), inspired by the cognitive process of professional actors. This architecture progressively guides the noise-to-speech generative trajectory by executing acoustic style adapting, fine-grained visual calibrating, and time-aware context aligning. Furthermore, we design the Joint Semantic and Alignment Regularization (JSAR) mechanism to simultaneously constrain frame-level temporal consistency on the contextual outputs and semantic consistency on the flow hidden states, ensuring robust alignment. Extensive experiments on both standard benchmarks and challenging in-the-wild dubbing benchmarks demonstrate that our method achieves the state-of-the-art performance across multiple metrics.

cs.SD↗

arXiv2026

Unified Medical Image Tokenizer for Autoregressive Synthesis and Understanding

Autoregressive modeling has driven major advances in multimodal AI, yet its application to medical imaging remains constrained by the absence of a unified image tokenizer that simultaneously preserves fine-grained anatomical structures and rich clinical semantics across heterogeneous modalities. Existing approaches jointly optimize image reconstruction and textual semantic objectives, relying on large-scale image-caption pairs and are prone to gradient interference. This is ill-suited for the medical domain where paired data are scarce and abundant unpaired images remain unexploited. This work identifies these issues in building unified medical image tokenizers, and introduces a principled two-stage training framework using visual representation as a bridge to address them. The propose visual representation alignment stage enables the utilization of large-scale unpaired medical images to ensure reconstruction fidelity and establish foundational semantics, alleviating the interference and better preparing for the second stage where fine-grained textual semantics are injected using image-text pairs. The resulting tokenizer, MedITok, is trained on over 33 million medical images spanning 9 modalities and 2 million image-text pairs. MedITok achieves state-of-the-art performance on 30+ benchmarks spanning 9 imaging modalities and 4 task families. It further enables autoregressive modeling for diagnostic and generative applications, serving as a scalable component for future multimodal models with unified synthesis and understanding capabilities in the medical domain. Project page: https://github.com/Masaaki-75/meditok

eess.IV↗

arXiv2026

PHASOR: Anatomy- and Phase-Consistent Volumetric Diffusion for CT Virtual Contrast Enhancement

Contrast-enhanced computed tomography (CECT) is pivotal for highlighting tissue perfusion and vascularity, yet its clinical ubiquity is impeded by the invasive nature of contrast agents and radiation risks. While virtual contrast enhancement (VCE) offers an alternative to synthesizing CECT from non-contrast CT (NCCT), existing methods struggle with anatomical heterogeneity and spatial misalignment, leading to inconsistent enhancement patterns and incorrect details. This paper introduces PHASOR, a volumetric diffusion framework for high-fidelity CT VCE. By treating CT volumes as coherent sequences, we leverage a video diffusion model to enhance structural coherence and volumetric accuracy. To ensure anatomy-phase consistent synthesis, we introduce two complementary modules. First, anatomy-routed mixture-of-experts (AR-MoE) anchors distinct enhancement patterns to anatomical semantics, with organ-specific memory to capture salient details. Second, intensity-phase aware representation alignment (IP-REPA) highlights intricate contrast signals while mitigating the impact of imperfect spatial alignment. Extensive experiments across three datasets demonstrate that PHASOR significantly outperforms state-of-the-art methods in both synthesis quality and enhancement accuracy.

cs.CV↗

arXiv2026

Project Imaging-X: A Survey of 1000+ Open-Access Medical Imaging Datasets for Foundation Model Development

Foundation models have demonstrated remarkable success across diverse domains and tasks, primarily due to the thrive of large-scale, diverse, and high-quality datasets. However, in the field of medical imaging, the curation and assembling of such medical datasets are highly challenging due to the reliance on clinical expertise and strict ethical and privacy constraints, resulting in a scarcity of large-scale unified medical datasets and hindering the development of powerful medical foundation models. In this work, we present the largest survey to date of medical image datasets, covering over 1,000 open-access datasets with a systematic catalog of their modalities, tasks, anatomies, annotations, limitations, and potential for integration. Our analysis exposes a landscape that is modest in scale, fragmented across narrowly scoped tasks, and unevenly distributed across organs and modalities, which in turn limits the utility of existing medical image datasets for developing versatile and robust medical foundation models. To turn fragmentation into scale, we propose a metadata-driven fusion paradigm (MDFP) that integrates public datasets with shared modalities or tasks, thereby transforming multiple small data silos into larger, more coherent resources. Building on MDFP, we release an interactive discovery portal that enables end-to-end, automated medical image dataset integration, and compile all surveyed datasets into a unified, structured table that clearly summarizes their key characteristics and provides reference links, offering the community an accessible and comprehensive repository. By charting the current terrain and offering a principled path to dataset consolidation, our survey provides a practical roadmap for scaling medical imaging corpora, supporting faster data discovery, more principled dataset creation, and more capable medical foundation models.

cs.CV↗

arXiv2026

One CT Unified Model Training Framework to Rule All Scanning Protocols

Non-ideal measurement computed tomography (NICT), which lowers radiation at the cost of image quality, is expanding the clinical use of CT. Although unified models have shown promise in NICT enhancement, most methods require paired data, which is an impractical demand due to inevitable organ motion. Unsupervised approaches attempt to overcome this limitation, but their assumption of homogeneous noise neglects the variability of scanning protocols, leading to poor generalization and potential model collapse. We further observe that distinct scanning protocols, which correspond to different physical imaging processes, produce discrete sub-manifolds in the feature space, contradicting these assumptions and limiting their effectiveness. To address this, we propose an Uncertainty-Guided Manifold Smoothing (UMS) framework to bridge the gaps between sub-manifolds. A classifier in UMS identifies sub-manifolds and predicts uncertainty scores, which guide the generation of diverse samples across the entire manifold. By leveraging the classifier's capability, UMS effectively fills the gaps between discrete sub-manifolds, and promotes a continuous and dense feature space. Due to the complexity of the global manifold, it's hard to directly model it. Therefore, we propose to dynamically incorporate the global- and sub-manifold-specific features. Specifically, we design a global- and sub-manifold-driven architecture guided by the classifier, which enables dynamic adaptation to subdomain variations. This dynamic mechanism improves the network's capacity to capture both shared and domain-specific features, thereby improving reconstruction performance. Extensive experiments on public datasets are conducted to validate the effectiveness of our method across different generation paradigms.

cs.CV↗

arXiv2026

TheraAgent: Multi-Agent Framework with Self-Evolving Memory and Evidence-Calibrated Reasoning for PET Theranostics

PET theranostics is transforming precision oncology, yet treatment response varies substantially; many patients receiving 177Lu-PSMA radioligand therapy (RLT) for metastatic castration-resistant prostate cancer (mCRPC) fail to respond, demanding reliable pre-therapy prediction. While LLM-based agents have shown remarkable potential in complex medical diagnosis, their application to PET theranostic outcome prediction remains unexplored, which faces three key challenges: (1) data and knowledge scarcity: RLT was only FDA-approved in 2022, yielding few training cases and insufficient domain knowledge in general LLMs; (2) heterogeneous information integration: robust prediction hinges on structured knowledge extraction from PET/CT, laboratory tests, and free-text clinical documentation; (3) evidence-grounded reasoning: clinical decisions must be anchored in trial evidence rather than LLM hallucinations. In this paper, we present TheraAgent, to our knowledge, the first agentic framework for PET theranostics, with three core innovations: (1) Multi-Expert Feature Extraction with Confidence-Weighted Consensus, where three specialized experts process heterogeneous inputs with uncertainty quantification; (2) Self-Evolving Agentic Memory (SEA-Mem), which learns prognostic patterns from accumulated cases, enabling case-based reasoning from limited data; (3) Evidence-Calibrated Reasoning, integrating a curated theranostics knowledge base to ground predictions in VISION/TheraP trial evidence. Evaluated on 35 real patients and 400 synthetic cases, TheraAgent achieves 75.7% overall accuracy on real patients and 87.0% on synthetic cases, outperforming MDAgents and MedAgent-Pro by over 20%. These results highlight a promising blueprint for trustworthy AI agents in PET theranostics, enabling trial-calibrated, multi-source decision support. Code will be released upon acceptance.

cs.AI↗