aiqbench analysis
This research introduces MedREAL, a multimodal framework that aligns high-level clinical reasoning with precise pixel-level grounding for medical image analysis. By integrating Seg Anchored Reasoning Pooling and a Reasoning-to-Visual fusion mechanism, the model generates evidence masks consistent with textual diagnoses, addressing critical trustworthiness gaps in current MLLMs. The accompanying MedRAVS-13K dataset provides a robust benchmark across four imaging modalities for advancing interpretable medical AI.
From Reasoning to Pixels: Grounded Medical Multimodal LLMs for VQA and Segmentation
arXiv:2608.26856v1 Announce Type: cross Abstract: Although Multimodal Large Language Models (MLLMs) have demonstrated impressive performance in Medical Visual Question Answering (Med-VQA), their reliance on global image features often lacks precise pixel-level grounding, thereby limiting clinical trustworthiness. To bridge the semantic gap between high-level clinical reasoning and spatial localization, we propose \textsc{\textsc{MedREAL}} (\textbf{Med}ical \textbf{RE}asoning-driven \textbf{A}nswering and \textbf{L}ocalization), a unified framework that seamlessly aligns linguistic reasoning with spatial grounding. Specifically, \textsc{MedREAL} introduces \textbf{S}eg \textbf{A}nchored \textbf{R}easoning \textbf{P}ooling (SARP) to distill task-relevant semantic evidence directly from \texttt{[SEG]} tokens within the MLLM's hidden states. Furthermore, a \textbf{R}easoning-to-\textbf{V}isual (R2V) fusion mechanism is proposed to effectively inject these reasoning-aware features into a segmentation pipeline for accurate mask decoding. To facilitate this paradigm, we construct MedRAVS-13K, a comprehensive dataset comprising 13,824 expertly validated samples across four diverse imaging modalities. Extensive experiments demonstrate that \textsc{MedREAL} significantly outperforms state-of-the-arts, achieving 68.49\% gIoU and 70.47\% cIoU on benchmark evaluations. By generating evidence masks that are strictly consistent with textual diagnoses, \textsc{MedREAL} provides a robust, interpretable framework for reasoning-driven medical image analysis.
Abstract:Although Multimodal Large Language Models (MLLMs) have demonstrated impressive performance in Medical Visual Question Answering (Med-VQA), their reliance on global image features often lacks precise pixel-level grounding, thereby limiting clinical trustworthiness. To bridge the semantic gap between high-level clinical reasoning and spatial localization, we propose \textsc{\textsc{MedREAL}} (\textbf{Med}ical \textbf{RE}asoning-driven \textbf{A}nswering and \textbf{L}ocalization), a unified framework that seamlessly aligns linguistic reasoning with spatial grounding. Specifically, \textsc{MedREAL} introduces \textbf{S}eg \textbf{A}nchored \textbf{R}easoning \textbf{P}ooling (SARP) to distill task-relevant semantic evidence directly from \texttt{[SEG]} tokens within the MLLM's hidden states. Furthermore, a \textbf{R}easoning-to-\textbf{V}isual (R2V) fusion mechanism is proposed to effectively inject these reasoning-aware features into a segmentation pipeline for accurate mask decoding. To facilitate this paradigm, we construct MedRAVS-13K, a comprehensive dataset comprising 13,824 expertly validated samples across four diverse imaging modalities. Extensive experiments demonstrate that \textsc{MedREAL} significantly outperforms state-of-the-arts, achieving 68.49\% gIoU and 70.47\% cIoU on benchmark evaluations. By generating evidence masks that are strictly consistent with textual diagnoses, \textsc{MedREAL} provides a robust, interpretable framework for reasoning-driven medical image analysis.
Computer Vision and Pattern Recognition (cs.CV); Artificial Intelligence (cs.AI)
arXiv:2608.26856 [cs.CV]
(or arXiv:2608.26856v1 [cs.CV] for this version)
https://doi.org/10.48550/arXiv.2608.26856 Focus to learn more arXiv-issued DOI via DataCite (pending registration)
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