ScienceBuddy-PV: A Verifier-Governed Recursive Improvement Protocol for Panvascular Intervention Research

Conventional pixel-wise loss functions fail to enforce topological constraints in coronary vessel segmentation, producing fragmented vascular trees despite high pixel-level accuracy. We present ARIADNE, a two-stage framework coupling preference-aligned perception with RL-based diagnostic reasoning for topologically coherent stenosis detection. The perception module employs DPO to fine-tune the Sa2VA vision-language foundation model using Betti number constraints as preference signals, aligning the policy toward geometrically complete vessel structures rather than pixel-wise overlap metrics. The reasoning module formulates stenosis localization as a Markov Decision Process with an explicit rejection mechanism that autonomously defers ambiguous anatomical candidates such as bifurcations and vessel crossings, shifting from coverage maximization to reliability optimization. On 1,400 clinical angiograms, ARIADNE achieves state-of-the-art centerline Dice of 0.838, reduces false positives by 41% compared to geometric baselines. External validation on multi-center benchmarks ARCADE and XCAD confirms generalization across acquisition protocols. This represents the first application of DPO for topological alignment in medical imaging, demonstrating that preference-based learning over structural constraints mitigates topological violations while maintaining diagnostic sensitivity in interventional cardiology workflows.

Surgical resection remains the only potentially curative treatment for pancreatic ductal adenocarcinoma (PDAC), and eligibility depends on accurate assessment of vascular invasion (VI), i.e., tumor extension into adjacent critical vessels. Despite its importance for preoperative staging and surgical planning, computational VI assessment remains underexplored. Two major challenges are the lack of public datasets and the diagnostic ambiguity at the tumor-vessel interface, which leads to substantial inter-rater variability even among expert radiologists. To address these limitations, we introduce the CURVAS-PDACVI Dataset and Challenge, an open benchmark for uncertainty-aware AI in PDAC staging based on a densely annotated dataset with five independent expert annotations per scan. We also propose a multi-metric evaluation framework that extends beyond spatial overlap to include probabilistic calibration and VI assessment. Evaluation of six state-of-the-art methods shows that strong global volumetric overlap does not necessarily translate into reliable performance at clinically critical tumor-vessel interfaces. In particular, methods optimized for binary segmentation perform competitively on average overlap metrics, but often degrade in high-complexity cases with low expert consensus, either collapsing in volume or overextending at uncertain boundaries. In contrast, methods that model inter-rater disagreement produce better calibrated probabilistic maps and show greater robustness in these ambiguous cases. The benchmark highlights the limitations of volumetric accuracy as a proxy for localized surgical utility, motivating uncertainty-aware probabilistic models for preoperative decision-making.

We introduce and release ScienceBuddy, an interactive scientific research workspace that brings continually improving scientific agents into researchers' everyday workflows. ScienceBuddy supports researchers in carrying out scientific tasks while transforming their requests, feedback, and execution evidence into tasks and evaluation rubrics for continual learning. At its core is recursive-in-recursive self-improvement, a paradigm that couples harness evolution with model reinforcement learning: the inner recursion improves the harness with the model fixed, while the outer recursion trains the model under the improved harness. Harness evolution shapes training experience, and model learning creates new opportunities for harness adaptation. We present case studies of researcher interaction, harness refinement, and model learning, with the benchmark cases spanning four scientific task families. By releasing ScienceBuddy as a research product, we make this paradigm available to the scientific community and take a step toward discovery intelligence: scientific AI that advances through sustained collaboration with researchers and evolves alongside the research it supports. Website: http://science-buddy.io