Automated diagnostic systems (ADS) have shown significant potential in the early detection of polyps during endoscopic examinations, thereby reducing the incidence of colorectal cancer. However, due to high annotation costs and strict privacy concerns, acquiring high-quality endoscopic images poses a considerable challenge in the development of ADS. Despite recent advancements in generating synthetic images for dataset expansion, existing endoscopic image generation algorithms failed to accurately generate the details of polyp boundary regions and typically required medical priors to specify plausible locations and shapes of polyps, which limited the realism and diversity of the generated images. To address these limitations, we present Polyp-Gen, the first full-automatic diffusion-based endoscopic image generation framework. Specifically, we devise a spatial-aware diffusion training scheme with a lesion-guided loss to enhance the structural context of polyp boundary regions. Moreover, to capture medical priors for the localization of potential polyp areas, we introduce a hierarchical retrieval-based sampling strategy to match similar fine-grained spatial features. In this way, our Polyp-Gen can generate realistic and diverse endoscopic images for building reliable ADS. Extensive experiments demonstrate the state-of-the-art generation quality, and the synthetic images can improve the downstream polyp detection task. Additionally, our Polyp-Gen has shown remarkable zeroshot generalizability on other datasets. The source code is available at https://github.com/CUHK-AIM-Group/Polyp-Gen.

Endoscopic procedures are essential for diagnosing and treating internal diseases, and multi-modal large language models (MLLMs) are increasingly applied to assist in endoscopy analysis. However, current benchmarks are limited, as they typically cover specific endoscopic scenarios and a small set of clinical tasks, failing to capture the real-world diversity of endoscopic scenarios and the full range of skills needed in clinical workflows. To address these issues, we introduce EndoBench, the first comprehensive benchmark specifically designed to assess MLLMs across the full spectrum of endoscopic practice with multi-dimensional capacities. EndoBench encompasses 4 distinct endoscopic scenarios, 12 specialized clinical tasks with 12 secondary subtasks, and 5 levels of visual prompting granularities, resulting in 6,832 rigorously validated VQA pairs from 21 diverse datasets. Our multi-dimensional evaluation framework mirrors the clinical workflow—spanning anatomical recognition, lesion analysis, spatial localization, and surgical operations—to holistically gauge the perceptual and diagnostic abilities of MLLMs in realistic scenarios. We benchmark 23 state-of-the-art models, including general-purpose, medical-specialized, and proprietary MLLMs, and establish human clinician performance as a reference standard. Our extensive experiments reveal: (1) proprietary MLLMs outperform open-source and medical-specialized models overall, but still trail human experts; (2) medical-domain supervised fine-tuning substantially boosts task-specific accuracy; and (3) model performance remains sensitive to prompt format and clinical task complexity. EndoBench establishes a new standard for evaluating and advancing MLLMs in endoscopy, highlighting both progress and persistent gaps between current models and expert clinical reasoning. We publicly release our benchmark and code.

Endoscopy super-resolution (SR) plays an important role in improving diagnostic results and reducing the misdiagnosis rate. Even though recent studies have investigated the SR for endoscopy, these methods apply equal importance to the whole image and do not consider the relationship among pixels, especially the depth information, which can provide diagnosis-related information for clinicians. To address this problem, we propose a dynamic depth-aware network for endoscopy super-resolution, which represents the first effort to comprehensively integrate the depth information to the SR task for endoscopic images. It includes a depth-wise feature extracting branch (DW-B) and a depth-guided SR branch (DGSR-B). The DW-B aims to extract the representative feature for each depth level (i.e. depth matrix) further to provide auxiliary information and guide the super-resolution of texture under different depth levels. In DGSR-B, a depth-guided block (DGB) consisting of depth-focus normalization (DFN) is introduced to inject both the depth matrix and depth map into the LR image feature, so as to guide the image generation for each depth region. To adaptively super-resolve the regions under different depth levels, we devise a dynamic depth-aware loss to assign different trainable weights to each region for SR optimization. Extensive experiments have been conducted on two main publicly available datasets, i.e., the Kvasir dataset and the EndoScene dataset, and the superior performance verifies the effectiveness of our method for SR task and polyp segmentation. Source code is to be released.