arXiv:2506.02327cs.CV2025-06ICCV被引 27

用生成模型模拟肿瘤演变,辅助医生制定个性化治疗方案。

Medical World Model: Generative Simulation of Tumor Evolution for Treatment Planning

  • 结合视觉语言模型与肿瘤生成模型,实现治疗决策的动态预测。
  • 在放射科医生的图灵测试中,对治疗后肿瘤的生成达到顶尖准确率。
  • 可为介入医生提供最优TACE方案建议,提升13%的决策准确率。

有效治疗与科学临床决策是现代医学的核心目标。本文提出医学世界模型(MeWM),首个用于临床决策的医学世界模型,能够基于临床决策视觉预测未来疾病状态。MeWM由两部分构成:(i) 视觉-语言模型作为策略模型,生成如治疗方案等行动计划;(ii) 肿瘤生成模型作为动力学模型,模拟给定治疗条件下的肿瘤进展或消退。在此基础上,我们引入逆动力学模型,结合生存分析评估治疗效果,并选择最优临床方案。结果表明,该模型通过合成治疗后肿瘤,实现了图灵测试中顶尖的特异性表现;其逆动力学模型在优化个体化治疗方案方面,各项指标均优于专业医疗GPT。尤为关键的是,该模型使介入医生在选择最佳TACE方案时,F1得分提升13%,为未来将医学世界模型作为第二阅片人奠定基础。

原文摘要 · Abstract (English)

Providing effective treatment and making informed clinical decisions are essential goals of modern medicine and clinical care. We are interested in simulating disease dynamics for clinical decision-making, leveraging recent advances in large generative models. To this end, we introduce the Medical World Model (MeWM), the first world model in medicine that visually predicts future disease states based on clinical decisions. MeWM comprises (i) vision-language models to serve as policy models, and (ii) tumor generative models as dynamics models. The policy model generates action plans, such as clinical treatments, while the dynamics model simulates tumor progression or regression under given treatment conditions. Building on this, we propose the inverse dynamics model that applies survival analysis to the simulated post-treatment tumor, enabling the evaluation of treatment efficacy and the selection of the optimal clinical action plan. As a result, the proposed MeWM simulates disease dynamics by synthesizing post-treatment tumors, with state-of-the-art specificity in Turing tests evaluated by radiologists. Simultaneously, its inverse dynamics model outperforms medical-specialized GPTs in optimizing individualized treatment protocols across all metrics. Notably, MeWM improves clinical decision-making for interventional physicians, boosting F1-score in selecting the optimal TACE protocol by 13%, paving the way for future integration of medical world models as the second readers.

生成模型肿瘤模拟个性化治疗临床决策

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