VISTA: Validation-Guided Integration of Spatial and Temporal Foundation Models with Anatomical Decoding for Rare-Pathology VCE Event Detection -- after competition results

Video Capsule Endoscopy (VCE) poses a challenging multi-label temporal classification problem, requiring simultaneous localization of 8 anatomical regions and detection of 9 pathological findings across tens of thousands of frames. We present GALAR-TemporalNet v2, a hierarchical temporal model that addresses three core challenges: extreme class imbalance, long-range temporal dependencies, and pathology--anatomy entanglement. Our architecture combines windowed self-attention for local modeling, a Dual-Graph GCN for global frame relationships, and Bidirectional Mamba for selective boundary context encoding. A novel anatomy prototype residual pathway decouples pathological deviation signals from normal organ appearance, and a frame-level GCN skip connection stabilizes training of visually confusable rare classes. The competition version, GALAR-TemporalNet, achieved an overall mAP@0.5 of 0.2644 and mAP@0.95 of 0.2353 on the RARE-VISION test set. Following the competition, the redesigned GALAR-TemporalNet v2 -- incorporating a restructured pathology branch, refined loss functions, and extended post-processing -- improved these results to mAP@0.5 of 0.3409 and mAP@0.95 of 0.3333.

The development of foundation models (FMs) is crucial for advancing endoscopic image analysis. However, existing endoscopy FMs mainly rely on self-supervised learning from uni-modal images or videos, overlooking the rich semantic knowledge contained in clinical reports. Furthermore, effectively leveraging these records is hindered by a fundamental modality gap: structured anatomical descriptions are not naturally mapped to specific frames within the high-redundancy, uncurated visual streams. In this paper, we present EndoVLM, a novel vision-language FM pre-trained on over 348K endoscopic examinations, each pairing a clinical report with its corresponding image collection. An Anatomy-Guided Sparse Pooling mechanism utilizes textual descriptions as queries to drive sparse attention, efficiently aggregating semantically salient frames into anatomy-specific visual representations across redundant image-sets. Next, a Progressive Semantic-Aware Alignment strategy models clinical taxonomy (anatomy and pathological status) via structured soft targets, bridging the gap from global patient-level matching to fine-grained localized alignment. Finally, a Semantic-Concentrated Masked Autoencoder is applied exclusively to these semantic-rich frames, integrating low-level visual precision with robust high-level semantic representation. Extensive experiments across various downstream tasks demonstrate that EndoVLM outperforms existing foundation models and remains competitive with task-specific methods. Remarkably, EndoVLM also exhibits robust zero-shot generalization capabilities, highlighting its potential for broader clinical application.

Capsule endoscopy (CE) enables non-invasive gastrointestinal screening, but current CE research remains largely limited to frame-level classification and detection, leaving video-level analysis underexplored. To bridge this gap, we introduce and formally define a new task, diagnosis-driven CE video summarization, which requires extracting key evidence frames that covers clinically meaningful findings and making accurate diagnoses from those evidence frames. This setting is challenging because diagnostically relevant events are extremely sparse and can be overwhelmed by tens of thousands of redundant normal frames, while individual observations are often ambiguous due to motion blur, debris, specular highlights, and rapid viewpoint changes. To facilitate research in this direction, we introduce VideoCAP, the first CE dataset with diagnosis-driven annotations derived from real clinical reports. VideoCAP comprises 240 full-length videos and provides realistic supervision for both key evidence frame extraction and diagnosis. To address this task, we further propose DiCE, a clinician-inspired framework that mirrors the standard CE reading workflow. DiCE first performs efficient candidate screening over the raw video, then uses a Context Weaver to organize candidates into coherent diagnostic contexts that preserve distinct lesion events, and an Evidence Converger to aggregate multi-frame evidence within each context into robust clip-level judgments. Experiments show that DiCE consistently outperforms state-of-the-art methods, producing concise and clinically reliable diagnostic summaries. These results highlight diagnosis-driven contextual reasoning as a promising paradigm for ultra-long CE video summarization.