Daily Papers

Multimodal agents are increasingly used for data visualization tasks but remain limited in autonomous review. Unlike humans, they may fail to recognize when a visualization is incorrect, determine what to change, repair it without disrupting correct content, and verify whether the intervention succeeded. Existing benchmarks largely evaluate predefined individual capabilities such as chart generation, instruction-guided editing, or defect detection, and therefore do not capture this gap in autonomous review. We introduce VisAudit, a benchmark for evaluating visualization diagnosis, repair, and verification. Given a rendered chart and configurable auxiliary evidence, including its source data table, intended text summary, and visualization code, an agent iteratively diagnoses potential defects, modifies and executes visualization code, inspects execution and visual feedback, and determines when no further intervention is needed. VisAudit defines three tracks spanning diagnosed repair, autonomous repair, and open-world verification, and contains 1,900 flawed instances across 21 chart types and 10 flaw categories, together with 300 initially correct charts. We construct the benchmark through controlled perturbations of validated source visualizations, with systematic verification and human-aligned quality control to ensure that injected defects are well-defined and recoverable from the available evidence. Experiments with leading multimodal models reveal a substantial gap from reliable autonomous review: the strongest evaluated model fully recovers only 47.4% of flawed charts in the autonomous-repair setting.

Automatic prompt optimization (APO) has been widely adopted to adapt vision-language models (VLMs) to downstream tasks without weight updates, yielding promising results. However, on multimodal tasks, the effectiveness of APO is fundamentally bottlenecked by a blind feedback channel: the optimizer reads the question, the prediction, and the gold answer, but never the input image on which the model failed, and therefore cannot diagnose visually grounded errors. As a remedy, we introduce Cross-Modal Visual Feedback (CMVF). CMVF incorporates (1) a failure-conditioned visual diagnosis stage, in which a stronger optimizer VLM inspects each failed image without access to predictions or labels, and (2) an error-aware aggregation stage that compresses these observations into reusable, task-level visual blind-spot patterns that drive the prompt rewrite. Crucially, the image is consumed only during optimization; the deployed artifact is an ordinary text prompt that runs at the same inference cost as any text-only baseline. Extensive results across 12 VQA datasets and 4 target VLMs demonstrate that CMVF consistently ranks first, improving over the strongest baseline on every target by 2.4 points on average, with gains of up to 6.5 points on individual benchmarks. Moreover, the optimizer self-organizes into expert-style visual checklists that transfer across models without re-optimization.

Medical vision-language models (VLMs) excel at image-text understanding but typically rely on a single-pass reasoning that neglects localized visual cues. In clinical practice, however, human experts iteratively scan, focus, and refine the regions of interest before reaching a final diagnosis. To narrow this machine-human perception gap, we introduce ViTAR, a novel VLM framework that emulates the iterative reasoning process of human experts through a cognitive chain of "think-act-rethink-answer". ViTAR treats medical images as interactive objects, enabling models to engage multi-step visual reasoning. To support this approach, we curate a high-quality instruction dataset comprising 1K interactive examples that encode expert-like diagnostic behaviors. In addition, a 16K visual question answering training data has been curated towards fine-grained visual diagnosis. We introduce a two-stage training strategy that begins with supervised fine-tuning to guide cognitive trajectories, followed by the reinforcement learning to optimize decision-making. Extensive evaluations demonstrate that ViTAR outperforms strong state-of-the-art models. Visual attention analysis reveals that from the "think" to "rethink" rounds, ViTAR increasingly anchors visual grounding to clinically critical regions and maintains high attention allocation to visual tokens during reasoning, providing mechanistic insight into its improved performance. These findings demonstrate that embedding expert-style iterative thinking chains into VLMs enhances both performance and trustworthiness of medical AI.

Large multimodal language models (MLLMs) have emerged as powerful tools for guiding evolutionary search toward interpretable programmatic policies. In existing program-evolution systems, however, reusable knowledge is usually carried by whole programs in the population, and it is difficult to trace how a visual observation led to a particular code change and its measured outcome. We present REFLEX, a train-free evolutionary framework that links these steps in one loop. A vision-enabled Critic turns task-specific behavioral evidence into a structured diagnosis; the diagnosis retrieves executable code snippets from a persistent Skill Memory; a text-only Actor writes the child program; and the child--parent fitness change updates the utility of each retrieved snippet. Every step is recorded in a single trace. Under matched backends and 100-call budgets over 10 paired seeds, REFLEX reaches the solve threshold in a median of 13, 20, and 24 LLM calls on Acrobot, Pendulum, and Lunar Lander, roughly half the calls required by official MLES and by a compute-matched Actor-only ablation. Frozen Skill Memory banks from Pendulum or Lunar Lander raise the final Acrobot score on all 10 paired seeds. On a 36-dimensional antenna-array design task with equal evaluation budgets and shared initialization, REFLEX reaches the harder 25.25 score threshold on 9/10 seeds, compared with at most 3/10 for CMA-ES, GA, and PSO.

Hepatocellular carcinoma is the most spread primary liver cancer across the world (sim80\% of the liver tumors). The gold standard for HCC diagnosis is liver biopsy. However, in the clinical routine, expert radiologists provide a visual diagnosis by interpreting hepatic CT-scans according to a standardized protocol, the LI-RADS, which uses five radiological criteria with an associated decision tree. In this paper, we propose an automatic approach to predict histology-proven HCC from CT images in order to reduce radiologists' inter-variability. We first show that standard deep learning methods fail to accurately predict HCC from CT-scans on a challenging database, and propose a two-step approach inspired by the LI-RADS system to improve the performance. We achieve improvements from 6 to 18 points of AUC with respect to deep learning baselines trained with different architectures. We also provide clinical validation of our method, achieving results that outperform non-expert radiologists and are on par with expert ones.

Despite the success of large language models (LLMs) in various domains, their potential in Traditional Chinese Medicine (TCM) remains largely underexplored due to two critical barriers: (1) the scarcity of high-quality TCM data and (2) the inherently multimodal nature of TCM diagnostics, which involve looking, listening, smelling, and pulse-taking. These sensory-rich modalities are beyond the scope of conventional LLMs. To address these challenges, we present ShizhenGPT, the first multimodal LLM tailored for TCM. To overcome data scarcity, we curate the largest TCM dataset to date, comprising 100GB+ of text and 200GB+ of multimodal data, including 1.2M images, 200 hours of audio, and physiological signals. ShizhenGPT is pretrained and instruction-tuned to achieve deep TCM knowledge and multimodal reasoning. For evaluation, we collect recent national TCM qualification exams and build a visual benchmark for Medicinal Recognition and Visual Diagnosis. Experiments demonstrate that ShizhenGPT outperforms comparable-scale LLMs and competes with larger proprietary models. Moreover, it leads in TCM visual understanding among existing multimodal LLMs and demonstrates unified perception across modalities like sound, pulse, smell, and vision, paving the way toward holistic multimodal perception and diagnosis in TCM. Datasets, models, and code are publicly available. We hope this work will inspire further exploration in this field.

Vision-Language Models (VLMs) often lose visual grounding during multi-step reasoning: as reasoning chains grow longer, later inference steps rely increasingly on language priors rather than image evidence. We identify a consistent benchmark-level signature associated with this degradation: across 2,510 re-examined samples from four benchmarks, attention entropy over image tokens typically decreases during Round 1 and rises again after image re-injection. However, we find that effective visual re-examination requires two complementary ingredients: image re-injection and targeted self-diagnosis. Without targeted diagnosis, re-examination can even hurt performance, whereas accurate self-diagnosis yields substantial gains -- a swing of several points on key benchmarks, indicating that diagnostic quality is a key factor in whether re-examination helps or hurts in our setting. We present ReGround, a two-stage framework that teaches VLMs to self-diagnose grounding failures and selectively re-examine visual evidence, without architectural modifications or external tools. Through capability bootstrapping, a stronger variant from the same model family provides diagnostic scaffolding only during data construction, while the policy model learns to diagnose autonomously at inference time and retains most of the assisted gains. Experiments on eight benchmarks across two VLM backbones demonstrate consistent gains, especially on visually intensive multi-step reasoning tasks, while incurring only modest inference overhead relative to tool-augmented baselines. Project page: https://sespoir.github.io/reground-page/ . Code: https://github.com/sespoir/ReGround .

Current AI-assisted skin image diagnosis has achieved dermatologist-level performance in classifying skin cancer, driven by rapid advancements in deep learning architectures. However, unlike traditional vision tasks, skin images in general present unique challenges due to the limited availability of well-annotated datasets, complex variations in conditions, and the necessity for detailed interpretations to ensure patient safety. Previous segmentation methods have sought to reduce image noise and enhance diagnostic performance, but these techniques require fine-grained, pixel-level ground truth masks for training. In contrast, with the rise of foundation models, the Segment Anything Model (SAM) has been introduced to facilitate promptable segmentation, enabling the automation of the segmentation process with simple yet effective prompts. Efforts applying SAM predominantly focus on dermatoscopy images, which present more easily identifiable lesion boundaries than clinical photos taken with smartphones. This limitation constrains the practicality of these approaches to real-world applications. To overcome the challenges posed by noisy clinical photos acquired via non-standardized protocols and to improve diagnostic accessibility, we propose a novel Cross-Attentive Fusion framework for interpretable skin lesion diagnosis. Our method leverages SAM to generate visual concepts for skin diseases using prompts, integrating local visual concepts with global image features to enhance model performance. Extensive evaluation on two skin disease datasets demonstrates our proposed method's effectiveness on lesion diagnosis and interpretability.

This paper systematically diagnoses the training failure modes of Token-Choice sparse Mixture-of-Experts (MoE) on video Diffusion Transformers. Starting from a pretrained dense model of about 5 billion parameters, we convert it into an MoE architecture following three laws: routed experts exactly clone the original FFN weights, shared experts are initialized to zero for verification and then to extremely small non-zero noise for actual training, while only the gating networks start from random initialization. Experiments reveal a hierarchy of five failure modes: (1) linear routers suffer global soft saturation with complete expert homogenization; (2) MLP routers introduce selective deadlock, where roughly one-third of layers degenerate into a single-expert mode that cannot be prevented by increasing the auxiliary loss; (3) cross-attention routers exhibit preliminary self-recovery, yet about nine layers remain stubbornly deadlocked; (4) deadlocked layers display a U-shaped distribution, concentrated in shallow visual processing layers and deep semantic integration layers; (5) bfloat16 mixed precision causes tiny weight updates to be truncated to zero by hardware. Based on routing decision time series over 65 million tokens across 5,000 training steps, we propose the Functional Redundancy Hypothesis: deadlock is a rational waiting strategy before the shared expert matures within the gate-shared expert-routed expert triadic system. This hypothesis is supported by the theory of functional redundancy in systems biology. On the engineering side, we summarize the Three Laws of dense-to-MoE conversion and provide a complete solution for the bfloat16 precision trap. We calibrate the current capability boundary of the Token-Choice paradigm and outline a three-step evolutionary roadmap from visual unification to a world model.

Most multimodal large language models (MLLMs) learn language-to-object grounding through causal language modeling where grounded objects are captured by bounding boxes as sequences of location tokens. This paradigm lacks pixel-level representations that are important for fine-grained visual understanding and diagnosis. In this work, we introduce GROUNDHOG, an MLLM developed by grounding Large Language Models to holistic segmentation. GROUNDHOG incorporates a masked feature extractor and converts extracted features into visual entity tokens for the MLLM backbone, which then connects groundable phrases to unified grounding masks by retrieving and merging the entity masks. To train GROUNDHOG, we carefully curated M3G2, a grounded visual instruction tuning dataset with Multi-Modal Multi-Grained Grounding, by harvesting a collection of segmentation-grounded datasets with rich annotations. Our experimental results show that GROUNDHOG achieves superior performance on various language grounding tasks without task-specific fine-tuning, and significantly reduces object hallucination. GROUNDHOG also demonstrates better grounding towards complex forms of visual input and provides easy-to-understand diagnosis in failure cases.

Recent advances in general medical AI have made significant strides, but existing models often lack the reasoning capabilities needed for complex medical decision-making. This paper presents GMAI-VL-R1, a multimodal medical reasoning model enhanced by reinforcement learning (RL) to improve its reasoning abilities. Through iterative training, GMAI-VL-R1 optimizes decision-making, significantly boosting diagnostic accuracy and clinical support. We also develop a reasoning data synthesis method, generating step-by-step reasoning data via rejection sampling, which further enhances the model's generalization. Experimental results show that after RL training, GMAI-VL-R1 excels in tasks such as medical image diagnosis and visual question answering. While the model demonstrates basic memorization with supervised fine-tuning, RL is crucial for true generalization. Our work establishes new evaluation benchmarks and paves the way for future advancements in medical reasoning models. Code, data, and model will be released at https://github.com/uni-medical/GMAI-VL-R1{this link}.

Although Vision Language Models (VLMs) have shown strong generalization in medical imaging, pathology presents unique challenges due to ultra-high resolution, complex tissue structures, and nuanced clinical semantics. These factors make pathology VLMs prone to hallucinations, i.e., generating outputs inconsistent with visual evidence, which undermines clinical trust. Existing RAG approaches in this domain largely depend on text-based knowledge bases, limiting their ability to leverage diagnostic visual cues. To address this, we propose Patho-AgenticRAG, a multimodal RAG framework with a database built on page-level embeddings from authoritative pathology textbooks. Unlike traditional text-only retrieval systems, it supports joint text-image search, enabling direct retrieval of textbook pages that contain both the queried text and relevant visual cues, thus avoiding the loss of critical image-based information. Patho-AgenticRAG also supports reasoning, task decomposition, and multi-turn search interactions, improving accuracy in complex diagnostic scenarios. Experiments show that Patho-AgenticRAG significantly outperforms existing multimodal models in complex pathology tasks like multiple-choice diagnosis and visual question answering. Our project is available at the Patho-AgenticRAG repository: https://github.com/Wenchuan-Zhang/Patho-AgenticRAG.

Ultrasound imaging has become the preferred imaging modality for early cancer screening due to its advantages of non-ionizing radiation, low cost, and real-time imaging capabilities. However, conventional ultrasound diagnosis heavily relies on physician expertise, presenting challenges of high subjectivity and low diagnostic efficiency. Vision-language models (VLMs) offer promising solutions for this issue, but existing general-purpose models demonstrate limited knowledge in ultrasound medical tasks, with poor generalization in multi-organ lesion recognition and low efficiency across multi-task diagnostics. To address these limitations, we propose EchoVLM, a vision-language model specifically designed for ultrasound medical imaging. The model employs a Mixture of Experts (MoE) architecture trained on data spanning seven anatomical regions. This design enables the model to perform multiple tasks, including ultrasound report generation, diagnosis and visual question-answering (VQA). The experimental results demonstrated that EchoVLM achieved significant improvements of 10.15 and 4.77 points in BLEU-1 scores and ROUGE-1 scores respectively compared to Qwen2-VL on the ultrasound report generation task. These findings suggest that EchoVLM has substantial potential to enhance diagnostic accuracy in ultrasound imaging, thereby providing a viable technical solution for future clinical applications. Source code and model weights are available at https://github.com/Asunatan/EchoVLM.

Recent advances in model architectures, compute, and data scale have driven rapid progress in video generation, producing increasingly realistic content. Yet, no prior method systematically measures how faithfully these systems render human bodies and motion dynamics. In this paper, we present HumanScore, a systematic framework to evaluate the quality of human motions in AI-generated videos. HumanScore defines six interpretable metrics spanning kinematic plausibility, temporal stability, and biomechanical consistency, enabling fine-grained diagnosis beyond visual realism alone. Through carefully designed prompts, we elicit a diverse set of movements at varying intensities and evaluate videos generated by thirteen state-of-the-art models. Our analysis reveals consistent gaps between perceptual plausibility and motion biomechanical fidelity, identifies recurrent failure modes (e.g., temporal jitter, anatomically implausible poses, and motion drift), and produces robust model rankings from quantitative and physically meaningful criteria.

Deep learning based automated pathological diagnosis has markedly improved diagnostic efficiency and reduced variability between observers, yet its clinical adoption remains limited by opaque model decisions and a lack of traceable rationale. To address this, recent multimodal visual reasoning architectures provide a unified framework that generates segmentation masks at the pixel level alongside semantically aligned textual explanations. By localizing lesion regions and producing expert style diagnostic narratives, these models deliver the transparent and interpretable insights necessary for dependable AI assisted pathology. Building on these advancements, we propose PathMR, a cell-level Multimodal visual Reasoning framework for Pathological image analysis. Given a pathological image and a textual query, PathMR generates expert-level diagnostic explanations while simultaneously predicting cell distribution patterns. To benchmark its performance, we evaluated our approach on the publicly available PathGen dataset as well as on our newly developed GADVR dataset. Extensive experiments on these two datasets demonstrate that PathMR consistently outperforms state-of-the-art visual reasoning methods in text generation quality, segmentation accuracy, and cross-modal alignment. These results highlight the potential of PathMR for improving interpretability in AI-driven pathological diagnosis. The code will be publicly available in https://github.com/zhangye-zoe/PathMR.

Vision-Language Models (VLMs) have shown promise in various 2D visual tasks, yet their readiness for 3D clinical diagnosis remains unclear due to stringent demands for recognition precision, reasoning ability, and domain knowledge. To systematically evaluate these dimensions, we present DeepTumorVQA, a diagnostic visual question answering (VQA) benchmark targeting abdominal tumors in CT scans. It comprises 9,262 CT volumes (3.7M slices) from 17 public datasets, with 395K expert-level questions spanning four categories: Recognition, Measurement, Visual Reasoning, and Medical Reasoning. DeepTumorVQA introduces unique challenges, including small tumor detection and clinical reasoning across 3D anatomy. Benchmarking four advanced VLMs (RadFM, M3D, Merlin, CT-CHAT), we find current models perform adequately on measurement tasks but struggle with lesion recognition and reasoning, and are still not meeting clinical needs. Two key insights emerge: (1) large-scale multimodal pretraining plays a crucial role in DeepTumorVQA testing performance, making RadFM stand out among all VLMs. (2) Our dataset exposes critical differences in VLM components, where proper image preprocessing and design of vision modules significantly affect 3D perception. To facilitate medical multimodal research, we have released DeepTumorVQA as a rigorous benchmark: https://github.com/Schuture/DeepTumorVQA.

Diagnosing a whole-slide image is an interactive, multi-stage process involving changes in magnification and movement between fields. Although recent pathology foundation models are strong, practical agentic systems that decide what field to examine next, adjust magnification, and deliver explainable diagnoses are still lacking. The blocker is data: scalable, clinically aligned supervision of expert viewing behavior that is tacit and experience-based, not written in textbooks or online, and therefore absent from large language model training. We introduce the AI Session Recorder, which works with standard WSI viewers to unobtrusively record routine navigation and convert the viewer logs into standardized behavioral commands (inspect or peek at discrete magnifications) and bounding boxes. A lightweight human-in-the-loop review turns AI-drafted rationales into the Pathology-CoT dataset, a form of paired "where to look" and "why it matters" supervision produced at roughly six times lower labeling time. Using this behavioral data, we build Pathologist-o3, a two-stage agent that first proposes regions of interest and then performs behavior-guided reasoning. On gastrointestinal lymph-node metastasis detection, it achieved 84.5% precision, 100.0% recall, and 75.4% accuracy, exceeding the state-of-the-art OpenAI o3 model and generalizing across backbones. To our knowledge, this constitutes one of the first behavior-grounded agentic systems in pathology. Turning everyday viewer logs into scalable, expert-validated supervision, our framework makes agentic pathology practical and establishes a path to human-aligned, upgradeable clinical AI.

General-purpose Large Vision-Language Models (LVLMs), despite their massive scale, often falter in dermatology due to "diffuse attention" - the inability to disentangle subtle pathological lesions from background noise. In this paper, we challenge the assumption that parameter scaling is the only path to medical precision. We introduce SkinFlow, a framework that treats diagnosis as an optimization of visual information transmission efficiency. Our approach utilizes a Virtual-Width Dynamic Vision Encoder (DVE) to "unfold" complex pathological manifolds without physical parameter expansion, coupled with a two-stage Reinforcement Learning strategy. This strategy sequentially aligns explicit medical descriptions (Stage I) and reconstructs implicit diagnostic textures (Stage II) within a constrained semantic space. Furthermore, we propose a clinically grounded evaluation protocol that prioritizes diagnostic safety and hierarchical relevance over rigid label matching. Empirical results are compelling: our 7B model establishes a new state-of-the-art on the Fitzpatrick17k benchmark, achieving a +12.06% gain in Top-1 accuracy and a +28.57% boost in Top-6 accuracy over the massive general-purpose models (e.g., Qwen3VL-235B and GPT-5.2). These findings demonstrate that optimizing geometric capacity and information flow yields superior diagnostic reasoning compared to raw parameter scaling.

The rapid advancement of large-scale vision-language models has showcased remarkable capabilities across various tasks. However, the lack of extensive and high-quality image-text data in medicine has greatly hindered the development of large-scale medical vision-language models. In this work, we present a diagnosis-guided bootstrapping strategy that exploits both image and label information to construct vision-language datasets. Based on the constructed dataset, we developed MedDr, a generalist foundation model for healthcare capable of handling diverse medical data modalities, including radiology, pathology, dermatology, retinography, and endoscopy. Moreover, during inference, we propose a simple but effective retrieval-augmented medical diagnosis strategy, which enhances the model's generalization ability. Extensive experiments on visual question answering, medical report generation, and medical image diagnosis demonstrate the superiority of our method.

To create culturally inclusive vision-language models (VLMs), the foremost requirement is developing a test benchmark that can diagnose the models' ability to respond to questions reflecting cultural elements. This paper addresses the necessity for such benchmarks, noting that existing research has relied on human annotators' manual efforts, which impedes diversity and efficiency. We propose a semi-automated pipeline for constructing cultural VLM benchmarks to enhance diversity and efficiency. This pipeline leverages human-VLM collaboration, where VLMs generate questions based on guidelines, human-annotated examples, and image-wise relevant knowledge, which are then reviewed by native speakers for quality and cultural relevance. The effectiveness of our adaptable pipeline is demonstrated through a specific application: creating a dataset tailored to Korean culture, dubbed K-Viscuit. The resulting benchmark features two types of questions: Type 1 questions measure visual recognition abilities, while Type 2 assess fine-grained visual reasoning skills. This ensures a thorough diagnosis of VLM models across various aspects. Our evaluation using K-Viscuit revealed that open-source models notably lag behind proprietary models in understanding Korean culture, highlighting areas for improvement. We provided diverse analyses of VLM performance across different cultural aspects. Besides, we explored the potential of incorporating external knowledge retrieval to enhance the generation process, suggesting future directions for improving cultural interpretation ability of VLMs. Our dataset and code will be made publicly available.

Clinical diagnosis of the eye is performed over multifarious data modalities including scalar clinical labels, vectorized biomarkers, two-dimensional fundus images, and three-dimensional Optical Coherence Tomography (OCT) scans. Clinical practitioners use all available data modalities for diagnosing and treating eye diseases like Diabetic Retinopathy (DR) or Diabetic Macular Edema (DME). Enabling usage of machine learning algorithms within the ophthalmic medical domain requires research into the relationships and interactions between all relevant data over a treatment period. Existing datasets are limited in that they neither provide data nor consider the explicit relationship modeling between the data modalities. In this paper, we introduce the Ophthalmic Labels for Investigating Visual Eye Semantics (OLIVES) dataset that addresses the above limitation. This is the first OCT and near-IR fundus dataset that includes clinical labels, biomarker labels, disease labels, and time-series patient treatment information from associated clinical trials. The dataset consists of 1268 near-IR fundus images each with at least 49 OCT scans, and 16 biomarkers, along with 4 clinical labels and a disease diagnosis of DR or DME. In total, there are 96 eyes' data averaged over a period of at least two years with each eye treated for an average of 66 weeks and 7 injections. We benchmark the utility of OLIVES dataset for ophthalmic data as well as provide benchmarks and concrete research directions for core and emerging machine learning paradigms within medical image analysis.

Multimodal large language models (MLLMs) that integrate visual and textual reasoning leverage chain-of-thought (CoT) prompting to tackle complex visual tasks, yet continue to exhibit visual hallucinations and an over-reliance on textual priors. We present a systematic diagnosis of state-of-the-art vision-language models using a three-stage evaluation framework, uncovering key failure modes. To address these, we propose an agent-based architecture that combines LLM reasoning with lightweight visual modules, enabling fine-grained analysis and iterative refinement of reasoning chains. Our results highlight future visual reasoning models should focus on integrating a broader set of specialized tools for analyzing visual content. Our system achieves significant gains (+10.3 on MMMU, +6.0 on MathVista over a 7B baseline), matching or surpassing much larger models. We will release our framework and evaluation suite to facilitate future research.

Brain tumor diagnosis is largely dependent on Magnetic Resonance Imaging (MRI) evaluation, which requires radiologists to synthesize thousands of images across multiple 3D sequences and longitudinal studies. This process requires advanced neuro-radiology training, poses substantial cognitive load, and is highly time-consuming. Despite increasing demands in radiology, this expertise is difficult to scale, straining the current health systems. Vision-Language Models (VLMs) provide an opportunity to reduce this burden through a semi-automated, interactive interpretation of complex brain MRIs. However, they are currently underutilized in neuro-oncology due to a lack of specialized benchmarks for evaluating them. We introduce a clinically relevant visual question answering (VQA) benchmark -- the UCSF-PDGM-VQA dataset -- consisting of 2,387 QA pairs from 473 glioma-related MRI studies in the public UCSF-PDGM dataset. We further establish a performance baseline for six state-of-the-art vision-language models (VLMs) and one large language model on this dataset. We find that current models are incapable of effectively processing multi-sequence, 3-dimensional MRI scans, thus resulting in a suppression of visual features and over-reliance on language priors, causing modality collapse. These findings underscore a critical deficiency in current model reliability and safety within clinical settings, necessitating the development of robust, domain-specific VLMs.

Multimodal large language models are increasingly capable of complex reasoning, yet their performance often degrades when they must externalize a problem through a tool and then reason over the tool's output, specifically when they rely on visual aids. This gap is especially important because real engineering and scientific workflows often rely on visualization tools for analysis, validation, and decision-making. To study this discrepancy, we introduce VAMPS (Visual-Assisted Mathematical Problem Solving), a benchmark for graph-assisted mathematics. VAMPS contains 1,168 multimodal, bilingual multiple-choice question-answer pairs drawn from Iranian University Entrance Exam algebra and calculus problems and expanded with human-reviewed LLM-generated synthetic variants, all selected so that plotting provides a natural solution strategy by revealing intersections, extrema, asymptotes, etc. Designed for both benchmarking and diagnosis, VAMPS goes beyond prior multimodal benchmarks that primarily evaluate reasoning over fixed visual inputs by testing whether a model can benefit from constructing a useful graph and grounding its answer in the resulting visualization. Overall, we found that across a diverse set of models, direct analytical solving surprisingly outperforms tool-enabled visual solving, even on problems where plotting is a natural strategy.

When it comes to deploying deep vision models, the behavior of these systems must be explicable to ensure confidence in their reliability and fairness. A common approach to evaluate deep learning models is to build a labeled test set with attributes of interest and assess how well it performs. However, creating a balanced test set (i.e., one that is uniformly sampled over all the important traits) is often time-consuming, expensive, and prone to mistakes. The question we try to address is: can we evaluate the sensitivity of deep learning models to arbitrary visual attributes without an annotated test set? This paper argues the case that Zero-shot Model Diagnosis (ZOOM) is possible without the need for a test set nor labeling. To avoid the need for test sets, our system relies on a generative model and CLIP. The key idea is enabling the user to select a set of prompts (relevant to the problem) and our system will automatically search for semantic counterfactual images (i.e., synthesized images that flip the prediction in the case of a binary classifier) using the generative model. We evaluate several visual tasks (classification, key-point detection, and segmentation) in multiple visual domains to demonstrate the viability of our methodology. Extensive experiments demonstrate that our method is capable of producing counterfactual images and offering sensitivity analysis for model diagnosis without the need for a test set.

Skin disease is one of the most common types of human diseases, which may happen to everyone regardless of age, gender or race. Due to the high visual diversity, human diagnosis highly relies on personal experience; and there is a serious shortage of experienced dermatologists in many countries. To alleviate this problem, computer-aided diagnosis with state-of-the-art (SOTA) machine learning techniques would be a promising solution. In this paper, we aim at understanding the performance of convolutional neural network (CNN) based approaches. We first build two versions of skin disease datasets from Internet images: (a) Skin-10, which contains 10 common classes of skin disease with a total of 10,218 images; (b) Skin-100, which is a larger dataset that consists of 19,807 images of 100 skin disease classes. Based on these datasets, we benchmark several SOTA CNN models and show that the accuracy of skin-100 is much lower than the accuracy of skin-10. We then implement an ensemble method based on several CNN models and achieve the best accuracy of 79.01\% for Skin-10 and 53.54\% for Skin-100. We also present an object detection based approach by introducing bounding boxes into the Skin-10 dataset. Our results show that object detection can help improve the accuracy of some skin disease classes.

Current VLM evaluations often conflate language priors with genuine spatial reasoning. To address this, we introduce CRISP, a novel structural-diagnostic evaluation paradigm that assesses visual spatial intelligence through consistency, the alignment between implicit perception and explicit reasoning. Unlike traditional black-box QA, CRISP utilizes metric 3D Scene Graphs and an oracle intervention protocol to decouple latent reasoning capabilities from perceptual bottlenecks. This granular diagnosis uncovers a systematic perception-reasoning disconnect. Crucially, we reveal that while proprietary models possess robust latent reasoning engines, they suffer from inaccurate metric estimation and a critical failure to leverage their implicit structural representations. Conversely, open-source models remain fundamentally bottlenecked by their lack of multi-hop compositional reasoning. By shifting the focus from merely ``guessing correctly'' via language priors to genuinely ``perceiving, verifying, and reasoning,'' CRISP offers a rigorous roadmap for multimodal alignment beyond end-to-end post-training. The code and dataset are available at https://github.com/iiyamayuki/CRISP-Bench.

Medical Visual Language Models have shown great potential in various healthcare applications, including medical image captioning and diagnostic assistance. However, most existing models rely on text-based instructions, limiting their usability in real-world clinical environments especially in scenarios such as surgery, text-based interaction is often impractical for physicians. In addition, current medical image analysis models typically lack comprehensive reasoning behind their predictions, which reduces their reliability for clinical decision-making. Given that medical diagnosis errors can have life-changing consequences, there is a critical need for interpretable and rational medical assistance. To address these challenges, we introduce an end-to-end speech-driven medical VLM, SilVar-Med, a multimodal medical image assistant that integrates speech interaction with VLMs, pioneering the task of voice-based communication for medical image analysis. In addition, we focus on the interpretation of the reasoning behind each prediction of medical abnormalities with a proposed reasoning dataset. Through extensive experiments, we demonstrate a proof-of-concept study for reasoning-driven medical image interpretation with end-to-end speech interaction. We believe this work will advance the field of medical AI by fostering more transparent, interactive, and clinically viable diagnostic support systems. Our code and dataset are publicly available at SiVar-Med.

Modern Artificial Intelligence (AI) increasingly relies on multi-agent architectures that blend visual and language understanding. Yet, a pressing challenge remains: How can we trust these agents especially in zero-shot settings with no fine-tuning? We introduce a novel modular Agentic AI visual classification framework that integrates generalist multimodal agents with a non-visual reasoning orchestrator and a Retrieval-Augmented Generation (RAG) module. Applied to apple leaf disease diagnosis, we benchmark three configurations: (I) zero-shot with confidence-based orchestration, (II) fine-tuned agents with improved performance, and (III) trust-calibrated orchestration enhanced by CLIP-based image retrieval and re-evaluation loops. Using confidence calibration metrics (ECE, OCR, CCC), the orchestrator modulates trust across agents. Our results demonstrate a 77.94\% accuracy improvement in the zero-shot setting using trust-aware orchestration and RAG, achieving 85.63\% overall. GPT-4o showed better calibration, while Qwen-2.5-VL displayed overconfidence. Furthermore, image-RAG grounded predictions with visually similar cases, enabling correction of agent overconfidence via iterative re-evaluation. The proposed system separates perception (vision agents) from meta-reasoning (orchestrator), enabling scalable and interpretable multi-agent AI. This blueprint is extensible to diagnostics, biology, and other trust-critical domains. All models, prompts, results, and system components including the complete software source code are openly released to support reproducibility, transparency, and community benchmarking at Github: https://github.com/Applied-AI-Research-Lab/Orchestrator-Agent-Trust

Robust benchmarks are crucial for evaluating Multimodal Large Language Models (MLLMs). Yet we find that models can ace many multimodal benchmarks without strong visual understanding, instead exploiting biases, linguistic priors, and superficial patterns. This is especially problematic for vision-centric benchmarks that are meant to require visual inputs. We adopt a diagnostic principle for benchmark design: if a benchmark can be gamed, it will be. Designers should therefore try to ``game'' their own benchmarks first, using diagnostic and debiasing procedures to systematically identify and mitigate non-visual biases. Effective diagnosis requires directly ``training on the test set'' -- probing the released test set for its intrinsic, exploitable patterns. We operationalize this standard with two components. First, we diagnose benchmark susceptibility using a ``Test-set Stress-Test'' (TsT) methodology. Our primary diagnostic tool involves fine-tuning a powerful Large Language Model via k-fold cross-validation on exclusively the non-visual, textual inputs of the test set to reveal shortcut performance and assign each sample a bias score s(x). We complement this with a lightweight Random Forest-based diagnostic operating on hand-crafted features for fast, interpretable auditing. Second, we debias benchmarks by filtering high-bias samples using an ``Iterative Bias Pruning'' (IBP) procedure. Applying this framework to four benchmarks -- VSI-Bench, CV-Bench, MMMU, and VideoMME -- we uncover pervasive non-visual biases. As a case study, we apply our full framework to create VSI-Bench-Debiased, demonstrating reduced non-visual solvability and a wider vision-blind performance gap than the original.

Large language models (LLMs) show promise in medical diagnosis, but real-world deployment remains challenging due to high-stakes clinical decisions and imperfect reasoning reliability. As a result, careful inspection of model behavior is essential for assessing whether diagnostic reasoning is reliable and clinically grounded. However, debugging medical LLMs remains difficult. First, developers often lack sufficient medical domain expertise to interpret model errors in clinically meaningful terms. Second, models can fail across a large and diverse set of instances involving different input types, tasks, and reasoning steps, making it challenging for developers to prioritize which errors deserve focused inspection. Third, developers struggle to identify recurring error patterns across cases, as existing debugging practices are largely instance-centric and rely on manual inspection of isolated failures. To address these challenges, we present VeriLLMed, a visual analytics system that integrates external biomedical knowledge to audit and debug medical LLM diagnostic reasoning. VeriLLMed transforms model outputs into comparable reasoning paths, constructs knowledge graph-grounded reference paths, and identifies three recurring classes of diagnosis errors: relation errors, branch errors, and missing errors. Case studies and expert evaluation demonstrate that VeriLLMed helps developers identify clinically implausible reasoning and generate actionable insights that can inform the improvement of medical LLMs.

Multimodal Large Language Models (MLLMs) show strong visual perception, yet remain limited in reasoning about space under changing viewpoints. We study this challenge as Perspective-Conditioned Spatial Reasoning (PCSR) in 360-degree omnidirectional images, where broad scene coverage reduces ambiguity from partial observations without eliminating the need for viewpoint-dependent inference. To assess this capability, we introduce PCSR-Bench, a diagnostic benchmark of 84,373 question-answer pairs from 2,600 omnidirectional images across 26 indoor environments. PCSR-Bench contains eight tasks spanning foundational perception (e.g., object counting, relative distance, and relative direction) and advanced PCSR, including compositional chains, egocentric rotation, perspective re-anchoring, ego-distortion, and limited-FOV visibility. We evaluate 14 representative MLLMs and observe a substantial perception-reasoning gap: accuracy reaches 57.59% on foundational relative direction, but drops to 13.49% on egocentric rotation, 7.13% on egocentric distortion, and 0.64% on open-ended compositional reasoning. To probe the plasticity of this gap, we conduct an RL-based diagnostic study on a 7B-scale model. Reward shaping improves a matched 7B baseline from 31.10% to 60.06% under a controlled setting, suggesting that PCSR is partial plasticity rather than being fully immutable. Still, the gains are task-selective, sensitive to reward design including both weight allocation and reward formulation, and partially dependent on the evaluation protocol. These results position PCSR as a key bottleneck in current MLLMs and highlight limited but meaningful room for recovery under targeted optimization.

Recent advances in Omni-Multimodal Large Language Models (Omni-MLLMs) have enabled strong integration of vision, audio, and language. However, their audio-visual intelligence (AVI) remains insufficiently evaluated due to the lack of systematic and comprehensive benchmarks. We introduce AVI-Bench, a cognitively inspired benchmark that evaluates Omni-MLLMs across three stages, perception, understanding, and reasoning, through cross-modal tasks requiring joint audio-visual interpretation. This design enables fine-grained diagnosis of model capabilities and failure modes. To further assess robustness beyond familiar domains, we propose AVI-Bench-PriSe, an extension that probes models' primitive audio-visual sensation using unfamiliar, low-semantic stimuli, testing generalization beyond common training distributions. Extensive experiments on both open-source and closed-source models reveal substantial limitations in current Omni-MLLMs. Based on these findings, we present a four-level AVI taxonomy. Overall, AVI-Bench provides a principled evaluation framework to guide the development of more robust and generalizable AVI. Project website: https://fudancvl.github.io/AVI-Bench/

Although document OCR systems perform increasingly well on routine documents, complex formulas, structured text, and long-tail formats remain error-prone. OCR predictions may omit fine-grained content or hallucinate unsupported outputs, while equivalent encodings of the same visible content must be accommodated. Existing OCR evaluation methods mostly report aggregate metrics, offering limited support for analyzing case-level errors and improving OCR performance. We propose OCR-EDR (OCR Error Diagnosis and Repair), a rendering-aware framework that advances from fine-grained diagnosis to iterative repair. Given a source image, an editable OCR prediction, and its rendered image, OCR-EDR first jointly assesses whether the prediction and its rendering are consistent with the source, preserving valid predictions, including rendering-equivalent ones, while diagnosing and localizing genuine errors. It then applies executable edits and may request an updated rendering for iterative reassessment. We construct OCRErrBench from diverse real OCR predictions, covering text and formulas, exact and rendering-equivalent positives, and genuine errors, and develop the DocEDR model to execute the diagnosis--repair loop. On OCRErrBench, DocEDR achieves 94.78% diagnostic accuracy. It repairs 86.23% of erroneous inputs to visual consistency, raises formula Case-F1 by 30.99 percentage points over DOCR-Inspector-7B on DOCRcaseBench, and improves formula CDM by up to 4.62 percentage points on the identified Bad subsets of four OCR systems on UniMER-Test. These results show that OCR-EDR turns fine-grained OCR analysis into verified corrections and performance gains.

Large vision language models (VLMs) combine large language models with vision encoders, demonstrating promise across various tasks. However, they often underperform in task-specific applications due to domain gaps between pre-training and fine-tuning. We introduce VITask, a novel framework that enhances task-specific adaptability of VLMs by integrating task-specific models (TSMs). VITask employs three key strategies: exemplar prompting (EP), response distribution alignment (RDA), and contrastive response tuning (CRT) to improve the task-specific performance of VLMs by adjusting their response distributions. EP allows TSM features to guide VLMs, while RDA enables VLMs to adapt without TSMs during inference by learning from exemplar-prompted models. CRT further optimizes the ranking of correct image-response pairs, thereby reducing the risk of generating undesired responses. Experiments on 12 medical diagnosis datasets across 9 imaging modalities show that VITask outperforms both vanilla instruction-tuned VLMs and TSMs, showcasing its ability to integrate complementary features from both models effectively. Additionally, VITask offers practical advantages such as flexible TSM integration and robustness to incomplete instructions, making it a versatile and efficient solution for task-specific VLM tuning. Our code are available at https://github.com/baiyang4/VITask.

While conversational generative AI has shown considerable potential in enhancing decision-making for agricultural professionals, its exploration has predominantly been anchored in text-based interactions. The evolution of multimodal conversational AI, leveraging vast amounts of image-text data from diverse sources, marks a significant stride forward. However, the application of such advanced vision-language models in the agricultural domain, particularly for crop disease diagnosis, remains underexplored. In this work, we present the crop disease domain multimodal (CDDM) dataset, a pioneering resource designed to advance the field of agricultural research through the application of multimodal learning techniques. The dataset comprises 137,000 images of various crop diseases, accompanied by 1 million question-answer pairs that span a broad spectrum of agricultural knowledge, from disease identification to management practices. By integrating visual and textual data, CDDM facilitates the development of sophisticated question-answering systems capable of providing precise, useful advice to farmers and agricultural professionals. We demonstrate the utility of the dataset by finetuning state-of-the-art multimodal models, showcasing significant improvements in crop disease diagnosis. Specifically, we employed a novel finetuning strategy that utilizes low-rank adaptation (LoRA) to finetune the visual encoder, adapter and language model simultaneously. Our contributions include not only the dataset but also a finetuning strategy and a benchmark to stimulate further research in agricultural technology, aiming to bridge the gap between advanced AI techniques and practical agricultural applications. The dataset is available at https: //github.com/UnicomAI/UnicomBenchmark/tree/main/CDDMBench.

Developing reliable AI systems to assist human clinicians in multi-modal medical diagnosis has long been a key objective for researchers. Recently, Multi-modal Large Language Models (MLLMs) have gained significant attention and achieved success across various domains. With strong reasoning capabilities and the ability to perform diverse tasks based on user instructions, they hold great potential for enhancing medical diagnosis. However, directly applying MLLMs to the medical domain still presents challenges. They lack detailed perception of visual inputs, limiting their ability to perform quantitative image analysis, which is crucial for medical diagnostics. Additionally, MLLMs often exhibit hallucinations and inconsistencies in reasoning, whereas clinical diagnoses must adhere strictly to established criteria. To address these challenges, we propose MedAgent-Pro, an evidence-based reasoning agentic system designed to achieve reliable, explainable, and precise medical diagnoses. This is accomplished through a hierarchical workflow: at the task level, knowledge-based reasoning generate reliable diagnostic plans for specific diseases following retrieved clinical criteria. While at the case level, multiple tool agents process multi-modal inputs, analyze different indicators according to the plan, and provide a final diagnosis based on both quantitative and qualitative evidence. Comprehensive experiments on both 2D and 3D medical diagnosis tasks demonstrate the superiority and effectiveness of MedAgent-Pro, while case studies further highlight its reliability and interpretability. The code is available at https://github.com/jinlab-imvr/MedAgent-Pro.

Medical Visual Question Answering (Med-VQA) answers clinical questions using medical images, aiding diagnosis. Designing the MedVQA system holds profound importance in assisting clinical diagnosis and enhancing diagnostic accuracy. Building upon this foundation, Hierarchical Medical VQA extends Medical VQA by organizing medical questions into a hierarchical structure and making level-specific predictions to handle fine-grained distinctions. Recently, many studies have proposed hierarchical MedVQA tasks and established datasets, However, several issues still remain: (1) imperfect hierarchical modeling leads to poor differentiation between question levels causing semantic fragmentation across hierarchies. (2) Excessive reliance on implicit learning in Transformer-based cross-modal self-attention fusion methods, which obscures crucial local semantic correlations in medical scenarios. To address these issues, this study proposes a HiCA-VQA method, including two modules: Hierarchical Prompting for fine-grained medical questions and Hierarchical Answer Decoders. The hierarchical prompting module pre-aligns hierarchical text prompts with image features to guide the model in focusing on specific image regions according to question types, while the hierarchical decoder performs separate predictions for questions at different levels to improve accuracy across granularities. The framework also incorporates a cross-attention fusion module where images serve as queries and text as key-value pairs. Experiments on the Rad-Restruct benchmark demonstrate that the HiCA-VQA framework better outperforms existing state-of-the-art methods in answering hierarchical fine-grained questions. This study provides an effective pathway for hierarchical visual question answering systems, advancing medical image understanding.

Automated clinical diagnosis remains a core challenge in medical AI, which usually requires models to integrate multi-modal data and reason across complex, case-specific contexts. Although recent methods have advanced medical report generation (MRG) and visual question answering (VQA) with medical vision-language models (VLMs), these methods, however, predominantly operate under a sample-isolated inference paradigm, as such processing cases independently without access to longitudinal electronic health records (EHRs) or structurally related patient examples. This paradigm limits reasoning to image-derived information alone, which ignores external complementary medical evidence for potentially more accurate diagnosis. To overcome this limitation, we propose HyperWalker, a Deep Diagnosis framework that reformulates clinical reasoning via dynamic hypergraphs and test-time training. First, we construct a dynamic hypergraph, termed iBrochure, to model the structural heterogeneity of EHR data and implicit high-order associations among multimodal clinical information. Within this hypergraph, a reinforcement learning agent, Walker, navigates to and identifies optimal diagnostic paths. To ensure comprehensive coverage of diverse clinical characteristics in test samples, we incorporate a linger mechanism, a multi-hop orthogonal retrieval strategy that iteratively selects clinically complementary neighborhood cases reflecting distinct clinical attributes. Experiments on MRG with MIMIC and medical VQA on EHRXQA demonstrate that HyperWalker achieves state-of-the-art performance. Code is available at: https://github.com/Bean-Young/HyperWalker

Multimodal alignment of histopathology encoders with transcriptomic and genomic data has been shown to significantly improve performance in downstream diagnostic tasks. Hematological cytology is unique in that visual single-cell evaluation is often paired with cytogenetics and molecular genetics for blood cancer diagnosis. In this study, we present a framework to align single white blood cell images with chromosomal aberrations (karyotype) and somatic mutations from targeted gene panels. Our training strategy follows a two-stage approach: (i) self-supervised, vision-only pretraining of a transformer aggregator using an iBOT head on a cohort of over 1500 patients, and (ii) genetic alignment via supervised contrastive loss on acute myeloid leukemia patients. Our genetically aligned patient encoder improves hematological diagnostic tasks, outperforming slide-level histopathology foundation models. Additionally, the model provides off-the-shelf retrieval capabilities for diseases and genetic alterations. Incorporating genetic data into patient encoders increases the quality of patient representations, providing a framework that aligns with clinical diagnostic workflows and paves the way for future multimodal hematology-specific AI. The code and model weights are available at https://github.com/marrlab/GenBloom.

Visual latent reasoning lets a multimodal large language model (MLLM) create intermediate visual evidence as continuous tokens, avoiding external tools or image generators. However, existing methods usually follow an output-as-input latent paradigm and yield unstable gains. We identify evidence for a feature-space mismatch that can contribute to this instability: dominant visual-latent models build on pre-norm MLLMs and reuse decoder hidden states as predicted latent inputs, even though these states occupy a substantially different norm regime from the input embeddings the model was trained to consume (Xie et al., 2025; Li et al., 2026; Team et al., 2026). This mismatch can make direct latent feedback unreliable. Motivated by this diagnosis, we propose GAP, a Granular Alignment Paradigm for visual latent modeling. GAP aligns visual latent reasoning at three levels: feature-level alignment maps decoder outputs into input-compatible visual latents through a lightweight PCA-aligned latent head; context-level alignment grounds latent targets with inspectable auxiliary visual supervision; and capacity-guided alignment assigns latent supervision selectively to examples where the base MLLM struggles. On Qwen2.5-VL 7B, the resulting model achieves the best mean aggregate perception and reasoning performance among our supervised variants. Inference-time intervention probing further suggests that generated latents provide task-relevant visual signal beyond merely adding token slots.

World Action Models (WAMs) have emerged as a promising paradigm by jointly modeling robot actions and future visual dynamics. However, their reliance on pixel-generative future supervision can entangle action-relevant state transitions with task-irrelevant visual content, limiting robustness under visual distribution shifts. We identify Training-Distribution Hallucination, a recurring phenomenon in which futures conditioned on visually shifted observations hallucinate training-domain content rather than remain faithful to the current scene. A controlled frame-triplet diagnosis further shows that DINOv3 features remain more stable across visual shifts while better preserving task-state distinctions than Wan-VAE latents. Rather than correcting the predicted futures, we propose Semantic-Temporal WAM (ST-WAM) to improve action robustness by using DINOv3 as a shared semantic representation for future prediction and history retrieval while retaining fine-grained VAE dynamics. Its Dual-Space Future Experts (DSFE) jointly predict future VAE latents and DINO features, while Current-Anchored Intent Retrieval (CAIR) retrieves task-relevant evidence from recent DINO history under the current visual-language context. ST-WAM is trained end-to-end without additional embodied pretraining or task-specific annotations, and requires no explicit future generation at inference. It achieves 98.7% on LIBERO and 92.8% on RoboTwin 2.0; more importantly, compared with Fast-WAM, it improves zero-shot LIBERO-Plus performance by 21.3 percentage points and more than doubles real-world success under visual shifts from 25.8% to 61.5%. These results demonstrate that semantic-temporal modeling effectively complements pixel-generative dynamics for robust manipulation.

Acute lymphoblastic leukemia (ALL) is a pervasive pediatric white blood cell cancer across the globe. With the popularity of convolutional neural networks (CNNs), computer-aided diagnosis of cancer has attracted considerable attention. Such tools are easily deployable and are cost-effective. Hence, these can enable extensive coverage of cancer diagnostic facilities. However, the development of such a tool for ALL cancer was challenging so far due to the non-availability of a large training dataset. The visual similarity between the malignant and normal cells adds to the complexity of the problem. This paper discusses the recent release of a large dataset and presents a novel deep learning architecture for the classification of cell images of ALL cancer. The proposed architecture, namely, SDCT-AuxNet^θ is a 2-module framework that utilizes a compact CNN as the main classifier in one module and a Kernel SVM as the auxiliary classifier in the other one. While CNN classifier uses features through bilinear-pooling, spectral-averaged features are used by the auxiliary classifier. Further, this CNN is trained on the stain deconvolved quantity images in the optical density domain instead of the conventional RGB images. A novel test strategy is proposed that exploits both the classifiers for decision making using the confidence scores of their predicted class labels. Elaborate experiments have been carried out on our recently released public dataset of 15114 images of ALL cancer and healthy cells to establish the validity of the proposed methodology that is also robust to subject-level variability. A weighted F1 score of 94.8% is obtained that is best so far on this challenging dataset.

Software development requires more than editing code: developers repeatedly run software, interact with its interfaces, visually inspect its behavior, and use these observations to decide what to change next and whether a change works. Existing coding agents and computer-use agents are largely studied in isolation, leaving this integrated development process underexplored. Diagnosing a runtime interaction failure requires agents to connect visual observations with the responsible code, then use the application again to verify the repair. We introduce CUA-SWE, a benchmark, environment, and evaluation pipeline for software engineering with computer use. Beyond studying how GUI feedback supports diagnosis and repair, we ask whether agents can complete software engineering tasks when required specification or operational information is available only through the running application's visual interface. CUA-SWE spans four software engineering domains and requires agents to modify code and configuration, execute commands, interact with running software, and inspect visual feedback within the same task. Each task includes deterministic, task-specific tests that verify whether the resulting software satisfies the requirements and preserves specified behavior. Our evaluation characterizes how frontier agents combine source-level execution with application screenshots and graphical interaction to produce verified software changes. We examine performance across domains and task information requirements, alongside the development behaviors associated with successful repairs. CUA-SWE provides a unified testbed for studying how agents use visual feedback and interaction to guide software engineering, with executable correctness criteria for the resulting software.

Multimodal large language models (MLLMs) can answer clinical questions about medical images, but trustworthy use requires visual grounding: models should localize the pathology they report rather than rely on spurious shortcuts. Whether MLLMs can visually ground clinical findings in retinal optical coherence tomography (OCT), the most widely used imaging modality in ophthalmology, remains largely unexplored. To address this gap, we introduce RetinaGroundBench, the first benchmark for biomarker visual grounding in retinal OCT. It comprises 815 B-scans exhaustively annotated by ophthalmologists with 4,537 bounding boxes covering 13 biomarkers across 8 diseases. Because MLLMs often fragment a single lesion into multiple partial predictions, we propose AggIoU, a metric that evaluates whether the union of overlapping predicted boxes covers the annotated region. Across 27 open-source MLLMs (0.8-38B parameters), we find that visual grounding remains largely unsolved: the best general-purpose model achieves a macro F1 of just 23.7%, with consistently low recall, despite reaching up to 73% balanced accuracy on biomarker presence questions. To narrow this gap, we developed RetGrounder, an MLLM fine-tuned using an OCT-specific strategy integrating grounding and textual information. Despite its relatively small size (8B), RetGrounder improves grounding F1 to 33.9%, a 43% relative improvement. Our benchmark provides a reference point for measuring progress in the field of OCT diagnosis with MLLMs.

The gigapixel scale of whole slide images (WSIs) poses a challenge for histopathology multi-modal chatbots, requiring a global WSI analysis for diagnosis, compounding evidence from different WSI patches. Current visual instruction datasets, generated through large language models, focus on creating question/answer pairs for individual image patches, which may lack diagnostic capacity on their own in histopathology, further complicated by the absence of spatial grounding in histopathology image captions. To bridge this gap, we introduce Quilt-Instruct, a large-scale dataset of 107,131 histopathology-specific instruction question/answer pairs, that is collected by leveraging educational histopathology videos from YouTube, which provides spatial localization of captions by automatically extracting narrators' cursor movements. In addition, we provide contextual reasoning by extracting diagnosis and supporting facts from the entire video content to guide the extrapolative reasoning of GPT-4. Using Quilt-Instruct, we train Quilt-LLaVA, which can reason beyond the given single image patch, enabling diagnostic reasoning and the capability of spatial awareness. To evaluate Quilt-LLaVA, we propose a comprehensive evaluation dataset created from 985 images and 1283 human-generated question-answers. We also thoroughly evaluate Quilt-LLaVA using public histopathology datasets, where Quilt-LLaVA significantly outperforms SOTA by over 10% on relative GPT-4 score and 4% and 9% on open and closed set VQA. Our code, data, and model are publicly available at quilt-llava.github.io.

WHO has declared that more than 2.2 billion people worldwide are suffering from visual disorders, such as media haze, glaucoma, and drusen. At least 1 billion of these cases could have been either prevented or successfully treated, yet they remain unaddressed due to poverty, a lack of specialists, inaccurate ocular fundus diagnoses by ophthalmologists, or the presence of a rare disease. To address this, the research has developed the Hybrid Trio-Network Model Algorithm for accurately diagnosing 12 distinct common and rare eye diseases. This algorithm utilized the RFMiD dataset of 3,200 fundus images and the Binary Relevance Method to detect diseases separately, ensuring expandability and avoiding incorrect correlations. Each detector, incorporating finely tuned hyperparameters to optimize performance, consisted of three feature components: A classical transfer learning CNN model, a two-stage CNN model, and a Siamese Network. The diagnosis was made using features extracted through this Trio-Model with Ensembled Machine Learning algorithms. The proposed model achieved an average accuracy of 97% and an AUC score of 0.96. Compared to past benchmark studies, an increase of over 10% in the F1-score was observed for most diseases. Furthermore, using the Siamese Network, the model successfully made predictions in diseases like optic disc pallor, which past studies failed to predict due to low confidence. This diagnostic tool presents a stable, adaptive, cost-effective, efficient, accessible, and fast solution for globalizing early detection of both common and rare diseases.

Large annotated datasets are essential for training robust Computer-Aided Diagnosis (CAD) models for breast cancer detection or risk prediction. However, acquiring such datasets with fine-detailed annotation is both costly and time-consuming. Vision-Language Models (VLMs), such as CLIP, which are pre-trained on large image-text pairs, offer a promising solution by enhancing robustness and data efficiency in medical imaging tasks. This paper introduces a novel Multi-View Mammography and Language Model for breast cancer classification and risk prediction, trained on a dataset of paired mammogram images and synthetic radiology reports. Our MV-MLM leverages multi-view supervision to learn rich representations from extensive radiology data by employing cross-modal self-supervision across image-text pairs. This includes multiple views and the corresponding pseudo-radiology reports. We propose a novel joint visual-textual learning strategy to enhance generalization and accuracy performance over different data types and tasks to distinguish breast tissues or cancer characteristics(calcification, mass) and utilize these patterns to understand mammography images and predict cancer risk. We evaluated our method on both private and publicly available datasets, demonstrating that the proposed model achieves state-of-the-art performance in three classification tasks: (1) malignancy classification, (2) subtype classification, and (3) image-based cancer risk prediction. Furthermore, the model exhibits strong data efficiency, outperforming existing fully supervised or VLM baselines while trained on synthetic text reports and without the need for actual radiology reports.

Spatial reasoning is a core aspect of human intelligence that allows perception, inference and planning in 3D environments. However, current vision-language models (VLMs) struggle to maintain geometric coherence and cross-view consistency for spatial reasoning in multi-view settings. We attribute this gap to the lack of fine-grained benchmarks that isolate multi-view reasoning from single-view perception and temporal factors. To address this, we present ReMindView-Bench, a cognitively grounded benchmark for evaluating how VLMs construct, align and maintain spatial mental models across complementary viewpoints. ReMindView-Bench systematically varies viewpoint spatial pattern and query type to probe key factors of spatial cognition. Evaluations of 15 current VLMs reveals consistent failures in cross-view alignment and perspective-taking in multi-view spatial reasoning, motivating deeper analysis on the reasoning process. Explicit phase-wise analysis using LLM-as-a-judge and self-consistency prompting shows that VLMs perform well on in-frame perception but degrade sharply when integrating information across views. Implicit analysis, including linear probing and entropy dynamics, further show progressive loss of task-relevant information and uncertainty separation between correct and incorrect trajectories. These results provide a cognitively grounded diagnosis of VLM spatial reasoning and reveal how multi-view spatial mental models are formed, degraded and destabilized across reasoning phases. The ReMindView-Bench benchmark is available at https://huggingface.co/datasets/Xue0823/ReMindView-Bench, and the source codes of benchmark construction and VLM reasoning analysis are available at https://github.com/pittisl/ReMindView-Bench.

Diagnosing and managing oral diseases necessitate advanced visual interpretation across diverse imaging modalities and integrated information synthesis. While current AI models excel at isolated tasks, they often fall short in addressing the complex, multimodal requirements of comprehensive clinical dental practice. Here we introduce DentVLM, a multimodal vision-language model engineered for expert-level oral disease diagnosis. DentVLM was developed using a comprehensive, large-scale, bilingual dataset of 110,447 images and 2.46 million visual question-answering (VQA) pairs. The model is capable of interpreting seven 2D oral imaging modalities across 36 diagnostic tasks, significantly outperforming leading proprietary and open-source models by 19.6% higher accuracy for oral diseases and 27.9% for malocclusions. In a clinical study involving 25 dentists, evaluating 1,946 patients and encompassing 3,105 QA pairs, DentVLM surpassed the diagnostic performance of 13 junior dentists on 21 of 36 tasks and exceeded that of 12 senior dentists on 12 of 36 tasks. When integrated into a collaborative workflow, DentVLM elevated junior dentists' performance to senior levels and reduced diagnostic time for all practitioners by 15-22%. Furthermore, DentVLM exhibited promising performance across three practical utility scenarios, including home-based dental health management, hospital-based intelligent diagnosis and multi-agent collaborative interaction. These findings establish DentVLM as a robust clinical decision support tool, poised to enhance primary dental care, mitigate provider-patient imbalances, and democratize access to specialized medical expertise within the field of dentistry.

Plant disease diagnosis is critical for food security, yet training disease-recognition models that generalize across crops, pathogens, and field conditions remains challenging because labeled disease images are far less abundant and standardized than data for other biotic stresses such as insects or weeds. Frontier vision-language models offer new opportunities through improved visual reasoning, but they still struggle with fine-grained disease identification due to the lack of structured, crop-specific symptom knowledge. To address this gap, we curate the largest plant disease image--symptom dataset to date, covering 335 crops, 1{,}251 disease classes, and approximately 839K images, designed to support training-free, agentic disease prediction. A scalable automated pipeline generates source-grounded symptom descriptions in which each claim is linked to a verbatim web quote; domain experts validate sampled crops and reconcile disease-name variants across sources. As a baseline, we introduce an autonomous visual reasoning agent that identifies anatomical context, narrows candidate diseases using symptom knowledge, sequentially compares reference images, and produces a fully explainable reasoning trace. Incorporating symptom knowledge improves accuracy by 16.2 percentage points on average at the full reference budget, with consistent gains across all four evaluation crops. Because the framework only requires crop-specific reference images and symptom knowledge, it can be extended to new crops without retraining, while the agentic baseline can directly benefit from future improvements in foundation model capabilities. Dataset and code are available at:https://sage-dataset.github.io/.

In the light of the COVID-19 pandemic, deep learning methods have been widely investigated in detecting COVID-19 from chest X-rays. However, a more pragmatic approach to applying AI methods to a medical diagnosis is designing a framework that facilitates human-machine interaction and expert decision making. Studies have shown that categorization can play an essential rule in accelerating real-world decision making. Inspired by descriptive document clustering, we propose a domain-independent explanatory clustering framework to group contextually related instances and support radiologists' decision making. While most descriptive clustering approaches employ domain-specific characteristics to form meaningful clusters, we focus on model-level explanation as a more general-purpose element of every learning process to achieve cluster homogeneity. We employ DeepSHAP to generate homogeneous clusters in terms of disease severity and describe the clusters using favorable and unfavorable saliency maps, which visualize the class discriminating regions of an image. These human-interpretable maps complement radiologist knowledge to investigate the whole cluster at once. Besides, as part of this study, we evaluate a model based on VGG-19, which can identify COVID and pneumonia cases with a positive predictive value of 95% and 97%, respectively, comparable to the recent explainable approaches for COVID diagnosis.

Medical Visual Question Answering (Med-VQA) combines computer vision and natural language processing to automatically answer clinical inquiries about medical images. However, current Med-VQA datasets exhibit two significant limitations: (1) they often lack visual and textual explanations for answers, hindering comprehension for patients and junior doctors; (2) they typically offer a narrow range of question formats, inadequately reflecting the diverse requirements in practical scenarios. These limitations pose significant challenges to the development of a reliable and user-friendly Med-VQA system. To address these challenges, we introduce a large-scale, Groundable, and Explainable Medical VQA benchmark for chest X-ray diagnosis (GEMeX), featuring several innovative components: (1) a multi-modal explainability mechanism that offers detailed visual and textual explanations for each question-answer pair, thereby enhancing answer comprehensibility; (2) four question types, open-ended, closed-ended, single-choice, and multiple-choice, to better reflect practical needs. With 151,025 images and 1,605,575 questions, GEMeX is the currently largest chest X-ray VQA dataset. Evaluation of 12 representative large vision language models (LVLMs) on GEMeX reveals suboptimal performance, underscoring the dataset's complexity. Meanwhile, we propose a strong model by fine-tuning an existing LVLM on the GEMeX training set. The substantial performance improvement showcases the dataset's effectiveness. The benchmark is available at https://www.med-vqa.com/GEMeX.

Breast cancer is one of the leading causes of death among women worldwide. We introduce Mammo-FM, the first foundation model specifically for mammography, pretrained on the largest and most diverse dataset to date - 140,677 patients (821,326 mammograms) across four U.S. institutions. Mammo-FM provides a unified foundation for core clinical tasks in breast imaging, including cancer diagnosis, pathology localization, structured report generation, and cancer risk prognosis within a single framework. Its alignment between images and text enables both visual and textual interpretability, improving transparency and clinical auditability, which are essential for real-world adoption. We rigorously evaluate Mammo-FM across diagnosis, prognosis, and report-generation tasks in in- and out-of-distribution datasets. Despite operating on native-resolution mammograms and using only one-third of the parameters of state-of-the-art generalist FMs, Mammo-FM consistently outperforms them across multiple public and private benchmarks. These results highlight the efficiency and value of domain-specific foundation models designed around the full spectrum of tasks within a clinical domain and emphasize the importance of rigorous, domain-aligned evaluation.

Clinical AI often optimizes predictive performance without engaging how clinicians decide where to look and what to write. We present Co-Annotator, which distills expert gaze and dictation into two guidance components: a gaze-aligned Vision Transformer producing fixation-aligned areas of interest (AOIs), and an ontology-bounded vision-language model (VLM) that pre-fills editable biomarker summaries for retinal optical coherence tomography (OCT). We first collect expert gaze and dictations (US1) to train the models, significantly improving diagnostic accuracy and biomarker generation. We then deploy the system with ophthalmology residents: a controlled resident study (US2) confirmed each modality is safe and independently beneficial, with AOI guidance producing lasting perceptual efficiency gains through post-guidance carryover and VLM guidance more than doubling biomarker documentation breadth. In a combined deployment across two academic institutions (US3), providing both modalities simultaneously produced efficiency gains that substantially exceeded either modality alone: correct diagnoses per minute increased by 40% and comment editing time fell by 67%, without compromising diagnostic accuracy. Notably, neither modality improved efficiency during guidance in US2, which makes the in-guidance efficiency gain under combined guidance in US3 the more striking result. Expert-distilled multimodal guidance can remove two distinct clinical workflow bottlenecks at once (visual search overhead and documentation burden) without compromising the diagnostic accuracy clinicians already achieve.

We present ReXVQA, the largest and most comprehensive benchmark for visual question answering (VQA) in chest radiology, comprising approximately 696,000 questions paired with 160,000 chest X-rays studies across training, validation, and test sets. Unlike prior efforts that rely heavily on template based queries, ReXVQA introduces a diverse and clinically authentic task suite reflecting five core radiological reasoning skills: presence assessment, location analysis, negation detection, differential diagnosis, and geometric reasoning. We evaluate eight state-of-the-art multimodal large language models, including MedGemma-4B-it, Qwen2.5-VL, Janus-Pro-7B, and Eagle2-9B. The best-performing model (MedGemma) achieves 83.24% overall accuracy. To bridge the gap between AI performance and clinical expertise, we conducted a comprehensive human reader study involving 3 radiology residents on 200 randomly sampled cases. Our evaluation demonstrates that MedGemma achieved superior performance (83.84% accuracy) compared to human readers (best radiology resident: 77.27%), representing a significant milestone where AI performance exceeds expert human evaluation on chest X-ray interpretation. The reader study reveals distinct performance patterns between AI models and human experts, with strong inter-reader agreement among radiologists while showing more variable agreement patterns between human readers and AI models. ReXVQA establishes a new standard for evaluating generalist radiological AI systems, offering public leaderboards, fine-grained evaluation splits, structured explanations, and category-level breakdowns. This benchmark lays the foundation for next-generation AI systems capable of mimicking expert-level clinical reasoning beyond narrow pathology classification. Our dataset will be open-sourced at https://huggingface.co/datasets/rajpurkarlab/ReXVQA

Multimodal large language models (MLLMs) demonstrate significant potential in the field of medical diagnosis. However, they face critical challenges in specialized domains such as ophthalmology, particularly the fragmentation of annotation granularity and inconsistencies in clinical reasoning logic, which hinder precise cross-modal understanding. This paper introduces FundusExpert, an ophthalmology-specific MLLM with integrated positioning-diagnosis reasoning capabilities, along with FundusGen, a dataset constructed through the intelligent Fundus-Engine system. Fundus-Engine automates localization and leverages MLLM-based semantic expansion to integrate global disease classification, local object detection, and fine-grained feature analysis within a single fundus image. Additionally, by constructing a clinically aligned cognitive chain, it guides the model to generate interpretable reasoning paths. FundusExpert, fine-tuned with instruction data from FundusGen, achieves the best performance in ophthalmic question-answering tasks, surpassing the average accuracy of the 40B MedRegA by 26.6%. It also excels in zero-shot report generation tasks, achieving a clinical consistency of 77.0%, significantly outperforming GPT-4o's 47.6%. Furthermore, we reveal a scaling law between data quality and model capability (L propto N^{0.068}), demonstrating that the cognitive alignment annotations in FundusGen enhance data utilization efficiency. By integrating region-level localization with diagnostic reasoning chains, our work develops a scalable, clinically-aligned MLLM and explores a pathway toward bridging the visual-language gap in specific MLLMs. Our project can be found at https://github.com/MeteorElf/FundusExpert.

Chest X-ray imaging is crucial for diagnosing pulmonary and cardiac diseases, yet its interpretation demands extensive clinical experience and suffers from inter-observer variability. While deep learning models offer high diagnostic accuracy, their black-box nature hinders clinical adoption in high-stakes medical settings. To address this, we propose X-Ray-CoT (Chest X-Ray Chain-of-Thought), a novel framework leveraging Vision-Language Large Models (LVLMs) for intelligent chest X-ray diagnosis and interpretable report generation. X-Ray-CoT simulates human radiologists' "chain-of-thought" by first extracting multi-modal features and visual concepts, then employing an LLM-based component with a structured Chain-of-Thought prompting strategy to reason and produce detailed natural language diagnostic reports. Evaluated on the CORDA dataset, X-Ray-CoT achieves competitive quantitative performance, with a Balanced Accuracy of 80.52% and F1 score of 78.65% for disease diagnosis, slightly surpassing existing black-box models. Crucially, it uniquely generates high-quality, explainable reports, as validated by preliminary human evaluations. Our ablation studies confirm the integral role of each proposed component, highlighting the necessity of multi-modal fusion and CoT reasoning for robust and transparent medical AI. This work represents a significant step towards trustworthy and clinically actionable AI systems in medical imaging.

Most current medical vision language models struggle to jointly generate diagnostic text and pixel-level segmentation masks in response to complex visual questions. This represents a major limitation towards clinical application, as assistive systems that fail to provide both modalities simultaneously offer limited value to medical practitioners. To alleviate this limitation, we first introduce RadDiagSeg-D, a dataset combining abnormality detection, diagnosis, and multi-target segmentation into a unified and hierarchical task. RadDiagSeg-D covers multiple imaging modalities and is precisely designed to support the development of models that produce descriptive text and corresponding segmentation masks in tandem. Subsequently, we leverage the dataset to propose a novel vision-language model, RadDiagSeg-M, capable of joint abnormality detection, diagnosis, and flexible segmentation. RadDiagSeg-M provides highly informative and clinically useful outputs, effectively addressing the need to enrich contextual information for assistive diagnosis. Finally, we benchmark RadDiagSeg-M and showcase its strong performance across all components involved in the task of multi-target text-and-mask generation, establishing a robust and competitive baseline.

Cardiovascular disease remains the leading cause of global mortality, with progress hindered by human interpretation of complex cardiac tests. Current AI vision-language models are limited to single-modality inputs and are non-interactive. We present MARCUS (Multimodal Autonomous Reasoning and Chat for Ultrasound and Signals), an agentic vision-language system for end-to-end interpretation of electrocardiograms (ECGs), echocardiograms, and cardiac magnetic resonance imaging (CMR) independently and as multimodal input. MARCUS employs a hierarchical agentic architecture comprising modality-specific vision-language expert models, each integrating domain-trained visual encoders with multi-stage language model optimization, coordinated by a multimodal orchestrator. Trained on 13.5 million images (0.25M ECGs, 1.3M echocardiogram images, 12M CMR images) and our novel expert-curated dataset spanning 1.6 million questions, MARCUS achieves state-of-the-art performance surpassing frontier models (GPT-5 Thinking, Gemini 2.5 Pro Deep Think). Across internal (Stanford) and external (UCSF) test cohorts, MARCUS achieves accuracies of 87-91% for ECG, 67-86% for echocardiography, and 85-88% for CMR, outperforming frontier models by 34-45% (P<0.001). On multimodal cases, MARCUS achieved 70% accuracy, nearly triple that of frontier models (22-28%), with 1.7-3.0x higher free-text quality scores. Our agentic architecture also confers resistance to mirage reasoning, whereby vision-language models derive reasoning from unintended textual signals or hallucinated visual content. MARCUS demonstrates that domain-specific visual encoders with an agentic orchestrator enable multimodal cardiac interpretation. We release our models, code, and benchmark open-source.

Developing 3D vision-language models with robust clinical reasoning remains a challenge due to the inherent complexity of volumetric medical imaging, the tendency of models to overfit superficial report patterns, and the lack of interpretability-aware reward designs. In this paper, we propose Med3D-R1, a reinforcement learning framework with a two-stage training process: Supervised Fine-Tuning (SFT) and Reinforcement Learning (RL). During SFT stage, we introduce a residual alignment mechanism to bridge the gap between high-dimensional 3D features and textual embeddings, and an abnormality re-weighting strategy to emphasize clinically informative tokens and reduce structural bias in reports. In RL stage, we redesign the consistency reward to explicitly promote coherent, step-by-step diagnostic reasoning. We evaluate our method on medical multiple-choice visual question answering using two 3D diagnostic benchmarks, CT-RATE and RAD-ChestCT, where our model attains state-of-the-art accuracies of 41.92\% on CT-RATE and 44.99\% on RAD-ChestCT. These results indicate improved abnormality diagnosis and clinical reasoning and outperform prior methods on both benchmarks. Overall, our approach holds promise for enhancing real-world diagnostic workflows by enabling more reliable and transparent 3D medical vision-language systems.

Scene understanding is central to general physical intelligence, and video is a primary modality for capturing both state and temporal dynamics of a scene. Yet understanding physical processes remains difficult, as models must combine object localization, hand-object interactions, relational parsing, temporal reasoning, and step-level procedural inference. Existing benchmarks usually evaluate these capabilities separately, limiting diagnosis of why models fail on procedural tasks. We introduce BARISTA, a densely annotated egocentric dataset and benchmark of 185 real-world coffee-preparation videos covering fully automatic, portafilter-based, and capsule-based workflows. BARISTA provides verified per-frame scene graphs linking persistent object identities to masks, tracks, boxes, attributes, typed relations, hand-object interactions, activities, and process steps. From these graphs, we derive zero-shot language-based tasks spanning phrase grounding, hand-object interaction recognition, referring, activity recognition, relation extraction, and temporal visual question answering. Experiments reveal strong variation across task families and no consistently dominant model family, positioning BARISTA as a challenging diagnostic benchmark for procedural video understanding. Code and dataset available at https://huggingface.co/datasets/ramblr/BARISTA.

Autoregressive visual models (AVMs) based on next-scale prediction have emerged as a prominent paradigm for image and video synthesis. However, decomposing the generation process into discrete scales with varying granularities in AVM makes semantic errors difficult to identify and correct, thereby undermining the quality of the final output. Prior efforts to enhance AVM can be categorized into training-based and training-free approaches. Although training-based efforts to enhance AVM generation quality come at substantial computational cost, existing training-free methods neglect intermediate generation states, leaving semantic errors undiagnosed and allowing them to accumulate into the final output. In this paper, we focus on training-free paradigms and propose Gazer, a framework that integrates multimodal large language model feedback into the AVM sampling loop for in-generation semantic correction. Concretely, Gazer operates via two cooperating stages: the Reflective Diagnosis stage diagnoses semantic errors from intermediate states, while the Semantic Correction stage rewinds and rectifies the generation trajectory to realign with the target prompt. Experiments on compositional image and video benchmarks demonstrate that Gazer improves semantic alignment and compositional accuracy across multiple AVMs without additional training.

Medical image annotation is essential for diagnosing diseases, yet manual annotation is time-consuming, costly, and prone to variability among experts. To address these challenges, we propose an automated explainable annotation system that integrates ensemble learning, visual explainability, and uncertainty quantification. Our approach combines three pre-trained deep learning models - ResNet50, EfficientNet, and DenseNet - enhanced with XGrad-CAM for visual explanations and Monte Carlo Dropout for uncertainty quantification. This ensemble mimics the consensus of multiple radiologists by intersecting saliency maps from models that agree on the diagnosis while uncertain predictions are flagged for human review. We evaluated our system using the TBX11K medical imaging dataset and a Fire segmentation dataset, demonstrating its robustness across different domains. Experimental results show that our method outperforms baseline models, achieving 93.04% accuracy on TBX11K and 96.4% accuracy on the Fire dataset. Moreover, our model produces precise pixel-level annotations despite being trained with only image-level labels, achieving Intersection over Union IoU scores of 36.07% and 64.7%, respectively. By enhancing the accuracy and interpretability of image annotations, our approach offers a reliable and transparent solution for medical diagnostics and other image analysis tasks.

In this paper, we consider the problem of visual representation learning for computational pathology, by exploiting large-scale image-text pairs gathered from public resources, along with the domain-specific knowledge in pathology. Specifically, we make the following contributions: (i) We curate a pathology knowledge tree that consists of 50,470 informative attributes for 4,718 diseases requiring pathology diagnosis from 32 human tissues. To our knowledge, this is the first comprehensive structured pathology knowledge base; (ii) We develop a knowledge-enhanced visual-language pretraining approach, where we first project pathology-specific knowledge into latent embedding space via a language model, and use it to guide the visual representation learning; (iii) We conduct thorough experiments to validate the effectiveness of our proposed components, demonstrating significant performance improvement on various downstream tasks, including cross-modal retrieval, zero-shot classification on pathology patches, and zero-shot tumor subtyping on whole slide images (WSIs).

Medical imaging technologies, including computed tomography (CT) or chest X-Ray (CXR), are largely employed to facilitate the diagnosis of the COVID-19. Since manual report writing is usually too time-consuming, a more intelligent auxiliary medical system that could generate medical reports automatically and immediately is urgently needed. In this article, we propose to use the medical visual language BERT (Medical-VLBERT) model to identify the abnormality on the COVID-19 scans and generate the medical report automatically based on the detected lesion regions. To produce more accurate medical reports and minimize the visual-and-linguistic differences, this model adopts an alternate learning strategy with two procedures that are knowledge pretraining and transferring. To be more precise, the knowledge pretraining procedure is to memorize the knowledge from medical texts, while the transferring procedure is to utilize the acquired knowledge for professional medical sentences generations through observations of medical images. In practice, for automatic medical report generation on the COVID-19 cases, we constructed a dataset of 368 medical findings in Chinese and 1104 chest CT scans from The First Affiliated Hospital of Jinan University, Guangzhou, China, and The Fifth Affiliated Hospital of Sun Yat-sen University, Zhuhai, China. Besides, to alleviate the insufficiency of the COVID-19 training samples, our model was first trained on the large-scale Chinese CX-CHR dataset and then transferred to the COVID-19 CT dataset for further fine-tuning. The experimental results showed that Medical-VLBERT achieved state-of-the-art performances on terminology prediction and report generation with the Chinese COVID-19 CT dataset and the CX-CHR dataset. The Chinese COVID-19 CT dataset is available at https://covid19ct.github.io/.

We present NV-Reason-CT, a generative vision--language model for chest and abdominal CT combining native 3D visual encoding with radiologist-guided reasoning. The model couples a native 3D vision transformer with a language model, passing all visual tokens and their explicit 3D coordinates into language decoding without further spatial token merging. This retains volumetric spatial information within the vision encoder and through the language model's positional encoding during joint processing with text. We train on a curated corpus of approximately 550,000 multimodal instruction examples from 70,111 unique CT image inputs, combining standardized reports, abnormality-focused and anatomy-specific questions, multi-turn interactions, and radiologist-authored reasoning from recorded and transcribed expert CT interpretations. Expert annotations provide direct supervision and guide additional report-grounded synthetic reasoning. End-to-end supervised fine-tuning (SFT) is followed by Group Relative Policy Optimization (GRPO), with verifiable rewards over chest and abdominal abnormality sets. The model supports abnormality classification, report generation, and interactive reasoning with reviewable observations, differential diagnoses, and uncertainty. Evaluation spans public CT benchmarks and a held-out NIH cohort. On CT-RATE, NV-Reason-CT achieves a macro-F1 of 0.614 and macro-AUROC of 0.871 without a task-specific classification head; generated reports achieve a report-derived macro-F1 of 0.592. In a preliminary study with expert radiologists, AI-assisted review received favorable confidence ratings and was associated with a 50% reduction in average reported interpretation and reporting time. We release the model and training code to support reproducible research on explainable AI for volumetric medical imaging.

Recent vision-language-action (VLA) models have shown strong performance on local robot manipulation, yet their success does not readily translate to long-horizon mobile manipulation. In our experiments, a pretrained subtask VLA achieves 80% success rate on atomic manipulation tasks but only 19% when these skills are composed into mobile manipulation. We argue that this gap stems from failures across the execution process rather than from local manipulation capability alone. To uncover these bottlenecks, we systematically diagnose failures in long-horizon mobile manipulation and identify three dominant regimes: task planning, navigation and base positioning, and local manipulation. Based on this diagnosis, we develop failure-guided agentic intervention that augments a fixed subtask VLA with demonstration-based planning guidance, adaptive visual memory, accessibility-aware base adjustment, and local end-effector adjustment. On RoboCasa365, these interventions progressively improve task success from 19% to 47%, with the finalized system reaching 49% on held-out episode seeds, compared with 18% for the baseline. The same design improves performance from 14% to 37% on BEHAVIOR-1K and from 5/20 to 13/20 on real-robot tasks. These results suggest that reliable mobile manipulation can be advanced by diagnosing and intervening on the current bottleneck, rather than uniformly scaling the underlying policy. Our code will be released at https://github.com/PKU-VaLuE-Lab/Cracking-Mobile-Manipulation.git.

Recent advancements in artificial intelligence (AI) have precipitated significant breakthroughs in healthcare, particularly in refining diagnostic procedures. However, previous studies have often been constrained to limited functionalities. This study introduces MiniGPT-Med, a vision-language model derived from large-scale language models and tailored for medical applications. MiniGPT-Med demonstrates remarkable versatility across various imaging modalities, including X-rays, CT scans, and MRIs, enhancing its utility. The model is capable of performing tasks such as medical report generation, visual question answering (VQA), and disease identification within medical imagery. Its integrated processing of both image and textual clinical data markedly improves diagnostic accuracy. Our empirical assessments confirm MiniGPT-Med's superior performance in disease grounding, medical report generation, and VQA benchmarks, representing a significant step towards reducing the gap in assisting radiology practice. Furthermore, it achieves state-of-the-art performance on medical report generation, higher than the previous best model by 19\% accuracy. MiniGPT-Med promises to become a general interface for radiology diagnoses, enhancing diagnostic efficiency across a wide range of medical imaging applications.

Surgical site infection (SSI) is one of the most common and costly healthcare-associated infections and and surgical wound care remains a significant clinical challenge in preventing SSIs and improving patient outcomes. While recent studies have explored the use of deep learning for preliminary surgical wound screening, progress has been hindered by concerns over data privacy and the high costs associated with expert annotation. Currently, no publicly available dataset or benchmark encompasses various types of surgical wounds, resulting in the absence of an open-source Surgical-Wound screening tool. To address this gap: (1) we present SurgWound, the first open-source dataset featuring a diverse array of surgical wound types. It contains 697 surgical wound images annotated by 3 professional surgeons with eight fine-grained clinical attributes. (2) Based on SurgWound, we introduce the first benchmark for surgical wound diagnosis, which includes visual question answering (VQA) and report generation tasks to comprehensively evaluate model performance. (3) Furthermore, we propose a three-stage learning framework, WoundQwen, for surgical wound diagnosis. In the first stage, we employ five independent MLLMs to accurately predict specific surgical wound characteristics. In the second stage, these predictions serve as additional knowledge inputs to two MLLMs responsible for diagnosing outcomes, which assess infection risk and guide subsequent interventions. In the third stage, we train a MLLM that integrates the diagnostic results from the previous two stages to produce a comprehensive report. This three-stage framework can analyze detailed surgical wound characteristics and provide subsequent instructions to patients based on surgical images, paving the way for personalized wound care, timely intervention, and improved patient outcomes.

Large Vision-Language Models (LVLMs) use their vision encoders to translate images into representations for downstream reasoning, but the encoders often underperform in domain-specific visual tasks such as medical image diagnosis or fine-grained classification, where representation errors can cascade through the language model, leading to incorrect responses. Existing adaptation methods modify the continuous feature interface between encoder and language model through projector tuning or other parameter-efficient updates, which still couples the two components and requires re-alignment whenever the encoder changes. We introduce CRAFT (Codebook RegulAted Fine-Tuning), a lightweight method that fine-tunes the encoder using a discrete codebook that anchors visual representations to a stable token space, achieving domain adaptation without modifying other parts of the model. This decoupled design allows the adapted encoder to seamlessly boost the performance of LVLMs with different language architectures, as long as they share the same codebook. Empirically, CRAFT achieves an average gain of 13.51% across 10 domain-specific benchmarks such as VQARAD and PlantVillage, while preserving the LLM's linguistic capabilities and outperforming peer methods that operate on continuous tokens.

Recent advancements in Large Vision-Language Models (LVLMs) have demonstrated remarkable multimodal perception and reasoning capabilities. While numerous benchmarks have evaluated LVLMs from holistic or task-specific perspectives, their capabilities on fine-grained image tasks-fundamental to computer vision-remain insufficiently understood. To address this gap, we introduce FG-BMK, a comprehensive fine-grained evaluation benchmark containing 1.01 million questions and 0.28 million images, covering diverse scenarios from common object-centric domains to specialized domains. FG-BMK jointly evaluates dialogue-level fine-grained semantic recognition and feature-level visual discriminability through human-oriented and machine-oriented paradigms, enabling diagnostic analysis of whether LVLM failures arise from insufficient visual representations, weak visual-to-semantic grounding, or limited fine-grained knowledge. Through extensive experiments on a diverse set of representative LVLMs/VLMs, we find that current LVLMs remain inadequate fine-grained recognizers, with failures arising from intertwined bottlenecks in visual representations, semantic grounding, modality alignment, and category-level knowledge. We further analyze training design factors for improving fine-grained capabilities and examine how visual and linguistic perturbations affect LVLM predictions. These findings provide diagnostic insights into the limitations of current LVLMs and offer guidance for future data construction and model design in developing more reliable LVLMs for fine-grained visual tasks. Our code is open-source and available at https://fg-bmk.github.io/.

While multimodal reasoning has advanced rapidly, solving complex geometry problems critically hinges on active visual assistance, such as constructing auxiliary lines, spurring the rise of Visual Chain-of-Thought (VCoT). However, existing evaluations typically assess visual generation quality and final answer accuracy in isolation, failing to examine whether intermediate visual aids are geometrically valid, effectively utilized in subsequent reasoning, or causally responsible for task success. To bridge this gap, we introduce GeoVAD-Bench, a diagnostic benchmark that pairs a fine-grained five-dimensional trajectory diagnosis covering perception, auxiliary quality, utilization, deductive reasoning, and final correctness with controlled No-Aux, Auto-Aux, and GT-Aux intervention settings to systematically isolate intermediate error modes, the causal gains of visual aids, and the resulting autonomy gap. Our findings reveal that while high-quality auxiliary aids offer substantial theoretical gains for geometric problem solving, autonomous generation is frequently hampered by compounding errors across geometric perception, faithful visual manipulation, visual-state grounding, and deductive reasoning. Guided by these diagnostic insights, we establish a specialized data construction pipeline encompassing geometric perception, diagram editing, and interleaved visual-textual reasoning trajectories, and develop a progressive SFT and multimodal RL training framework. The resulting model, GeoWeave-8B, outperforms the base model by +25.3% in final geometric accuracy and achieves a +30.4% gain in process average across the four intermediate diagnostic dimensions.

Recent text-to-image models have made substantial progress in photorealism, aesthetics, and text-image alignment. Yet visually appealing images can still violate real-world plausibility, exhibiting malformed object structures, impossible anatomy, physically implausible interactions, or inconsistent spatial relationships. Such failures are not well captured by existing fidelity, aesthetics, preference, or alignment metrics. To address this gap, we introduce TerraVis, a framework for evaluating world-grounded visual consistency in generated images. TerraVis defines a structured taxonomy of world-consistency violations spanning object-, interaction-, and scene-level failures, and employs a multi-stage evaluation framework to identify and quantify them. Given an image, TerraVis first uses an MLLM to assess its eligibility for evaluation, then detects violations across 18 taxonomy-defined types and classifies them as minor or major to derive an overall world-consistency score. Across diverse open-source and proprietary text-to-image models on two widely used benchmarks, TerraVis achieves the strongest correlation with human judgments of world consistency among existing metrics. Our benchmark results further show that models that achieve strong performance on conventional metrics can still exhibit substantial world-consistency failures. These findings highlight world consistency as a complementary evaluation dimension and demonstrate that TerraVis enables systematic quantification, diagnosis, and comparison of such failures. Our code is publicly available at https://github.com/ShyFoo/TerraVis.

Depression has proven to be a significant public health issue, profoundly affecting the psychological well-being of individuals. If it remains undiagnosed, depression can lead to severe health issues, which can manifest physically and even lead to suicide. Generally, Diagnosing depression or any other mental disorder involves conducting semi-structured interviews alongside supplementary questionnaires, including variants of the Patient Health Questionnaire (PHQ) by Clinicians and mental health professionals. This approach places significant reliance on the experience and judgment of trained physicians, making the diagnosis susceptible to personal biases. Given that the underlying mechanisms causing depression are still being actively researched, physicians often face challenges in diagnosing and treating the condition, particularly in its early stages of clinical presentation. Recently, significant strides have been made in Artificial neural computing to solve problems involving text, image, and speech in various domains. Our analysis has aimed to leverage these state-of-the-art (SOTA) models in our experiments to achieve optimal outcomes leveraging multiple modalities. The experiments were performed on the Extended Distress Analysis Interview Corpus Wizard of Oz dataset (E-DAIC) corpus presented in the Audio/Visual Emotion Challenge (AVEC) 2019 Challenge. The proposed solutions demonstrate better results achieved by Proprietary and Open-source Large Language Models (LLMs), which achieved a Root Mean Square Error (RMSE) score of 3.98 on Textual Modality, beating the AVEC 2019 challenge baseline results and current SOTA regression analysis architectures. Additionally, the proposed solution achieved an accuracy of 71.43% in the classification task. The paper also includes a novel audio-visual multi-modal network that predicts PHQ-8 scores with an RMSE of 6.51.

As deep learning models gain attraction in medical data, ensuring transparent and trustworthy decision-making is essential. In skin cancer diagnosis, while advancements in lesion detection and classification have improved accuracy, the black-box nature of these methods poses challenges in understanding their decision processes, leading to trust issues among physicians. This study leverages the CLIP (Contrastive Language-Image Pretraining) model, trained on different skin lesion datasets, to capture meaningful relationships between visual features and diagnostic criteria terms. To further enhance transparency, we propose a method called MedGrad E-CLIP, which builds on gradient-based E-CLIP by incorporating a weighted entropy mechanism designed for complex medical imaging like skin lesions. This approach highlights critical image regions linked to specific diagnostic descriptions. The developed integrated pipeline not only classifies skin lesions by matching corresponding descriptions but also adds an essential layer of explainability developed especially for medical data. By visually explaining how different features in an image relates to diagnostic criteria, this approach demonstrates the potential of advanced vision-language models in medical image analysis, ultimately improving transparency, robustness, and trust in AI-driven diagnostic systems.

EEG signals capture brain activity with high temporal and low spatial resolution, supporting applications such as neurological diagnosis, cognitive monitoring, and brain-computer interfaces. However, effective analysis is hindered by limited labeled data, high dimensionality, and the absence of scalable models that fully capture spatiotemporal dependencies. Existing self-supervised learning (SSL) methods often focus on either spatial or temporal features, leading to suboptimal representations. To this end, we propose EEG-VJEPA, a novel adaptation of the Video Joint Embedding Predictive Architecture (V-JEPA) for EEG classification. By treating EEG as video-like sequences, EEG-VJEPA learns semantically meaningful spatiotemporal representations using joint embeddings and adaptive masking. To our knowledge, this is the first work that exploits V-JEPA for EEG classification and explores the visual concepts learned by the model. Evaluations on the publicly available Temple University Hospital (TUH) Abnormal EEG dataset show that EEG-VJEPA outperforms existing state-of-the-art models in classification accuracy. Beyond classification accuracy, EEG-VJEPA captures physiologically relevant spatial and temporal signal patterns, offering interpretable embeddings that may support human-AI collaboration in diagnostic workflows. These findings position EEG-VJEPA as a promising framework for scalable, trustworthy EEG analysis in real-world clinical settings.

The 7-point checklist (7PCL) is a widely used diagnostic tool in dermoscopy for identifying malignant melanoma by assigning point values to seven specific attributes. However, the traditional 7PCL is limited to distinguishing between malignant melanoma and melanocytic Nevi, and falls short in scenarios where multiple skin diseases with appearances similar to melanoma coexist. To address this limitation, we propose a novel diagnostic framework that integrates a clinical knowledge-based topological graph (CKTG) with a gradient diagnostic strategy featuring a data-driven weighting system (GD-DDW). The CKTG captures both the internal and external relationships among the 7PCL attributes, while the GD-DDW emulates dermatologists' diagnostic processes, prioritizing visual observation before making predictions. Additionally, we introduce a multimodal feature extraction approach leveraging a dual-attention mechanism to enhance feature extraction through cross-modal interaction and unimodal collaboration. This method incorporates meta-information to uncover interactions between clinical data and image features, ensuring more accurate and robust predictions. Our approach, evaluated on the EDRA dataset, achieved an average AUC of 88.6%, demonstrating superior performance in melanoma detection and feature prediction. This integrated system provides data-driven benchmarks for clinicians, significantly enhancing the precision of melanoma diagnosis.

The availability of clean and diverse labeled data is a major roadblock for training models on complex tasks such as visual question answering (VQA). The extensive work on large vision-and-language models has shown that self-supervised learning is effective for pretraining multimodal interactions. In this technical report, we focus on visual representations. We review and evaluate self-supervised methods to leverage unlabeled images and pretrain a model, which we then fine-tune on a custom VQA task that allows controlled evaluation and diagnosis. We compare energy-based models (EBMs) with contrastive learning (CL). While EBMs are growing in popularity, they lack an evaluation on downstream tasks. We find that both EBMs and CL can learn representations from unlabeled images that enable training a VQA model on very little annotated data. In a simple setting similar to CLEVR, we find that CL representations also improve systematic generalization, and even match the performance of representations from a larger, supervised, ImageNet-pretrained model. However, we find EBMs to be difficult to train because of instabilities and high variability in their results. Although EBMs prove useful for OOD detection, other results on supervised energy-based training and uncertainty calibration are largely negative. Overall, CL currently seems a preferable option over EBMs.

Vision-Language-Action (VLA) models have recently achieved remarkable progress in robotic manipulation, yet they remain limited in failure diagnosis and learning from failures. Additionally, existing failure datasets are mostly generated programmatically in simulation, which limits their generalization to the real world. In light of these, we introduce ViFailback, a framework designed to diagnose robotic manipulation failures and provide both textual and visual correction guidance. Our framework utilizes explicit visual symbols to enhance annotation efficiency. We further release the ViFailback dataset, a large-scale collection of 58,126 Visual Question Answering (VQA) pairs along with their corresponding 5,202 real-world manipulation trajectories. Based on the dataset, we establish ViFailback-Bench, a benchmark of 11 fine-grained VQA tasks designed to assess the failure diagnosis and correction abilities of Vision-Language Models (VLMs), featuring ViFailback-Bench Lite for closed-ended and ViFailback-Bench Hard for open-ended evaluation. To demonstrate the effectiveness of our framework, we built the ViFailback-8B VLM, which not only achieves significant overall performance improvement on ViFailback-Bench but also generates visual symbols for corrective action guidance. Finally, by integrating ViFailback-8B with a VLA model, we conduct real-world robotic experiments demonstrating its ability to assist the VLA model in recovering from failures. Project Website: https://x1nyuzhou.github.io/vifailback.github.io/

Dermatological diagnosis represents a complex multimodal challenge that requires integrating visual features with specialized clinical knowledge. While vision-language pretraining (VLP) has advanced medical AI, its effectiveness in dermatology is limited by text length constraints and the lack of structured texts. In this paper, we introduce MAKE, a Multi-Aspect Knowledge-Enhanced vision-language pretraining framework for zero-shot dermatological tasks. Recognizing that comprehensive dermatological descriptions require multiple knowledge aspects that exceed standard text constraints, our framework introduces: (1) a multi-aspect contrastive learning strategy that decomposes clinical narratives into knowledge-enhanced sub-texts through large language models, (2) a fine-grained alignment mechanism that connects subcaptions with diagnostically relevant image features, and (3) a diagnosis-guided weighting scheme that adaptively prioritizes different sub-captions based on clinical significance prior. Through pretraining on 403,563 dermatological image-text pairs collected from education resources, MAKE significantly outperforms state-of-the-art VLP models on eight datasets across zero-shot skin disease classification, concept annotation, and cross-modal retrieval tasks. Our code will be made publicly available at https: //github.com/SiyuanYan1/MAKE.

Visual anomaly detection has been widely used in industrial inspection and medical diagnosis. Existing methods typically demand substantial training samples, limiting their utility in zero-/few-shot scenarios. While recent efforts have leveraged CLIP's zero-shot recognition capability for this task, they often ignore optimizing visual features to focus on local anomalies, reducing their efficacy. In this work, we propose AF-CLIP (Anomaly-Focused CLIP) by dramatically enhancing its visual representations to focus on local defects. Our approach introduces a lightweight adapter that emphasizes anomaly-relevant patterns in visual features, simultaneously optimizing both class-level features for image classification and patch-level features for precise localization. To capture anomalies of different sizes and improve detection accuracy, prior to the adapter, we develop a multi-scale spatial aggregation mechanism to effectively consolidate neighborhood context. Complementing these visual enhancements, we design learnable textual prompts that generically characterize normal and abnormal states. After optimization on auxiliary datasets using a composite objective function, AF-CLIP demonstrates strong zero-shot detection capability. Our method is also extended to few-shot scenarios by extra memory banks. Experimental results across diverse industrial and medical datasets demonstrate the effectiveness and generalization of our proposed method. Code is available at https://github.com/Faustinaqq/AF-CLIP.

The visual examination of tissue biopsy sections is fundamental for cancer diagnosis, with pathologists analyzing sections at multiple magnifications to discern tumor cells and their subtypes. However, existing attention-based multiple instance learning (MIL) models, used for analyzing Whole Slide Images (WSIs) in cancer diagnostics, often overlook the contextual information of tumor and neighboring tiles, leading to misclassifications. To address this, we propose the Context-Aware Multiple Instance Learning (CAMIL) architecture. CAMIL incorporates neighbor-constrained attention to consider dependencies among tiles within a WSI and integrates contextual constraints as prior knowledge into the MIL model. We evaluated CAMIL on subtyping non-small cell lung cancer (TCGA-NSCLC) and detecting lymph node (CAMELYON16) metastasis, achieving test AUCs of 0.959\% and 0.975\%, respectively, outperforming other state-of-the-art methods. Additionally, CAMIL enhances model interpretability by identifying regions of high diagnostic value.

Identifying, tracking, and predicting wound heal-stage progression is a fundamental task towards proper diagnosis, effective treatment, facilitating healing, and reducing pain. Traditionally, a medical expert might observe a wound to determine the current healing state and recommend treatment. However, sourcing experts who can produce such a diagnosis solely from visual indicators can be difficult, time-consuming and expensive. In addition, lesions may take several weeks to undergo the healing process, demanding resources to monitor and diagnose continually. Automating this task can be challenging; datasets that follow wound progression from onset to maturation are small, rare, and often collected without computer vision in mind. To tackle these challenges, we introduce a self-supervised learning scheme composed of (a) learning embeddings of wound's temporal dynamics, (b) clustering for automatic stage discovery, and (c) fine-tuned classification. The proposed self-supervised and flexible learning framework is biologically inspired and trained on a small dataset with zero human labeling. The HealNet framework achieved high pre-text and downstream classification accuracy; when evaluated on held-out test data, HealNet achieved 97.7% pre-text accuracy and 90.62% heal-stage classification accuracy.

Recent vision-language models (VLMs) have advanced vision-and-language navigation (VLN), enabling models to predict navigation actions from visual observations and language instructions. In this work, we explore VLN with panoramic observations and introduce PanoVLN. The motivation is straightforward: more complete visual context should enable better-informed navigation decisions. For example, a panorama can reveal a passage outside a perspective camera's field of view, allowing the model to identify the intended route without additional exploration. However, we find that simply replacing perspective images with panoramas yields only limited gains. Our diagnosis suggests that fully exploiting wider visibility requires modifications to action prediction, training supervision, and visual representation. First, wider visibility supports longer-horizon action planning. We make the model predict longer action sequences, enabling larger turns and subsequent movement from a single panorama. Specifically, we introduce a confidence-guided execution (CGE) strategy that dynamically determines how many predicted actions to execute before replanning. Second, wider visibility also brings more complex route choices. We therefore construct training routes with frequent branching points and clear instructions to provide targeted supervision for route selection. Third, panoramic navigation requires understanding spatial relationships across viewing directions, beyond recognizing individual landmarks. We combine semantic and geometric features from RGB panoramas to capture both scene content and spatial layout without adding visual tokens. With a 4B backbone and RGB-only input, PanoVLN surpasses the previous SOTA by 11.9% and 8.7% in success rate on R2R-CE and RxR-CE Val-Unseen. Real-world experiments on a quadruped further demonstrate faster navigation with fewer pauses than prior VLN methods.

Agricultural visual models are typically evaluated for either recognition or localization, but reliable diagnosis requires identifying what is present and localizing the evidence. Agricultural visual question answering (VQA) datasets carry rich semantic labels but rarely link them to image regions, and adding such annotations by hand is costly at scale. We introduce AgroGround, a large-scale dataset for grounded agricultural recognition: identifying plant diseases and other agricultural targets and localizing their image regions. An automated pipeline converts the labels of eight agricultural VQA datasets into annotations for disease lesions and whole objects, producing 794,850 instruction examples. Healthy images provide negative supervision for disease queries, teaching the model to return empty predictions. We fine-tune a shared vision-language model on known-target grounding instructions combined with instructions requiring both recognition and localization. We evaluate predicted identities, regions, joint correctness, and healthy-image abstention on 1,480 human-verified images disjoint from all training data. Grounding-only fine-tuning reduces recognition accuracy from 51.8\% to 29.1\%, while adding recognition-and-localization instructions raises it to 72.6\%. With images and annotations held fixed, combining the two formats raises joint accuracy from 19.2\% to 43.3\% at comparable grounding. Healthy negatives raise abstention on healthy images to 95.0\%, and reinforcement learning improves lesion-level grounding. The resulting 2B model exceeds its annotation teacher in grounding F1 on our benchmark and on the external PlantSeg test set. AgroGround establishes a benchmark for grounded agricultural recognition, measuring joint correctness of identity and localization along with abstention on healthy images. The code is available at https://github.com/AB-Abdulla/AgroGround.

Biomedical visual question answering (VQA) has been widely studied and has demonstrated significant application value and potential in fields such as assistive medical diagnosis. Despite their success, current biomedical VQA models perform multimodal information interaction only at the model level within large language models (LLMs), leading to suboptimal multimodal semantic alignment when dealing with complex tasks. To address this issue, we propose BioD2C: a novel Dual-level Semantic Consistency Constraint Framework for Biomedical VQA, which achieves dual-level semantic interaction alignment at both the model and feature levels, enabling the model to adaptively learn visual features based on the question. Specifically, we firstly integrate textual features into visual features via an image-text fusion mechanism as feature-level semantic interaction, obtaining visual features conditioned on the given text; and then introduce a text-queue-based cross-modal soft semantic loss function to further align the image semantics with the question semantics. Specifically, in this work, we establish a new dataset, BioVGQ, to address inherent biases in prior datasets by filtering manually-altered images and aligning question-answer pairs with multimodal context, and train our model on this dataset. Extensive experimental results demonstrate that BioD2C achieves state-of-the-art (SOTA) performance across multiple downstream datasets, showcasing its robustness, generalizability, and potential to advance biomedical VQA research.

Diabetic retinopathy (DR) is a growing health problem worldwide and is a leading cause of visual impairment and blindness, especially among working people aged 20-65. Its incidence is increasing along with the number of diabetes cases, and it is more common in developed countries than in developing countries. Recent research in the field of diabetic retinopathy diagnosis is using advanced technologies, such as analysis of images obtained by ophthalmoscopy. Automatic methods for analyzing eye images based on neural networks, deep learning and image analysis algorithms can improve the efficiency of diagnosis. This paper describes an automatic DR diagnosis method that includes processing and analysis of ophthalmoscopic images of the eye. It uses morphological algorithms to identify the optic disc and lesions characteristic of DR, such as microaneurysms, hemorrhages and exudates. Automated DR diagnosis has the potential to improve the efficiency of early detection of this disease and contribute to reducing the number of cases of diabetes-related visual impairment. The final step was to create an application with a graphical user interface that allowed retinal images taken at cooperating ophthalmology offices to be uploaded to the server. These images were then analyzed using a developed algorithm to make a diagnosis.

Coronary stenosis is a major risk factor for ischemic heart events leading to increased mortality, and medical treatments for this condition require meticulous, labor-intensive analysis. Coronary angiography provides critical visual cues for assessing stenosis, supporting clinicians in making informed decisions for diagnosis and treatment. Recent advances in deep learning have shown great potential for automated localization and severity measurement of stenosis. In real-world scenarios, however, the success of these competent approaches is often hindered by challenges such as limited labeled data and class imbalance. In this study, we propose a novel data augmentation approach that uses an inpainting method based on a diffusion model to generate realistic lesions, allowing user-guided control of severity. Extensive evaluation on lesion detection and severity classification across various synthetic dataset sizes shows superior performance of our method on both a large-scale in-house dataset and a public coronary angiography dataset. Furthermore, our approach maintains high detection and classification performance even when trained with limited data, highlighting its clinical importance in improving the assessment of severity of stenosis and optimizing data utilization for more reliable decision support.

Histopathology is essential for cancer diagnosis and treatment selection, and pathology foundation models learn visual representations from whole-slide images (WSIs). However, existing foundation models are trained on disparate datasets using varying strategies, leading to inconsistent performance and limited generalizability. Here, we introduce ELF (Ensemble Learning of Foundation models), which integrates five pretrained pathology foundation models into unified slide-level representations. Trained on 53,699 WSIs spanning 20 anatomical sites, ELF leverages ensemble learning to capture complementary information across models. ELF's slide-level architecture is designed for data-efficient downstream evaluation, including settings with limited data such as therapeutic response prediction. We evaluate ELF for disease classification, biomarker detection, as well as anticancer and immunotherapy response prediction across multiple cancer types. ELF achieves higher performance than the evaluated constituent and slide-level foundation models across the tested tasks, supporting further evaluation of ensemble learning for pathology applications in oncology.

Today's scene graph generation (SGG) task is still far from practical, mainly due to the severe training bias, e.g., collapsing diverse "human walk on / sit on / lay on beach" into "human on beach". Given such SGG, the down-stream tasks such as VQA can hardly infer better scene structures than merely a bag of objects. However, debiasing in SGG is not trivial because traditional debiasing methods cannot distinguish between the good and bad bias, e.g., good context prior (e.g., "person read book" rather than "eat") and bad long-tailed bias (e.g., "near" dominating "behind / in front of"). In this paper, we present a novel SGG framework based on causal inference but not the conventional likelihood. We first build a causal graph for SGG, and perform traditional biased training with the graph. Then, we propose to draw the counterfactual causality from the trained graph to infer the effect from the bad bias, which should be removed. In particular, we use Total Direct Effect (TDE) as the proposed final predicate score for unbiased SGG. Note that our framework is agnostic to any SGG model and thus can be widely applied in the community who seeks unbiased predictions. By using the proposed Scene Graph Diagnosis toolkit on the SGG benchmark Visual Genome and several prevailing models, we observed significant improvements over the previous state-of-the-art methods.

Large language models (LLMs) and vision-language models (VLMs) are usually frozen after deployment, so they do not learn from the cases they solve. This is especially concerning in medicine, where new clinical evidence, updated guidelines, and new therapies can change established practice. Fine-tuning can update the model, but it requires access to model weights and additional training. Parameter-free methods avoid training, but they may overfit a fixed validation set, lack reliable domain knowledge, or lose visual details by saving experience only as text. To address these limitations, we present a model-agnostic framework that allows frozen LLMs and VLMs to learn from deployment experience through three forms of external expertise: a Skill that guides reasoning and tool use, a Knowledge Memory that stores reliable facts supported by earlier cases or trusted external evidence, and a Multimodal Knowledge Base that keeps visual examples and guides the model to relate each retrieved case to the current image. Instead of relying on a fixed validation set, a validation strategy keeps an update only if it helps on new cases without degrading performance on earlier ones. Across six benchmarks covering clinical diagnosis, clinical workflows, medical reasoning, and medical and non-medical visual reasoning, and with four open-weight and closed-source base models, our framework improves performance during online deployment by up to 34.2% over the base model on medical tasks, generalizes to unseen cases, transfers to other models without further optimization, and works in non-medical domains.

Medical vision-language models (VLMs) have shown increasing potential for radiological image interpretation. Medical VLMs encode radiological images into visual representations that capture both anatomical and phenotypic information for diagnosis. Existing approaches improve pathological phenotype representations through semantic-guided representation alignment. However, pathological phenotypes arise as lesion-specific visual changes superimposed on underlying normal anatomy. Such semantic alignment approaches fail to model the phenotype-specific increment relative to the corresponding normal anatomical representation. To address this gap, we propose ΔRepresentation, a visual phenotype representation learning framework based on counterfactual reasoning for medical VLMs. It comprises BaseAnatomy, a geometry-supervised representation learning module, and ΔPhenotype, a counterfactual incremental representation learning module. BaseAnatomy provides fine-grained geometric supervision through spatial relationships across and within anatomical structures. ΔPhenotype computes the representation increment between lesion representations and their corresponding normal anatomical representations, and supervises increments associated with the same phenotype to cluster in the representation space. Experiments on ReXGroundingCT and LIDC-IDRI demonstrate that ΔRepresentation effectively structures pathological phenotype representations and improves lesion grounding and phenotype characterization accuracy in medical VLMs. Code is available at https://anonymous.4open.science/r/deltarep-CF6D.

The non-invasive assessment of increasingly incidentally discovered renal masses is a critical challenge in urologic oncology, where diagnostic uncertainty frequently leads to the overtreatment of benign or indolent tumors. In this study, we developed and validated RenalCLIP using a dataset of 27,866 CT scans from 8,809 patients across nine Chinese medical centers and the public TCIA cohort, a visual-language foundation model for characterization, diagnosis and prognosis of renal mass. The model was developed via a two-stage pre-training strategy that first enhances the image and text encoders with domain-specific knowledge before aligning them through a contrastive learning objective, to create robust representations for superior generalization and diagnostic precision. RenalCLIP achieved better performance and superior generalizability across 10 core tasks spanning the full clinical workflow of kidney cancer, including anatomical assessment, diagnostic classification, and survival prediction, compared with other state-of-the-art general-purpose CT foundation models. Especially, for complicated task like recurrence-free survival prediction in the TCIA cohort, RenalCLIP achieved a C-index of 0.726, representing a substantial improvement of approximately 20% over the leading baselines. Furthermore, RenalCLIP's pre-training imparted remarkable data efficiency; in the diagnostic classification task, it only needs 20% training data to achieve the peak performance of all baseline models even after they were fully fine-tuned on 100% of the data. Additionally, it achieved superior performance in report generation, image-text retrieval and zero-shot diagnosis tasks. Our findings establish that RenalCLIP provides a robust tool with the potential to enhance diagnostic accuracy, refine prognostic stratification, and personalize the management of patients with kidney cancer.

Artificial intelligence for plant disease analysis has advanced from task-specific classifiers to multi-modal models capable of jointly interpreting visual and textual information. However, practical deployment in precision agriculture remains limited because most existing approaches treat disease understanding as isolated prediction tasks, failing to capture the complementary relationships among symptom recognition, severity assessment, and question-driven diagnostic reasoning. In tomato pathology, accurate interpretation of diseased leaves requires more than label prediction; it demands integrating visual symptoms with semantic context to support a comprehensive and explainable understanding. Here, we present SOLAR, a multimodal generative model that understands tomato disease spanning six question-answering tasks. SOLAR learns to align visual features with task-aware language representations by Fusion Expert module based on mixture-of-expert, enabling it to generate contextually relevant answers across diverse diagnostic tasks. By formulating tomato disease analysis as a generative Visual Question Answering (VQA) task, SOLAR provides a flexible framework that supports multi-task inference within a single model while improving performance and cross-task knowledge sharing. We evaluate SOLAR on 41,677 images, including 216,209 Question-Answering (QA) pairs to understand tomato leaf disease under both closed and open-ended QA settings. Experimental results show that SOLAR consistently outperforms state-of-the-art vision-only, vision-language, and task-specific models across all tasks, demonstrating superior accuracy, robustness, and multimodal reasoning. These findings highlight the potential of generative multimodal modeling as an effective direction for understanding of plant disease. The code for this study is available at https://github.com/EnalisUs/SOLAR.

Despite significant advancements in general artificial intelligence, such as GPT-4, their effectiveness in the medical domain (general medical AI, GMAI) remains constrained due to the absence of specialized medical knowledge. To address this challenge, we present GMAI-VL-5.5M, a comprehensive multimodal medical dataset created by converting hundreds of specialized medical datasets into meticulously constructed image-text pairs. This dataset features comprehensive task coverage, diverse modalities, and high-quality image-text data. Building upon this multimodal dataset, we propose GMAI-VL, a general medical vision-language model with a progressively three-stage training strategy. This approach significantly enhances the model's ability by integrating visual and textual information, thereby improving its ability to process multimodal data and support accurate diagnosis and clinical decision-making. Experimental evaluations demonstrate that GMAI-VL achieves state-of-the-art results across a wide range of multimodal medical tasks, such as visual question answering and medical image diagnosis. Our contributions include the development of the GMAI-VL-5.5M dataset, the introduction of the GMAI-VL model, and the establishment of new benchmarks in multiple medical domains. Code and dataset will be released at https://github.com/uni-medical/GMAI-VL.

While Multimodal Large Language Models (MLLMs) show promising performance in automated electrocardiogram interpretation, it remains unclear whether they genuinely perform actual step-by-step reasoning or just rely on superficial visual cues. To investigate this, we introduce ECG-Reasoning-Benchmark, a novel multi-turn evaluation framework comprising over 6,400 samples to systematically assess step-by-step reasoning across 17 core ECG diagnoses. Our comprehensive evaluation of state-of-the-art models reveals a critical failure in executing multi-step logical deduction. Although models possess the medical knowledge to retrieve clinical criteria for a diagnosis, they exhibit near-zero success rates (6% Completion) in maintaining a complete reasoning chain, primarily failing to ground the corresponding ECG findings to the actual visual evidence in the ECG signal. These results demonstrate that current MLLMs bypass actual visual interpretation, exposing a critical flaw in existing training paradigms and underscoring the necessity for robust, reasoning-centric medical AI. The code and data are available at https://github.com/Jwoo5/ecg-reasoning-benchmark.

Native Omni-modal Large Language Models (OLLMs) have shifted from pipeline architectures to unified representation spaces. However, this native integration gives rise to a critical yet underexplored phenomenon: modality preference. To bridge this gap, we first systematically quantify modality preference of OLLMs using a newly-curated conflict-based benchmark and the modality selection rate metric. Our evaluation of ten representative OLLMs reveals a notable paradigm shift: unlike the ``text-dominance'' of traditional VLMs, most OLLMs exhibit a pronounced visual preference. To further understand the underlying mechanism, we conduct layer-wise probing and demonstrate that such modality preference is not static but emerges progressively in the mid-to-late layers. Building upon these insights, we leverage these internal signals to diagnose cross-modal hallucinations, achieving competitive performance across three downstream multi-modal benchmarks without task-specific data. Our work provides both a mechanistic understanding and a practical tool for building more trustworthy OLLMs. Our code and related resources are publicly available at: https://github.com/icip-cas/OmniPreference

Medical multimodal large language models (MLLMs) are increasingly expected to perform complex image understanding tasks, yet their reliability is often compromised by frequent errors in visual interpretation. To systematically trace these failures, we traverse the hierarchy from high-level clinical tasks down to fundamental visual perception. We therefore introduce Perception-Bench, a large-scale benchmark comprising 1.13 million samples that assesses medical MLLMs across six dimensions: attribute judgment, spatial grounding, spatial understanding, disease prediction, anomaly detection, and report generation, spanning both 2D and 3D radiology images. Our analysis on Perception-Bench reveals that existing MLLMs lack the ability to capture even the most basic lesion attributes, such as location, size, and density. This inability to ground clinical outputs in primary visual evidence reveals that the models' diagnostic unreliability is rooted in a critical but overlooked bottleneck in low-level visual perception. Motivated by this, we propose RadSight, a perception-driven MLLM built upon a dual 2D/3D encoder architecture that preserves native imaging spatial structures. RadSight formulates medical image understanding as a four-stage progressive process: visual-language alignment, fine-grained visual perception, clinical diagnosis, and diagnostic interpretation. The model is trained on an 8.37 million perception-oriented corpus using progressive curriculum learning. On Perception-Bench, RadSight consistently outperforms existing MLLMs across all six evaluation dimensions, with particularly strong gains in spatial grounding and clinical diagnosis. It also achieves consistent improvements on public 2D and 3D medical benchmarks, further demonstrating that robust low-level visual perception is a critical foundation for reliable clinical understanding. Code and model will be publicly available.

Microscopic assessment of histopathology images is vital for accurate cancer diagnosis and treatment. Whole Slide Image (WSI) classification and captioning have become crucial tasks in computer-aided pathology. However, microscopic WSI face challenges such as redundant patches and unknown patch positions due to subjective pathologist captures. Moreover, generating automatic pathology captions remains a significant challenge. To address these issues, we introduce a novel GNN-ViTCap framework for classification and caption generation from histopathological microscopic images. First, a visual feature extractor generates patch embeddings. Redundant patches are then removed by dynamically clustering these embeddings using deep embedded clustering and selecting representative patches via a scalar dot attention mechanism. We build a graph by connecting each node to its nearest neighbors in the similarity matrix and apply a graph neural network to capture both local and global context. The aggregated image embeddings are projected into the language model's input space through a linear layer and combined with caption tokens to fine-tune a large language model. We validate our method on the BreakHis and PatchGastric datasets. GNN-ViTCap achieves an F1 score of 0.934 and an AUC of 0.963 for classification, along with a BLEU-4 score of 0.811 and a METEOR score of 0.569 for captioning. Experimental results demonstrate that GNN-ViTCap outperforms state of the art approaches, offering a reliable and efficient solution for microscopy based patient diagnosis.

Rare cancers comprise 20-25% of all malignancies but face major diagnostic challenges due to limited expert availability-especially in pediatric oncology, where they represent over 70% of cases. While pathology vision-language (VL) foundation models show promising zero-shot capabilities for common cancer subtyping, their clinical performance for rare cancers remains limited. Existing multi-instance learning (MIL) methods rely only on visual features, overlooking cross-modal knowledge and compromising interpretability critical for rare cancer diagnosis. To address this limitation, we propose PathPT, a novel framework that fully exploits the potential of vision-language pathology foundation models through spatially-aware visual aggregation and task-specific prompt tuning. Unlike conventional MIL, PathPT converts WSI-level supervision into fine-grained tile-level guidance by leveraging the zero-shot capabilities of VL models, thereby preserving localization on cancerous regions and enabling cross-modal reasoning through prompts aligned with histopathological semantics. We benchmark PathPT on eight rare cancer datasets(four adult and four pediatric) spanning 56 subtypes and 2,910 WSIs, as well as three common cancer datasets, evaluating four state-of-the-art VL models and four MIL frameworks under three few-shot settings. Results show that PathPT consistently delivers superior performance, achieving substantial gains in subtyping accuracy and cancerous region grounding ability. This work advances AI-assisted diagnosis for rare cancers, offering a scalable solution for improving subtyping accuracy in settings with limited access to specialized expertise.

A LaTeX manuscript that compiles without error is not necessarily publication-ready. The resulting PDFs frequently suffer from misplaced floats, overflowing equations, inconsistent table scaling, widow and orphan lines, and poor page balance, forcing authors into repetitive compile-inspect-edit cycles. Rule-based tools are blind to rendered visuals, operating only on source code and log files. Text-only LLMs perform open-loop text editing, unable to predict or verify the two-dimensional layout consequences of their changes. Reliable typesetting optimization therefore requires a visual closed loop with verification after every edit. We formalize this problem as Visual Typesetting Optimization (VTO), the task of transforming a compilable LaTeX paper into a visually polished, page-budget-compliant PDF through iterative visual verification and source-level revision, and introduce a five-category taxonomy of typesetting defects to guide diagnosis. We present PaperFit, a vision-in-the-loop agent that iteratively renders pages, diagnoses defects, and applies constrained repairs. To benchmark VTO, we construct PaperFit-Bench with 200 papers across 10 venue templates and 13 defect types at different difficulty. Extensive experiments show that PaperFit outperforms all baselines by a large margin, establishing that bridging the gap from compilable source to publication-ready PDF requires vision-in-the-loop optimization and that VTO constitutes a critical missing stage in the document automation pipeline.

Medical Vision-Language Models (Med-VLMs) require reliable reasoning from fine-grained visual evidence, yet existing models can produce plausible clinical answers by relying on language priors or medical templates rather than truly attending to diagnosis-critical regions. On-Policy Distillation (OPD) offers dense token-level supervision on student-generated trajectories and provides a privacy-compatible means of capability transfer without requiring the redistribution of raw patient data. However, standard OPD uniformly distills all tokens, causing sparse evidence-dependent tokens to be diluted by abundant clinical narrative tokens. Inspired by the success of OPD in the large language model community, we propose Med-OPD, to our knowledge the first unified post-training framework that integrates on-policy distillation with medical evidence-aware supervision for Med-VLMs. We introduce Medical Evidence Advantage (MEA), a teacher-grounded counterfactual signal that uses an answer-aware hint to focus teacher scoring on evidence supporting the target diagnosis, and measures each token's dependence on medical visual evidence by comparing teacher likelihoods under the original and evidence-degraded imaging modalities. Based on MEA, Med-OPD redistributes the distillation signal at both the token and trajectory levels, emphasizing diagnosis-critical tokens and evidence-reliant rollouts. Experiments on OmniMedVQA subsets show that Med-OPD consistently outperforms SFT and standard OPD across CT, MRI, Disease Diagnosis, and Lesion Grading. These results demonstrate that evidence-aware distillation can better strengthen medical VLMs' reliance on key visual evidence and improve reliable multimodal medical reasoning. The source code and data is publicly available at: https://github.com/yunhang8658/MedOPD.git

Vision evaluations are typically done through multi-step processes. In most contemporary fields, experts analyze images using structured, evidence-based adaptive questioning. In plant pathology, botanists inspect leaf images, identify visual cues, infer diagnostic intent, and probe further with targeted questions that adapt to species, symptoms, and severity. This structured probing is crucial for accurate disease diagnosis and treatment formulation. Yet current vision-language models are evaluated on single-turn question answering. To address this gap, we introduce PlantInquiryVQA, a benchmark for studying multi-step, intent-driven visual reasoning in botanical diagnosis. We formalize a Chain of Inquiry framework modeling diagnostic trajectories as ordered question-answer sequences conditioned on grounded visual cues and explicit epistemic intent. We release a dataset of 24,950 expert-curated plant images and 138,068 question-answer pairs annotated with visual grounding, severity labels, and domain-specific reasoning templates. Evaluations on top-tier Multimodal Large Language Models reveal that while they describe visual symptoms adequately, they struggle with safe clinical reasoning and accurate diagnosis. Importantly, structured question-guided inquiry significantly improves diagnostic correctness, reduces hallucination, and increases reasoning efficiency. We hope PlantInquiryVQA serves as a foundational benchmark in advancing research to train diagnostic agents to reason like expert botanists rather than static classifiers.

Medical vision-and-language models (MVLMs) have attracted substantial interest due to their capability to offer a natural language interface for interpreting complex medical data. Their applications are versatile and have the potential to improve diagnostic accuracy and decision-making for individual patients while also contributing to enhanced public health monitoring, disease surveillance, and policy-making through more efficient analysis of large data sets. MVLMS integrate natural language processing with medical images to enable a more comprehensive and contextual understanding of medical images alongside their corresponding textual information. Unlike general vision-and-language models trained on diverse, non-specialized datasets, MVLMs are purpose-built for the medical domain, automatically extracting and interpreting critical information from medical images and textual reports to support clinical decision-making. Popular clinical applications of MVLMs include automated medical report generation, medical visual question answering, medical multimodal segmentation, diagnosis and prognosis and medical image-text retrieval. Here, we provide a comprehensive overview of MVLMs and the various medical tasks to which they have been applied. We conduct a detailed analysis of various vision-and-language model architectures, focusing on their distinct strategies for cross-modal integration/exploitation of medical visual and textual features. We also examine the datasets used for these tasks and compare the performance of different models based on standardized evaluation metrics. Furthermore, we highlight potential challenges and summarize future research trends and directions. The full collection of papers and codes is available at: https://github.com/YtongXie/Medical-Vision-and-Language-Tasks-and-Methodologies-A-Survey.

Large vision-language models (LVLMs) have shown great promise in medical applications, particularly in visual question answering (MedVQA) and diagnosis from medical images. However, existing datasets and models often fail to consider critical aspects of medical diagnostics, such as the integration of historical records and the analysis of disease progression over time. In this paper, we introduce MMXU (Multimodal and MultiX-ray Understanding), a novel dataset for MedVQA that focuses on identifying changes in specific regions between two patient visits. Unlike previous datasets that primarily address single-image questions, MMXU enables multi-image questions, incorporating both current and historical patient data. We demonstrate the limitations of current LVLMs in identifying disease progression on MMXU-test, even those that perform well on traditional benchmarks. To address this, we propose a MedRecord-Augmented Generation (MAG) approach, incorporating both global and regional historical records. Our experiments show that integrating historical records significantly enhances diagnostic accuracy by at least 20\%, bridging the gap between current LVLMs and human expert performance. Additionally, we fine-tune models with MAG on MMXU-dev, which demonstrates notable improvements. We hope this work could illuminate the avenue of advancing the use of LVLMs in medical diagnostics by emphasizing the importance of historical context in interpreting medical images. Our dataset is released at https://github.com/linjiemu/MMXU{https://github.com/linjiemu/MMXU}.

Glaucoma is the leading cause of irreversible blindness worldwide and poses significant diagnostic challenges due to its reliance on subjective evaluation. However, recent advances in computer vision and deep learning have demonstrated the potential for automated assessment. In this paper, we survey recent studies on AI-based glaucoma diagnosis using fundus, optical coherence tomography, and visual field images, with a particular emphasis on deep learning-based methods. We provide an updated taxonomy that organizes methods into architectural paradigms and includes links to available source code to enhance the reproducibility of the methods. Through rigorous benchmarking on widely-used public datasets, we reveal performance gaps in generalizability, uncertainty estimation, and multimodal integration. Additionally, our survey curates key datasets while highlighting limitations such as scale, labeling inconsistencies, and bias. We outline open research challenges and detail promising directions for future studies. This survey is expected to be useful for both AI researchers seeking to translate advances into practice and ophthalmologists aiming to improve clinical workflows and diagnosis using the latest AI outcomes.

Artificial intelligence (AI) is vital in ophthalmology, tackling tasks like diagnosis, classification, and visual question answering (VQA). However, existing AI models in this domain often require extensive annotation and are task-specific, limiting their clinical utility. While recent developments have brought about foundation models for ophthalmology, they are limited by the need to train separate weights for each imaging modality, preventing a comprehensive representation of multi-modal features. This highlights the need for versatile foundation models capable of handling various tasks and modalities in ophthalmology. To address this gap, we present EyeFound, a multimodal foundation model for ophthalmic images. Unlike existing models, EyeFound learns generalizable representations from unlabeled multimodal retinal images, enabling efficient model adaptation across multiple applications. Trained on 2.78 million images from 227 hospitals across 11 ophthalmic modalities, EyeFound facilitates generalist representations and diverse multimodal downstream tasks, even for detecting challenging rare diseases. It outperforms previous work RETFound in diagnosing eye diseases, predicting systemic disease incidents, and zero-shot multimodal VQA. EyeFound provides a generalizable solution to improve model performance and lessen the annotation burden on experts, facilitating widespread clinical AI applications for retinal imaging.

Medical vision-language models (VLMs) and AI agents have made significant progress in learning to analyze and reason about clinical images. However, existing medical visual question answering (VQA) benchmarks collapse model capabilities into a single accuracy score, obscuring where and why models fail. We propose DeepTumorVQA, a hierarchical benchmark that follows the multi-stage evidence chain in tumor diagnosis and decomposes 3D CT reasoning into four stages: recognition, measurement, visual reasoning, and medical reasoning. Higher-level questions remain independently scorable, while their ground-truth evidence chains are defined over lower-level primitives. The benchmark contains 476K questions across 42 clinical subtypes on 9,262 3D CT volumes. In addition to a direct reasoning mode for VLMs, DeepTumorVQA provides tool-interaction environments for agent evaluation, where a model can call external tools, including segmentation models, measurement programs, and medical knowledge modules, before answering the question. Evaluating over 30 model configurations, we find that reliable quantitative measurement is the primary bottleneck, making later-stage visual and medical reasoning harder for VLMs, while tool augmentation substantially mitigates this issue. When tools are available, leveraging medical knowledge and tools to reason about medical images becomes a new challenge. We further show that ground-truth step-by-step tool-use traces from DeepTumorVQA can supervise agents and reduce tool-use and reasoning failures. This stage-wise progression from recognition to measurement to visual and medical reasoning provides a concrete roadmap for future medical VLM and AI agent studies. All data and code are released at https://github.com/Schuture/DeepTumorVQA.

Multimodal large language models (MLLMs) have shown great potential in medical applications, yet existing benchmarks inadequately capture real-world clinical complexity. We introduce MEDSYN, a multilingual, multimodal benchmark of highly complex clinical cases with up to 7 distinct visual clinical evidence (CE) types per case. Mirroring clinical workflow, we evaluate 18 MLLMs on differential diagnosis (DDx) generation and final diagnosis (FDx) selection. While top models often match or even outperform human experts on DDx generation, all MLLMs exhibit a much larger DDx--FDx performance gap compared to expert clinicians, indicating a failure mode in synthesis of heterogeneous CE types. Ablations attribute this failure to (i) overreliance on less discriminative textual CE (e.g., medical history) and (ii) a cross-modal CE utilization gap. We introduce Evidence Sensitivity to quantify the latter and show that a smaller gap correlates with higher diagnostic accuracy. Finally, we demonstrate how it can be used to guide interventions to improve model performance. We will open-source our benchmark and code.

Recent reasoning based medical MLLMs have made progress in generating step by step textual reasoning chains. However, they still struggle with complex tasks that necessitate dynamic and iterative focusing on fine-grained visual regions to achieve precise grounding and diagnosis. We introduce Ophiuchus, a versatile, tool-augmented framework that equips an MLLM to (i) decide when additional visual evidence is needed, (ii) determine where to probe and ground within the medical image, and (iii) seamlessly weave the relevant sub-image content back into an interleaved, multimodal chain of thought. In contrast to prior approaches limited by the performance ceiling of specialized tools, Ophiuchus integrates the model's inherent grounding and perception capabilities with external tools, thereby fostering higher-level reasoning. The core of our method is a three-stage training strategy: cold-start training with tool-integrated reasoning data to achieve basic tool selection and adaptation for inspecting key regions; self-reflection fine-tuning to strengthen reflective reasoning and encourage revisiting tool outputs; and Agentic Tool Reinforcement Learning to directly optimize task-specific rewards and emulate expert-like diagnostic behavior. Extensive experiments show that Ophiuchus consistently outperforms both closed-source and open-source SOTA methods across diverse medical benchmarks, including VQA, detection, and reasoning-based segmentation. Our approach illuminates a path toward medical AI agents that can genuinely "think with images" through tool-integrated reasoning. Datasets, codes, and trained models will be released publicly.

The clinical translation of dermatological AI is hindered by opaque reasoning and systematic performance disparities across skin tones. Here we present SkinGPT-R1, a multimodal large language model that integrates chain-of-thought diagnostic reasoning with a fairness-aware mixture-of-experts architecture for interpretable and equitable skin disease diagnosis. Through parameter-efficient adaptation of a frozen reasoning backbone, SkinGPT-R1 generates structured diagnostic reports comprising visual findings, differential reasoning, and final diagnosis. Across seven external datasets spanning diverse pathologies and imaging conditions, SkinGPT-R1 achieves state-of-the-art accuracy on six benchmarks, including 82.50\% on a challenging 40-class long-tail classification task (+19.30\% over leading baselines). Blinded evaluation by five board-certified dermatologists on 1,000 phenotypically balanced cases yields a mean score of 3.6 out of 5, with the highest ratings in safety (3.8) and reasoning coherence (3.6), indicating that the generated rationales are clinically safe, logically grounded, and suitable for supporting diagnostic decision-making. Critically, SkinGPT-R1 mitigates algorithmic bias across the full Fitzpatrick spectrum, achieving a robust worst-group performance of 41.40\% on the Fitz17k benchmark and a five-fold relative improvement in lower-bound accuracy on the DDI dataset compared to standard multimodal baselines. These results establish a framework for trustworthy, fair, and explainable AI-assisted dermatological diagnosis.

Multi-modal interpretation of biomedical images opens up novel opportunities in biomedical image analysis. Conventional AI approaches typically rely on disjointed training, i.e., Large Language Models (LLMs) for clinical text generation and segmentation models for target extraction, which results in inflexible real-world deployment and a failure to leverage holistic biomedical information. To this end, we introduce UniBiomed, the first universal foundation model for grounded biomedical image interpretation. UniBiomed is based on a novel integration of Multi-modal Large Language Model (MLLM) and Segment Anything Model (SAM), which effectively unifies the generation of clinical texts and the segmentation of corresponding biomedical objects for grounded interpretation. In this way, UniBiomed is capable of tackling a wide range of biomedical tasks across ten diverse biomedical imaging modalities. To develop UniBiomed, we curate a large-scale dataset comprising over 27 million triplets of images, annotations, and text descriptions across ten imaging modalities. Extensive validation on 84 internal and external datasets demonstrated that UniBiomed achieves state-of-the-art performance in segmentation, disease recognition, region-aware diagnosis, visual question answering, and report generation. Moreover, unlike previous models that rely on clinical experts to pre-diagnose images and manually craft precise textual or visual prompts, UniBiomed can provide automated and end-to-end grounded interpretation for biomedical image analysis. This represents a novel paradigm shift in clinical workflows, which will significantly improve diagnostic efficiency. In summary, UniBiomed represents a novel breakthrough in biomedical AI, unlocking powerful grounded interpretation capabilities for more accurate and efficient biomedical image analysis.

Recently a number of studies demonstrated impressive performance on diverse vision-language multi-modal tasks such as image captioning and visual question answering by extending the BERT architecture with multi-modal pre-training objectives. In this work we explore a broad set of multi-modal representation learning tasks in the medical domain, specifically using radiology images and the unstructured report. We propose Medical Vision Language Learner (MedViLL), which adopts a BERT-based architecture combined with a novel multi-modal attention masking scheme to maximize generalization performance for both vision-language understanding tasks (diagnosis classification, medical image-report retrieval, medical visual question answering) and vision-language generation task (radiology report generation). By statistically and rigorously evaluating the proposed model on four downstream tasks with three radiographic image-report datasets (MIMIC-CXR, Open-I, and VQA-RAD), we empirically demonstrate the superior downstream task performance of MedViLL against various baselines, including task-specific architectures. The source code is publicly available at: https://github.com/SuperSupermoon/MedViLL

Advanced autoregressive models have reshaped multimodal AI. However, their transformative potential in medical imaging remains largely untapped due to the absence of a unified visual tokenizer -- one capable of capturing fine-grained visual structures for faithful image reconstruction and realistic image synthesis, as well as rich semantics for accurate diagnosis and image interpretation. To this end, we present MedITok, the first unified tokenizer tailored for medical images, encoding both low-level structural details and high-level clinical semantics within a unified latent space. To balance these competing objectives, we introduce a novel two-stage training framework: a visual representation alignment stage that cold-starts the tokenizer reconstruction learning with a visual semantic constraint, followed by a textual semantic representation alignment stage that infuses detailed clinical semantics into the latent space. Trained on the meticulously collected large-scale dataset with over 30 million medical images and 2 million image-caption pairs, MedITok achieves state-of-the-art performance on more than 30 datasets across 9 imaging modalities and 4 different tasks. By providing a unified token space for autoregressive modeling, MedITok supports a wide range of tasks in clinical diagnostics and generative healthcare applications. Model and code will be made publicly available at: https://github.com/Masaaki-75/meditok.

Medical image grounding aims to align natural language phrases with specific regions in medical images, serving as a foundational task for intelligent diagnosis, visual question answering (VQA), and automated report generation (MRG). However, existing research is constrained by limited modality coverage, coarse-grained annotations, and the absence of a unified, generalizable grounding framework. To address these challenges, we construct a large-scale medical grounding dataset Med-GLIP-5M comprising over 5.3 million region-level annotations across seven imaging modalities, covering diverse anatomical structures and pathological findings. The dataset supports both segmentation and grounding tasks with hierarchical region labels, ranging from organ-level boundaries to fine-grained lesions. Based on this foundation, we propose Med-GLIP, a modality-aware grounding framework trained on Med-GLIP-5M. Rather than relying on explicitly designed expert modules, Med-GLIP implicitly acquires hierarchical semantic understanding from diverse training data -- enabling it to recognize multi-granularity structures, such as distinguishing lungs from pneumonia lesions. Extensive experiments demonstrate that Med-GLIP consistently outperforms state-of-the-art baselines across multiple grounding benchmarks. Furthermore, integrating its spatial outputs into downstream tasks, including medical VQA and report generation, leads to substantial performance gains. Our dataset will be released soon.

Automated radiology report generation holds immense potential to alleviate the heavy workload of radiologists. Despite the formidable vision-language capabilities of recent Multimodal Large Language Models (MLLMs), their clinical deployment is severely constrained by inherent limitations: their "black-box" decision-making renders the generated reports untraceable due to the lack of explicit visual evidence to support the diagnosis, and they struggle to access external domain knowledge. To address these challenges, we propose the Evidence-driven Radiology Report Generation Agent (EviAgent). Unlike opaque end-to-end paradigms, EviAgent coordinates a transparent reasoning trajectory by breaking down the complex generation process into granular operational units. We integrate multi-dimensional visual experts and retrieval mechanisms as external support modules, endowing the system with explicit visual evidence and high-quality clinical priors. Extensive experiments on MIMIC-CXR, CheXpert Plus, and IU-Xray datasets demonstrate that EviAgent outperforms both large-scale generalist models and specialized medical models, providing a robust and trustworthy solution for automated radiology report generation.

To address this gap, we introduce TomaMMU, a large-scale Tomato leaf disease MultiModal Understanding dataset, alongside TomaBench, a benchmark for evaluating VLMs on tomato disease understanding. TomaMMU comprises 28,808 high-quality images spanning 15 categories and 213,119 human-annotated visual question-answer pairs, generated through a three-stage pipeline comprising Data Collection, Human Annotation, and Question-Answer Generation. Building on this foundation, TomaBench organizes seven agricultural tasks into a hierarchical three-level taxonomy spanning Basic Perception, Pathology Understanding, and Expert Diagnosis, which together enable systematic evaluation from low-level visual recognition to high-level diagnostic reasoning. The tasks assess visual symptom recognition, taxonomic relationships, and diagnostic reasoning, offering a comprehensive view of how well models grasp plant pathology. Our results pronounced gaps in fine-grained recognition and factually grounded reasoning with 14 state-of-the-art VLMs, consistently underperforming on both challenging MCQs and open-ended questions. These results suggest that current VLMs struggle to translate visual perception into reliable diagnostic knowledge, motivating the need for targeted domain adaptation. Simple fine-tuning on TomaMMU substantially narrows this gap, boosting accuracy on challenging MCQs to 96.09%, outperforming recent VLMs, and pointing toward promising directions for future work. All data and code is available in https://huggingface.co/datasets/enalis/TomaMMU.

Reliable interpretation of multimodal data in dentistry is essential for automated oral healthcare, yet current multimodal large language models (MLLMs) struggle to capture fine-grained dental visual details and lack sufficient reasoning ability for precise diagnosis. To address these limitations, we present DentalGPT, a specialized dental MLLM developed through high-quality domain knowledge injection and reinforcement learning. Specifically, the largest annotated multimodal dataset for dentistry to date was constructed by aggregating over 120k dental images paired with detailed descriptions that highlight diagnostically relevant visual features, making it the multimodal dataset with the most extensive collection of dental images to date. Training on this dataset significantly enhances the MLLM's visual understanding of dental conditions, while the subsequent reinforcement learning stage further strengthens its capability for multimodal complex reasoning. Comprehensive evaluations on intraoral and panoramic benchmarks, along with dental subsets of medical VQA benchmarks, show that DentalGPT achieves superior performance in disease classification and dental VQA tasks, outperforming many state-of-the-art MLLMs despite having only 7B parameters. These results demonstrate that high-quality dental data combined with staged adaptation provides an effective pathway for building capable and domain-specialized dental MLLMs.

Whole slide imaging (WSI) has transformed digital pathology by enabling computational analysis of gigapixel histopathology images. Recent foundation model advances have accelerated progress in computational pathology, facilitating joint reasoning across pathology images, clinical reports, and structured data. Despite this progress, challenges remain: the extreme resolution of WSIs creates computational hurdles for visual learning; limited expert annotations constrain supervised approaches; integrating multimodal information while preserving biological interpretability remains difficult; and the opacity of modeling ultra-long visual sequences hinders clinical transparency. This review comprehensively surveys recent advances in multimodal computational pathology. We systematically analyze four research directions: (1) self-supervised representation learning and structure-aware token compression for WSIs; (2) multimodal data generation and augmentation; (3) parameter-efficient adaptation and reasoning-enhanced few-shot learning; and (4) multi-agent collaborative reasoning for trustworthy diagnosis. We specifically examine how token compression enables cross-scale modeling and how multi-agent mechanisms simulate a pathologist's "Chain of Thought" across magnifications to achieve uncertainty-aware evidence fusion. Finally, we discuss open challenges and argue that future progress depends on unified multimodal frameworks integrating high-resolution visual data with clinical and biomedical knowledge to support interpretable and safe AI-assisted diagnosis.