Daily Papers

Text-guided image editors can now manipulate authentic medical scans with high fidelity, enabling lesion implantation/removal that threatens clinical trust and safety. Existing defenses are inadequate for healthcare. Medical detectors are largely black-box, while MLLM-based explainers are typically post-hoc, lack medical expertise, and may hallucinate evidence on ambiguous cases. We present MedForge, a data-and-method solution for pre-hoc, evidence-grounded medical forgery detection. We introduce MedForge-90K, a large-scale benchmark of realistic lesion edits across 19 pathologies with expert-guided reasoning supervision via doctor inspection guidelines and gold edit locations. Building on it, MedForge-Reasoner performs localize-then-analyze reasoning, predicting suspicious regions before producing a verdict, and is further aligned with Forgery-aware GSPO to strengthen grounding and reduce hallucinations. Experiments demonstrate state-of-the-art detection accuracy and trustworthy, expert-aligned explanations.

AI-generated medical images are gaining growing popularity due to their potential to address the data scarcity challenge in the real world. However, the issue of accurate identification of these synthetic images, particularly when they exhibit remarkable realism with their real copies, remains a concern. To mitigate this challenge, image generators such as DALLE and Imagen, have integrated digital watermarks aimed at facilitating the discernment of synthetic images' authenticity. These watermarks are embedded within the image pixels and are invisible to the human eye while remains their detectability. Nevertheless, a comprehensive investigation into the potential impact of these invisible watermarks on the utility of synthetic medical images has been lacking. In this study, we propose the incorporation of invisible watermarks into synthetic medical images and seek to evaluate their efficacy in the context of downstream classification tasks. Our goal is to pave the way for discussions on the viability of such watermarks in boosting the detectability of synthetic medical images, fortifying ethical standards, and safeguarding against data pollution and potential scams.

Multimodal large language models have unlocked new possibilities for various multimodal tasks. However, their potential in image manipulation detection remains unexplored. When directly applied to the IMD task, M-LLMs often produce reasoning texts that suffer from hallucinations and overthinking. To address this, in this work, we propose ForgerySleuth, which leverages M-LLMs to perform comprehensive clue fusion and generate segmentation outputs indicating specific regions that are tampered with. Moreover, we construct the ForgeryAnalysis dataset through the Chain-of-Clues prompt, which includes analysis and reasoning text to upgrade the image manipulation detection task. A data engine is also introduced to build a larger-scale dataset for the pre-training phase. Our extensive experiments demonstrate the effectiveness of ForgeryAnalysis and show that ForgerySleuth significantly outperforms existing methods in generalization, robustness, and explainability.

Accurate and interpretable detection of AI-generated images is essential for mitigating risks associated with AI misuse. However, the substantial domain gap among generative models makes it challenging to develop a generalizable forgery detection model. Moreover, since every pixel in an AI-generated image is synthesized, traditional saliency-based forgery explanation methods are not well suited for this task. To address these challenges, we formulate detection and explanation as a unified Forgery Detection and Reasoning task (FDR-Task), leveraging Multi-Modal Large Language Models (MLLMs) to provide accurate detection through reliable reasoning over forgery attributes. To facilitate this task, we introduce the Multi-Modal Forgery Reasoning dataset (MMFR-Dataset), a large-scale dataset containing 120K images across 10 generative models, with 378K reasoning annotations on forgery attributes, enabling comprehensive evaluation of the FDR-Task. Furthermore, we propose FakeReasoning, a forgery detection and reasoning framework with three key components: 1) a dual-branch visual encoder that integrates CLIP and DINO to capture both high-level semantics and low-level artifacts; 2) a Forgery-Aware Feature Fusion Module that leverages DINO's attention maps and cross-attention mechanisms to guide MLLMs toward forgery-related clues; 3) a Classification Probability Mapper that couples language modeling and forgery detection, enhancing overall performance. Experiments across multiple generative models demonstrate that FakeReasoning not only achieves robust generalization but also outperforms state-of-the-art methods on both detection and reasoning tasks.

This work introduces Federated Adaptive Gain via Dual Signal Trust (FedAgain), a novel federated learning algorithm designed to enhance anomaly detection in medical imaging under decentralized and heterogeneous conditions. Focusing on the task of kidney stone classification, FedAgain addresses the common challenge of corrupted or low-quality client data in real-world clinical environments by implementing a dual-signal trust mechanism based on reconstruction error and model divergence. This mechanism enables the central server to dynamically down-weight updates from untrustworthy clients without accessing their raw data, thereby preserving both model integrity and data privacy. FedAgain employs deep convolutional autoencoders trained in two diverse kidney stone datasets and is evaluated in 16 types of endoscopy-specific corruption at five severity levels. Extensive experiments demonstrate that FedAgain effectively suppresses "expert forger" clients, enhances robustness to image corruptions, and offers a privacy-preserving solution for collaborative medical anomaly detection. Compared to traditional FedAvg, FedAgain achieves clear improvements in all 16 types of corruption, with precision gains of up to +14.49\% and F1 score improvements of up to +10.20\%, highlighting its robustness and effectiveness in challenging imaging scenarios.

In this paper we propose a novel image representation called face X-ray for detecting forgery in face images. The face X-ray of an input face image is a greyscale image that reveals whether the input image can be decomposed into the blending of two images from different sources. It does so by showing the blending boundary for a forged image and the absence of blending for a real image. We observe that most existing face manipulation methods share a common step: blending the altered face into an existing background image. For this reason, face X-ray provides an effective way for detecting forgery generated by most existing face manipulation algorithms. Face X-ray is general in the sense that it only assumes the existence of a blending step and does not rely on any knowledge of the artifacts associated with a specific face manipulation technique. Indeed, the algorithm for computing face X-ray can be trained without fake images generated by any of the state-of-the-art face manipulation methods. Extensive experiments show that face X-ray remains effective when applied to forgery generated by unseen face manipulation techniques, while most existing face forgery detection or deepfake detection algorithms experience a significant performance drop.

Objective: To enhance automated de-identification of radiology reports by scaling transformer-based models through extensive training datasets and benchmarking performance against commercial cloud vendor systems for protected health information (PHI) detection. Materials and Methods: In this retrospective study, we built upon a state-of-the-art, transformer-based, PHI de-identification pipeline by fine-tuning on two large annotated radiology corpora from Stanford University, encompassing chest X-ray, chest CT, abdomen/pelvis CT, and brain MR reports and introducing an additional PHI category (AGE) into the architecture. Model performance was evaluated on test sets from Stanford and the University of Pennsylvania (Penn) for token-level PHI detection. We further assessed (1) the stability of synthetic PHI generation using a "hide-in-plain-sight" method and (2) performance against commercial systems. Precision, recall, and F1 scores were computed across all PHI categories. Results: Our model achieved overall F1 scores of 0.973 on the Penn dataset and 0.996 on the Stanford dataset, outperforming or maintaining the previous state-of-the-art model performance. Synthetic PHI evaluation showed consistent detectability (overall F1: 0.959 [0.958-0.960]) across 50 independently de-identified Penn datasets. Our model outperformed all vendor systems on synthetic Penn reports (overall F1: 0.960 vs. 0.632-0.754). Discussion: Large-scale, multimodal training improved cross-institutional generalization and robustness. Synthetic PHI generation preserved data utility while ensuring privacy. Conclusion: A transformer-based de-identification model trained on diverse radiology datasets outperforms prior academic and commercial systems in PHI detection and establishes a new benchmark for secure clinical text processing.

The rapid development of generative AI facilitates content creation and makes image manipulation easier and more difficult to detect. While multimodal Large Language Models (LLMs) have encoded rich world knowledge, they are not inherently tailored for combating AI-generated Content (AIGC) and struggle to comprehend local forgery details. In this work, we investigate the application of multimodal LLMs in forgery detection. We propose a framework capable of evaluating image authenticity, localizing tampered regions, providing evidence, and tracing generation methods based on semantic tampering clues. Our method demonstrates that the potential of LLMs in forgery analysis can be effectively unlocked through meticulous prompt engineering and the application of few-shot learning techniques. We conduct qualitative and quantitative experiments and show that GPT4V can achieve an accuracy of 92.1% in Autosplice and 86.3% in LaMa, which is competitive with state-of-the-art AIGC detection methods. We further discuss the limitations of multimodal LLMs in such tasks and propose potential improvements.

A pre-trained visual-language model, contrastive language-image pre-training (CLIP), successfully accomplishes various downstream tasks with text prompts, such as finding images or localizing regions within the image. Despite CLIP's strong multi-modal data capabilities, it remains limited in specialized environments, such as medical applications. For this purpose, many CLIP variants-i.e., BioMedCLIP, and MedCLIP-SAMv2-have emerged, but false positives related to normal regions persist. Thus, we aim to present a simple yet important goal of reducing false positives in medical anomaly detection. We introduce a Contrastive LAnguage Prompting (CLAP) method that leverages both positive and negative text prompts. This straightforward approach identifies potential lesion regions by visual attention to the positive prompts in the given image. To reduce false positives, we attenuate attention on normal regions using negative prompts. Extensive experiments with the BMAD dataset, including six biomedical benchmarks, demonstrate that CLAP method enhances anomaly detection performance. Our future plans include developing an automated fine prompting method for more practical usage.

Face manipulation techniques have achieved significant advances, presenting serious challenges to security and social trust. Recent works demonstrate that leveraging multimodal models can enhance the generalization and interpretability of face forgery detection. However, existing annotation approaches, whether through human labeling or direct Multimodal Large Language Model (MLLM) generation, often suffer from hallucination issues, leading to inaccurate text descriptions, especially for high-quality forgeries. To address this, we propose Face Forgery Text Generator (FFTG), a novel annotation pipeline that generates accurate text descriptions by leveraging forgery masks for initial region and type identification, followed by a comprehensive prompting strategy to guide MLLMs in reducing hallucination. We validate our approach through fine-tuning both CLIP with a three-branch training framework combining unimodal and multimodal objectives, and MLLMs with our structured annotations. Experimental results demonstrate that our method not only achieves more accurate annotations with higher region identification accuracy, but also leads to improvements in model performance across various forgery detection benchmarks. Our Codes are available in https://github.com/skJack/VLFFD.git.

In this paper we present TruFor, a forensic framework that can be applied to a large variety of image manipulation methods, from classic cheapfakes to more recent manipulations based on deep learning. We rely on the extraction of both high-level and low-level traces through a transformer-based fusion architecture that combines the RGB image and a learned noise-sensitive fingerprint. The latter learns to embed the artifacts related to the camera internal and external processing by training only on real data in a self-supervised manner. Forgeries are detected as deviations from the expected regular pattern that characterizes each pristine image. Looking for anomalies makes the approach able to robustly detect a variety of local manipulations, ensuring generalization. In addition to a pixel-level localization map and a whole-image integrity score, our approach outputs a reliability map that highlights areas where localization predictions may be error-prone. This is particularly important in forensic applications in order to reduce false alarms and allow for a large scale analysis. Extensive experiments on several datasets show that our method is able to reliably detect and localize both cheapfakes and deepfakes manipulations outperforming state-of-the-art works. Code is publicly available at https://grip-unina.github.io/TruFor/

The rise of AI-generated image editing tools has made localized forgeries increasingly realistic, posing challenges for visual content integrity. Although recent efforts have explored localized AIGC detection, existing datasets predominantly focus on object-level forgeries while overlooking broader scene edits in regions such as sky or ground. To address these limitations, we introduce BR-Gen, a large-scale dataset of 150,000 locally forged images with diverse scene-aware annotations, which are based on semantic calibration to ensure high-quality samples. BR-Gen is constructed through a fully automated Perception-Creation-Evaluation pipeline to ensure semantic coherence and visual realism. In addition, we further propose NFA-ViT, a Noise-guided Forgery Amplification Vision Transformer that enhances the detection of localized forgeries by amplifying forgery-related features across the entire image. NFA-ViT mines heterogeneous regions in images, i.e., potential edited areas, by noise fingerprints. Subsequently, attention mechanism is introduced to compel the interaction between normal and abnormal features, thereby propagating the generalization traces throughout the entire image, allowing subtle forgeries to influence a broader context and improving overall detection robustness. Extensive experiments demonstrate that BR-Gen constructs entirely new scenarios that are not covered by existing methods. Take a step further, NFA-ViT outperforms existing methods on BR-Gen and generalizes well across current benchmarks. All data and codes are available at https://github.com/clpbc/BR-Gen.

Generative models, particularly text-to-image (T2I) diffusion models, play a crucial role in medical image analysis. However, these models are prone to training data memorization, posing significant risks to patient privacy. Synthetic chest X-ray generation is one of the most common applications in medical image analysis with the MIMIC-CXR dataset serving as the primary data repository for this task. This study adopts a data-driven approach and presents the first systematic attempt to identify prompts and text tokens in MIMIC-CXR that contribute the most to training data memorization. Our analysis reveals an unexpected finding: prompts containing traces of de-identification procedures are among the most memorized, with de-identification markers contributing the most. Furthermore, we also find existing inference-time memorization mitigation strategies are ineffective and fail to sufficiently reduce the model's reliance on memorized text tokens highlighting a broader issue in T2I synthesis with MIMIC-CXR. On this front, we propose actionable strategies to enhance privacy and improve the reliability of generative models in medical imaging. Finally, our results provide a foundation for future work on developing and benchmarking memorization mitigation techniques for synthetic chest X-ray generation using the MIMIC-CXR dataset.

Accurate diagnostic coding of medical notes is crucial for enhancing patient care, medical research, and error-free billing in healthcare organizations. Manual coding is a time-consuming task for providers, and diagnostic codes often exhibit low sensitivity and specificity, whereas the free text in medical notes can be a more precise description of a patients status. Thus, accurate automated diagnostic coding of medical notes has become critical for a learning healthcare system. Recent developments in long-document transformer architectures have enabled attention-based deep-learning models to adjudicate medical notes. In addition, contrastive loss functions have been used to jointly pre-train large language and image models with noisy labels. To further improve the automated adjudication of medical notes, we developed an approach based on i) models for ICD-10 diagnostic code sequences using a large real-world data set, ii) large language models for medical notes, and iii) contrastive pre-training to build an integrated model of both ICD-10 diagnostic codes and corresponding medical text. We demonstrate that a contrastive approach for pre-training improves performance over prior state-of-the-art models for the MIMIC-III-50, MIMIC-III-rare50, and MIMIC-III-full diagnostic coding tasks.

Critical retained foreign objects (RFOs), including surgical instruments like sponges and needles, pose serious patient safety risks and carry significant financial and legal implications for healthcare institutions. Detecting critical RFOs using artificial intelligence remains challenging due to their rarity and the limited availability of chest X-ray datasets that specifically feature critical RFOs cases. Existing datasets only contain non-critical RFOs, like necklace or zipper, further limiting their utility for developing clinically impactful detection algorithms. To address these limitations, we introduce "Hopkins RFOs Bench", the first and largest dataset of its kind, containing 144 chest X-ray images of critical RFO cases collected over 18 years from the Johns Hopkins Health System. Using this dataset, we benchmark several state-of-the-art object detection models, highlighting the need for enhanced detection methodologies for critical RFO cases. Recognizing data scarcity challenges, we further explore image synthetic methods to bridge this gap. We evaluate two advanced synthetic image methods, DeepDRR-RFO, a physics-based method, and RoentGen-RFO, a diffusion-based method, for creating realistic radiographs featuring critical RFOs. Our comprehensive analysis identifies the strengths and limitations of each synthetic method, providing insights into effectively utilizing synthetic data to enhance model training. The Hopkins RFOs Bench and our findings significantly advance the development of reliable, generalizable AI-driven solutions for detecting critical RFOs in clinical chest X-rays.

In this paper, we study the problem of generalizable synthetic image detection, aiming to detect forgery images from diverse generative methods, e.g., GANs and diffusion models. Cutting-edge solutions start to explore the benefits of pre-trained models, and mainly follow the fixed paradigm of solely training an attached classifier, e.g., combining frozen CLIP-ViT with a learnable linear layer in UniFD. However, our analysis shows that such a fixed paradigm is prone to yield detectors with insufficient learning regarding forgery representations. We attribute the key challenge to the lack of forgery adaptation, and present a novel forgery-aware adaptive transformer approach, namely FatFormer. Based on the pre-trained vision-language spaces of CLIP, FatFormer introduces two core designs for the adaption to build generalized forgery representations. First, motivated by the fact that both image and frequency analysis are essential for synthetic image detection, we develop a forgery-aware adapter to adapt image features to discern and integrate local forgery traces within image and frequency domains. Second, we find that considering the contrastive objectives between adapted image features and text prompt embeddings, a previously overlooked aspect, results in a nontrivial generalization improvement. Accordingly, we introduce language-guided alignment to supervise the forgery adaptation with image and text prompts in FatFormer. Experiments show that, by coupling these two designs, our approach tuned on 4-class ProGAN data attains a remarkable detection performance, achieving an average of 98% accuracy to unseen GANs, and surprisingly generalizes to unseen diffusion models with 95% accuracy.

With the rapid development of facial manipulation techniques, face forgery detection has received considerable attention in digital media forensics due to security concerns. Most existing methods formulate face forgery detection as a classification problem and utilize binary labels or manipulated region masks as supervision. However, without considering the correlation between local regions, these global supervisions are insufficient to learn a generalized feature and prone to overfitting. To address this issue, we propose a novel perspective of face forgery detection via local relation learning. Specifically, we propose a Multi-scale Patch Similarity Module (MPSM), which measures the similarity between features of local regions and forms a robust and generalized similarity pattern. Moreover, we propose an RGB-Frequency Attention Module (RFAM) to fuse information in both RGB and frequency domains for more comprehensive local feature representation, which further improves the reliability of the similarity pattern. Extensive experiments show that the proposed method consistently outperforms the state-of-the-arts on widely-used benchmarks. Furthermore, detailed visualization shows the robustness and interpretability of our method.

The rapid progress in synthetic image generation and manipulation has now come to a point where it raises significant concerns for the implications towards society. At best, this leads to a loss of trust in digital content, but could potentially cause further harm by spreading false information or fake news. This paper examines the realism of state-of-the-art image manipulations, and how difficult it is to detect them, either automatically or by humans. To standardize the evaluation of detection methods, we propose an automated benchmark for facial manipulation detection. In particular, the benchmark is based on DeepFakes, Face2Face, FaceSwap and NeuralTextures as prominent representatives for facial manipulations at random compression level and size. The benchmark is publicly available and contains a hidden test set as well as a database of over 1.8 million manipulated images. This dataset is over an order of magnitude larger than comparable, publicly available, forgery datasets. Based on this data, we performed a thorough analysis of data-driven forgery detectors. We show that the use of additional domainspecific knowledge improves forgery detection to unprecedented accuracy, even in the presence of strong compression, and clearly outperforms human observers.

With the increasing prevalence of synthetic images, evaluating image authenticity and locating forgeries accurately while maintaining human interpretability remains a challenging task. Existing detection models primarily focus on simple authenticity classification, ultimately providing only a forgery probability or binary judgment, which offers limited explanatory insights into image authenticity. Moreover, while MLLM-based detection methods can provide more interpretable results, they still lag behind expert models in terms of pure authenticity classification accuracy. To address this, we propose DF-LLaVA, a simple yet effective framework that unlocks the intrinsic discrimination potential of MLLMs. Our approach first extracts latent knowledge from MLLMs and then injects it into training via prompts. This framework allows LLaVA to achieve outstanding detection accuracy exceeding expert models while still maintaining the interpretability offered by MLLMs. Extensive experiments confirm the superiority of our DF-LLaVA, achieving both high accuracy and explainability in synthetic image detection. Code is available online at: https://github.com/Eliot-Shen/DF-LLaVA.

Objective: Patient notes in electronic health records (EHRs) may contain critical information for medical investigations. However, the vast majority of medical investigators can only access de-identified notes, in order to protect the confidentiality of patients. In the United States, the Health Insurance Portability and Accountability Act (HIPAA) defines 18 types of protected health information (PHI) that needs to be removed to de-identify patient notes. Manual de-identification is impractical given the size of EHR databases, the limited number of researchers with access to the non-de-identified notes, and the frequent mistakes of human annotators. A reliable automated de-identification system would consequently be of high value. Materials and Methods: We introduce the first de-identification system based on artificial neural networks (ANNs), which requires no handcrafted features or rules, unlike existing systems. We compare the performance of the system with state-of-the-art systems on two datasets: the i2b2 2014 de-identification challenge dataset, which is the largest publicly available de-identification dataset, and the MIMIC de-identification dataset, which we assembled and is twice as large as the i2b2 2014 dataset. Results: Our ANN model outperforms the state-of-the-art systems. It yields an F1-score of 97.85 on the i2b2 2014 dataset, with a recall 97.38 and a precision of 97.32, and an F1-score of 99.23 on the MIMIC de-identification dataset, with a recall 99.25 and a precision of 99.06. Conclusion: Our findings support the use of ANNs for de-identification of patient notes, as they show better performance than previously published systems while requiring no feature engineering.

Recently, the rapid development of AIGC has significantly boosted the diversities of fake media spread in the Internet, posing unprecedented threats to social security, politics, law, and etc. To detect the ever-increasingly diverse malicious fake media in the new era of AIGC, recent studies have proposed to exploit Large Vision Language Models (LVLMs) to design robust forgery detectors due to their impressive performance on a wide range of multimodal tasks. However, it still lacks a comprehensive benchmark designed to comprehensively assess LVLMs' discerning capabilities on forgery media. To fill this gap, we present Forensics-Bench, a new forgery detection evaluation benchmark suite to assess LVLMs across massive forgery detection tasks, requiring comprehensive recognition, location and reasoning capabilities on diverse forgeries. Forensics-Bench comprises 63,292 meticulously curated multi-choice visual questions, covering 112 unique forgery detection types from 5 perspectives: forgery semantics, forgery modalities, forgery tasks, forgery types and forgery models. We conduct thorough evaluations on 22 open-sourced LVLMs and 3 proprietary models GPT-4o, Gemini 1.5 Pro, and Claude 3.5 Sonnet, highlighting the significant challenges of comprehensive forgery detection posed by Forensics-Bench. We anticipate that Forensics-Bench will motivate the community to advance the frontier of LVLMs, striving for all-around forgery detectors in the era of AIGC. The deliverables will be updated at https://Forensics-Bench.github.io/.

The rapid progress of photorealistic synthesis techniques has reached at a critical point where the boundary between real and manipulated images starts to blur. Thus, benchmarking and advancing digital forgery analysis have become a pressing issue. However, existing face forgery datasets either have limited diversity or only support coarse-grained analysis. To counter this emerging threat, we construct the ForgeryNet dataset, an extremely large face forgery dataset with unified annotations in image- and video-level data across four tasks: 1) Image Forgery Classification, including two-way (real / fake), three-way (real / fake with identity-replaced forgery approaches / fake with identity-remained forgery approaches), and n-way (real and 15 respective forgery approaches) classification. 2) Spatial Forgery Localization, which segments the manipulated area of fake images compared to their corresponding source real images. 3) Video Forgery Classification, which re-defines the video-level forgery classification with manipulated frames in random positions. This task is important because attackers in real world are free to manipulate any target frame. and 4) Temporal Forgery Localization, to localize the temporal segments which are manipulated. ForgeryNet is by far the largest publicly available deep face forgery dataset in terms of data-scale (2.9 million images, 221,247 videos), manipulations (7 image-level approaches, 8 video-level approaches), perturbations (36 independent and more mixed perturbations) and annotations (6.3 million classification labels, 2.9 million manipulated area annotations and 221,247 temporal forgery segment labels). We perform extensive benchmarking and studies of existing face forensics methods and obtain several valuable observations.

The increasing interest in developing Artificial Intelligence applications in the medical domain, suffers from the lack of high-quality dataset, mainly due to privacy-related issues. Moreover, the recent rising of Multimodal Large Language Models (MLLM) leads to a need for multimodal medical datasets, where clinical reports and findings are attached to the corresponding CT or MR scans. This paper illustrates the entire workflow for building the data set MedPix 2.0. Starting from the well-known multimodal dataset MedPix\textregistered, mainly used by physicians, nurses and healthcare students for Continuing Medical Education purposes, a semi-automatic pipeline was developed to extract visual and textual data followed by a manual curing procedure where noisy samples were removed, thus creating a MongoDB database. Along with the dataset, we developed a GUI aimed at navigating efficiently the MongoDB instance, and obtaining the raw data that can be easily used for training and/or fine-tuning MLLMs. To enforce this point, we also propose a CLIP-based model trained on MedPix 2.0 for scan classification tasks.

Anti-forensics seeks to eliminate or conceal traces of tampering artifacts. Typically, anti-forensic methods are designed to deceive binary detectors and persuade them to misjudge the authenticity of an image. However, to the best of our knowledge, no attempts have been made to deceive forgery detectors at the pixel level and mis-locate forged regions. Traditional adversarial attack methods cannot be directly used against forgery localization due to the following defects: 1) they tend to just naively induce the target forensic models to flip their pixel-level pristine or forged decisions; 2) their anti-forensics performance tends to be severely degraded when faced with the unseen forensic models; 3) they lose validity once the target forensic models are retrained with the anti-forensics images generated by them. To tackle the three defects, we propose SEAR (Self-supErvised Anti-foRensics), a novel self-supervised and adversarial training algorithm that effectively trains deep-learning anti-forensic models against forgery localization. SEAR sets a pretext task to reconstruct perturbation for self-supervised learning. In adversarial training, SEAR employs a forgery localization model as a supervisor to explore tampering features and constructs a deep-learning concealer to erase corresponding traces. We have conducted largescale experiments across diverse datasets. The experimental results demonstrate that, through the combination of self-supervised learning and adversarial learning, SEAR successfully deceives the state-of-the-art forgery localization methods, as well as tackle the three defects regarding traditional adversarial attack methods mentioned above.

Recent advances in generative models enable highly realistic image manipulations, creating an urgent need for robust forgery detection methods. Current datasets for training and evaluating these methods are limited in scale and diversity. To address this, we propose a methodology for creating high-quality inpainting datasets and apply it to create DiQuID, comprising over 95,000 inpainted images generated from 78,000 original images sourced from MS-COCO, RAISE, and OpenImages. Our methodology consists of three components: (1) Semantically Aligned Object Replacement (SAOR) that identifies suitable objects through instance segmentation and generates contextually appropriate prompts, (2) Multiple Model Image Inpainting (MMII) that employs various state-of-the-art inpainting pipelines primarily based on diffusion models to create diverse manipulations, and (3) Uncertainty-Guided Deceptiveness Assessment (UGDA) that evaluates image realism through comparative analysis with originals. The resulting dataset surpasses existing ones in diversity, aesthetic quality, and technical quality. We provide comprehensive benchmarking results using state-of-the-art forgery detection methods, demonstrating the dataset's effectiveness in evaluating and improving detection algorithms. Through a human study with 42 participants on 1,000 images, we show that while humans struggle with images classified as deceiving by our methodology, models trained on our dataset maintain high performance on these challenging cases. Code and dataset are available at https://github.com/mever-team/DiQuID.

The burgeoning integration of 3D medical imaging into healthcare has led to a substantial increase in the workload of medical professionals. To assist clinicians in their diagnostic processes and alleviate their workload, the development of a robust system for retrieving similar case studies presents a viable solution. While the concept holds great promise, the field of 3D medical text-image retrieval is currently limited by the absence of robust evaluation benchmarks and curated datasets. To remedy this, our study presents a groundbreaking dataset, BIMCV-R (This dataset will be released upon acceptance.), which includes an extensive collection of 8,069 3D CT volumes, encompassing over 2 million slices, paired with their respective radiological reports. Expanding upon the foundational work of our dataset, we craft a retrieval strategy, MedFinder. This approach employs a dual-stream network architecture, harnessing the potential of large language models to advance the field of medical image retrieval beyond existing text-image retrieval solutions. It marks our preliminary step towards developing a system capable of facilitating text-to-image, image-to-text, and keyword-based retrieval tasks.

Existing Multimodal Large Language Models (MLLMs) for image forgery detection and localization predominantly operate under a text-centric Chain-of-Thought (CoT) paradigm. However, forcing these models to textually characterize imperceptible low-level tampering traces inevitably leads to hallucinations, as linguistic modalities are insufficient to capture such fine-grained pixel-level inconsistencies. To overcome this, we propose ForgeryVCR, a framework that incorporates a forensic toolbox to materialize imperceptible traces into explicit visual intermediates via Visual-Centric Reasoning. To enable efficient tool utilization, we introduce a Strategic Tool Learning post-training paradigm, encompassing gain-driven trajectory construction for Supervised Fine-Tuning (SFT) and subsequent Reinforcement Learning (RL) optimization guided by a tool utility reward. This paradigm empowers the MLLM to act as a proactive decision-maker, learning to spontaneously invoke multi-view reasoning paths including local zoom-in for fine-grained inspection and the analysis of invisible inconsistencies in compression history, noise residuals, and frequency domains. Extensive experiments reveal that ForgeryVCR achieves state-of-the-art (SOTA) performance in both detection and localization tasks, demonstrating superior generalization and robustness with minimal tool redundancy. The project page is available at https://youqiwong.github.io/projects/ForgeryVCR/.

Medical coding is the task of assigning medical codes to clinical free-text documentation. Healthcare professionals manually assign such codes to track patient diagnoses and treatments. Automated medical coding can considerably alleviate this administrative burden. In this paper, we reproduce, compare, and analyze state-of-the-art automated medical coding machine learning models. We show that several models underperform due to weak configurations, poorly sampled train-test splits, and insufficient evaluation. In previous work, the macro F1 score has been calculated sub-optimally, and our correction doubles it. We contribute a revised model comparison using stratified sampling and identical experimental setups, including hyperparameters and decision boundary tuning. We analyze prediction errors to validate and falsify assumptions of previous works. The analysis confirms that all models struggle with rare codes, while long documents only have a negligible impact. Finally, we present the first comprehensive results on the newly released MIMIC-IV dataset using the reproduced models. We release our code, model parameters, and new MIMIC-III and MIMIC-IV training and evaluation pipelines to accommodate fair future comparisons.

Recent research advances achieve human-level accuracy for de-identifying free-text clinical notes on research datasets, but gaps remain in reproducing this in large real-world settings. This paper summarizes lessons learned from building a system used to de-identify over one billion real clinical notes, in a fully automated way, that was independently certified by multiple organizations for production use. A fully automated solution requires a very high level of accuracy that does not require manual review. A hybrid context-based model architecture is described, which outperforms a Named Entity Recogniton (NER) - only model by 10% on the i2b2-2014 benchmark. The proposed system makes 50%, 475%, and 575% fewer errors than the comparable AWS, Azure, and GCP services respectively while also outperforming ChatGPT by 33%. It exceeds 98% coverage of sensitive data across 7 European languages, without a need for fine tuning. A second set of described models enable data obfuscation -- replacing sensitive data with random surrogates -- while retaining name, date, gender, clinical, and format consistency. Both the practical need and the solution architecture that provides for reliable & linked anonymized documents are described.

The rapid development of generative AI is a double-edged sword, which not only facilitates content creation but also makes image manipulation easier and more difficult to detect. Although current image forgery detection and localization (IFDL) methods are generally effective, they tend to face two challenges: 1) black-box nature with unknown detection principle, 2) limited generalization across diverse tampering methods (e.g., Photoshop, DeepFake, AIGC-Editing). To address these issues, we propose the explainable IFDL task and design FakeShield, a multi-modal framework capable of evaluating image authenticity, generating tampered region masks, and providing a judgment basis based on pixel-level and image-level tampering clues. Additionally, we leverage GPT-4o to enhance existing IFDL datasets, creating the Multi-Modal Tamper Description dataSet (MMTD-Set) for training FakeShield's tampering analysis capabilities. Meanwhile, we incorporate a Domain Tag-guided Explainable Forgery Detection Module (DTE-FDM) and a Multi-modal Forgery Localization Module (MFLM) to address various types of tamper detection interpretation and achieve forgery localization guided by detailed textual descriptions. Extensive experiments demonstrate that FakeShield effectively detects and localizes various tampering techniques, offering an explainable and superior solution compared to previous IFDL methods.

With the rapid advancement of Artificial Intelligence Generated Content (AIGC) technologies, synthetic images have become increasingly prevalent in everyday life, posing new challenges for authenticity assessment and detection. Despite the effectiveness of existing methods in evaluating image authenticity and locating forgeries, these approaches often lack human interpretability and do not fully address the growing complexity of synthetic data. To tackle these challenges, we introduce FakeVLM, a specialized large multimodal model designed for both general synthetic image and DeepFake detection tasks. FakeVLM not only excels in distinguishing real from fake images but also provides clear, natural language explanations for image artifacts, enhancing interpretability. Additionally, we present FakeClue, a comprehensive dataset containing over 100,000 images across seven categories, annotated with fine-grained artifact clues in natural language. FakeVLM demonstrates performance comparable to expert models while eliminating the need for additional classifiers, making it a robust solution for synthetic data detection. Extensive evaluations across multiple datasets confirm the superiority of FakeVLM in both authenticity classification and artifact explanation tasks, setting a new benchmark for synthetic image detection. The dataset and code will be released in: https://github.com/opendatalab/FakeVLM.

The misuse of advanced generative AI models has resulted in the widespread proliferation of falsified data, particularly forged human-centric audiovisual content, which poses substantial societal risks (e.g., financial fraud and social instability). In response to this growing threat, several works have preliminarily explored countermeasures. However, the lack of sufficient and diverse training data, along with the absence of a standardized benchmark, hinder deeper exploration. To address this challenge, we first build Mega-MMDF, a large-scale, diverse, and high-quality dataset for multimodal deepfake detection. Specifically, we employ 21 forgery pipelines through the combination of 10 audio forgery methods, 12 visual forgery methods, and 6 audio-driven face reenactment methods. Mega-MMDF currently contains 0.1 million real samples and 1.1 million forged samples, making it one of the largest and most diverse multimodal deepfake datasets, with plans for continuous expansion. Building on it, we present DeepfakeBench-MM, the first unified benchmark for multimodal deepfake detection. It establishes standardized protocols across the entire detection pipeline and serves as a versatile platform for evaluating existing methods as well as exploring novel approaches. DeepfakeBench-MM currently supports 5 datasets and 11 multimodal deepfake detectors. Furthermore, our comprehensive evaluations and in-depth analyses uncover several key findings from multiple perspectives (e.g., augmentation, stacked forgery). We believe that DeepfakeBench-MM, together with our large-scale Mega-MMDF, will serve as foundational infrastructures for advancing multimodal deepfake detection.

Recent studies on face forgery detection have shown satisfactory performance for methods involved in training datasets, but are not ideal enough for unknown domains. This motivates many works to improve the generalization, but forgery-irrelevant information, such as image background and identity, still exists in different domain features and causes unexpected clustering, limiting the generalization. In this paper, we propose a controllable guide-space (GS) method to enhance the discrimination of different forgery domains, so as to increase the forgery relevance of features and thereby improve the generalization. The well-designed guide-space can simultaneously achieve both the proper separation of forgery domains and the large distance between real-forgery domains in an explicit and controllable manner. Moreover, for better discrimination, we use a decoupling module to weaken the interference of forgery-irrelevant correlations between domains. Furthermore, we make adjustments to the decision boundary manifold according to the clustering degree of the same domain features within the neighborhood. Extensive experiments in multiple in-domain and cross-domain settings confirm that our method can achieve state-of-the-art generalization.

Multimodal Large Language Models (MLLMs), such as GPT4o, have shown strong capabilities in visual reasoning and explanation generation. However, despite these strengths, they face significant challenges in the increasingly critical task of Image Forgery Detection and Localization (IFDL). Moreover, existing IFDL methods are typically limited to the learning of low-level semantic-agnostic clues and merely provide a single outcome judgment. To tackle these issues, we propose ForgeryGPT, a novel framework that advances the IFDL task by capturing high-order forensics knowledge correlations of forged images from diverse linguistic feature spaces, while enabling explainable generation and interactive dialogue through a newly customized Large Language Model (LLM) architecture. Specifically, ForgeryGPT enhances traditional LLMs by integrating the Mask-Aware Forgery Extractor, which enables the excavating of precise forgery mask information from input images and facilitating pixel-level understanding of tampering artifacts. The Mask-Aware Forgery Extractor consists of a Forgery Localization Expert (FL-Expert) and a Mask Encoder, where the FL-Expert is augmented with an Object-agnostic Forgery Prompt and a Vocabulary-enhanced Vision Encoder, allowing for effectively capturing of multi-scale fine-grained forgery details. To enhance its performance, we implement a three-stage training strategy, supported by our designed Mask-Text Alignment and IFDL Task-Specific Instruction Tuning datasets, which align vision-language modalities and improve forgery detection and instruction-following capabilities. Extensive experiments demonstrate the effectiveness of the proposed method.

Anomaly detection (AD) aims at detecting abnormal samples that deviate from the expected normal patterns. Generally, it can be trained merely on normal data, without a requirement for abnormal samples, and thereby plays an important role in rare disease recognition and health screening in the medical domain. Despite the emergence of numerous methods for medical AD, the lack of a fair and comprehensive evaluation causes ambiguous conclusions and hinders the development of this field. To address this problem, this paper builds a benchmark with unified comparison. Seven medical datasets with five image modalities, including chest X-rays, brain MRIs, retinal fundus images, dermatoscopic images, and histopathology images, are curated for extensive evaluation. Thirty typical AD methods, including reconstruction and self-supervised learning-based methods, are involved in comparison of image-level anomaly classification and pixel-level anomaly segmentation. Furthermore, for the first time, we systematically investigate the effect of key components in existing methods, revealing unresolved challenges and potential future directions. The datasets and code are available at https://github.com/caiyu6666/MedIAnomaly.

Seeking health-related advice on the internet has become a common practice in the digital era. Determining the trustworthiness of medical claims found online and finding appropriate evidence for this information is increasingly challenging. Fact-checking has emerged as an approach to assess the veracity of factual claims using evidence from credible knowledge sources. To help advance the automation of this task, in this paper, we introduce a novel dataset of 750 health-related claims, labeled for veracity by medical experts and backed with evidence from appropriate clinical studies. We provide an analysis of the dataset, highlighting its characteristics and challenges. The dataset can be used for Machine Learning tasks related to automated fact-checking such as evidence retrieval, veracity prediction, and explanation generation. For this purpose, we provide baseline models based on different approaches, examine their performance, and discuss the findings.

Recent advances in generative artificial intelligence have enabled the creation of highly realistic image forgeries, raising significant concerns about digital media authenticity. While existing detection methods demonstrate promising results on benchmark datasets, they face critical limitations in real-world applications. First, existing detectors typically fail to detect semantic inconsistencies with the person's identity, such as implausible behaviors or incompatible environmental contexts in given images. Second, these methods rely heavily on low-level visual cues, making them effective for known forgeries but less reliable against new or unseen manipulation techniques. To address these challenges, we present a novel personalized vision-language model (VLM) that integrates low-level visual artifact analysis and high-level semantic inconsistency detection. Unlike previous VLM-based methods, our approach avoids resource-intensive supervised fine-tuning that often struggles to preserve distinct identity characteristics. Instead, we employ a lightweight method that dynamically encodes identity-specific information into specialized identifier tokens. This design enables the model to learn distinct identity characteristics while maintaining robust generalization capabilities. We further enhance detection capabilities through a lightweight detection adapter that extracts fine-grained information from shallow features of the vision encoder, preserving critical low-level evidence. Comprehensive experiments demonstrate that our approach achieves 94.25% accuracy and 94.08% F1 score, outperforming both traditional forgery detectors and general VLMs while requiring only 10 extra tokens.

A significant and growing number of published scientific articles is found to involve fraudulent practices, posing a serious threat to the credibility and safety of research in fields such as medicine. We propose Pub-Guard-LLM, the first large language model-based system tailored to fraud detection of biomedical scientific articles. We provide three application modes for deploying Pub-Guard-LLM: vanilla reasoning, retrieval-augmented generation, and multi-agent debate. Each mode allows for textual explanations of predictions. To assess the performance of our system, we introduce an open-source benchmark, PubMed Retraction, comprising over 11K real-world biomedical articles, including metadata and retraction labels. We show that, across all modes, Pub-Guard-LLM consistently surpasses the performance of various baselines and provides more reliable explanations, namely explanations which are deemed more relevant and coherent than those generated by the baselines when evaluated by multiple assessment methods. By enhancing both detection performance and explainability in scientific fraud detection, Pub-Guard-LLM contributes to safeguarding research integrity with a novel, effective, open-source tool.

The development of larger models for medical image analysis has led to increased performance. However, it also affected our ability to explain and validate model decisions. Models can use non-relevant parts of images, also called spurious correlations or shortcuts, to obtain high performance on benchmark datasets but fail in real-world scenarios. In this work, we challenge the capacity of convolutional neural networks (CNN) to classify chest X-rays and eye fundus images while masking out clinically relevant parts of the image. We show that all models trained on the PadChest dataset, irrespective of the masking strategy, are able to obtain an Area Under the Curve (AUC) above random. Moreover, the models trained on full images obtain good performance on images without the region of interest (ROI), even superior to the one obtained on images only containing the ROI. We also reveal a possible spurious correlation in the Chaksu dataset while the performances are more aligned with the expectation of an unbiased model. We go beyond the performance analysis with the usage of the explainability method SHAP and the analysis of embeddings. We asked a radiology resident to interpret chest X-rays under different masking to complement our findings with clinical knowledge. Our code is available at https://github.com/TheoSourget/MMC_Masking and https://github.com/TheoSourget/MMC_Masking_EyeFundus

Anomaly detection in medical images is an important yet challenging task due to the diversity of possible anomalies and the practical impossibility of collecting comprehensively annotated data sets. In this work, we tackle unsupervised medical anomaly detection proposing a modernized autoencoder-based framework, the Q-Former Autoencoder, that leverages state-of-the-art pretrained vision foundation models, such as DINO, DINOv2 and Masked Autoencoder. Instead of training encoders from scratch, we directly utilize frozen vision foundation models as feature extractors, enabling rich, multi-stage, high-level representations without domain-specific fine-tuning. We propose the usage of the Q-Former architecture as the bottleneck, which enables the control of the length of the reconstruction sequence, while efficiently aggregating multiscale features. Additionally, we incorporate a perceptual loss computed using features from a pretrained Masked Autoencoder, guiding the reconstruction towards semantically meaningful structures. Our framework is evaluated on four diverse medical anomaly detection benchmarks, achieving state-of-the-art results on BraTS2021, RESC, and RSNA. Our results highlight the potential of vision foundation model encoders, pretrained on natural images, to generalize effectively to medical image analysis tasks without further fine-tuning. We release the code and models at https://github.com/emirhanbayar/QFAE.

Detecting deepfakes has become an important task. Most existing detection methods provide only real/fake predictions without offering human-comprehensible explanations. Recent studies leveraging MLLMs for deepfake detection have shown improvements in explainability. However, the performance of pre-trained MLLMs (e.g., LLaVA) remains limited due to a lack of understanding of their capabilities for this task and strategies to enhance them. In this work, we empirically assess the strengths and weaknesses of MLLMs specifically in deepfake detection via forgery features analysis. Building on these assessments, we propose a novel framework called {X}^2-DFD, consisting of three core modules. The first module, Model Feature Assessment (MFA), measures the detection capabilities of forgery features intrinsic to MLLMs, and gives a descending ranking of these features. The second module, Strong Feature Strengthening (SFS), enhances the detection and explanation capabilities by fine-tuning the MLLM on a dataset constructed based on the top-ranked features. The third module, Weak Feature Supplementing (WFS), improves the fine-tuned MLLM's capabilities on lower-ranked features by integrating external dedicated deepfake detectors. To verify the effectiveness of this framework, we further present a practical implementation, where an automated forgery features generation, evaluation, and ranking procedure is designed for MFA module; an automated generation procedure of the fine-tuning dataset containing real and fake images with explanations based on top-ranked features is developed for SFS model; an external conventional deepfake detector focusing on blending artifact, which corresponds to a low detection capability in the pre-trained MLLM, is integrated for WFS module. Experiments show that our approach enhances both detection and explanation performance.

Currency recognition systems often overlook usability and authenticity assessment, especially in low-resource environments where visually impaired users and offline validation are common. While existing methods focus on denomination classification, they typically ignore physical degradation and forgery, limiting their applicability in real-world conditions. This paper presents a unified framework for currency evaluation that integrates three modules: denomination classification using lightweight CNN models, damage quantification through a novel Unified Currency Damage Index (UCDI), and counterfeit detection using feature-based template matching. The dataset consists of over 82,000 annotated images spanning clean, damaged, and counterfeit notes. Our Custom_CNN model achieves high classification performance with low parameter count. The UCDI metric provides a continuous usability score based on binary mask loss, chromatic distortion, and structural feature loss. The counterfeit detection module demonstrates reliable identification of forged notes across varied imaging conditions. The framework supports real-time, on-device inference and addresses key deployment challenges in constrained environments. Results show that accurate, interpretable, and compact solutions can support inclusive currency evaluation in practical settings.

Cervical disc herniation (CDH) is a prevalent musculoskeletal disorder that significantly impacts health and requires labor-intensive analysis from experts. Despite advancements in automated detection of medical imaging, two significant challenges hinder the real-world application of these methods. First, the computational complexity and resource demands present a significant gap for real-time application. Second, noise in MRI reduces the effectiveness of existing methods by distorting feature extraction. To address these challenges, we propose three key contributions: Firstly, we introduced MedDet, which leverages the multi-teacher single-student knowledge distillation for model compression and efficiency, meanwhile integrating generative adversarial training to enhance performance. Additionally, we customize the second-order nmODE to improve the model's resistance to noise in MRI. Lastly, we conducted comprehensive experiments on the CDH-1848 dataset, achieving up to a 5% improvement in mAP compared to previous methods. Our approach also delivers over 5 times faster inference speed, with approximately 67.8% reduction in parameters and 36.9% reduction in FLOPs compared to the teacher model. These advancements significantly enhance the performance and efficiency of automated CDH detection, demonstrating promising potential for future application in clinical practice. See project website https://steve-zeyu-zhang.github.io/MedDet

Visual counterfeits are increasingly causing an existential conundrum in mainstream media with rapid evolution in neural image synthesis methods. Though detection of such counterfeits has been a taxing problem in the image forensics community, a recent class of forensic detectors -- universal detectors -- are able to surprisingly spot counterfeit images regardless of generator architectures, loss functions, training datasets, and resolutions. This intriguing property suggests the possible existence of transferable forensic features (T-FF) in universal detectors. In this work, we conduct the first analytical study to discover and understand T-FF in universal detectors. Our contributions are 2-fold: 1) We propose a novel forensic feature relevance statistic (FF-RS) to quantify and discover T-FF in universal detectors and, 2) Our qualitative and quantitative investigations uncover an unexpected finding: color is a critical T-FF in universal detectors. Code and models are available at https://keshik6.github.io/transferable-forensic-features/

The rapid advancements in generative technology have emerged as a double-edged sword. While offering powerful tools that enhance convenience, they also pose significant social concerns. As defenders, current synthetic image detection methods often lack artifact-level textual interpretability and are overly focused on image manipulation detection, and current datasets usually suffer from outdated generators and a lack of fine-grained annotations. In this paper, we introduce SynthScars, a high-quality and diverse dataset consisting of 12,236 fully synthetic images with human-expert annotations. It features 4 distinct image content types, 3 categories of artifacts, and fine-grained annotations covering pixel-level segmentation, detailed textual explanations, and artifact category labels. Furthermore, we propose LEGION (LEarning to Ground and explain for Synthetic Image detectiON), a multimodal large language model (MLLM)-based image forgery analysis framework that integrates artifact detection, segmentation, and explanation. Building upon this capability, we further explore LEGION as a controller, integrating it into image refinement pipelines to guide the generation of higher-quality and more realistic images. Extensive experiments show that LEGION outperforms existing methods across multiple benchmarks, particularly surpassing the second-best traditional expert on SynthScars by 3.31% in mIoU and 7.75% in F1 score. Moreover, the refined images generated under its guidance exhibit stronger alignment with human preferences. The code, model, and dataset will be released.

With the surge in realistic text tampering, detecting fraudulent text in images has gained prominence for maintaining information security. However, the high costs associated with professional text manipulation and annotation limit the availability of real-world datasets, with most relying on synthetic tampering, which inadequately replicates real-world tampering attributes. To address this issue, we present the Real Text Manipulation (RTM) dataset, encompassing 14,250 text images, which include 5,986 manually and 5,258 automatically tampered images, created using a variety of techniques, alongside 3,006 unaltered text images for evaluating solution stability. Our evaluations indicate that existing methods falter in text forgery detection on the RTM dataset. We propose a robust baseline solution featuring a Consistency-aware Aggregation Hub and a Gated Cross Neighborhood-attention Fusion module for efficient multi-modal information fusion, supplemented by a Tampered-Authentic Contrastive Learning module during training, enriching feature representation distinction. This framework, extendable to other dual-stream architectures, demonstrated notable localization performance improvements of 7.33% and 6.38% on manual and overall manipulations, respectively. Our contributions aim to propel advancements in real-world text tampering detection. Code and dataset will be made available at https://github.com/DrLuo/RTM

The progress in generative models, particularly Generative Adversarial Networks (GANs), opened new possibilities for image generation but raised concerns about potential malicious uses, especially in sensitive areas like medical imaging. This study introduces MITS-GAN, a novel approach to prevent tampering in medical images, with a specific focus on CT scans. The approach disrupts the output of the attacker's CT-GAN architecture by introducing finely tuned perturbations that are imperceptible to the human eye. Specifically, the proposed approach involves the introduction of appropriate Gaussian noise to the input as a protective measure against various attacks. Our method aims to enhance tamper resistance, comparing favorably to existing techniques. Experimental results on a CT scan demonstrate MITS-GAN's superior performance, emphasizing its ability to generate tamper-resistant images with negligible artifacts. As image tampering in medical domains poses life-threatening risks, our proactive approach contributes to the responsible and ethical use of generative models. This work provides a foundation for future research in countering cyber threats in medical imaging. Models and codes are publicly available on https://iplab.dmi.unict.it/MITS-GAN-2024/.

Ensuring the quality and integrity of medical images is crucial for maintaining diagnostic accuracy in deep learning-based Computer-Aided Diagnosis and Computer-Aided Detection (CAD) systems. Covariate shifts are subtle variations in the data distribution caused by different imaging devices or settings and can severely degrade model performance, similar to the effects of adversarial attacks. Therefore, it is vital to have a lightweight and fast method to assess the quality of these images prior to using CAD models. AdverX-Ray addresses this need by serving as an image-quality assessment layer, designed to detect covariate shifts effectively. This Adversarial Variational Autoencoder prioritizes the discriminator's role, using the suboptimal outputs of the generator as negative samples to fine-tune the discriminator's ability to identify high-frequency artifacts. Images generated by adversarial networks often exhibit severe high-frequency artifacts, guiding the discriminator to focus excessively on these components. This makes the discriminator ideal for this approach. Trained on patches from X-ray images of specific machine models, AdverX-Ray can evaluate whether a scan matches the training distribution, or if a scan from the same machine is captured under different settings. Extensive comparisons with various OOD detection methods show that AdverX-Ray significantly outperforms existing techniques, achieving a 96.2% average AUROC using only 64 random patches from an X-ray. Its lightweight and fast architecture makes it suitable for real-time applications, enhancing the reliability of medical imaging systems. The code and pretrained models are publicly available.

Detecting forged remote sensing images is becoming increasingly critical, as such imagery plays a vital role in environmental monitoring, urban planning, and national security. While diffusion models have emerged as the dominant paradigm for image generation, their impact on remote sensing forgery detection remains underexplored. Existing benchmarks primarily target GAN-based forgeries or focus on natural images, limiting progress in this critical domain. To address this gap, we introduce RSFAKE-1M, a large-scale dataset of 500K forged and 500K real remote sensing images. The fake images are generated by ten diffusion models fine-tuned on remote sensing data, covering six generation conditions such as text prompts, structural guidance, and inpainting. This paper presents the construction of RSFAKE-1M along with a comprehensive experimental evaluation using both existing detectors and unified baselines. The results reveal that diffusion-based remote sensing forgeries remain challenging for current methods, and that models trained on RSFAKE-1M exhibit notably improved generalization and robustness. Our findings underscore the importance of RSFAKE-1M as a foundation for developing and evaluating next-generation forgery detection approaches in the remote sensing domain. The dataset and other supplementary materials are available at https://huggingface.co/datasets/TZHSW/RSFAKE/.

Rapid spread of false images and videos on online platforms is an emerging problem. Anyone may add, delete, clone or modify people and entities from an image using various editing software which are readily available. This generates false and misleading proof to hide the crime. Now-a-days, these false and counterfeit images and videos are flooding on the internet. These spread false information. Many methods are available in literature for detecting those counterfeit contents but new methods of counterfeiting are also evolving. Generative Adversarial Networks (GAN) are observed to be one effective method as it modifies the context and definition of images producing plausible results via image-to-image translation. This work uses an independent discriminant network that can identify GAN generated image or video. A discriminant network has been created using a convolutional neural network based on InceptionResNetV2. The article also proposes a platform where users can detect forged images and videos. This proposed work has the potential to help the forensics domain to detect counterfeit videos and hidden criminal evidence towards the identification of criminal activities.

Several studies showed that Large Language Models (LLMs) can answer medical questions correctly, even outperforming the average human score in some medical exams. However, to our knowledge, no study has been conducted to assess the ability of language models to validate existing or generated medical text for correctness and consistency. In this paper, we introduce MEDEC (https://github.com/abachaa/MEDEC), the first publicly available benchmark for medical error detection and correction in clinical notes, covering five types of errors (Diagnosis, Management, Treatment, Pharmacotherapy, and Causal Organism). MEDEC consists of 3,848 clinical texts, including 488 clinical notes from three US hospital systems that were not previously seen by any LLM. The dataset has been used for the MEDIQA-CORR shared task to evaluate seventeen participating systems [Ben Abacha et al., 2024]. In this paper, we describe the data creation methods and we evaluate recent LLMs (e.g., o1-preview, GPT-4, Claude 3.5 Sonnet, and Gemini 2.0 Flash) for the tasks of detecting and correcting medical errors requiring both medical knowledge and reasoning capabilities. We also conducted a comparative study where two medical doctors performed the same task on the MEDEC test set. The results showed that MEDEC is a sufficiently challenging benchmark to assess the ability of models to validate existing or generated notes and to correct medical errors. We also found that although recent LLMs have a good performance in error detection and correction, they are still outperformed by medical doctors in these tasks. We discuss the potential factors behind this gap, the insights from our experiments, the limitations of current evaluation metrics, and share potential pointers for future research.

The task of Detecting and Grounding Multi-Modal Media Manipulation (DGM^4) is a branch of misinformation detection. Unlike traditional binary classification, it includes complex subtasks such as forgery content localization and forgery method classification. Consider that existing methods are often limited in performance due to neglecting the erroneous interference caused by unreliable unimodal data and failing to establish comprehensive forgery supervision for mining fine-grained tampering traces. In this paper, we present a Fine-grained Multiple Supervisory (FMS) network, which incorporates modality reliability supervision, unimodal internal supervision and cross-modal supervision to provide comprehensive guidance for DGM^4 detection. For modality reliability supervision, we propose the Multimodal Decision Supervised Correction (MDSC) module. It leverages unimodal weak supervision to correct the multi-modal decision-making process. For unimodal internal supervision, we propose the Unimodal Forgery Mining Reinforcement (UFMR) module. It amplifies the disparity between real and fake information within unimodal modality from both feature-level and sample-level perspectives. For cross-modal supervision, we propose the Multimodal Forgery Alignment Reasoning (MFAR) module. It utilizes soft-attention interactions to achieve cross-modal feature perception from both consistency and inconsistency perspectives, where we also design the interaction constraints to ensure the interaction quality. Extensive experiments demonstrate the superior performance of our FMS compared to state-of-the-art methods.

Artificial intelligence (AI) has significant potential in healthcare applications, but its training and deployment faces challenges due to healthcare's diverse data, complex tasks, and the need to preserve privacy. Foundation models that perform well on medical tasks and require less task-specific tuning data are critical to accelerate the development of healthcare AI applications. We introduce MedGemma, a collection of medical vision-language foundation models based on Gemma 3 4B and 27B. MedGemma demonstrates advanced medical understanding and reasoning on images and text, significantly exceeding the performance of similar-sized generative models and approaching the performance of task-specific models, while maintaining the general capabilities of the Gemma 3 base models. For out-of-distribution tasks, MedGemma achieves 2.6-10% improvement on medical multimodal question answering, 15.5-18.1% improvement on chest X-ray finding classification, and 10.8% improvement on agentic evaluations compared to the base models. Fine-tuning MedGemma further improves performance in subdomains, reducing errors in electronic health record information retrieval by 50% and reaching comparable performance to existing specialized state-of-the-art methods for pneumothorax classification and histopathology patch classification. We additionally introduce MedSigLIP, a medically-tuned vision encoder derived from SigLIP. MedSigLIP powers the visual understanding capabilities of MedGemma and as an encoder achieves comparable or better performance than specialized medical image encoders. Taken together, the MedGemma collection provides a strong foundation of medical image and text capabilities, with potential to significantly accelerate medical research and development of downstream applications. The MedGemma collection, including tutorials and model weights, can be found at https://goo.gle/medgemma.

With the rapid development of artificial intelligence, large language models (LLMs) have shown promising capabilities in mimicking human-level language comprehension and reasoning. This has sparked significant interest in applying LLMs to enhance various aspects of healthcare, ranging from medical education to clinical decision support. However, medicine involves multifaceted data modalities and nuanced reasoning skills, presenting challenges for integrating LLMs. This paper provides a comprehensive review on the applications and implications of LLMs in medicine. It begins by examining the fundamental applications of general-purpose and specialized LLMs, demonstrating their utilities in knowledge retrieval, research support, clinical workflow automation, and diagnostic assistance. Recognizing the inherent multimodality of medicine, the review then focuses on multimodal LLMs, investigating their ability to process diverse data types like medical imaging and EHRs to augment diagnostic accuracy. To address LLMs' limitations regarding personalization and complex clinical reasoning, the paper explores the emerging development of LLM-powered autonomous agents for healthcare. Furthermore, it summarizes the evaluation methodologies for assessing LLMs' reliability and safety in medical contexts. Overall, this review offers an extensive analysis on the transformative potential of LLMs in modern medicine. It also highlights the pivotal need for continuous optimizations and ethical oversight before these models can be effectively integrated into clinical practice. Visit https://github.com/mingze-yuan/Awesome-LLM-Healthcare for an accompanying GitHub repository containing latest papers.

On existing public benchmarks, face forgery detection techniques have achieved great success. However, when used in multi-person videos, which often contain many people active in the scene with only a small subset having been manipulated, their performance remains far from being satisfactory. To take face forgery detection to a new level, we construct a novel large-scale dataset, called FFIW-10K, which comprises 10,000 high-quality forgery videos, with an average of three human faces in each frame. The manipulation procedure is fully automatic, controlled by a domain-adversarial quality assessment network, making our dataset highly scalable with low human cost. In addition, we propose a novel algorithm to tackle the task of multi-person face forgery detection. Supervised by only video-level label, the algorithm explores multiple instance learning and learns to automatically attend to tampered faces. Our algorithm outperforms representative approaches for both forgery classification and localization on FFIW-10K, and also shows high generalization ability on existing benchmarks. We hope that our dataset and study will help the community to explore this new field in more depth.

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.

In this work, we present MedImageInsight, an open-source medical imaging embedding model. MedImageInsight is trained on medical images with associated text and labels across a diverse collection of domains, including X-Ray, CT, MRI, dermoscopy, OCT, fundus photography, ultrasound, histopathology, and mammography. Rigorous evaluations demonstrate MedImageInsight's ability to achieve state-of-the-art (SOTA) or human expert level performance across classification, image-image search, and fine-tuning tasks. Specifically, on public datasets, MedImageInsight achieves SOTA in CT 3D medical image retrieval, as well as SOTA in disease classification and search for chest X-ray, dermatology, and OCT imaging. Furthermore, MedImageInsight achieves human expert performance in bone age estimation (on both public and partner data), as well as AUC above 0.9 in most other domains. When paired with a text decoder, MedImageInsight achieves near SOTA level single image report findings generation with less than 10\% the parameters of other models. Compared to fine-tuning GPT-4o with only MIMIC-CXR data for the same task, MedImageInsight outperforms in clinical metrics, but underperforms on lexical metrics where GPT-4o sets a new SOTA. Importantly for regulatory purposes, MedImageInsight can generate ROC curves, adjust sensitivity and specificity based on clinical need, and provide evidence-based decision support through image-image search (which can also enable retrieval augmented generation). In an independent clinical evaluation of image-image search in chest X-ray, MedImageInsight outperformed every other publicly available foundation model evaluated by large margins (over 6 points AUC), and significantly outperformed other models in terms of AI fairness (across age and gender). We hope releasing MedImageInsight will help enhance collective progress in medical imaging AI research and development.

In recent years, deep learning has greatly streamlined the process of generating realistic fake face images. Aware of the dangers, researchers have developed various tools to spot these counterfeits. Yet none asked the fundamental question: What digital manipulations make a real photographic face image fake, while others do not? In this paper, we put face forgery in a semantic context and define that computational methods that alter semantic face attributes to exceed human discrimination thresholds are sources of face forgery. Guided by our new definition, we construct a large face forgery image dataset, where each image is associated with a set of labels organized in a hierarchical graph. Our dataset enables two new testing protocols to probe the generalization of face forgery detectors. Moreover, we propose a semantics-oriented face forgery detection method that captures label relations and prioritizes the primary task (\ie, real or fake face detection). We show that the proposed dataset successfully exposes the weaknesses of current detectors as the test set and consistently improves their generalizability as the training set. Additionally, we demonstrate the superiority of our semantics-oriented method over traditional binary and multi-class classification-based detectors.

Large numbers of synthesized videos from diffusion models pose threats to information security and authenticity, leading to an increasing demand for generated content detection. However, existing video-level detection algorithms primarily focus on detecting facial forgeries and often fail to identify diffusion-generated content with a diverse range of semantics. To advance the field of video forensics, we propose an innovative algorithm named Multi-Modal Detection(MM-Det) for detecting diffusion-generated videos. MM-Det utilizes the profound perceptual and comprehensive abilities of Large Multi-modal Models (LMMs) by generating a Multi-Modal Forgery Representation (MMFR) from LMM's multi-modal space, enhancing its ability to detect unseen forgery content. Besides, MM-Det leverages an In-and-Across Frame Attention (IAFA) mechanism for feature augmentation in the spatio-temporal domain. A dynamic fusion strategy helps refine forgery representations for the fusion. Moreover, we construct a comprehensive diffusion video dataset, called Diffusion Video Forensics (DVF), across a wide range of forgery videos. MM-Det achieves state-of-the-art performance in DVF, demonstrating the effectiveness of our algorithm. Both source code and DVF are available at https://github.com/SparkleXFantasy/MM-Det.

Handwriting verification has stood as a steadfast identity authentication method for decades. However, this technique risks potential privacy breaches due to the inclusion of personal information in handwritten biometrics such as signatures. To address this concern, we propose using the Random Digit String (RDS) for privacy-preserving handwriting verification. This approach allows users to authenticate themselves by writing an arbitrary digit sequence, effectively ensuring privacy protection. To evaluate the effectiveness of RDS, we construct a new HRDS4BV dataset composed of online naturally handwritten RDS. Unlike conventional handwriting, RDS encompasses unconstrained and variable content, posing significant challenges for modeling consistent personal writing style. To surmount this, we propose the Pattern Attentive VErification Network (PAVENet), along with a Discriminative Pattern Mining (DPM) module. DPM adaptively enhances the recognition of consistent and discriminative writing patterns, thus refining handwriting style representation. Through comprehensive evaluations, we scrutinize the applicability of online RDS verification and showcase a pronounced outperformance of our model over existing methods. Furthermore, we discover a noteworthy forgery phenomenon that deviates from prior findings and discuss its positive impact in countering malicious impostor attacks. Substantially, our work underscores the feasibility of privacy-preserving biometric verification and propels the prospects of its broader acceptance and application.

Deepfake detection remains a challenging task due to the difficulty of generalizing to new types of forgeries. This problem primarily stems from the overfitting of existing detection methods to forgery-irrelevant features and method-specific patterns. The latter is often ignored by previous works. This paper presents a novel approach to address the two types of overfitting issues by uncovering common forgery features. Specifically, we first propose a disentanglement framework that decomposes image information into three distinct components: forgery-irrelevant, method-specific forgery, and common forgery features. To ensure the decoupling of method-specific and common forgery features, a multi-task learning strategy is employed, including a multi-class classification that predicts the category of the forgery method and a binary classification that distinguishes the real from the fake. Additionally, a conditional decoder is designed to utilize forgery features as a condition along with forgery-irrelevant features to generate reconstructed images. Furthermore, a contrastive regularization technique is proposed to encourage the disentanglement of the common and specific forgery features. Ultimately, we only utilize the common forgery features for the purpose of generalizable deepfake detection. Extensive evaluations demonstrate that our framework can perform superior generalization than current state-of-the-art methods.

Recent studies in deepfake detection have yielded promising results when the training and testing face forgeries are from the same dataset. However, the problem remains challenging when one tries to generalize the detector to forgeries created by unseen methods in the training dataset. This work addresses the generalizable deepfake detection from a simple principle: a generalizable representation should be sensitive to diverse types of forgeries. Following this principle, we propose to enrich the "diversity" of forgeries by synthesizing augmented forgeries with a pool of forgery configurations and strengthen the "sensitivity" to the forgeries by enforcing the model to predict the forgery configurations. To effectively explore the large forgery augmentation space, we further propose to use the adversarial training strategy to dynamically synthesize the most challenging forgeries to the current model. Through extensive experiments, we show that the proposed strategies are surprisingly effective (see Figure 1), and they could achieve superior performance than the current state-of-the-art methods. Code is available at https://github.com/liangchen527/SLADD.

We propose a new comprehensive benchmark to revolutionize the current deepfake detection field to the next generation. Predominantly, existing works identify top-notch detection algorithms and models by adhering to the common practice: training detectors on one specific dataset (e.g., FF++) and testing them on other prevalent deepfake datasets. This protocol is often regarded as a "golden compass" for navigating SoTA detectors. But can these stand-out "winners" be truly applied to tackle the myriad of realistic and diverse deepfakes lurking in the real world? If not, what underlying factors contribute to this gap? In this work, we found the dataset (both train and test) can be the "primary culprit" due to: (1) forgery diversity: Deepfake techniques are commonly referred to as both face forgery and entire image synthesis. Most existing datasets only contain partial types of them, with limited forgery methods implemented; (2) forgery realism: The dominated training dataset, FF++, contains out-of-date forgery techniques from the past four years. "Honing skills" on these forgeries makes it difficult to guarantee effective detection generalization toward nowadays' SoTA deepfakes; (3) evaluation protocol: Most detection works perform evaluations on one type, which hinders the development of universal deepfake detectors. To address this dilemma, we construct a highly diverse deepfake detection dataset called DF40, which comprises 40 distinct deepfake techniques. We then conduct comprehensive evaluations using 4 standard evaluation protocols and 8 representative detection methods, resulting in over 2,000 evaluations. Through these evaluations, we provide an extensive analysis from various perspectives, leading to 7 new insightful findings. We also open up 4 valuable yet previously underexplored research questions to inspire future works. Our project page is https://github.com/YZY-stack/DF40.

The automated generation of imaging reports proves invaluable in alleviating the workload of radiologists. A clinically applicable reports generation algorithm should demonstrate its effectiveness in producing reports that accurately describe radiology findings and attend to patient-specific indications. In this paper, we introduce a novel method, Structural Entities extraction and patient indications Incorporation (SEI) for chest X-ray report generation. Specifically, we employ a structural entities extraction (SEE) approach to eliminate presentation-style vocabulary in reports and improve the quality of factual entity sequences. This reduces the noise in the following cross-modal alignment module by aligning X-ray images with factual entity sequences in reports, thereby enhancing the precision of cross-modal alignment and further aiding the model in gradient-free retrieval of similar historical cases. Subsequently, we propose a cross-modal fusion network to integrate information from X-ray images, similar historical cases, and patient-specific indications. This process allows the text decoder to attend to discriminative features of X-ray images, assimilate historical diagnostic information from similar cases, and understand the examination intention of patients. This, in turn, assists in triggering the text decoder to produce high-quality reports. Experiments conducted on MIMIC-CXR validate the superiority of SEI over state-of-the-art approaches on both natural language generation and clinical efficacy metrics.

Training prohibited item detection models requires a large amount of X-ray security images, but collecting and annotating these images is time-consuming and laborious. To address data insufficiency, X-ray security image synthesis methods composite images to scale up datasets. However, previous methods primarily follow a two-stage pipeline, where they implement labor-intensive foreground extraction in the first stage and then composite images in the second stage. Such a pipeline introduces inevitable extra labor cost and is not efficient. In this paper, we propose a one-stage X-ray security image synthesis pipeline (Xsyn) based on text-to-image generation, which incorporates two effective strategies to improve the usability of synthetic images. The Cross-Attention Refinement (CAR) strategy leverages the cross-attention map from the diffusion model to refine the bounding box annotation. The Background Occlusion Modeling (BOM) strategy explicitly models background occlusion in the latent space to enhance imaging complexity. To the best of our knowledge, compared with previous methods, Xsyn is the first to achieve high-quality X-ray security image synthesis without extra labor cost. Experiments demonstrate that our method outperforms all previous methods with 1.2% mAP improvement, and the synthetic images generated by our method are beneficial to improve prohibited item detection performance across various X-ray security datasets and detectors. Code is available at https://github.com/pILLOW-1/Xsyn/.

Deepfake detection is a long-established research topic vital for mitigating the spread of malicious misinformation. Unlike prior methods that provide either binary classification results or textual explanations separately, we introduce a novel method capable of generating both simultaneously. Our method harnesses the multi-modal learning capability of the pre-trained CLIP and the unprecedented interpretability of large language models (LLMs) to enhance both the generalization and explainability of deepfake detection. Specifically, we introduce a multi-modal face forgery detector (M2F2-Det) that employs tailored face forgery prompt learning, incorporating the pre-trained CLIP to improve generalization to unseen forgeries. Also, M2F2-Det incorporates an LLM to provide detailed textual explanations of its detection decisions, enhancing interpretability by bridging the gap between natural language and subtle cues of facial forgeries. Empirically, we evaluate M2F2-Det on both detection and explanation generation tasks, where it achieves state-of-the-art performance, demonstrating its effectiveness in identifying and explaining diverse forgeries.

Images manipulated using image editing tools can mislead viewers and pose significant risks to social security. However, accurately localizing the manipulated regions within an image remains a challenging problem. One of the main barriers in this area is the high cost of data acquisition and the severe lack of high-quality annotated datasets. To address this challenge, we introduce novel methods that mitigate data scarcity by leveraging readily available web data. We utilize a large collection of manually forged images from the web, as well as automatically generated annotations derived from a simpler auxiliary task, constrained image manipulation localization. Specifically, we introduce a new paradigm CAAAv2, which automatically and accurately annotates manipulated regions at the pixel level. To further improve annotation quality, we propose a novel metric, QES, which filters out unreliable annotations. Through CAAA v2 and QES, we construct MIMLv2, a large-scale, diverse, and high-quality dataset containing 246,212 manually forged images with pixel-level mask annotations. This is over 120x larger than existing handcrafted datasets like IMD20. Additionally, we introduce Object Jitter, a technique that further enhances model training by generating high-quality manipulation artifacts. Building on these advances, we develop a new model, Web-IML, designed to effectively leverage web-scale supervision for the image manipulation localization task. Extensive experiments demonstrate that our approach substantially alleviates the data scarcity problem and significantly improves the performance of various models on multiple real-world forgery benchmarks. With the proposed web supervision, Web-IML achieves a striking performance gain of 31% and surpasses previous SOTA TruFor by 24.1 average IoU points. The dataset and code will be made publicly available at https://github.com/qcf-568/MIML.

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.

Annotating medical data for training AI models is often costly and limited due to the shortage of specialists with relevant clinical expertise. This challenge is further compounded by privacy and ethical concerns associated with sensitive patient information. As a result, well-trained medical segmentation models on private datasets constitute valuable intellectual property requiring robust protection mechanisms. Existing model protection techniques primarily focus on classification and generative tasks, while segmentation models-crucial to medical image analysis-remain largely underexplored. In this paper, we propose a novel, stealthy, and harmless method, StealthMark, for verifying the ownership of medical segmentation models under black-box conditions. Our approach subtly modulates model uncertainty without altering the final segmentation outputs, thereby preserving the model's performance. To enable ownership verification, we incorporate model-agnostic explanation methods, e.g. LIME, to extract feature attributions from the model outputs. Under specific triggering conditions, these explanations reveal a distinct and verifiable watermark. We further design the watermark as a QR code to facilitate robust and recognizable ownership claims. We conducted extensive experiments across four medical imaging datasets and five mainstream segmentation models. The results demonstrate the effectiveness, stealthiness, and harmlessness of our method on the original model's segmentation performance. For example, when applied to the SAM model, StealthMark consistently achieved ASR above 95% across various datasets while maintaining less than a 1% drop in Dice and AUC scores, significantly outperforming backdoor-based watermarking methods and highlighting its strong potential for practical deployment. Our implementation code is made available at: https://github.com/Qinkaiyu/StealthMark.

In existing splicing forgery datasets, the insufficient semantic variety of spliced regions causes a problem that trained detection models overfit semantic features rather than splicing traces. Meanwhile, because of the absence of a reasonable dataset, different detection methods proposed cannot reach a consensus on experimental settings. To address these urgent issues, GreatSplicing, an manually created splicing dataset with considerable amount and high quality, is proposed in this paper. GreatSplicing comprises 5,000 spliced images and covers spliced regions with 335 distinct semantic categories, allowing neural networks to grasp splicing traces better. Extensive experiments demonstrate that models trained on GreatSplicing exhibit minimal misidentification rates and superior cross-dataset detection capabilities compared to existing datasets. Furthermore, GreatSplicing is available for all research purposes and could be downloaded from www.greatsplicing.net.

The rapid advancement of Artificial Intelligence Generated Content (AIGC) technologies, particularly in video generation, has led to unprecedented creative capabilities but also increased threats to information integrity, identity security, and public trust. Existing detection methods, while effective in general scenarios, lack robust solutions for human-centric videos, which pose greater risks due to their realism and potential for legal and ethical misuse. Moreover, current detection approaches often suffer from poor generalization, limited scalability, and reliance on labor-intensive supervised fine-tuning. To address these challenges, we propose AvatarShield, the first interpretable MLLM-based framework for detecting human-centric fake videos, enhanced via Group Relative Policy Optimization (GRPO). Through our carefully designed accuracy detection reward and temporal compensation reward, it effectively avoids the use of high-cost text annotation data, enabling precise temporal modeling and forgery detection. Meanwhile, we design a dual-encoder architecture, combining high-level semantic reasoning and low-level artifact amplification to guide MLLMs in effective forgery detection. We further collect FakeHumanVid, a large-scale human-centric video benchmark that includes synthesis methods guided by pose, audio, and text inputs, enabling rigorous evaluation of detection methods in real-world scenes. Extensive experiments show that AvatarShield significantly outperforms existing approaches in both in-domain and cross-domain detection, setting a new standard for human-centric video forensics.

This paper presents a new synthetic dataset of ID and travel documents, called SIDTD. The SIDTD dataset is created to help training and evaluating forged ID documents detection systems. Such a dataset has become a necessity as ID documents contain personal information and a public dataset of real documents can not be released. Moreover, forged documents are scarce, compared to legit ones, and the way they are generated varies from one fraudster to another resulting in a class of high intra-variability. In this paper we trained state-of-the-art models on this dataset and we compare them to the performance achieved in larger, but private, datasets. The creation of this dataset will help to document image analysis community to progress in the task of ID document verification.

Automatic medical report generation (MRG) is of great research value as it has the potential to relieve radiologists from the heavy burden of report writing. Despite recent advancements, accurate MRG remains challenging due to the need for precise clinical understanding and the identification of clinical findings. Moreover, the imbalanced distribution of diseases makes the challenge even more pronounced, as rare diseases are underrepresented in training data, making their diagnostic performance unreliable. To address these challenges, we propose diagnosis-driven prompts for medical report generation (PromptMRG), a novel framework that aims to improve the diagnostic accuracy of MRG with the guidance of diagnosis-aware prompts. Specifically, PromptMRG is based on encoder-decoder architecture with an extra disease classification branch. When generating reports, the diagnostic results from the classification branch are converted into token prompts to explicitly guide the generation process. To further improve the diagnostic accuracy, we design cross-modal feature enhancement, which retrieves similar reports from the database to assist the diagnosis of a query image by leveraging the knowledge from a pre-trained CLIP. Moreover, the disease imbalanced issue is addressed by applying an adaptive logit-adjusted loss to the classification branch based on the individual learning status of each disease, which overcomes the barrier of text decoder's inability to manipulate disease distributions. Experiments on two MRG benchmarks show the effectiveness of the proposed method, where it obtains state-of-the-art clinical efficacy performance on both datasets.

In recent years, methods for producing highly realistic synthetic images have significantly advanced, allowing the creation of high-quality images from text prompts that describe the desired content. Even more impressively, Stable Diffusion (SD) models now provide users with the option of creating synthetic images in an image-to-image translation fashion, modifying images in the latent space of advanced autoencoders. This striking evolution, however, brings an alarming consequence: it is possible to pass an image through SD autoencoders to reproduce a synthetic copy of the image with high realism and almost no visual artifacts. This process, known as SD image laundering, can transform real images into lookalike synthetic ones and risks complicating forensic analysis for content authenticity verification. Our paper investigates the forensic implications of image laundering, revealing a serious potential to obscure traces of real content, including sensitive and harmful materials that could be mistakenly classified as synthetic, thereby undermining the protection of individuals depicted. To address this issue, we propose a two-stage detection pipeline that effectively differentiates between pristine, laundered, and fully synthetic images (those generated from text prompts), showing robustness across various conditions. Finally, we highlight another alarming property of image laundering, which appears to mask the unique artifacts exploited by forensic detectors to solve the camera model identification task, strongly undermining their performance. Our experimental code is available at https://github.com/polimi-ispl/synthetic-image-detection.

Foundation Models that are capable of processing and generating multi-modal data have transformed AI's role in medicine. However, a key limitation of their reliability is hallucination, where inaccurate or fabricated information can impact clinical decisions and patient safety. We define medical hallucination as any instance in which a model generates misleading medical content. This paper examines the unique characteristics, causes, and implications of medical hallucinations, with a particular focus on how these errors manifest themselves in real-world clinical scenarios. Our contributions include (1) a taxonomy for understanding and addressing medical hallucinations, (2) benchmarking models using medical hallucination dataset and physician-annotated LLM responses to real medical cases, providing direct insight into the clinical impact of hallucinations, and (3) a multi-national clinician survey on their experiences with medical hallucinations. Our results reveal that inference techniques such as Chain-of-Thought (CoT) and Search Augmented Generation can effectively reduce hallucination rates. However, despite these improvements, non-trivial levels of hallucination persist. These findings underscore the ethical and practical imperative for robust detection and mitigation strategies, establishing a foundation for regulatory policies that prioritize patient safety and maintain clinical integrity as AI becomes more integrated into healthcare. The feedback from clinicians highlights the urgent need for not only technical advances but also for clearer ethical and regulatory guidelines to ensure patient safety. A repository organizing the paper resources, summaries, and additional information is available at https://github.com/mitmedialab/medical hallucination.

De-identification of electronic health records (EHR) is a vital step towards advancing health informatics research and maximising the use of available data. It is a two-step process where step one is the identification of protected health information (PHI), and step two is replacing such PHI with surrogates. Despite the recent advances in automatic de-identification of EHR, significant obstacles remain if the abundant health data available are to be used to the full potential. Accuracy in de-identification could be considered a necessary, but not sufficient condition for the use of EHR without individual patient consent. We present here a comprehensive review of the progress to date, both the impressive successes in achieving high accuracy and the significant risks and challenges that remain. To best of our knowledge, this is the first paper to present a complete picture of end-to-end automatic de-identification. We review 18 recently published automatic de-identification systems -designed to de-identify EHR in the form of free text- to show the advancements made in improving the overall accuracy of the system, and in identifying individual PHI. We argue that despite the improvements in accuracy there remain challenges in surrogate generation and replacements of identified PHIs, and the risks posed to patient protection and privacy.

Motivated by the strong performance of CLIP-based models in natural image-text domains, recent efforts have adapted these architectures to medical tasks, particularly in radiology, where large paired datasets of images and reports, such as chest X-rays, are available. While these models have shown encouraging results in terms of accuracy and discriminative performance, their fairness and robustness in the different clinical tasks remain largely underexplored. In this study, we extensively evaluate six widely used CLIP-based models on chest X-ray classification using three publicly available datasets: MIMIC-CXR, NIH-CXR14, and NEATX. We assess the models fairness across six conditions and patient subgroups based on age, sex, and race. Additionally, we assess the robustness to shortcut learning by evaluating performance on pneumothorax cases with and without chest drains. Our results indicate performance gaps between patients of different ages, but more equitable results for the other attributes. Moreover, all models exhibit lower performance on images without chest drains, suggesting reliance on spurious correlations. We further complement the performance analysis with a study of the embeddings generated by the models. While the sensitive attributes could be classified from the embeddings, we do not see such patterns using PCA, showing the limitations of these visualisation techniques when assessing models. Our code is available at https://github.com/TheoSourget/clip_cxr_fairness

Existing face forgery detection usually follows the paradigm of training models in a single domain, which leads to limited generalization capacity when unseen scenarios and unknown attacks occur. In this paper, we elaborately investigate the generalization capacity of deepfake detection models when jointly trained on multiple face forgery detection datasets. We first find a rapid degradation of detection accuracy when models are directly trained on combined datasets due to the discrepancy across collection scenarios and generation methods. To address the above issue, a Generalized Multi-Scenario Deepfake Detection framework (GM-DF) is proposed to serve multiple real-world scenarios by a unified model. First, we propose a hybrid expert modeling approach for domain-specific real/forgery feature extraction. Besides, as for the commonality representation, we use CLIP to extract the common features for better aligning visual and textual features across domains. Meanwhile, we introduce a masked image reconstruction mechanism to force models to capture rich forged details. Finally, we supervise the models via a domain-aware meta-learning strategy to further enhance their generalization capacities. Specifically, we design a novel domain alignment loss to strongly align the distributions of the meta-test domains and meta-train domains. Thus, the updated models are able to represent both specific and common real/forgery features across multiple datasets. In consideration of the lack of study of multi-dataset training, we establish a new benchmark leveraging multi-source data to fairly evaluate the models' generalization capacity on unseen scenarios. Both qualitative and quantitative experiments on five datasets conducted on traditional protocols as well as the proposed benchmark demonstrate the effectiveness of our approach.

Automated X-ray inspection is crucial for efficient and unobtrusive security screening in various public settings. However, challenges such as object occlusion, variations in the physical properties of items, diversity in X-ray scanning devices, and limited training data hinder accurate and reliable detection of illicit items. Despite the large body of research in the field, reported experimental evaluations are often incomplete, with frequently conflicting outcomes. To shed light on the research landscape and facilitate further research, a systematic, detailed, and thorough comparative evaluation of recent Deep Learning (DL)-based methods for X-ray object detection is conducted. For this, a comprehensive evaluation framework is developed, composed of: a) Six recent, large-scale, and widely used public datasets for X-ray illicit item detection (OPIXray, CLCXray, SIXray, EDS, HiXray, and PIDray), b) Ten different state-of-the-art object detection schemes covering all main categories in the literature, including generic Convolutional Neural Network (CNN), custom CNN, generic transformer, and hybrid CNN-transformer architectures, and c) Various detection (mAP50 and mAP50:95) and time/computational-complexity (inference time (ms), parameter size (M), and computational load (GFLOPS)) metrics. A thorough analysis of the results leads to critical observations and insights, emphasizing key aspects such as: a) Overall behavior of the object detection schemes, b) Object-level detection performance, c) Dataset-specific observations, and d) Time efficiency and computational complexity analysis. To support reproducibility of the reported experimental results, the evaluation code and model weights are made publicly available at https://github.com/jgenc/xray-comparative-evaluation.

In this paper we present a hybrid method for the automatic detection of dermatological pathologies in medical reports. We use a large language model combined with medical ontologies to predict, given a first appointment or follow-up medical report, the pathology a person may suffer from. The results show that teaching the model to learn the type, severity and location on the body of a dermatological pathology, as well as in which order it has to learn these three features, significantly increases its accuracy. The article presents the demonstration of state-of-the-art results for classification of medical texts with a precision of 0.84, micro and macro F1-score of 0.82 and 0.75, and makes both the method and the data set used available to the community.

Detecting deepfakes has become increasingly challenging as forgery faces synthesized by AI-generated methods, particularly diffusion models, achieve unprecedented quality and resolution. Existing forgery detection approaches relying on spatial and frequency features demonstrate limited efficacy against high-quality, entirely synthesized forgeries. In this paper, we propose a novel detection method grounded in the observation that facial attributes governed by complex physical laws and multiple parameters are inherently difficult to replicate. Specifically, we focus on illumination, particularly the specular reflection component in the Phong illumination model, which poses the greatest replication challenge due to its parametric complexity and nonlinear formulation. We introduce a fast and accurate face texture estimation method based on Retinex theory to enable precise specular reflection separation. Furthermore, drawing from the mathematical formulation of specular reflection, we posit that forgery evidence manifests not only in the specular reflection itself but also in its relationship with corresponding face texture and direct light. To address this issue, we design the Specular-Reflection-Inconsistency-Network (SRI-Net), incorporating a two-stage cross-attention mechanism to capture these correlations and integrate specular reflection related features with image features for robust forgery detection. Experimental results demonstrate that our method achieves superior performance on both traditional deepfake datasets and generative deepfake datasets, particularly those containing diffusion-generated forgery faces.

The emergence and popularity of facial deepfake methods spur the vigorous development of deepfake datasets and facial forgery detection, which to some extent alleviates the security concerns about facial-related artificial intelligence technologies. However, when it comes to human body forgery, there has been a persistent lack of datasets and detection methods, due to the later inception and complexity of human body generation methods. To mitigate this issue, we introduce TikTok-DeepFake (TT-DF), a novel large-scale diffusion-based dataset containing 6,120 forged videos with 1,378,857 synthetic frames, specifically tailored for body forgery detection. TT-DF offers a wide variety of forgery methods, involving multiple advanced human image animation models utilized for manipulation, two generative configurations based on the disentanglement of identity and pose information, as well as different compressed versions. The aim is to simulate any potential unseen forged data in the wild as comprehensively as possible, and we also furnish a benchmark on TT-DF. Additionally, we propose an adapted body forgery detection model, Temporal Optical Flow Network (TOF-Net), which exploits the spatiotemporal inconsistencies and optical flow distribution differences between natural data and forged data. Our experiments demonstrate that TOF-Net achieves favorable performance on TT-DF, outperforming current state-of-the-art extendable facial forgery detection models. For our TT-DF dataset, please refer to https://github.com/HashTAG00002/TT-DF.

Although vanilla Convolutional Neural Network (CNN) based detectors can achieve satisfactory performance on fake face detection, we observe that the detectors tend to seek forgeries on a limited region of face, which reveals that the detectors is short of understanding of forgery. Therefore, we propose an attention-based data augmentation framework to guide detector refine and enlarge its attention. Specifically, our method tracks and occludes the Top-N sensitive facial regions, encouraging the detector to mine deeper into the regions ignored before for more representative forgery. Especially, our method is simple-to-use and can be easily integrated with various CNN models. Extensive experiments show that the detector trained with our method is capable to separately point out the representative forgery of fake faces generated by different manipulation techniques, and our method enables a vanilla CNN-based detector to achieve state-of-the-art performance without structure modification.

Image copy detection (ICD) aims to determine whether a query image is an edited copy of any image from a reference set. Currently, there are very limited public benchmarks for ICD, while all overlook a critical challenge in real-world applications, i.e., the distraction from hard negative queries. Specifically, some queries are not edited copies but are inherently similar to some reference images. These hard negative queries are easily false recognized as edited copies, significantly compromising the ICD accuracy. This observation motivates us to build the first ICD benchmark featuring this characteristic. Based on existing ICD datasets, this paper constructs a new dataset by additionally adding 100, 000 and 24, 252 hard negative pairs into the training and test set, respectively. Moreover, this paper further reveals a unique difficulty for solving the hard negative problem in ICD, i.e., there is a fundamental conflict between current metric learning and ICD. This conflict is: the metric learning adopts symmetric distance while the edited copy is an asymmetric (unidirectional) process, e.g., a partial crop is close to its holistic reference image and is an edited copy, while the latter cannot be the edited copy of the former (in spite the distance is equally small). This insight results in an Asymmetrical-Similarity Learning (ASL) method, which allows the similarity in two directions (the query <-> the reference image) to be different from each other. Experimental results show that ASL outperforms state-of-the-art methods by a clear margin, confirming that solving the symmetric-asymmetric conflict is critical for ICD. The NDEC dataset and code are available at https://github.com/WangWenhao0716/ASL.

Existing AI-generated image (AIGI) detection methods often suffer from limited generalization performance. In this paper, we identify a crucial yet previously overlooked asymmetry phenomenon in AIGI detection: during training, models tend to quickly overfit to specific fake patterns in the training set, while other information is not adequately captured, leading to poor generalization when faced with new fake methods. A key insight is to incorporate the rich semantic knowledge embedded within large-scale vision foundation models (VFMs) to expand the previous discriminative space (based on forgery patterns only), such that the discrimination is decided by both forgery and semantic cues, thereby reducing the overfitting to specific forgery patterns. A straightforward solution is to fully fine-tune VFMs, but it risks distorting the well-learned semantic knowledge, pushing the model back toward overfitting. To this end, we design a novel approach called Effort: Efficient orthogonal modeling for generalizable AIGI detection. Specifically, we employ Singular Value Decomposition (SVD) to construct the orthogonal semantic and forgery subspaces. By freezing the principal components and adapting the residual components (sim0.19M parameters), we preserve the original semantic subspace and use its orthogonal subspace for learning forgeries. Extensive experiments on AIGI detection benchmarks demonstrate the superior effectiveness of our approach.

Large vision-language models (VLMs) are increasingly deployed for optical character recognition (OCR) in healthcare settings, raising critical concerns about protected health information (PHI) exposure during document processing. This work presents the first systematic evaluation of inference-time vision token masking as a privacy-preserving mechanism for medical document OCR using DeepSeek-OCR. We introduce seven masking strategies (V3-V9) targeting different architectural layers (SAM encoder blocks, compression layers, dual vision encoders, projector fusion) and evaluate PHI reduction across HIPAA-defined categories using 100 synthetic medical billing statements (drawn from a corpus of 38,517 annotated documents) with perfect ground-truth annotations. All masking strategies converge to 42.9% PHI reduction, successfully suppressing long-form spatially-distributed identifiers (patient names, dates of birth, physical addresses at 100% effectiveness) while failing to prevent short structured identifiers (medical record numbers, social security numbers, email addresses, account numbers at 0% effectiveness). Ablation studies varying mask expansion radius (r=1,2,3) demonstrate that increased spatial coverage does not improve reduction beyond this ceiling, indicating that language model contextual inference - not insufficient visual masking - drives structured identifier leakage. A simulated hybrid architecture combining vision masking with NLP post-processing achieves 88.6% total PHI reduction (assuming 80% NLP accuracy on remaining identifiers). This negative result establishes boundaries for vision-only privacy interventions in VLMs, provides guidance distinguishing PHI types amenable to vision-level versus language-level redaction, and redirects future research toward decoder-level fine-tuning and hybrid defense-in-depth architectures for HIPAA-compliant medical document processing.

Security concerns related to Large Language Models (LLMs) have been extensively explored, yet the safety implications for Multimodal Large Language Models (MLLMs), particularly in medical contexts (MedMLLMs), remain insufficiently studied. This paper delves into the underexplored security vulnerabilities of MedMLLMs, especially when deployed in clinical environments where the accuracy and relevance of question-and-answer interactions are critically tested against complex medical challenges. By combining existing clinical medical data with atypical natural phenomena, we redefine two types of attacks: mismatched malicious attack (2M-attack) and optimized mismatched malicious attack (O2M-attack). Using our own constructed voluminous 3MAD dataset, which covers a wide range of medical image modalities and harmful medical scenarios, we conduct a comprehensive analysis and propose the MCM optimization method, which significantly enhances the attack success rate on MedMLLMs. Evaluations with this dataset and novel attack methods, including white-box attacks on LLaVA-Med and transfer attacks on four other state-of-the-art models, indicate that even MedMLLMs designed with enhanced security features are vulnerable to security breaches. Our work underscores the urgent need for a concerted effort to implement robust security measures and enhance the safety and efficacy of open-source MedMLLMs, particularly given the potential severity of jailbreak attacks and other malicious or clinically significant exploits in medical settings. For further research and replication, anonymous access to our code is available at https://github.com/dirtycomputer/O2M_attack. Warning: Medical large model jailbreaking may generate content that includes unverified diagnoses and treatment recommendations. Always consult professional medical advice.

We present our on-going effort of constructing a large-scale benchmark for face forgery detection. The first version of this benchmark, DeeperForensics-1.0, represents the largest face forgery detection dataset by far, with 60,000 videos constituted by a total of 17.6 million frames, 10 times larger than existing datasets of the same kind. Extensive real-world perturbations are applied to obtain a more challenging benchmark of larger scale and higher diversity. All source videos in DeeperForensics-1.0 are carefully collected, and fake videos are generated by a newly proposed end-to-end face swapping framework. The quality of generated videos outperforms those in existing datasets, validated by user studies. The benchmark features a hidden test set, which contains manipulated videos achieving high deceptive scores in human evaluations. We further contribute a comprehensive study that evaluates five representative detection baselines and make a thorough analysis of different settings.

Deepfake has taken the world by storm, triggering a trust crisis. Current deepfake detection methods are typically inadequate in generalizability, with a tendency to overfit to image contents such as the background, which are frequently occurring but relatively unimportant in the training dataset. Furthermore, current methods heavily rely on a few dominant forgery regions and may ignore other equally important regions, leading to inadequate uncovering of forgery cues. In this paper, we strive to address these shortcomings from three aspects: (1) We propose an innovative two-stream network that effectively enlarges the potential regions from which the model extracts forgery evidence. (2) We devise three functional modules to handle the multi-stream and multi-scale features in a collaborative learning scheme. (3) Confronted with the challenge of obtaining forgery annotations, we propose a Semi-supervised Patch Similarity Learning strategy to estimate patch-level forged location annotations. Empirically, our method demonstrates significantly improved robustness and generalizability, outperforming previous methods on six benchmarks, and improving the frame-level AUC on Deepfake Detection Challenge preview dataset from 0.797 to 0.835 and video-level AUC on CelebDF_v1 dataset from 0.811 to 0.847. Our implementation is available at https://github.com/sccsok/Locate-and-Verify.

This short technical report demonstrates a simple technique that yields state of the art results in medical image-text matching tasks. We analyze the use of OpenAI's CLIP, a general image-text matching model, and observe that CLIP's limited textual input size has negative impact on downstream performance in the medical domain where encoding longer textual contexts is often required. We thus train and release ClipMD, which is trained with a simple sliding window technique to encode textual captions. ClipMD was tested on two medical image-text datasets and compared with other image-text matching models. The results show that ClipMD outperforms other models on both datasets by a large margin. We make our code and pretrained model publicly available.

The remarkable ease of use of diffusion models for image generation has led to a proliferation of synthetic content online. While these models are often employed for legitimate purposes, they are also used to generate fake images that support misinformation and hate speech. Consequently, it is crucial to develop robust tools capable of detecting whether an image has been generated by such models. Many current detection methods, however, require large volumes of sample images for training. Unfortunately, due to the rapid evolution of the field, existing datasets often cover only a limited range of models and quickly become outdated. In this work, we introduce DRAGON, a comprehensive dataset comprising images from 25 diffusion models, spanning both recent advancements and older, well-established architectures. The dataset contains a broad variety of images representing diverse subjects. To enhance image realism, we propose a simple yet effective pipeline that leverages a large language model to expand input prompts, thereby generating more diverse and higher-quality outputs, as evidenced by improvements in standard quality metrics. The dataset is provided in multiple sizes (ranging from extra-small to extra-large) to accomodate different research scenarios. DRAGON is designed to support the forensic community in developing and evaluating detection and attribution techniques for synthetic content. Additionally, the dataset is accompanied by a dedicated test set, intended to serve as a benchmark for assessing the performance of newly developed methods.

Simultaneous localisation and categorization of objects in medical images, also referred to as medical object detection, is of high clinical relevance because diagnostic decisions often depend on rating of objects rather than e.g. pixels. For this task, the cumbersome and iterative process of method configuration constitutes a major research bottleneck. Recently, nnU-Net has tackled this challenge for the task of image segmentation with great success. Following nnU-Net's agenda, in this work we systematize and automate the configuration process for medical object detection. The resulting self-configuring method, nnDetection, adapts itself without any manual intervention to arbitrary medical detection problems while achieving results en par with or superior to the state-of-the-art. We demonstrate the effectiveness of nnDetection on two public benchmarks, ADAM and LUNA16, and propose 11 further medical object detection tasks on public data sets for comprehensive method evaluation. Code is at https://github.com/MIC-DKFZ/nnDetection .

Signature synthesis is a computation technique that generates artificial specimens which can support decision making in automatic signature verification. A lot of work has been dedicated to this subject, which centres on synthesizing dynamic and static two-dimensional handwriting on canvas. This paper proposes a framework to generate synthetic 3D on-air signatures exploiting the lognormality principle, which mimics the complex neuromotor control processes at play as the fingertip moves. Addressing the usual cases involving the development of artificial individuals and duplicated samples, this paper contributes to the synthesis of: (1) the trajectory and velocity of entirely 3D new signatures; (2) kinematic information when only the 3D trajectory of the signature is known, and (3) duplicate samples of 3D real signatures. Validation was conducted by generating synthetic 3D signature databases mimicking real ones and showing that automatic signature verifications of genuine and skilled forgeries report performances similar to those of real and synthetic databases. We also observed that training 3D automatic signature verifiers with duplicates can reduce errors. We further demonstrated that our proposal is also valid for synthesizing 3D air writing and gestures. Finally, a perception test confirmed the human likeness of the generated specimens. The databases generated are publicly available, only for research purposes, at .

Recent image manipulation localization and detection techniques typically leverage forensic artifacts and traces that are produced by a noise-sensitive filter, such as SRM or Bayar convolution. In this paper, we showcase that different filters commonly used in such approaches excel at unveiling different types of manipulations and provide complementary forensic traces. Thus, we explore ways of combining the outputs of such filters to leverage the complementary nature of the produced artifacts for performing image manipulation localization and detection (IMLD). We assess two distinct combination methods: one that produces independent features from each forensic filter and then fuses them (this is referred to as late fusion) and one that performs early mixing of different modal outputs and produces combined features (this is referred to as early fusion). We use the latter as a feature encoding mechanism, accompanied by a new decoding mechanism that encompasses feature re-weighting, for formulating the proposed MMFusion architecture. We demonstrate that MMFusion achieves competitive performance for both image manipulation localization and detection, outperforming state-of-the-art models across several image and video datasets. We also investigate further the contribution of each forensic filter within MMFusion for addressing different types of manipulations, building on recent AI explainability measures.

Since the proliferation of LLMs, there have been concerns about their misuse for harmful content creation and spreading. Recent studies justify such fears, providing evidence of LLM vulnerabilities and high potential of their misuse. Humans are no longer able to distinguish between high-quality machine-generated and authentic human-written texts. Therefore, it is crucial to develop automated means to accurately detect machine-generated content. It would enable to identify such content in online information space, thus providing an additional information about its credibility. This work addresses the problem by proposing a robust fine-tuning process of LLMs for the detection task, making the detectors more robust against obfuscation and more generalizable to out-of-distribution data.

Artificial intelligence is revealing what medicine never intended to encode. Deep vision models, trained on chest X-rays, can now detect not only disease but also invisible traces of social inequality. In this study, we show that state-of-the-art architectures (DenseNet121, SwinV2-B, MedMamba) can predict a patient's health insurance type, a strong proxy for socioeconomic status, from normal chest X-rays with significant accuracy (AUC around 0.70 on MIMIC-CXR-JPG, 0.68 on CheXpert). The signal was unlikely contributed by demographic features by our machine learning study combining age, race, and sex labels to predict health insurance types; it also remains detectable when the model is trained exclusively on a single racial group. Patch-based occlusion reveals that the signal is diffuse rather than localized, embedded in the upper and mid-thoracic regions. This suggests that deep networks may be internalizing subtle traces of clinical environments, equipment differences, or care pathways; learning socioeconomic segregation itself. These findings challenge the assumption that medical images are neutral biological data. By uncovering how models perceive and exploit these hidden social signatures, this work reframes fairness in medical AI: the goal is no longer only to balance datasets or adjust thresholds, but to interrogate and disentangle the social fingerprints embedded in clinical data itself.

Medical Vision-Language Models (MVLMs) have achieved par excellence generalization in medical image analysis, yet their performance under noisy, corrupted conditions remains largely untested. Clinical imaging is inherently susceptible to acquisition artifacts and noise; however, existing evaluations predominantly assess generally clean datasets, overlooking robustness -- i.e., the model's ability to perform under real-world distortions. To address this gap, we first introduce MediMeta-C, a corruption benchmark that systematically applies several perturbations across multiple medical imaging datasets. Combined with MedMNIST-C, this establishes a comprehensive robustness evaluation framework for MVLMs. We further propose RobustMedCLIP, a visual encoder adaptation of a pretrained MVLM that incorporates few-shot tuning to enhance resilience against corruptions. Through extensive experiments, we benchmark 5 major MVLMs across 5 medical imaging modalities, revealing that existing models exhibit severe degradation under corruption and struggle with domain-modality tradeoffs. Our findings highlight the necessity of diverse training and robust adaptation strategies, demonstrating that efficient low-rank adaptation when paired with few-shot tuning, improves robustness while preserving generalization across modalities.

Patient notes contain a wealth of information of potentially great interest to medical investigators. However, to protect patients' privacy, Protected Health Information (PHI) must be removed from the patient notes before they can be legally released, a process known as patient note de-identification. The main objective for a de-identification system is to have the highest possible recall. Recently, the first neural-network-based de-identification system has been proposed, yielding state-of-the-art results. Unlike other systems, it does not rely on human-engineered features, which allows it to be quickly deployed, but does not leverage knowledge from human experts or from electronic health records (EHRs). In this work, we explore a method to incorporate human-engineered features as well as features derived from EHRs to a neural-network-based de-identification system. Our results show that the addition of features, especially the EHR-derived features, further improves the state-of-the-art in patient note de-identification, including for some of the most sensitive PHI types such as patient names. Since in a real-life setting patient notes typically come with EHRs, we recommend developers of de-identification systems to leverage the information EHRs contain.

LLM watermarks stand out as a promising way to attribute ownership of LLM-generated text. One threat to watermark credibility comes from spoofing attacks, where an unauthorized third party forges the watermark, enabling it to falsely attribute arbitrary texts to a particular LLM. While recent works have demonstrated that state-of-the-art schemes are in fact vulnerable to spoofing, they lack deeper qualitative analysis of the texts produced by spoofing methods. In this work, we for the first time reveal that there are observable differences between genuine and spoofed watermark texts. Namely, we show that regardless of their underlying approach, all current spoofing methods consistently leave observable artifacts in spoofed texts, indicative of watermark forgery. We build upon these findings to propose rigorous statistical tests that reliably reveal the presence of such artifacts, effectively discovering that a watermark was spoofed. Our experimental evaluation shows high test power across all current spoofing methods, providing insights into their fundamental limitations, and suggesting a way to mitigate this threat.

Advances in photo editing and manipulation tools have made it significantly easier to create fake imagery. Learning to detect such manipulations, however, remains a challenging problem due to the lack of sufficient amounts of manipulated training data. In this paper, we propose a learning algorithm for detecting visual image manipulations that is trained only using a large dataset of real photographs. The algorithm uses the automatically recorded photo EXIF metadata as supervisory signal for training a model to determine whether an image is self-consistent -- that is, whether its content could have been produced by a single imaging pipeline. We apply this self-consistency model to the task of detecting and localizing image splices. The proposed method obtains state-of-the-art performance on several image forensics benchmarks, despite never seeing any manipulated images at training. That said, it is merely a step in the long quest for a truly general purpose visual forensics tool.

Multimodal models trained on large natural image-text pair datasets have exhibited astounding abilities in generating high-quality images. Medical imaging data is fundamentally different to natural images, and the language used to succinctly capture relevant details in medical data uses a different, narrow but semantically rich, domain-specific vocabulary. Not surprisingly, multi-modal models trained on natural image-text pairs do not tend to generalize well to the medical domain. Developing generative imaging models faithfully representing medical concepts while providing compositional diversity could mitigate the existing paucity of high-quality, annotated medical imaging datasets. In this work, we develop a strategy to overcome the large natural-medical distributional shift by adapting a pre-trained latent diffusion model on a corpus of publicly available chest x-rays (CXR) and their corresponding radiology (text) reports. We investigate the model's ability to generate high-fidelity, diverse synthetic CXR conditioned on text prompts. We assess the model outputs quantitatively using image quality metrics, and evaluate image quality and text-image alignment by human domain experts. We present evidence that the resulting model (RoentGen) is able to create visually convincing, diverse synthetic CXR images, and that the output can be controlled to a new extent by using free-form text prompts including radiology-specific language. Fine-tuning this model on a fixed training set and using it as a data augmentation method, we measure a 5% improvement of a classifier trained jointly on synthetic and real images, and a 3% improvement when trained on a larger but purely synthetic training set. Finally, we observe that this fine-tuning distills in-domain knowledge in the text-encoder and can improve its representation capabilities of certain diseases like pneumothorax by 25%.

As synthetic media, including video, audio, and text, become increasingly indistinguishable from real content, the risks of misinformation, identity fraud, and social manipulation escalate. This survey traces the evolution of deepfake detection from early single-modal methods to sophisticated multi-modal approaches that integrate audio-visual and text-visual cues. We present a structured taxonomy of detection techniques and analyze the transition from GAN-based to diffusion model-driven deepfakes, which introduce new challenges due to their heightened realism and robustness against detection. Unlike prior surveys that primarily focus on single-modal detection or earlier deepfake techniques, this work provides the most comprehensive study to date, encompassing the latest advancements in multi-modal deepfake detection, generalization challenges, proactive defense mechanisms, and emerging datasets specifically designed to support new interpretability and reasoning tasks. We further explore the role of Vision-Language Models (VLMs) and Multimodal Large Language Models (MLLMs) in strengthening detection robustness against increasingly sophisticated deepfake attacks. By systematically categorizing existing methods and identifying emerging research directions, this survey serves as a foundation for future advancements in combating AI-generated facial forgeries. A curated list of all related papers can be found at https://github.com/qiqitao77/Comprehensive-Advances-in-Deepfake-Detection-Spanning-Diverse-Modalities{https://github.com/qiqitao77/Awesome-Comprehensive-Deepfake-Detection}.

The widespread dissemination of Deepfakes demands effective approaches that can detect perceptually convincing forged images. In this paper, we aim to capture the subtle manipulation artifacts at different scales using transformer models. In particular, we introduce a Multi-modal Multi-scale TRansformer (M2TR), which operates on patches of different sizes to detect local inconsistencies in images at different spatial levels. M2TR further learns to detect forgery artifacts in the frequency domain to complement RGB information through a carefully designed cross modality fusion block. In addition, to stimulate Deepfake detection research, we introduce a high-quality Deepfake dataset, SR-DF, which consists of 4,000 DeepFake videos generated by state-of-the-art face swapping and facial reenactment methods. We conduct extensive experiments to verify the effectiveness of the proposed method, which outperforms state-of-the-art Deepfake detection methods by clear margins.

The rapid advancement of face forgery techniques has introduced a growing variety of forgeries. Incremental Face Forgery Detection (IFFD), involving gradually adding new forgery data to fine-tune the previously trained model, has been introduced as a promising strategy to deal with evolving forgery methods. However, a naively trained IFFD model is prone to catastrophic forgetting when new forgeries are integrated, as treating all forgeries as a single ''Fake" class in the Real/Fake classification can cause different forgery types overriding one another, thereby resulting in the forgetting of unique characteristics from earlier tasks and limiting the model's effectiveness in learning forgery specificity and generality. In this paper, we propose to stack the latent feature distributions of previous and new tasks brick by brick, i.e., achieving aligned feature isolation. In this manner, we aim to preserve learned forgery information and accumulate new knowledge by minimizing distribution overriding, thereby mitigating catastrophic forgetting. To achieve this, we first introduce Sparse Uniform Replay (SUR) to obtain the representative subsets that could be treated as the uniformly sparse versions of the previous global distributions. We then propose a Latent-space Incremental Detector (LID) that leverages SUR data to isolate and align distributions. For evaluation, we construct a more advanced and comprehensive benchmark tailored for IFFD. The leading experimental results validate the superiority of our method.

The digitization of healthcare has facilitated the sharing and re-using of medical data but has also raised concerns about confidentiality and privacy. HIPAA (Health Insurance Portability and Accountability Act) mandates removing re-identifying information before the dissemination of medical records. Thus, effective and efficient solutions for de-identifying medical data, especially those in free-text forms, are highly needed. While various computer-assisted de-identification methods, including both rule-based and learning-based, have been developed and used in prior practice, such solutions still lack generalizability or need to be fine-tuned according to different scenarios, significantly imposing restrictions in wider use. The advancement of large language models (LLM), such as ChatGPT and GPT-4, have shown great potential in processing text data in the medical domain with zero-shot in-context learning, especially in the task of privacy protection, as these models can identify confidential information by their powerful named entity recognition (NER) capability. In this work, we developed a novel GPT4-enabled de-identification framework (``DeID-GPT") to automatically identify and remove the identifying information. Compared to existing commonly used medical text data de-identification methods, our developed DeID-GPT showed the highest accuracy and remarkable reliability in masking private information from the unstructured medical text while preserving the original structure and meaning of the text. This study is one of the earliest to utilize ChatGPT and GPT-4 for medical text data processing and de-identification, which provides insights for further research and solution development on the use of LLMs such as ChatGPT/GPT-4 in healthcare. Codes and benchmarking data information are available at https://github.com/yhydhx/ChatGPT-API.

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.

Multimodal language models (MLMs) show promise for clinical decision support and diagnostic reasoning, raising the prospect of end-to-end automated medical image interpretation. However, clinicians are highly selective in adopting AI tools; a model that makes errors on seemingly simple perception tasks such as determining image orientation or identifying whether a CT scan is contrast-enhance are unlikely to be adopted for clinical tasks. We introduce Medblink, a benchmark designed to probe these models for such perceptual abilities. Medblink spans eight clinically meaningful tasks across multiple imaging modalities and anatomical regions, totaling 1,429 multiple-choice questions over 1,605 images. We evaluate 19 state-of-the-art MLMs, including general purpose (GPT4o, Claude 3.5 Sonnet) and domain specific (Med Flamingo, LLaVA Med, RadFM) models. While human annotators achieve 96.4% accuracy, the best-performing model reaches only 65%. These results show that current MLMs frequently fail at routine perceptual checks, suggesting the need to strengthen their visual grounding to support clinical adoption. Data is available on our project page.

Detecting unknown deepfake manipulations remains one of the most challenging problems in face forgery detection. Current state-of-the-art approaches fail to generalize to unseen manipulations, as they primarily rely on supervised training with existing deepfakes or pseudo-fakes, which leads to overfitting to specific forgery patterns. In contrast, self-supervised methods offer greater potential for generalization, but existing work struggles to learn discriminative representations only from self-supervision. In this paper, we propose ExposeAnyone, a fully self-supervised approach based on a diffusion model that generates expression sequences from audio. The key idea is, once the model is personalized to specific subjects using reference sets, it can compute the identity distances between suspected videos and personalized subjects via diffusion reconstruction errors, enabling person-of-interest face forgery detection. Extensive experiments demonstrate that 1) our method outperforms the previous state-of-the-art method by 4.22 percentage points in the average AUC on DF-TIMIT, DFDCP, KoDF, and IDForge datasets, 2) our model is also capable of detecting Sora2-generated videos, where the previous approaches perform poorly, and 3) our method is highly robust to corruptions such as blur and compression, highlighting the applicability in real-world face forgery detection.

Visual Language Models (VLMs) have demonstrated impressive capabilities in visual grounding tasks. However, their effectiveness in the medical domain, particularly for abnormality detection and localization within medical images, remains underexplored. A major challenge is the complex and abstract nature of medical terminology, which makes it difficult to directly associate pathological anomaly terms with their corresponding visual features. In this work, we introduce a novel approach to enhance VLM performance in medical abnormality detection and localization by leveraging decomposed medical knowledge. Instead of directly prompting models to recognize specific abnormalities, we focus on breaking down medical concepts into fundamental attributes and common visual patterns. This strategy promotes a stronger alignment between textual descriptions and visual features, improving both the recognition and localization of abnormalities in medical images.We evaluate our method on the 0.23B Florence-2 base model and demonstrate that it achieves comparable performance in abnormality grounding to significantly larger 7B LLaVA-based medical VLMs, despite being trained on only 1.5% of the data used for such models. Experimental results also demonstrate the effectiveness of our approach in both known and previously unseen abnormalities, suggesting its strong generalization capabilities.

With recent advances in computer vision and graphics, it is now possible to generate videos with extremely realistic synthetic faces, even in real time. Countless applications are possible, some of which raise a legitimate alarm, calling for reliable detectors of fake videos. In fact, distinguishing between original and manipulated video can be a challenge for humans and computers alike, especially when the videos are compressed or have low resolution, as it often happens on social networks. Research on the detection of face manipulations has been seriously hampered by the lack of adequate datasets. To this end, we introduce a novel face manipulation dataset of about half a million edited images (from over 1000 videos). The manipulations have been generated with a state-of-the-art face editing approach. It exceeds all existing video manipulation datasets by at least an order of magnitude. Using our new dataset, we introduce benchmarks for classical image forensic tasks, including classification and segmentation, considering videos compressed at various quality levels. In addition, we introduce a benchmark evaluation for creating indistinguishable forgeries with known ground truth; for instance with generative refinement models.

Highly realistic AI generated face forgeries known as deepfakes have raised serious social concerns. Although DNN-based face forgery detection models have achieved good performance, they are vulnerable to latest generative methods that have less forgery traces and adversarial attacks. This limitation of generalization and robustness hinders the credibility of detection results and requires more explanations. In this work, we provide counterfactual explanations for face forgery detection from an artifact removal perspective. Specifically, we first invert the forgery images into the StyleGAN latent space, and then adversarially optimize their latent representations with the discrimination supervision from the target detection model. We verify the effectiveness of the proposed explanations from two aspects: (1) Counterfactual Trace Visualization: the enhanced forgery images are useful to reveal artifacts by visually contrasting the original images and two different visualization methods; (2) Transferable Adversarial Attacks: the adversarial forgery images generated by attacking the detection model are able to mislead other detection models, implying the removed artifacts are general. Extensive experiments demonstrate that our method achieves over 90% attack success rate and superior attack transferability. Compared with naive adversarial noise methods, our method adopts both generative and discriminative model priors, and optimize the latent representations in a synthesis-by-analysis way, which forces the search of counterfactual explanations on the natural face manifold. Thus, more general counterfactual traces can be found and better adversarial attack transferability can be achieved.

Convolutional networks, transformers, hybrid models, and Mamba-based architectures have demonstrated strong performance across various medical image classification tasks. However, these methods were primarily designed to classify clean images using labeled data. In contrast, real-world clinical data often involve image corruptions that are unique to multi-center studies and stem from variations in imaging equipment across manufacturers. In this paper, we introduce the Medical Vision Transformer (MedViTV2), a novel architecture incorporating Kolmogorov-Arnold Network (KAN) layers into the transformer architecture for the first time, aiming for generalized medical image classification. We have developed an efficient KAN block to reduce computational load while enhancing the accuracy of the original MedViT. Additionally, to counteract the fragility of our MedViT when scaled up, we propose an enhanced Dilated Neighborhood Attention (DiNA), an adaptation of the efficient fused dot-product attention kernel capable of capturing global context and expanding receptive fields to scale the model effectively and addressing feature collapse issues. Moreover, a hierarchical hybrid strategy is introduced to stack our Local Feature Perception and Global Feature Perception blocks in an efficient manner, which balances local and global feature perceptions to boost performance. Extensive experiments on 17 medical image classification datasets and 12 corrupted medical image datasets demonstrate that MedViTV2 achieved state-of-the-art results in 27 out of 29 experiments with reduced computational complexity. MedViTV2 is 44\% more computationally efficient than the previous version and significantly enhances accuracy, achieving improvements of 4.6\% on MedMNIST, 5.8\% on NonMNIST, and 13.4\% on the MedMNIST-C benchmark.

Sophisticated text-centric forgeries, fueled by rapid AIGC advancements, pose a significant threat to societal security and information authenticity. Current methods for text-centric forgery analysis are often limited to coarse-grained visual analysis and lack the capacity for sophisticated reasoning. Moreover, they typically treat detection, grounding, and explanation as discrete sub-tasks, overlooking their intrinsic relationships for holistic performance enhancement. To address these challenges, we introduce LogicLens, a unified framework for Visual-Textual Co-reasoning that reformulates these objectives into a joint task. The deep reasoning of LogicLens is powered by our novel Cross-Cues-aware Chain of Thought (CCT) mechanism, which iteratively cross-validates visual cues against textual logic. To ensure robust alignment across all tasks, we further propose a weighted multi-task reward function for GRPO-based optimization. Complementing this framework, we first designed the PR^2 (Perceiver, Reasoner, Reviewer) pipeline, a hierarchical and iterative multi-agent system that generates high-quality, cognitively-aligned annotations. Then, we constructed RealText, a diverse dataset comprising 5,397 images with fine-grained annotations, including textual explanations, pixel-level segmentation, and authenticity labels for model training. Extensive experiments demonstrate the superiority of LogicLens across multiple benchmarks. In a zero-shot evaluation on T-IC13, it surpasses the specialized framework by 41.4% and GPT-4o by 23.4% in macro-average F1 score. Moreover, on the challenging dense-text T-SROIE dataset, it establishes a significant lead over other MLLM-based methods in mF1, CSS, and the macro-average F1. Our dataset, model, and code will be made publicly available.

Multimodal Large Language Models (MLLMs) have tremendous potential to improve the accuracy, availability, and cost-effectiveness of healthcare by providing automated solutions or serving as aids to medical professionals. Despite promising first steps in developing medical MLLMs in the past few years, their capabilities and limitations are not well-understood. Recently, many benchmark datasets have been proposed that test the general medical knowledge of such models across a variety of medical areas. However, the systematic failure modes and vulnerabilities of such models are severely underexplored with most medical benchmarks failing to expose the shortcomings of existing models in this safety-critical domain. In this paper, we introduce MediConfusion, a challenging medical Visual Question Answering (VQA) benchmark dataset, that probes the failure modes of medical MLLMs from a vision perspective. We reveal that state-of-the-art models are easily confused by image pairs that are otherwise visually dissimilar and clearly distinct for medical experts. Strikingly, all available models (open-source or proprietary) achieve performance below random guessing on MediConfusion, raising serious concerns about the reliability of existing medical MLLMs for healthcare deployment. We also extract common patterns of model failure that may help the design of a new generation of more trustworthy and reliable MLLMs in healthcare.

Trustworthiness is essential for the precise and interpretable application of artificial intelligence (AI) in medical imaging. Traditionally, precision and interpretability have been addressed as separate tasks, namely medical image analysis and explainable AI, each developing its own models independently. In this study, for the first time, we investigate the development of a unified medical vision-language pre-training model that can achieve both accurate analysis and interpretable understanding of medical images across various modalities. To build the model, we construct MedConcept-23M, a large-scale dataset comprising 23 million medical image-text pairs extracted from 6.2 million scientific articles, enriched with concepts from the Unified Medical Language System (UMLS). Based on MedConcept-23M, we introduce ConceptCLIP, a medical AI model utilizing concept-enhanced contrastive language-image pre-training. The pre-training of ConceptCLIP involves two primary components: image-text alignment learning (IT-Align) and patch-concept alignment learning (PC-Align). This dual alignment strategy enhances the model's capability to associate specific image regions with relevant concepts, thereby improving both the precision of analysis and the interpretability of the AI system. We conducted extensive experiments on 5 diverse types of medical image analysis tasks, spanning 51 subtasks across 10 image modalities, with the broadest range of downstream tasks. The results demonstrate the effectiveness of the proposed vision-language pre-training model. Further explainability analysis across 6 modalities reveals that ConceptCLIP achieves superior performance, underscoring its robust ability to advance explainable AI in medical imaging. These findings highlight ConceptCLIP's capability in promoting trustworthy AI in the field of medicine.

Assessing whether an article supports an assertion is essential for hallucination detection and claim verification. While large language models (LLMs) have the potential to automate this task, achieving strong performance requires frontier models such as GPT-5 that are prohibitively expensive to deploy at scale. To efficiently perform biomedical evidence attribution, we present Med-V1, a family of small language models with only three billion parameters. Trained on high-quality synthetic data newly developed in this study, Med-V1 substantially outperforms (+27.0% to +71.3%) its base models on five biomedical benchmarks unified into a verification format. Despite its smaller size, Med-V1 performs comparably to frontier LLMs such as GPT-5, along with high-quality explanations for its predictions. We use Med-V1 to conduct a first-of-its-kind use case study that quantifies hallucinations in LLM-generated answers under different citation instructions. Results show that the format instruction strongly affects citation validity and hallucination, with GPT-5 generating more claims but exhibiting hallucination rates similar to GPT-4o. Additionally, we present a second use case showing that Med-V1 can automatically identify high-stakes evidence misattributions in clinical practice guidelines, revealing potentially negative public health impacts that are otherwise challenging to identify at scale. Overall, Med-V1 provides an efficient and accurate lightweight alternative to frontier LLMs for practical and real-world applications in biomedical evidence attribution and verification tasks. Med-V1 is available at https://github.com/ncbi-nlp/Med-V1.

Medical image classification is a critical problem for healthcare, with the potential to alleviate the workload of doctors and facilitate diagnoses of patients. However, two challenges arise when deploying deep learning models to real-world healthcare applications. First, neural models tend to learn spurious correlations instead of desired features, which could fall short when generalizing to new domains (e.g., patients with different ages). Second, these black-box models lack interpretability. When making diagnostic predictions, it is important to understand why a model makes a decision for trustworthy and safety considerations. In this paper, to address these two limitations, we propose a new paradigm to build robust and interpretable medical image classifiers with natural language concepts. Specifically, we first query clinical concepts from GPT-4, then transform latent image features into explicit concepts with a vision-language model. We systematically evaluate our method on eight medical image classification datasets to verify its effectiveness. On challenging datasets with strong confounding factors, our method can mitigate spurious correlations thus substantially outperform standard visual encoders and other baselines. Finally, we show how classification with a small number of concepts brings a level of interpretability for understanding model decisions through case studies in real medical data.

Medical image classification in radiology faces significant challenges, particularly in generalizing to unseen pathologies. In contrast, CLIP offers a promising solution by leveraging multimodal learning to improve zero-shot classification performance. However, in the medical domain, lesions can be small and might not be well represented in the embedding space. Therefore, in this paper, we explore the potential of visual prompt engineering to enhance the capabilities of Vision Language Models (VLMs) in radiology. Leveraging BiomedCLIP, trained on extensive biomedical image-text pairs, we investigate the impact of embedding visual markers directly within radiological images to guide the model's attention to critical regions. Our evaluation on the JSRT dataset, focusing on lung nodule malignancy classification, demonstrates that incorporating visual prompts x2013 such as arrows, circles, and contours x2013 significantly improves classification metrics including AUROC, AUPRC, F1 score, and accuracy. Moreover, the study provides attention maps, showcasing enhanced model interpretability and focus on clinically relevant areas. These findings underscore the efficacy of visual prompt engineering as a straightforward yet powerful approach to advance VLM performance in medical image analysis.

Chest radiography is an extremely powerful imaging modality, allowing for a detailed inspection of a patient's thorax, but requiring specialized training for proper interpretation. With the advent of high performance general purpose computer vision algorithms, the accurate automated analysis of chest radiographs is becoming increasingly of interest to researchers. However, a key challenge in the development of these techniques is the lack of sufficient data. Here we describe MIMIC-CXR-JPG v2.0.0, a large dataset of 377,110 chest x-rays associated with 227,827 imaging studies sourced from the Beth Israel Deaconess Medical Center between 2011 - 2016. Images are provided with 14 labels derived from two natural language processing tools applied to the corresponding free-text radiology reports. MIMIC-CXR-JPG is derived entirely from the MIMIC-CXR database, and aims to provide a convenient processed version of MIMIC-CXR, as well as to provide a standard reference for data splits and image labels. All images have been de-identified to protect patient privacy. The dataset is made freely available to facilitate and encourage a wide range of research in medical computer vision.

The integration of Large Language Models (LLMs) into healthcare applications offers promising advancements in medical diagnostics, treatment recommendations, and patient care. However, the susceptibility of LLMs to adversarial attacks poses a significant threat, potentially leading to harmful outcomes in delicate medical contexts. This study investigates the vulnerability of LLMs to two types of adversarial attacks in three medical tasks. Utilizing real-world patient data, we demonstrate that both open-source and proprietary LLMs are susceptible to manipulation across multiple tasks. This research further reveals that domain-specific tasks demand more adversarial data in model fine-tuning than general domain tasks for effective attack execution, especially for more capable models. We discover that while integrating adversarial data does not markedly degrade overall model performance on medical benchmarks, it does lead to noticeable shifts in fine-tuned model weights, suggesting a potential pathway for detecting and countering model attacks. This research highlights the urgent need for robust security measures and the development of defensive mechanisms to safeguard LLMs in medical applications, to ensure their safe and effective deployment in healthcare settings.