Lei Zhu | Search arXiv

arXiv2026

ViT3Flow: A Test-Time Training Transformer MeanFlow for Postoperative Radiograph Synthesis in Scoliosis

Predicting postoperative spinal morphology from preoperative radiographs could provide valuable support for scoliosis surgical planning, but remains challenging because surgical correction induces large spatial changes while anatomical structures must be faithfully retained. We formulate this problem as postoperative scoliosis radiograph synthesis and construct ScoliSurg, the first paired dataset for this task, comprising 632 preoperative--postoperative whole-spine radiograph pairs with structured morphology information. We further propose ViT$^{3}$Flow, a single-NFE conditional MeanFlow framework for efficient postoperative radiograph synthesis. ViT$^{3}$Flow models surgical correction as finite-interval generative transport and replaces conventional self-attention with test-time-training token mixers that perform sample-specific inner adaptation to the anatomy and deformity pattern of each case. In addition, a Spinal Morphology Extraction Agent extracts distributions of dominant-curve region and direction from the preoperative radiograph. These distributions guide Diagnosis-Routed Interval Cross-Attention (DRICA), which performs interval-dependent vertical, horizontal, joint, and global retrieval from a separate preoperative token stream. This design enables the evolving postoperative representation to incorporate spatially corresponding anatomical evidence throughout the transport process. Extensive experiments on ScoliSurg demonstrate that ViT$^{3}$Flow achieves the best performance among the compared methods in perceptual image quality, anatomical fidelity, and clinically relevant geometric accuracy, while requiring only a single network evaluation. These results highlight the potential of ViT$^{3}$Flow for efficient and anatomically faithful postoperative radiograph synthesis in scoliosis surgical planning.

cs.CV↗

arXiv2026

Unfold The World: Factorize 4D Properties in Reinforcing Spatial Reasoning

Despite the remarkable prowess of Vision-Language Models (VLMs) in general multimodal tasks, they remain fundamentally ``flat'' when reasoning about the physical world. We argue that this spatial bottleneck stems from a profound dimensional mismatch: while VLMs are trained to interpret 2D projections, true spatial reasoning demands the recovery of latent 3D geometry and temporal continuity. To conquer this high-dimensional complexity, we advocate a shift from monolithic learning to a ``divide and conquer'' paradigm. We present FactoSR, a factorized reinforcement learning framework that explicitly interpret the dimensions collapsed by visual projection. At its core, FactoSR decomposes the monolithic problem of world-consistent reasoning into three orthogonal, geometric sub-objectives: planar correspondence ($XY$), depth consistency ($Z$), and temporal reversibility ($T$). By optimizing these verifiable constraints within a unified policy learning mechanism, we effectively transform an ill-posed projection recovery problem into a series of tangible reasoning steps. Extensive evaluations on multi-view and video benchmarks demonstrate that this elegant decomposition yields substantial gains in 3D and 4D reasoning, achieving a 5.9% boost on VSI-Bench and 4.5% on All-Angles-Bench. Our findings suggest that reinforcing explicit, factorized 4D consistency is a critical step toward evolving VLMs into robust, world-aware reasoners.

cs.CV↗