Daily Papers

The applicability of current lesion segmentation models for chest X-rays (CXRs) has been limited both by a small number of target labels and the reliance on long, detailed expert-level text inputs, creating a barrier to practical use. To address these limitations, we introduce a new paradigm: instruction-guided lesion segmentation (ILS), which is designed to segment diverse lesion types based on simple, user-friendly instructions. Under this paradigm, we construct MIMIC-ILS, the first large-scale instruction-answer dataset for CXR lesion segmentation, using our fully automated multimodal pipeline that generates annotations from chest X-ray images and their corresponding reports. MIMIC-ILS contains 1.1M instruction-answer pairs derived from 192K images and 91K unique segmentation masks, covering seven major lesion types. To empirically demonstrate its utility, we introduce ROSALIA, a vision-language model fine-tuned on MIMIC-ILS. ROSALIA can segment diverse lesions and provide textual explanations in response to user instructions. The model achieves high segmentation and textual accuracy in our newly proposed task, highlighting the effectiveness of our pipeline and the value of MIMIC-ILS as a foundational resource for pixel-level CXR lesion grounding.

The rapid evolution of artificial intelligence, especially in large language models (LLMs), has significantly impacted various domains, including healthcare. In chest X-ray (CXR) analysis, previous studies have employed LLMs, but with limitations: either underutilizing the multi-tasking capabilities of LLMs or lacking clinical accuracy. This paper presents M4CXR, a multi-modal LLM designed to enhance CXR interpretation. The model is trained on a visual instruction-following dataset that integrates various task-specific datasets in a conversational format. As a result, the model supports multiple tasks such as medical report generation (MRG), visual grounding, and visual question answering (VQA). M4CXR achieves state-of-the-art clinical accuracy in MRG by employing a chain-of-thought prompting strategy, in which it identifies findings in CXR images and subsequently generates corresponding reports. The model is adaptable to various MRG scenarios depending on the available inputs, such as single-image, multi-image, and multi-study contexts. In addition to MRG, M4CXR performs visual grounding at a level comparable to specialized models and also demonstrates outstanding performance in VQA. Both quantitative and qualitative assessments reveal M4CXR's versatility in MRG, visual grounding, and VQA, while consistently maintaining clinical accuracy.

Chest X-Ray (CXR) imaging for pulmonary diagnosis raises significant challenges, primarily because bone structures can obscure critical details necessary for accurate diagnosis. Recent advances in deep learning, particularly with diffusion models, offer significant promise for effectively minimizing the visibility of bone structures in CXR images, thereby improving clarity and diagnostic accuracy. Nevertheless, existing diffusion-based methods for bone suppression in CXR imaging struggle to balance the complete suppression of bones with preserving local texture details. Additionally, their high computational demand and extended processing time hinder their practical use in clinical settings. To address these limitations, we introduce a Global-Local Latent Consistency Model (GL-LCM) architecture. This model combines lung segmentation, dual-path sampling, and global-local fusion, enabling fast high-resolution bone suppression in CXR images. To tackle potential boundary artifacts and detail blurring in local-path sampling, we further propose Local-Enhanced Guidance, which addresses these issues without additional training. Comprehensive experiments on a self-collected dataset SZCH-X-Rays, and the public dataset JSRT, reveal that our GL-LCM delivers superior bone suppression and remarkable computational efficiency, significantly outperforming several competitive methods. Our code is available at https://github.com/diaoquesang/GL-LCM.

Lung diseases represent a significant global health challenge, with Chest X-Ray (CXR) being a key diagnostic tool due to their accessibility and affordability. Nonetheless, the detection of pulmonary lesions is often hindered by overlapping bone structures in CXR images, leading to potential misdiagnoses. To address this issue, we developed an end-to-end framework called BS-LDM, designed to effectively suppress bone in high-resolution CXR images. This framework is based on conditional latent diffusion models and incorporates a multi-level hybrid loss-constrained vector-quantized generative adversarial network which is crafted for perceptual compression, ensuring the preservation of details. To further enhance the framework's performance, we introduce offset noise and a temporal adaptive thresholding strategy. These additions help minimize discrepancies in generating low-frequency information, thereby improving the clarity of the generated soft tissue images. Additionally, we have compiled a high-quality bone suppression dataset named SZCH-X-Rays. This dataset includes 818 pairs of high-resolution CXR and dual-energy subtraction soft tissue images collected from a partner hospital. Moreover, we processed 241 data pairs from the JSRT dataset into negative images, which are more commonly used in clinical practice. Our comprehensive experimental and clinical evaluations reveal that BS-LDM excels in bone suppression, underscoring its significant clinical value.

The widespread use of chest X-rays (CXRs), coupled with a shortage of radiologists, has driven growing interest in automated CXR analysis and AI-assisted reporting. While existing vision-language models (VLMs) show promise in specific tasks such as report generation or abnormality detection, they often lack support for interactive diagnostic capabilities. In this work we present RadVLM, a compact, multitask conversational foundation model designed for CXR interpretation. To this end, we curate a large-scale instruction dataset comprising over 1 million image-instruction pairs containing both single-turn tasks -- such as report generation, abnormality classification, and visual grounding -- and multi-turn, multi-task conversational interactions. After fine-tuning RadVLM on this instruction dataset, we evaluate it across different tasks along with re-implemented baseline VLMs. Our results show that RadVLM achieves state-of-the-art performance in conversational capabilities and visual grounding while remaining competitive in other radiology tasks. Ablation studies further highlight the benefit of joint training across multiple tasks, particularly for scenarios with limited annotated data. Together, these findings highlight the potential of RadVLM as a clinically relevant AI assistant, providing structured CXR interpretation and conversational capabilities to support more effective and accessible diagnostic workflows.

Chest X-rays (CXRs) are commonly utilized as a low-dose modality for lung screening. Nonetheless, the efficacy of CXRs is somewhat impeded, given that approximately 75% of the lung area overlaps with bone, which in turn hampers the detection and diagnosis of diseases. As a remedial measure, bone suppression techniques have been introduced. The current dual-energy subtraction imaging technique in the clinic requires costly equipment and subjects being exposed to high radiation. To circumvent these issues, deep learning-based image generation algorithms have been proposed. However, existing methods fall short in terms of producing high-quality images and capturing texture details, particularly with pulmonary vessels. To address these issues, this paper proposes a new bone suppression framework, termed BS-Diff, that comprises a conditional diffusion model equipped with a U-Net architecture and a simple enhancement module to incorporate an autoencoder. Our proposed network cannot only generate soft tissue images with a high bone suppression rate but also possesses the capability to capture fine image details. Additionally, we compiled the largest dataset since 2010, including data from 120 patients with high-definition, high-resolution paired CXRs and soft tissue images collected by our affiliated hospital. Extensive experiments, comparative analyses, ablation studies, and clinical evaluations indicate that the proposed BS-Diff outperforms several bone-suppression models across multiple metrics. Our code can be accessed at https://github.com/Benny0323/BS-Diff.

Radiology reporting is a complex task that requires detailed image understanding, integration of multiple inputs, including comparison with prior imaging, and precise language generation. This makes it ideal for the development and use of generative multimodal models. Here, we extend report generation to include the localisation of individual findings on the image - a task we call grounded report generation. Prior work indicates that grounding is important for clarifying image understanding and interpreting AI-generated text. Therefore, grounded reporting stands to improve the utility and transparency of automated report drafting. To enable evaluation of grounded reporting, we propose a novel evaluation framework - RadFact - leveraging the reasoning capabilities of large language models (LLMs). RadFact assesses the factuality of individual generated sentences, as well as correctness of generated spatial localisations when present. We introduce MAIRA-2, a large multimodal model combining a radiology-specific image encoder with a LLM, and trained for the new task of grounded report generation on chest X-rays. MAIRA-2 uses more comprehensive inputs than explored previously: the current frontal image, the current lateral image, the prior frontal image and prior report, as well as the Indication, Technique and Comparison sections of the current report. We demonstrate that these additions significantly improve report quality and reduce hallucinations, establishing a new state of the art on findings generation (without grounding) on MIMIC-CXR while demonstrating the feasibility of grounded reporting as a novel and richer task.

This paper proposes a novel framework for lung segmentation in chest X-rays. It consists of two key contributions, a criss-cross attention based segmentation network and radiorealistic chest X-ray image synthesis (i.e. a synthesized radiograph that appears anatomically realistic) for data augmentation. The criss-cross attention modules capture rich global contextual information in both horizontal and vertical directions for all the pixels thus facilitating accurate lung segmentation. To reduce the manual annotation burden and to train a robust lung segmentor that can be adapted to pathological lungs with hazy lung boundaries, an image-to-image translation module is employed to synthesize radiorealistic abnormal CXRs from the source of normal ones for data augmentation. The lung masks of synthetic abnormal CXRs are propagated from the segmentation results of their normal counterparts, and then serve as pseudo masks for robust segmentor training. In addition, we annotate 100 CXRs with lung masks on a more challenging NIH Chest X-ray dataset containing both posterioranterior and anteroposterior views for evaluation. Extensive experiments validate the robustness and effectiveness of the proposed framework. The code and data can be found from https://github.com/rsummers11/CADLab/tree/master/Lung_Segmentation_XLSor .

Chest X-ray (CXR) is the most frequently ordered imaging test, supporting diverse clinical tasks from thoracic disease detection to postoperative monitoring. However, task-specific classification models are limited in scope, require costly labeled data, and lack generalizability to out-of-distribution datasets. To address these challenges, we introduce CheXFound, a self-supervised vision foundation model that learns robust CXR representations and generalizes effectively across a wide range of downstream tasks. We pretrain CheXFound on a curated CXR-1M dataset, comprising over one million unique CXRs from publicly available sources. We propose a Global and Local Representations Integration (GLoRI) module for downstream adaptations, by incorporating disease-specific local features with global image features for enhanced performance in multilabel classification. Our experimental results show that CheXFound outperforms state-of-the-art models in classifying 40 disease findings across different prevalence levels on the CXR-LT 24 dataset and exhibits superior label efficiency on downstream tasks with limited training data. Additionally, CheXFound achieved significant improvements on new tasks with out-of-distribution datasets, including opportunistic cardiovascular disease risk estimation and mortality prediction. These results highlight CheXFound's strong generalization capabilities, enabling diverse adaptations with improved label efficiency. The project source code is publicly available at https://github.com/RPIDIAL/CheXFound.

Despite the progress in automatic detection of radiologic findings from chest X-ray (CXR) images in recent years, a quantitative evaluation of the explainability of these models is hampered by the lack of locally labeled datasets for different findings. With the exception of a few expert-labeled small-scale datasets for specific findings, such as pneumonia and pneumothorax, most of the CXR deep learning models to date are trained on global "weak" labels extracted from text reports, or trained via a joint image and unstructured text learning strategy. Inspired by the Visual Genome effort in the computer vision community, we constructed the first Chest ImaGenome dataset with a scene graph data structure to describe 242,072 images. Local annotations are automatically produced using a joint rule-based natural language processing (NLP) and atlas-based bounding box detection pipeline. Through a radiologist constructed CXR ontology, the annotations for each CXR are connected as an anatomy-centered scene graph, useful for image-level reasoning and multimodal fusion applications. Overall, we provide: i) 1,256 combinations of relation annotations between 29 CXR anatomical locations (objects with bounding box coordinates) and their attributes, structured as a scene graph per image, ii) over 670,000 localized comparison relations (for improved, worsened, or no change) between the anatomical locations across sequential exams, as well as ii) a manually annotated gold standard scene graph dataset from 500 unique patients.

Chest X-rays (CXRs) are the most frequently performed imaging test in clinical practice. Recent advances in the development of vision-language foundation models (FMs) give rise to the possibility of performing automated CXR interpretation, which can assist physicians with clinical decision-making and improve patient outcomes. However, developing FMs that can accurately interpret CXRs is challenging due to the (1) limited availability of large-scale vision-language datasets in the medical image domain, (2) lack of vision and language encoders that can capture the complexities of medical data, and (3) absence of evaluation frameworks for benchmarking the abilities of FMs on CXR interpretation. In this work, we address these challenges by first introducing CheXinstruct - a large-scale instruction-tuning dataset curated from 28 publicly-available datasets. We then present CheXagent - an instruction-tuned FM capable of analyzing and summarizing CXRs. To build CheXagent, we design a clinical large language model (LLM) for parsing radiology reports, a vision encoder for representing CXR images, and a network to bridge the vision and language modalities. Finally, we introduce CheXbench - a novel benchmark designed to systematically evaluate FMs across 8 clinically-relevant CXR interpretation tasks. Extensive quantitative evaluations and qualitative reviews with five expert radiologists demonstrate that CheXagent outperforms previously-developed general- and medical-domain FMs on CheXbench tasks. Furthermore, in an effort to improve model transparency, we perform a fairness evaluation across factors of sex, race and age to highlight potential performance disparities. Our project is at https://stanford-aimi.github.io/chexagent.html.

Chest X-ray imaging (CXR) is an important diagnostic tool used in hospitals to assess patient conditions and monitor changes over time. Generative models, specifically diffusion-based models, have shown promise in generating realistic synthetic X-rays. However, these models mainly focus on conditional generation using single-time-point data, i.e., typically CXRs taken at a specific time with their corresponding reports, limiting their clinical utility, particularly for capturing temporal changes. To address this limitation, we propose a novel framework, EHRXDiff, which predicts future CXR images by integrating previous CXRs with subsequent medical events, e.g., prescriptions, lab measures, etc. Our framework dynamically tracks and predicts disease progression based on a latent diffusion model, conditioned on the previous CXR image and a history of medical events. We comprehensively evaluate the performance of our framework across three key aspects, including clinical consistency, demographic consistency, and visual realism. We demonstrate that our framework generates high-quality, realistic future images that capture potential temporal changes, suggesting its potential for further development as a clinical simulation tool. This could offer valuable insights for patient monitoring and treatment planning in the medical field.

Radiology reports are crucial for planning treatment strategies and enhancing doctor-patient communication, yet manually writing these reports is burdensome for radiologists. While automatic report generation offers a solution, existing methods often rely on single-view radiographs, limiting diagnostic accuracy. To address this problem, we propose MCL, a Multi-view enhanced Contrastive Learning method for chest X-ray report generation. Specifically, we first introduce multi-view enhanced contrastive learning for visual representation by maximizing agreements between multi-view radiographs and their corresponding report. Subsequently, to fully exploit patient-specific indications (e.g., patient's symptoms) for report generation, we add a transitional ``bridge" for missing indications to reduce embedding space discrepancies caused by their presence or absence. Additionally, we construct Multi-view CXR and Two-view CXR datasets from public sources to support research on multi-view report generation. Our proposed MCL surpasses recent state-of-the-art methods across multiple datasets, achieving a 5.0% F1 RadGraph improvement on MIMIC-CXR, a 7.3% BLEU-1 improvement on MIMIC-ABN, a 3.1% BLEU-4 improvement on Multi-view CXR, and an 8.2% F1 CheXbert improvement on Two-view CXR.

Automatic radiology report generation is a promising application of multimodal deep learning, aiming to reduce reporting workload and improve consistency. However, current state-of-the-art (SOTA) systems - such as Multimodal AI for Radiology Applications (MAIRA-2) and Medical Pathways Language Model-Multimodal (MedPaLM-M) - depend on large-scale multimodal training, clinical metadata, and multiple imaging views, making them resource-intensive and inaccessible for most settings. We introduce a compact image-to-text architecture that generates the Findings section of chest X-ray reports from a single frontal image. The model combines a frozen Self-Distillation with No Labels v3 (DINOv3) Vision Transformer (ViT) encoder with a Generative Pre-trained Transformer 2 (GPT-2) decoder enhanced by layer-wise anatomical attention. This mechanism integrates lung and heart segmentation masks through hierarchical Gaussian smoothing, biasing attention toward clinically relevant regions without adding trainable parameters. Evaluated on the official Medical Information Mart for Intensive Care-Chest X-ray (MIMIC-CXR) dataset using Chest Radiograph Expert (CheXpert) and Radiology Graph (RadGraph) metrics, our approach achieved substantial gains: CheXpert Macro-F1 for five key pathologies increased by 168% (0.083 -> 0.238) and Micro-F1 by 146% (0.137 -> 0.337), while broader performance across 14 observations improved by 86% (0.170 -> 0.316). Structural coherence also improved, with RadGraph F1 rising by 9.7%. Despite its small size and purely image-conditioned design, the model demonstrates that decoder-level anatomical guidance improves spatial grounding and enhances coherence in clinically relevant regions. The source code is publicly available at: https://github.com/devMuniz02/UDEM-CXR-Reporting-Thesis-2025.

Accurately grounding regions of interest (ROIs) is critical for diagnosis and treatment planning in medical imaging. While multimodal large language models (MLLMs) combine visual perception with natural language, current medical-grounding pipelines still rely on supervised fine-tuning with explicit spatial hints, making them ill-equipped to handle the implicit queries common in clinical practice. This work makes three core contributions. We first define Unified Medical Reasoning Grounding (UMRG), a novel vision-language task that demands clinical reasoning and pixel-level grounding. Second, we release U-MRG-14K, a dataset of 14K samples featuring pixel-level masks alongside implicit clinical queries and reasoning traces, spanning 10 modalities, 15 super-categories, and 108 specific categories. Finally, we introduce MedReasoner, a modular framework that distinctly separates reasoning from segmentation: an MLLM reasoner is optimized with reinforcement learning, while a frozen segmentation expert converts spatial prompts into masks, with alignment achieved through format and accuracy rewards. MedReasoner achieves state-of-the-art performance on U-MRG-14K and demonstrates strong generalization to unseen clinical queries, underscoring the significant promise of reinforcement learning for interpretable medical grounding.

Automated radiology report generation offers an effective solution to alleviate radiologists' workload. However, most existing methods focus primarily on single or fixed-view images to model current disease conditions, which limits diagnostic accuracy and overlooks disease progression. Although some approaches utilize longitudinal data to track disease progression, they still rely on single images to analyze current visits. To address these issues, we propose enhanced contrastive learning with Multi-view Longitudinal data to facilitate chest X-ray Report Generation, named MLRG. Specifically, we introduce a multi-view longitudinal contrastive learning method that integrates spatial information from current multi-view images and temporal information from longitudinal data. This method also utilizes the inherent spatiotemporal information of radiology reports to supervise the pre-training of visual and textual representations. Subsequently, we present a tokenized absence encoding technique to flexibly handle missing patient-specific prior knowledge, allowing the model to produce more accurate radiology reports based on available prior knowledge. Extensive experiments on MIMIC-CXR, MIMIC-ABN, and Two-view CXR datasets demonstrate that our MLRG outperforms recent state-of-the-art methods, achieving a 2.3% BLEU-4 improvement on MIMIC-CXR, a 5.5% F1 score improvement on MIMIC-ABN, and a 2.7% F1 RadGraph improvement on Two-view CXR.

Accurate retinal vessel (RV) segmentation is a crucial step in the quantitative assessment of retinal vasculature, which is needed for the early detection of retinal diseases and other conditions. Numerous studies have been conducted to tackle the problem of segmenting vessels automatically using a pixel-wise classification approach. The common practice of creating ground truth labels is to categorize pixels as foreground and background. This approach is, however, biased, and it ignores the uncertainty of a human annotator when it comes to annotating e.g. thin vessels. In this work, we propose a simple and effective method that casts the RV segmentation task as an image-level regression. For this purpose, we first introduce a novel Segmentation Annotation Uncertainty-Aware (SAUNA) transform, which adds pixel uncertainty to the ground truth using the pixel's closeness to the annotation boundary and vessel thickness. To train our model with soft labels, we generalize the earlier proposed Jaccard metric loss to arbitrary hypercubes for soft Jaccard index (Intersection-over-Union) optimization. Additionally, we employ a stable version of the Focal-L1 loss for pixel-wise regression. We conduct thorough experiments and compare our method to a diverse set of baselines across 5 retinal image datasets. Our empirical results indicate that the integration of the SAUNA transform and these segmentation losses led to significant performance boosts for different segmentation models. Particularly, our methodology enables UNet-like architectures to substantially outperform computational-intensive baselines. Our implementation is available at https://github.com/Oulu-IMEDS/SAUNA.

Chest Xray imaging is a widely used diagnostic tool in modern medicine, and its high utilization creates substantial workloads for radiologists. To alleviate this burden, vision language models are increasingly applied to automate Chest Xray radiology report generation (CXRRRG), aiming for clinically accurate descriptions while reducing manual effort. Conventional approaches, however, typically rely on single images, failing to capture the longitudinal context necessary for producing clinically faithful comparison statements. Recently, growing attention has been directed toward incorporating longitudinal data into CXR RRG, enabling models to leverage historical studies in ways that mirror radiologists diagnostic workflows. Nevertheless, existing surveys primarily address single image CXRRRG and offer limited guidance for longitudinal settings, leaving researchers without a systematic framework for model design. To address this gap, this survey provides the first comprehensive review of longitudinal radiology report generation (LRRG). Specifically, we examine dataset construction strategies, report generation architectures alongside longitudinally tailored designs, and evaluation protocols encompassing both longitudinal specific measures and widely used benchmarks. We further summarize LRRG methods performance, alongside analyses of different ablation studies, which collectively highlight the critical role of longitudinal information and architectural design choices in improving model performance. Finally, we summarize five major limitations of current research and outline promising directions for future development, aiming to lay a foundation for advancing this emerging field.

Recent advances in large multimodal models (LMMs) have recognized fine-grained grounding as an imperative factor of visual understanding and dialogue. However, the benefits of such representation in LMMs are limited to the natural image domain, and these models perform poorly for remote sensing (RS). The distinct overhead viewpoint, scale variation, and presence of small objects in high-resolution RS imagery present a unique challenge in region-level comprehension. Moreover, the development of the grounding conversation capability of LMMs within RS is hindered by the lack of granular, RS domain-specific grounded data. Addressing these limitations, we propose GeoPixel - the first end-to-end high resolution RS-LMM that supports pixel-level grounding. This capability allows fine-grained visual perception by generating interleaved masks in conversation. GeoPixel supports up to 4K HD resolution in any aspect ratio, ideal for high-precision RS image analysis. To support the grounded conversation generation (GCG) in RS imagery, we curate a visually grounded dataset GeoPixelD through a semi-automated pipeline that utilizes set-of-marks prompting and spatial priors tailored for RS data to methodically control the data generation process. GeoPixel demonstrates superior performance in pixel-level comprehension, surpassing existing LMMs in both single-target and multi-target segmentation tasks. Our methodological ablation studies validate the effectiveness of each component in the overall architecture. Our code and data will be publicly released.

Purpose: Recent advancements in large language models (LLMs) have expanded their capabilities in a multimodal fashion, potentially replicating the image interpretation of human radiologists. This study aimed to develop open-source multimodal large language model for interpreting chest X-ray images (CXR-LLaVA). We also examined the effect of prompt engineering and model parameters such as temperature and nucleus sampling. Materials and Methods: For training, we collected 659,287 publicly available CXRs: 417,336 CXRs had labels for certain radiographic abnormalities (dataset 1); 241,951 CXRs provided free-text radiology reports (dataset 2). After pre-training the Resnet50 as an image encoder, the contrastive language-image pre-training was used to align CXRs and corresponding radiographic abnormalities. Then, the Large Language Model Meta AI-2 was fine-tuned using dataset 2, which were refined using GPT-4, with generating various question answering scenarios. The code can be found at https://github.com/ECOFRI/CXR_LLaVA. Results: In the test set, we observed that the model's performance fluctuated based on its parameters. On average, it achieved F1 score of 0.34 for five pathologic findings (atelectasis, cardiomegaly, consolidation, edema, and pleural effusion), which was improved to 0.46 through prompt engineering. In the independent set, the model achieved an average F1 score of 0.30 for the same pathologic findings. Notably, for the pediatric chest radiograph dataset, which was unseen during training, the model differentiated abnormal radiographs with an F1 score ranging from 0.84 to 0.85. Conclusion: CXR-LLaVA demonstrates promising potential in CXR interpretation. Both prompt engineering and model parameter adjustments can play pivotal roles in interpreting CXRs.

Vision-Language Models (VLMs) have shown remarkable performance in User Interface (UI) grounding tasks, driven by their ability to process increasingly high-resolution screenshots. However, screenshots are tokenized into thousands of visual tokens (e.g., about 4700 for 2K resolution), incurring significant computational overhead and diluting attention. In contrast, humans typically focus on regions of interest when interacting with UI. In this work, we pioneer the task of efficient UI grounding. Guided by practical analysis of the task's characteristics and challenges, we propose FocusUI, an efficient UI grounding framework that selects patches most relevant to the instruction while preserving positional continuity for precise grounding. FocusUI addresses two key challenges: (1) Eliminating redundant tokens in visual encoding. We construct patch-level supervision by fusing an instruction-conditioned score with a rule-based UI-graph score that down-weights large homogeneous regions to select distinct and instruction-relevant visual tokens. (2) Preserving positional continuity during visual token selection. We find that general visual token pruning methods suffer from severe accuracy degradation on UI grounding tasks due to broken positional information. We introduce a novel PosPad strategy, which compresses each contiguous sequence of dropped visual tokens into a single special marker placed at the sequence's last index to preserve positional continuity. Comprehensive experiments on four grounding benchmarks demonstrate that FocusUI surpasses GUI-specific baselines. On the ScreenSpot-Pro benchmark, FocusUI-7B achieves a performance improvement of 3.7% over GUI-Actor-7B. Even with only 30% visual token retention, FocusUI-7B drops by only 3.2% while achieving up to 1.44x faster inference and 17% lower peak GPU memory.

Our approach, which we call Embeddings for Language/Image-aligned X-Rays, or ELIXR, leverages a language-aligned image encoder combined or grafted onto a fixed LLM, PaLM 2, to perform a broad range of tasks. We train this lightweight adapter architecture using images paired with corresponding free-text radiology reports from the MIMIC-CXR dataset. ELIXR achieved state-of-the-art performance on zero-shot chest X-ray (CXR) classification (mean AUC of 0.850 across 13 findings), data-efficient CXR classification (mean AUCs of 0.893 and 0.898 across five findings (atelectasis, cardiomegaly, consolidation, pleural effusion, and pulmonary edema) for 1% (~2,200 images) and 10% (~22,000 images) training data), and semantic search (0.76 normalized discounted cumulative gain (NDCG) across nineteen queries, including perfect retrieval on twelve of them). Compared to existing data-efficient methods including supervised contrastive learning (SupCon), ELIXR required two orders of magnitude less data to reach similar performance. ELIXR also showed promise on CXR vision-language tasks, demonstrating overall accuracies of 58.7% and 62.5% on visual question answering and report quality assurance tasks, respectively. These results suggest that ELIXR is a robust and versatile approach to CXR AI.

In recent times, the need for effective super-resolution (SR) techniques has surged, especially for large-scale images ranging 2K to 8K resolutions. For DNN-based SISR, decomposing images into overlapping patches is typically necessary due to computational constraints. In such patch-decomposing scheme, one can allocate computational resources differently based on each patch's difficulty to further improve efficiency while maintaining SR performance. However, this approach has a limitation: computational resources is uniformly allocated within a patch, leading to lower efficiency when the patch contain pixels with varying levels of restoration difficulty. To address the issue, we propose the Pixel-level Classifier for Single Image Super-Resolution (PCSR), a novel method designed to distribute computational resources adaptively at the pixel level. A PCSR model comprises a backbone, a pixel-level classifier, and a set of pixel-level upsamplers with varying capacities. The pixel-level classifier assigns each pixel to an appropriate upsampler based on its restoration difficulty, thereby optimizing computational resource usage. Our method allows for performance and computational cost balance during inference without re-training. Our experiments demonstrate PCSR's advantage over existing patch-distributing methods in PSNR-FLOP trade-offs across different backbone models and benchmarks. The code is available at https://github.com/3587jjh/PCSR.

Despite significant advancements in Large Vision-Language Models (LVLMs)' capabilities, existing pixel-grounding models operate in single-image settings, limiting their ability to perform detailed, fine-grained comparisons across multiple images. Conversely, current multi-image understanding models lack pixel-level grounding. Our work addresses this gap by introducing the task of multi-image pixel-grounded reasoning alongside PRIMA, an LVLM that integrates pixel-level grounding with robust multi-image reasoning to produce contextually rich, pixel-grounded explanations. Central to PRIMA is SQuARE, a vision module that injects cross-image relational context into compact query-based visual tokens before fusing them with the language backbone. To support training and evaluation, we curate M4SEG, a new multi-image reasoning segmentation benchmark consisting of sim744K question-answer pairs that require fine-grained visual understanding across multiple images. PRIMA outperforms state-of-the-art baselines with 7.83% and 11.25% improvements in Recall and S-IoU, respectively. Ablation studies further demonstrate the effectiveness of the proposed SQuARE module in capturing cross-image relationships.

Multimodal large language models (MLLMs) have recently achieved remarkable progress in radiology by integrating visual perception with natural language understanding. However, they often generate clinically unsupported descriptions, known as medical hallucinations, which pose serious risks in medical applications that demand accuracy and image-grounded outputs. Through empirical analysis, we find that prompt-induced hallucinations remain prevalent in radiology MLLMs, largely due to over-sensitivity to clinical sections. To address this, we introduce Clinical Contrastive Cecoding (CCD), a training-free and retrieval-free inference framework that integrates structured clinical signals from task-specific radiology expert models. CCD introduces a dual-stage contrastive mechanism to refine token-level logits during generation, thereby enhancing clinical fidelity without modifying the base MLLM. Experiments on three datasets and multiple models demonstrate that CCD consistently improves overall performance on radiology report generation (RRG). On the MIMIC-CXR dataset, it yields up to a 17% improvement in RadGraph-F1 when applied to state-of-the-art RRG models. Our approach provides a lightweight and generalisable solution for mitigating medical hallucinations, effectively bridging expert models and MLLMs in radiology.

Pixel grounding, encompassing tasks such as Referring Expression Segmentation (RES), has garnered considerable attention due to its immense potential for bridging the gap between vision and language modalities. However, advancements in this domain are currently constrained by limitations inherent in existing datasets, including limited object categories, insufficient textual diversity, and a scarcity of high-quality annotations. To mitigate these limitations, we introduce GroundingSuite, which comprises: (1) an automated data annotation framework leveraging multiple Vision-Language Model (VLM) agents; (2) a large-scale training dataset encompassing 9.56 million diverse referring expressions and their corresponding segmentations; and (3) a meticulously curated evaluation benchmark consisting of 3,800 images. The GroundingSuite training dataset facilitates substantial performance improvements, enabling models trained on it to achieve state-of-the-art results. Specifically, a cIoU of 68.9 on gRefCOCO and a gIoU of 55.3 on RefCOCOm. Moreover, the GroundingSuite annotation framework demonstrates superior efficiency compared to the current leading data annotation method, i.e., 4.5 times faster than the GLaMM.

Remote sensing (RS) visual grounding aims to use natural language expression to locate specific objects (in the form of the bounding box or segmentation mask) in RS images, enhancing human interaction with intelligent RS interpretation systems. Early research in this area was primarily based on horizontal bounding boxes (HBBs), but as more diverse RS datasets have become available, tasks involving oriented bounding boxes (OBBs) and segmentation masks have emerged. In practical applications, different targets require different grounding types: HBB can localize an object's position, OBB provides its orientation, and mask depicts its shape. However, existing specialized methods are typically tailored to a single type of RS visual grounding task and are hard to generalize across tasks. In contrast, large vision-language models (VLMs) exhibit powerful multi-task learning capabilities but struggle to handle dense prediction tasks like segmentation. This paper proposes GeoGround, a novel framework that unifies support for HBB, OBB, and mask RS visual grounding tasks, allowing flexible output selection. Rather than customizing the architecture of VLM, our work aims to elegantly support pixel-level visual grounding output through the Text-Mask technique. We define prompt-assisted and geometry-guided learning to enhance consistency across different signals. To support model training, we present refGeo, a large-scale RS visual instruction-following dataset containing 161k image-text pairs. Experimental results show that GeoGround demonstrates strong performance across four RS visual grounding tasks, matching or surpassing the performance of specialized methods on multiple benchmarks. Code available at https://github.com/zytx121/GeoGround

Chest X-ray plays a central role in thoracic diagnosis, and its interpretation inherently requires multi-step, evidence-grounded reasoning. However, large vision-language models (LVLMs) often generate plausible responses that are not faithfully grounded in diagnostic evidence and provide limited visual evidence for verification, while also requiring costly retraining to support new diagnostic tasks, limiting their reliability and adaptability in clinical settings. To address these limitations, we present CXReasonAgent, a diagnostic agent that integrates a large language model (LLM) with clinically grounded diagnostic tools to perform evidence-grounded diagnostic reasoning using image-derived diagnostic and visual evidence. To evaluate these capabilities, we introduce CXReasonDial, a multi-turn dialogue benchmark with 1,946 dialogues across 12 diagnostic tasks, and show that CXReasonAgent produces faithfully grounded responses, enabling more reliable and verifiable diagnostic reasoning than LVLMs. These findings highlight the importance of integrating clinically grounded diagnostic tools, particularly in safety-critical clinical settings.

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.

Recent studies in text-to-image customization show great success in generating personalized object variants given several images of a subject. While existing methods focus more on preserving the identity of the subject, they often fall short of controlling the spatial relationship between objects. In this work, we introduce GroundingBooth, a framework that achieves zero-shot instance-level spatial grounding on both foreground subjects and background objects in the text-to-image customization task. Our proposed text-image grounding module and masked cross-attention layer allow us to generate personalized images with both accurate layout alignment and identity preservation while maintaining text-image coherence. With such layout control, our model inherently enables the customization of multiple subjects at once. Our model is evaluated on both layout-guided image synthesis and reference-based customization tasks, showing strong results compared to existing methods. Our work is the first work to achieve a joint grounding on both subject-driven foreground generation and text-driven background generation.

In the field of chest X-ray (CXR) diagnosis, existing works often focus solely on determining where a radiologist looks, typically through tasks such as detection, segmentation, or classification. However, these approaches are often designed as black-box models, lacking interpretability. In this paper, we introduce Interpretable Artificial Intelligence (I-AI) a novel and unified controllable interpretable pipeline for decoding the intense focus of radiologists in CXR diagnosis. Our I-AI addresses three key questions: where a radiologist looks, how long they focus on specific areas, and what findings they diagnose. By capturing the intensity of the radiologist's gaze, we provide a unified solution that offers insights into the cognitive process underlying radiological interpretation. Unlike current methods that rely on black-box machine learning models, which can be prone to extracting erroneous information from the entire input image during the diagnosis process, we tackle this issue by effectively masking out irrelevant information. Our proposed I-AI leverages a vision-language model, allowing for precise control over the interpretation process while ensuring the exclusion of irrelevant features. To train our I-AI model, we utilize an eye gaze dataset to extract anatomical gaze information and generate ground truth heatmaps. Through extensive experimentation, we demonstrate the efficacy of our method. We showcase that the attention heatmaps, designed to mimic radiologists' focus, encode sufficient and relevant information, enabling accurate classification tasks using only a portion of CXR. The code, checkpoints, and data are at https://github.com/UARK-AICV/IAI

In this paper, we propose an efficient multi-level convolution architecture for 3D visual grounding. Conventional methods are difficult to meet the requirements of real-time inference due to the two-stage or point-based architecture. Inspired by the success of multi-level fully sparse convolutional architecture in 3D object detection, we aim to build a new 3D visual grounding framework following this technical route. However, as in 3D visual grounding task the 3D scene representation should be deeply interacted with text features, sparse convolution-based architecture is inefficient for this interaction due to the large amount of voxel features. To this end, we propose text-guided pruning (TGP) and completion-based addition (CBA) to deeply fuse 3D scene representation and text features in an efficient way by gradual region pruning and target completion. Specifically, TGP iteratively sparsifies the 3D scene representation and thus efficiently interacts the voxel features with text features by cross-attention. To mitigate the affect of pruning on delicate geometric information, CBA adaptively fixes the over-pruned region by voxel completion with negligible computational overhead. Compared with previous single-stage methods, our method achieves top inference speed and surpasses previous fastest method by 100\% FPS. Our method also achieves state-of-the-art accuracy even compared with two-stage methods, with +1.13 lead of Acc@0.5 on ScanRefer, and +2.6 and +3.2 leads on NR3D and SR3D respectively. The code is available at https://github.com/GWxuan/TSP3D{https://github.com/GWxuan/TSP3D}.

Diffusion-based methods, endowed with a formidable generative prior, have received increasing attention in Image Super-Resolution (ISR) recently. However, as low-resolution (LR) images often undergo severe degradation, it is challenging for ISR models to perceive the semantic and degradation information, resulting in restoration images with incorrect content or unrealistic artifacts. To address these issues, we propose a Cross-modal Priors for Super-Resolution (XPSR) framework. Within XPSR, to acquire precise and comprehensive semantic conditions for the diffusion model, cutting-edge Multimodal Large Language Models (MLLMs) are utilized. To facilitate better fusion of cross-modal priors, a Semantic-Fusion Attention is raised. To distill semantic-preserved information instead of undesired degradations, a Degradation-Free Constraint is attached between LR and its high-resolution (HR) counterpart. Quantitative and qualitative results show that XPSR is capable of generating high-fidelity and high-realism images across synthetic and real-world datasets. Codes are released at https://github.com/qyp2000/XPSR.

Visual grounding is essential for precise perception and reasoning in multimodal large language models (MLLMs), especially in medical imaging domains. While existing medical visual grounding benchmarks primarily focus on single-image scenarios, real-world clinical applications often involve sequential images, where accurate lesion localization across different modalities and temporal tracking of disease progression (e.g., pre- vs. post-treatment comparison) require fine-grained cross-image semantic alignment and context-aware reasoning. To remedy the underrepresentation of image sequences in existing medical visual grounding benchmarks, we propose MedSG-Bench, the first benchmark tailored for Medical Image Sequences Grounding. It comprises eight VQA-style tasks, formulated into two paradigms of the grounding tasks, including 1) Image Difference Grounding, which focuses on detecting change regions across images, and 2) Image Consistency Grounding, which emphasizes detection of consistent or shared semantics across sequential images. MedSG-Bench covers 76 public datasets, 10 medical imaging modalities, and a wide spectrum of anatomical structures and diseases, totaling 9,630 question-answer pairs. We benchmark both general-purpose MLLMs (e.g., Qwen2.5-VL) and medical-domain specialized MLLMs (e.g., HuatuoGPT-vision), observing that even the advanced models exhibit substantial limitations in medical sequential grounding tasks. To advance this field, we construct MedSG-188K, a large-scale instruction-tuning dataset tailored for sequential visual grounding, and further develop MedSeq-Grounder, an MLLM designed to facilitate future research on fine-grained understanding across medical sequential images. The benchmark, dataset, and model are available at https://huggingface.co/MedSG-Bench

Chest X-rays (CXRs) are among the most frequently performed imaging examinations worldwide, yet rising imaging volumes increase radiologist workload and the risk of diagnostic errors. Although artificial intelligence (AI) systems have shown promise for CXR interpretation, most generate only final predictions, without making explicit how visual evidence is translated into radiographic findings and diagnostic predictions. We present CheXOne, a reasoning-enabled vision-language model for CXR interpretation. CheXOne jointly generates diagnostic predictions and explicit, clinically grounded reasoning traces that connect visual evidence, radiographic findings, and these predictions. The model is trained on 14.7 million instruction and reasoning samples curated from 30 public datasets spanning 36 CXR interpretation tasks, using a two-stage framework that combines instruction tuning with reinforcement learning to improve reasoning quality. We evaluate CheXOne in zero-shot settings across visual question answering, report generation, visual grounding and reasoning assessment, covering 17 evaluation settings. CheXOne outperforms existing medical and general-domain foundation models and achieves strong performance on independent public benchmarks. A clinical reader study demonstrates that CheXOne-drafted reports are comparable to or better than resident-written reports in 55% of cases, while effectively addressing clinical indications and enhancing both report writing and CXR interpretation efficiency. Further analyses involving radiologists reveal that the generated reasoning traces show high clinical factuality and provide causal support for the final predictions, offering a plausible explanation for the performance gains. These results suggest that explicit reasoning can improve model performance, interpretability and clinical utility in AI-assisted CXR interpretation.

Automated multi-label chest X-rays (CXR) image classification has achieved substantial progress in clinical diagnosis via utilizing sophisticated deep learning approaches. However, most deep models have high computational demands, which makes them less feasible for compact devices with low computational requirements. To overcome this problem, we propose a knowledge distillation (KD) strategy to create the compact deep learning model for the real-time multi-label CXR image classification. We study different alternatives of CNNs and Transforms as the teacher to distill the knowledge to a smaller student. Then, we employed explainable artificial intelligence (XAI) to provide the visual explanation for the model decision improved by the KD. Our results on three benchmark CXR datasets show that our KD strategy provides the improved performance on the compact student model, thus being the feasible choice for many limited hardware platforms. For instance, when using DenseNet161 as the teacher network, EEEA-Net-C2 achieved an AUC of 83.7%, 87.1%, and 88.7% on the ChestX-ray14, CheXpert, and PadChest datasets, respectively, with fewer parameters of 4.7 million and computational cost of 0.3 billion FLOPS.

GUI grounding, which translates natural language instructions into precise pixel coordinates, is essential for developing practical GUI agents. However, we observe that existing grounding models exhibit significant coordinate prediction instability, minor visual perturbations (e.g. cropping a few pixels) can drastically alter predictions, flipping results between correct and incorrect. This instability severely undermines model performance, especially for samples with high-resolution and small UI elements. To address this issue, we propose Multi-View Prediction (MVP), a training-free framework that enhances grounding performance through multi-view inference. Our key insight is that while single-view predictions may be unstable, aggregating predictions from multiple carefully cropped views can effectively distinguish correct coordinates from outliers. MVP comprises two components: (1) Attention-Guided View Proposal, which derives diverse views guided by instruction-to-image attention scores, and (2) Multi-Coordinates Clustering, which ensembles predictions by selecting the centroid of the densest spatial cluster. Extensive experiments demonstrate MVP's effectiveness across various models and benchmarks. Notably, on ScreenSpot-Pro, MVP boosts UI-TARS-1.5-7B to 56.1%, GTA1-7B to 61.7%, Qwen3VL-8B-Instruct to 65.3%, and Qwen3VL-32B-Instruct to 74.0%. The code is available at https://github.com/ZJUSCL/MVP.

We present VinDr-CXR-VQA, a large-scale chest X-ray dataset for explainable Medical Visual Question Answering (Med-VQA) with spatial grounding. The dataset contains 17,597 question-answer pairs across 4,394 images, each annotated with radiologist-verified bounding boxes and clinical reasoning explanations. Our question taxonomy spans six diagnostic types-Where, What, Is there, How many, Which, and Yes/No-capturing diverse clinical intents. To improve reliability, we construct a balanced distribution of 41.7% positive and 58.3% negative samples, mitigating hallucinations in normal cases. Benchmarking with MedGemma-4B-it demonstrates improved performance (F1 = 0.624, +11.8% over baseline) while enabling lesion localization. VinDr-CXR-VQA aims to advance reproducible and clinically grounded Med-VQA research. The dataset and evaluation tools are publicly available at huggingface.co/datasets/Dangindev/VinDR-CXR-VQA.

Unified visual grounding pursues a simple and generic technical route to leverage multi-task data with less task-specific design. The most advanced methods typically present boxes and masks as vertex sequences to model referring detection and segmentation as an autoregressive sequential vertex generation paradigm. However, generating high-dimensional vertex sequences sequentially is error-prone because the upstream of the sequence remains static and cannot be refined based on downstream vertex information, even if there is a significant location gap. Besides, with limited vertexes, the inferior fitting of objects with complex contours restricts the performance upper bound. To deal with this dilemma, we propose a parallel vertex generation paradigm for superior high-dimension scalability with a diffusion model by simply modifying the noise dimension. An intuitive materialization of our paradigm is Parallel Vertex Diffusion (PVD) to directly set vertex coordinates as the generation target and use a diffusion model to train and infer. We claim that it has two flaws: (1) unnormalized coordinate caused a high variance of loss value; (2) the original training objective of PVD only considers point consistency but ignores geometry consistency. To solve the first flaw, Center Anchor Mechanism (CAM) is designed to convert coordinates as normalized offset values to stabilize the training loss value. For the second flaw, Angle summation loss (ASL) is designed to constrain the geometry difference of prediction and ground truth vertexes for geometry-level consistency. Empirical results show that our PVD achieves state-of-the-art in both referring detection and segmentation, and our paradigm is more scalable and efficient than sequential vertex generation with high-dimension data.

Chest X-Ray (CXR) report generation is a promising approach to improving the efficiency of CXR interpretation. However, a significant increase in diagnostic accuracy is required before that can be realised. Motivated by this, we propose a framework that is more inline with a radiologist's workflow by considering longitudinal data. Here, the decoder is additionally conditioned on the report from the subject's previous imaging study via a prompt. We also propose a new reward for reinforcement learning based on CXR-BERT, which computes the similarity between reports. We conduct experiments on the MIMIC-CXR dataset. The results indicate that longitudinal data improves CXR report generation. CXR-BERT is also shown to be a promising alternative to the current state-of-the-art reward based on RadGraph. This investigation indicates that longitudinal CXR report generation can offer a substantial increase in diagnostic accuracy. Our Hugging Face model is available at: https://huggingface.co/aehrc/cxrmate and code is available at: https://github.com/aehrc/cxrmate.

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%.

Different from Object Detection, Visual Grounding deals with detecting a bounding box for each text-image pair. This one box for each text-image data provides sparse supervision signals. Although previous works achieve impressive results, their passive utilization of annotation, i.e. the sole use of the box annotation as regression ground truth, results in a suboptimal performance. In this paper, we present SegVG, a novel method transfers the box-level annotation as Segmentation signals to provide an additional pixel-level supervision for Visual Grounding. Specifically, we propose the Multi-layer Multi-task Encoder-Decoder as the target grounding stage, where we learn a regression query and multiple segmentation queries to ground the target by regression and segmentation of the box in each decoding layer, respectively. This approach allows us to iteratively exploit the annotation as signals for both box-level regression and pixel-level segmentation. Moreover, as the backbones are typically initialized by pretrained parameters learned from unimodal tasks and the queries for both regression and segmentation are static learnable embeddings, a domain discrepancy remains among these three types of features, which impairs subsequent target grounding. To mitigate this discrepancy, we introduce the Triple Alignment module, where the query, text, and vision tokens are triangularly updated to share the same space by triple attention mechanism. Extensive experiments on five widely used datasets validate our state-of-the-art (SOTA) performance.

Developing an interpretable system for generating reports in chest X-ray (CXR) analysis is becoming increasingly crucial in Computer-aided Diagnosis (CAD) systems, enabling radiologists to comprehend the decisions made by these systems. Despite the growth of diverse datasets and methods focusing on report generation, there remains a notable gap in how closely these models' generated reports align with the interpretations of real radiologists. In this study, we tackle this challenge by initially introducing Fine-Grained CXR (FG-CXR) dataset, which provides fine-grained paired information between the captions generated by radiologists and the corresponding gaze attention heatmaps for each anatomy. Unlike existing datasets that include a raw sequence of gaze alongside a report, with significant misalignment between gaze location and report content, our FG-CXR dataset offers a more grained alignment between gaze attention and diagnosis transcript. Furthermore, our analysis reveals that simply applying black-box image captioning methods to generate reports cannot adequately explain which information in CXR is utilized and how long needs to attend to accurately generate reports. Consequently, we propose a novel explainable radiologist's attention generator network (Gen-XAI) that mimics the diagnosis process of radiologists, explicitly constraining its output to closely align with both radiologist's gaze attention and transcript. Finally, we perform extensive experiments to illustrate the effectiveness of our method. Our datasets and checkpoint is available at https://github.com/UARK-AICV/FG-CXR.

This paper introduces a novel one-stage end-to-end detector specifically designed to detect small lesions in medical images. Precise localization of small lesions presents challenges due to their appearance and the diverse contextual backgrounds in which they are found. To address this, our approach introduces a new type of pixel-based anchor that dynamically moves towards the targeted lesion for detection. We refer to this new architecture as GravityNet, and the novel anchors as gravity points since they appear to be "attracted" by the lesions. We conducted experiments on two well-established medical problems involving small lesions to evaluate the performance of the proposed approach: microcalcifications detection in digital mammograms and microaneurysms detection in digital fundus images. Our method demonstrates promising results in effectively detecting small lesions in these medical imaging tasks.

Medical imaging is frequently used in clinical practice and trials for diagnosis and treatment. Writing imaging reports is time-consuming and can be error-prone for inexperienced radiologists. Therefore, automatically generating radiology reports is highly desired to lighten the workload of radiologists and accordingly promote clinical automation, which is an essential task to apply artificial intelligence to the medical domain. In this paper, we propose to generate radiology reports with memory-driven Transformer, where a relational memory is designed to record key information of the generation process and a memory-driven conditional layer normalization is applied to incorporating the memory into the decoder of Transformer. Experimental results on two prevailing radiology report datasets, IU X-Ray and MIMIC-CXR, show that our proposed approach outperforms previous models with respect to both language generation metrics and clinical evaluations. Particularly, this is the first work reporting the generation results on MIMIC-CXR to the best of our knowledge. Further analyses also demonstrate that our approach is able to generate long reports with necessary medical terms as well as meaningful image-text attention mappings.

Despite recent advancements in semantic segmentation, where and what pixels are hard to segment remains largely unexplored. Existing research only separates an image into easy and hard regions and empirically observes the latter are associated with object boundaries. In this paper, we conduct a comprehensive analysis of hard pixel errors, categorizing them into three types: false responses, merging mistakes, and displacements. Our findings reveal a quantitative association between hard pixels and aliasing, which is distortion caused by the overlapping of frequency components in the Fourier domain during downsampling. To identify the frequencies responsible for aliasing, we propose using the equivalent sampling rate to calculate the Nyquist frequency, which marks the threshold for aliasing. Then, we introduce the aliasing score as a metric to quantify the extent of aliasing. While positively correlated with the proposed aliasing score, three types of hard pixels exhibit different patterns. Here, we propose two novel de-aliasing filter (DAF) and frequency mixing (FreqMix) modules to alleviate aliasing degradation by accurately removing or adjusting frequencies higher than the Nyquist frequency. The DAF precisely removes the frequencies responsible for aliasing before downsampling, while the FreqMix dynamically selects high-frequency components within the encoder block. Experimental results demonstrate consistent improvements in semantic segmentation and low-light instance segmentation tasks. The code is available at: https://github.com/Linwei-Chen/Seg-Aliasing.

Pre-Trained Vision-Language Models (VL-PTMs) have shown promising capabilities in grounding natural language in image data, facilitating a broad variety of cross-modal tasks. However, we note that there exists a significant gap between the objective forms of model pre-training and fine-tuning, resulting in a need for large amounts of labeled data to stimulate the visual grounding capability of VL-PTMs for downstream tasks. To address the challenge, we present Cross-modal Prompt Tuning (CPT, alternatively, Colorful Prompt Tuning), a novel paradigm for tuning VL-PTMs, which reformulates visual grounding into a fill-in-the-blank problem with color-based co-referential markers in image and text, maximally mitigating the gap. In this way, CPT enables strong few-shot and even zero-shot visual grounding capabilities of VL-PTMs. Comprehensive experimental results show that the prompt-tuned VL-PTMs outperform their fine-tuned counterparts by a large margin (e.g., 17.3% absolute accuracy improvement, and 73.8% relative standard deviation reduction on average with one shot in RefCOCO evaluation). We make the data and code for this paper publicly available at https://github.com/thunlp/CPT.

GUI grounding is a critical capability for vision-language models (VLMs) that enables automated interaction with graphical user interfaces by locating target elements from natural language instructions. However, grounding on GUI screenshots remains challenging due to high-resolution images, small UI elements, and ambiguous user instructions. In this work, we propose AdaZoom-GUI, an adaptive zoom-based GUI grounding framework that improves both localization accuracy and instruction understanding. Our approach introduces an instruction refinement module that rewrites natural language commands into explicit and detailed descriptions, allowing the grounding model to focus on precise element localization. In addition, we design a conditional zoom-in strategy that selectively performs a second-stage inference on predicted small elements, improving localization accuracy while avoiding unnecessary computation and context loss on simpler cases. To support this framework, we construct a high-quality GUI grounding dataset and train the grounding model using Group Relative Policy Optimization (GRPO), enabling the model to predict both click coordinates and element bounding boxes. Experiments on public benchmarks demonstrate that our method achieves state-of-the-art performance among models with comparable or even larger parameter sizes, highlighting its effectiveness for high-resolution GUI understanding and practical GUI agent deployment.

The development of successful artificial intelligence models for chest X-ray analysis relies on large, diverse datasets with high-quality annotations. While several databases of chest X-ray images have been released, most include disease diagnosis labels but lack detailed pixel-level anatomical segmentation labels. To address this gap, we introduce an extensive chest X-ray multi-center segmentation dataset with uniform and fine-grain anatomical annotations for images coming from six well-known publicly available databases: CANDID-PTX, ChestX-ray8, Chexpert, MIMIC-CXR-JPG, Padchest, and VinDr-CXR, resulting in 676,803 segmentation masks. Our methodology utilizes the HybridGNet model to ensure consistent and high-quality segmentations across all datasets. Rigorous validation, including expert physician evaluation and automatic quality control, was conducted to validate the resulting masks. Additionally, we provide individualized quality indices per mask and an overall quality estimation per dataset. This dataset serves as a valuable resource for the broader scientific community, streamlining the development and assessment of innovative methodologies in chest X-ray analysis. The CheXmask dataset is publicly available at: https://physionet.org/content/chexmask-cxr-segmentation-data/.

Medical imaging provides critical evidence for clinical diagnosis, treatment planning, and surgical decisions, yet most existing imaging models are narrowly focused and require multiple specialized networks, limiting their generalization. Although large-scale language and multimodal models exhibit strong reasoning and multi-task capabilities, real-world clinical applications demand precise visual grounding, multimodal integration, and chain-of-thought reasoning. We introduce Citrus-V, a multimodal medical foundation model that combines image analysis with textual reasoning. The model integrates detection, segmentation, and multimodal chain-of-thought reasoning, enabling pixel-level lesion localization, structured report generation, and physician-like diagnostic inference in a single framework. We propose a novel multimodal training approach and release a curated open-source data suite covering reasoning, detection, segmentation, and document understanding tasks. Evaluations demonstrate that Citrus-V outperforms existing open-source medical models and expert-level imaging systems across multiple benchmarks, delivering a unified pipeline from visual grounding to clinical reasoning and supporting precise lesion quantification, automated reporting, and reliable second opinions.

Recent advances of large multi-modality models (LMM) have greatly improved the ability of image quality assessment (IQA) method to evaluate and explain the quality of visual content. However, these advancements are mostly focused on overall quality assessment, and the detailed examination of local quality, which is crucial for comprehensive visual understanding, is still largely unexplored. In this work, we introduce Q-Ground, the first framework aimed at tackling fine-scale visual quality grounding by combining large multi-modality models with detailed visual quality analysis. Central to our contribution is the introduction of the QGround-100K dataset, a novel resource containing 100k triplets of (image, quality text, distortion segmentation) to facilitate deep investigations into visual quality. The dataset comprises two parts: one with human-labeled annotations for accurate quality assessment, and another labeled automatically by LMMs such as GPT4V, which helps improve the robustness of model training while also reducing the costs of data collection. With the QGround-100K dataset, we propose a LMM-based method equipped with multi-scale feature learning to learn models capable of performing both image quality answering and distortion segmentation based on text prompts. This dual-capability approach not only refines the model's understanding of region-aware image quality but also enables it to interactively respond to complex, text-based queries about image quality and specific distortions. Q-Ground takes a step towards sophisticated visual quality analysis in a finer scale, establishing a new benchmark for future research in the area. Codes and dataset are available at https://github.com/Q-Future/Q-Ground.

Automated structured radiology report generation (SRRG) from chest X-ray images offers significant potential to reduce workload of radiologists by generating reports in structured formats that ensure clarity, consistency, and adherence to clinical reporting standards. While radiologists effectively utilize available clinical contexts in their diagnostic reasoning, existing SRRG systems overlook these essential elements. This fundamental gap leads to critical problems including temporal hallucinations when referencing non-existent clinical contexts. To address these limitations, we propose contextualized SRRG (C-SRRG) that comprehensively incorporates rich clinical context for SRRG. We curate C-SRRG dataset by integrating comprehensive clinical context encompassing 1) multi-view X-ray images, 2) clinical indication, 3) imaging techniques, and 4) prior studies with corresponding comparisons based on patient histories. Through extensive benchmarking with state-of-the-art multimodal large language models, we demonstrate that incorporating clinical context with the proposed C-SRRG significantly improves report generation quality. We publicly release dataset, code, and checkpoints to facilitate future research for clinically-aligned automated RRG at https://github.com/vuno/contextualized-srrg.

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

We present a radiology-specific multimodal model for the task for generating radiological reports from chest X-rays (CXRs). Our work builds on the idea that large language model(s) can be equipped with multimodal capabilities through alignment with pre-trained vision encoders. On natural images, this has been shown to allow multimodal models to gain image understanding and description capabilities. Our proposed model (MAIRA-1) leverages a CXR-specific image encoder in conjunction with a fine-tuned large language model based on Vicuna-7B, and text-based data augmentation, to produce reports with state-of-the-art quality. In particular, MAIRA-1 significantly improves on the radiologist-aligned RadCliQ metric and across all lexical metrics considered. Manual review of model outputs demonstrates promising fluency and accuracy of generated reports while uncovering failure modes not captured by existing evaluation practices. More information and resources can be found on the project website: https://aka.ms/maira.

Radiologists play a crucial role by translating medical images into medical reports. However, the field faces staffing shortages and increasing workloads. While automated approaches using vision-language models (VLMs) show promise as assistants, they require exceptionally high accuracy. Most current VLMs in radiology rely solely on supervised fine-tuning (SFT). Meanwhile, in the general domain, additional preference fine-tuning has become standard practice. The challenge in radiology lies in the prohibitive cost of obtaining radiologist feedback. We propose a scalable automated preference alignment technique for VLMs in radiology, focusing on chest X-ray (CXR) report generation. Our method leverages publicly available datasets with an LLM-as-a-Judge mechanism, eliminating the need for additional expert radiologist feedback. We evaluate and benchmark five direct alignment algorithms (DAAs). Our results show up to a 57.4% improvement in average GREEN scores, a LLM-based metric for evaluating CXR reports, and a 9.2% increase in an average across six metrics (domain specific and general), compared to the SFT baseline. We study reward overoptimization via length exploitation, with reports lengthening by up to 3.2x. To assess a potential alignment tax, we benchmark on six additional diverse tasks, finding no significant degradations. A reader study involving four board-certified radiologists indicates win rates of up to 0.62 over the SFT baseline, while significantly penalizing verbosity. Our analysis provides actionable insights for the development of VLMs in high-stakes fields like radiology.

3D visual grounding aims to locate objects based on natural language descriptions in 3D scenes. Existing methods rely on a pre-defined Object Lookup Table (OLT) to query Visual Language Models (VLMs) for reasoning about object locations, which limits the applications in scenarios with undefined or unforeseen targets. To address this problem, we present OpenGround, a novel zero-shot framework for open-world 3D visual grounding. Central to OpenGround is the Active Cognition-based Reasoning (ACR) module, which is designed to overcome the fundamental limitation of pre-defined OLTs by progressively augmenting the cognitive scope of VLMs. The ACR module performs human-like perception of the target via a cognitive task chain and actively reasons about contextually relevant objects, thereby extending VLM cognition through a dynamically updated OLT. This allows OpenGround to function with both pre-defined and open-world categories. We also propose a new dataset named OpenTarget, which contains over 7000 object-description pairs to evaluate our method in open-world scenarios. Extensive experiments demonstrate that OpenGround achieves competitive performance on Nr3D, state-of-the-art on ScanRefer, and delivers a substantial 17.6% improvement on OpenTarget. Project Page at https://why-102.github.io/openground.io/.

GUI grounding, which localizes interface elements from screenshots given natural language queries, remains challenging for small icons and dense layouts. Test-time zoom-in methods improve localization by cropping and re-running inference at higher resolution, but apply cropping uniformly across all instances with fixed crop sizes, ignoring whether the model is actually uncertain on each case. We propose UI-Zoomer, a training-free adaptive zoom-in framework that treats both the trigger and scale of zoom-in as a prediction uncertainty quantification problem. A confidence-aware gate fuses spatial consensus among stochastic candidates with token-level generation confidence to selectively trigger zoom-in only when localization is uncertain. When triggered, an uncertainty-driven crop sizing module decomposes prediction variance into inter-sample positional spread and intra-sample box extent, deriving a per-instance crop radius via the law of total variance. Extensive experiments on ScreenSpot-Pro, UI-Vision, and ScreenSpot-v2 demonstrate consistent improvements over strong baselines across multiple model architectures, achieving gains of up to +13.4\%, +10.3\%, and +4.2\% respectively, with no additional training required.

GUI grounding, the task of mapping natural-language instructions to pixel coordinates, is crucial for autonomous agents, yet remains difficult for current VLMs. The core bottleneck is reliable patch-to-pixel mapping, which breaks when extrapolating to high-resolution displays unseen during training. Current approaches generate coordinates as text tokens directly from visual features, forcing the model to infer complex position-to-pixel mappings implicitly; as a result, accuracy degrades and failures proliferate on new resolutions. We address this with two complementary innovations. First, RULER tokens serve as explicit coordinate markers, letting the model reference positions similar to gridlines on a map and adjust rather than generate coordinates from scratch. Second, Interleaved MRoPE (I-MRoPE) improves spatial encoding by ensuring that width and height dimensions are represented equally, addressing the asymmetry of standard positional schemes. Experiments on ScreenSpot, ScreenSpot-V2, and ScreenSpot-Pro show consistent gains in grounding accuracy, with the largest improvements on high-resolution interfaces. By providing explicit spatial guidance rather than relying on implicit learning, our approach enables more reliable GUI automation across diverse resolutions and platforms.

Chest X-rays (CXR) are the most common medical imaging study and are used to diagnose multiple medical conditions. This study examines the impact of synthetic data supplementation, using diffusion models, on the performance of deep learning (DL) classifiers for CXR analysis. We employed three datasets: CheXpert, MIMIC-CXR, and Emory Chest X-ray, training conditional denoising diffusion probabilistic models (DDPMs) to generate synthetic frontal radiographs. Our approach ensured that synthetic images mirrored the demographic and pathological traits of the original data. Evaluating the classifiers' performance on internal and external datasets revealed that synthetic data supplementation enhances model accuracy, particularly in detecting less prevalent pathologies. Furthermore, models trained on synthetic data alone approached the performance of those trained on real data. This suggests that synthetic data can potentially compensate for real data shortages in training robust DL models. However, despite promising outcomes, the superiority of real data persists.

Power batteries are essential components in electric vehicles, where internal structural defects can pose serious safety risks. We conduct a comprehensive study on a new task, power battery detection (PBD), which aims to localize the dense endpoints of cathode and anode plates from industrial X-ray images for quality inspection. Manual inspection is inefficient and error-prone, while traditional vision algorithms struggle with densely packed plates, low contrast, scale variation, and imaging artifacts. To address this issue and drive more attention into this meaningful task, we present PBD5K, the first large-scale benchmark for this task, consisting of 5,000 X-ray images from nine battery types with fine-grained annotations and eight types of real-world visual interference. To support scalable and consistent labeling, we develop an intelligent annotation pipeline that combines image filtering, model-assisted pre-labeling, cross-verification, and layered quality evaluation. We formulate PBD as a point-level segmentation problem and propose MDCNeXt, a model designed to extract and integrate multi-dimensional structure clues including point, line, and count information from the plate itself. To improve discrimination between plates and suppress visual interference, MDCNeXt incorporates two state space modules. The first is a prompt-filtered module that learns contrastive relationships guided by task-specific prompts. The second is a density-aware reordering module that refines segmentation in regions with high plate density. In addition, we propose a distance-adaptive mask generation strategy to provide robust supervision under varying spatial distributions of anode and cathode positions. The source code and datasets will be publicly available at https://github.com/Xiaoqi-Zhao-DLUT/X-ray-PBD{PBD5K}.

This paper introduces Grounding DINO 1.5, a suite of advanced open-set object detection models developed by IDEA Research, which aims to advance the "Edge" of open-set object detection. The suite encompasses two models: Grounding DINO 1.5 Pro, a high-performance model designed for stronger generalization capability across a wide range of scenarios, and Grounding DINO 1.5 Edge, an efficient model optimized for faster speed demanded in many applications requiring edge deployment. The Grounding DINO 1.5 Pro model advances its predecessor by scaling up the model architecture, integrating an enhanced vision backbone, and expanding the training dataset to over 20 million images with grounding annotations, thereby achieving a richer semantic understanding. The Grounding DINO 1.5 Edge model, while designed for efficiency with reduced feature scales, maintains robust detection capabilities by being trained on the same comprehensive dataset. Empirical results demonstrate the effectiveness of Grounding DINO 1.5, with the Grounding DINO 1.5 Pro model attaining a 54.3 AP on the COCO detection benchmark and a 55.7 AP on the LVIS-minival zero-shot transfer benchmark, setting new records for open-set object detection. Furthermore, the Grounding DINO 1.5 Edge model, when optimized with TensorRT, achieves a speed of 75.2 FPS while attaining a zero-shot performance of 36.2 AP on the LVIS-minival benchmark, making it more suitable for edge computing scenarios. Model examples and demos with API will be released at https://github.com/IDEA-Research/Grounding-DINO-1.5-API

This paper presents a comprehensive evaluation of GPT-4V's capabilities across diverse medical imaging tasks, including Radiology Report Generation, Medical Visual Question Answering (VQA), and Visual Grounding. While prior efforts have explored GPT-4V's performance in medical image analysis, to the best of our knowledge, our study represents the first quantitative evaluation on publicly available benchmarks. Our findings highlight GPT-4V's potential in generating descriptive reports for chest X-ray images, particularly when guided by well-structured prompts. Meanwhile, its performance on the MIMIC-CXR dataset benchmark reveals areas for improvement in certain evaluation metrics, such as CIDEr. In the domain of Medical VQA, GPT-4V demonstrates proficiency in distinguishing between question types but falls short of the VQA-RAD benchmark in terms of accuracy. Furthermore, our analysis finds the limitations of conventional evaluation metrics like the BLEU scores, advocating for the development of more semantically robust assessment methods. In the field of Visual Grounding, GPT-4V exhibits preliminary promise in recognizing bounding boxes, but its precision is lacking, especially in identifying specific medical organs and signs. Our evaluation underscores the significant potential of GPT-4V in the medical imaging domain, while also emphasizing the need for targeted refinements to fully unlock its capabilities.

The primary aim of single-image super-resolution is to construct high-resolution (HR) images from corresponding low-resolution (LR) inputs. In previous approaches, which have generally been supervised, the training objective typically measures a pixel-wise average distance between the super-resolved (SR) and HR images. Optimizing such metrics often leads to blurring, especially in high variance (detailed) regions. We propose an alternative formulation of the super-resolution problem based on creating realistic SR images that downscale correctly. We present an algorithm addressing this problem, PULSE (Photo Upsampling via Latent Space Exploration), which generates high-resolution, realistic images at resolutions previously unseen in the literature. It accomplishes this in an entirely self-supervised fashion and is not confined to a specific degradation operator used during training, unlike previous methods (which require supervised training on databases of LR-HR image pairs). Instead of starting with the LR image and slowly adding detail, PULSE traverses the high-resolution natural image manifold, searching for images that downscale to the original LR image. This is formalized through the "downscaling loss," which guides exploration through the latent space of a generative model. By leveraging properties of high-dimensional Gaussians, we restrict the search space to guarantee realistic outputs. PULSE thereby generates super-resolved images that both are realistic and downscale correctly. We show proof of concept of our approach in the domain of face super-resolution (i.e., face hallucination). We also present a discussion of the limitations and biases of the method as currently implemented with an accompanying model card with relevant metrics. Our method outperforms state-of-the-art methods in perceptual quality at higher resolutions and scale factors than previously possible.

Recent advancements in Large Vision-Language Models are accelerating the development of Graphical User Interface (GUI) agents that utilize human-like vision perception capabilities to enhance productivity on digital devices. Compared to approaches predicated on GUI metadata, which are platform-dependent and vulnerable to implementation variations, vision-based approaches offer broader applicability. In this vision-based paradigm, the GUI instruction grounding, which maps user instruction to the location of corresponding element on the given screenshot, remains a critical challenge, particularly due to limited public training dataset and resource-intensive manual instruction data annotation. In this paper, we delve into unexplored challenges in this task including element-to-screen ratio, unbalanced element type, and implicit instruction. To address these challenges, we introduce a large-scale data synthesis pipeline UI-E2I-Synth for generating varying complex instruction datasets using GPT-4o instead of human annotators. Furthermore, we propose a new GUI instruction grounding benchmark UI-I2E-Bench, which is designed to address the limitations of existing benchmarks by incorporating diverse annotation aspects. Our model, trained on the synthesized data, achieves superior performance in GUI instruction grounding, demonstrating the advancements of proposed data synthesis pipeline. The proposed benchmark, accompanied by extensive analyses, provides practical insights for future research in GUI grounding. We will release corresponding artifacts at https://colmon46.github.io/i2e-bench-leaderboard/ .

We introduce RegionFocus, a visual test-time scaling approach for Vision Language Model Agents. Understanding webpages is challenging due to the visual complexity of GUI images and the large number of interface elements, making accurate action selection difficult. Our approach dynamically zooms in on relevant regions, reducing background clutter and improving grounding accuracy. To support this process, we propose an image-as-map mechanism that visualizes key landmarks at each step, providing a transparent action record and enables the agent to effectively choose among action candidates. Even with a simple region selection strategy, we observe significant performance gains of 28+\% on Screenspot-pro and 24+\% on WebVoyager benchmarks on top of two state-of-the-art open vision language model agents, UI-TARS and Qwen2.5-VL, highlighting the effectiveness of visual test-time scaling in interactive settings. We achieve a new state-of-the-art grounding performance of 61.6\% on the ScreenSpot-Pro benchmark by applying RegionFocus to a Qwen2.5-VL-72B model. Our code will be released publicly at https://github.com/tiangeluo/RegionFocus.

RGBA images, with the additional alpha channel, are crucial for any application that needs blending, masking, or transparency effects, making them more versatile than standard RGB images. Nevertheless, existing image inpainting methods are designed exclusively for RGB images. Conventional approaches to transparent image inpainting typically involve placing a background underneath RGBA images and employing a two-stage process: image inpainting followed by image matting. This pipeline, however, struggles to preserve transparency consistency in edited regions, and matting can introduce jagged edges along transparency boundaries. To address these challenges, we propose Trans-Adapter, a plug-and-play adapter that enables diffusion-based inpainting models to process transparent images directly. Trans-Adapter also supports controllable editing via ControlNet and can be seamlessly integrated into various community models. To evaluate our method, we introduce LayerBench, along with a novel non-reference alpha edge quality evaluation metric for assessing transparency edge quality. We conduct extensive experiments on LayerBench to demonstrate the effectiveness of our approach.

We introduce a novel training-free spatial grounding technique for text-to-image generation using Diffusion Transformers (DiT). Spatial grounding with bounding boxes has gained attention for its simplicity and versatility, allowing for enhanced user control in image generation. However, prior training-free approaches often rely on updating the noisy image during the reverse diffusion process via backpropagation from custom loss functions, which frequently struggle to provide precise control over individual bounding boxes. In this work, we leverage the flexibility of the Transformer architecture, demonstrating that DiT can generate noisy patches corresponding to each bounding box, fully encoding the target object and allowing for fine-grained control over each region. Our approach builds on an intriguing property of DiT, which we refer to as semantic sharing. Due to semantic sharing, when a smaller patch is jointly denoised alongside a generatable-size image, the two become "semantic clones". Each patch is denoised in its own branch of the generation process and then transplanted into the corresponding region of the original noisy image at each timestep, resulting in robust spatial grounding for each bounding box. In our experiments on the HRS and DrawBench benchmarks, we achieve state-of-the-art performance compared to previous training-free spatial grounding approaches.

Generative super-resolution (GSR) currently sets the state-of-the-art in terms of perceptual image quality, overcoming the "regression-to-the-mean" blur of prior non-generative models. However, from a human perspective, such models do not fully conform to the optimal balance between quality and fidelity. Instead, a different class of artifacts, in which generated details fail to perceptually match the low resolution image (LRI) or ground-truth image (GTI), is a critical but under studied issue in GSR, limiting its practical deployments. In this work, we focus on measuring, analyzing, and mitigating these artifacts (i.e., "hallucinations"). We observe that hallucinations are not well-characterized with existing image metrics or quality models, as they are orthogonal to both exact fidelity and no-reference quality. Instead, we take advantage of a multimodal large language model (MLLM) by constructing a prompt that assesses hallucinatory visual elements and generates a "Hallucination Score" (HS). We find that our HS is closely aligned with human evaluations, and also provides complementary insights to prior image metrics used for super-resolution (SR) models. In addition, we find certain deep feature distances have strong correlations with HS. We therefore propose to align the GSR models by using such features as differentiable reward functions to mitigate hallucinations.

Recent advances in vision--language pretraining have enabled strong medical foundation models, yet most analyze radiographs in isolation, overlooking the key clinical task of comparing prior and current images to assess interval change. For chest radiographs (CXRs), capturing interval change is essential, as radiologists must evaluate not only the static appearance of findings but also how they evolve over time. We introduce TILA (Temporal Inversion-aware Learning and Alignment), a simple yet effective framework that uses temporal inversion, reversing image pairs, as a supervisory signal to enhance the sensitivity of existing temporal vision-language models to directional change. TILA integrates inversion-aware objectives across pretraining, fine-tuning, and inference, complementing conventional appearance modeling with explicit learning of temporal order. We also propose a unified evaluation protocol to assess order sensitivity and consistency under temporal inversion, and introduce MS-CXR-Tretrieval, a retrieval evaluation set constructed through a general protocol that can be applied to any temporal CXR dataset. Experiments on public datasets and real-world hospital cohorts demonstrate that TILA consistently improves progression classification and temporal embedding alignment when applied to multiple existing architectures.

Current large multimodal models (LMMs) face challenges in grounding, which requires the model to relate language components to visual entities. Contrary to the common practice that fine-tunes LMMs with additional grounding supervision, we find that the grounding ability can in fact emerge in LMMs trained without explicit grounding supervision. To reveal this emerging grounding, we introduce an "attend-and-segment" method which leverages attention maps from standard LMMs to perform pixel-level segmentation. Furthermore, to enhance the grounding ability, we propose DIFFLMM, an LMM utilizing a diffusion-based visual encoder, as opposed to the standard CLIP visual encoder, and trained with the same weak supervision. Without being constrained by the biases and limited scale of grounding-specific supervision data, our approach is more generalizable and scalable. We achieve competitive performance on both grounding-specific and general visual question answering benchmarks, compared with grounding LMMs and generalist LMMs, respectively. Notably, we achieve a 44.2 grounding mask recall on grounded conversation generation without any grounding supervision, outperforming the extensively supervised model GLaMM. Project page: https://GroundLMM-ICCV.github.io.

In this work, we present LesionLocator, a framework for zero-shot longitudinal lesion tracking and segmentation in 3D medical imaging, establishing the first end-to-end model capable of 4D tracking with dense spatial prompts. Our model leverages an extensive dataset of 23,262 annotated medical scans, as well as synthesized longitudinal data across diverse lesion types. The diversity and scale of our dataset significantly enhances model generalizability to real-world medical imaging challenges and addresses key limitations in longitudinal data availability. LesionLocator outperforms all existing promptable models in lesion segmentation by nearly 10 dice points, reaching human-level performance, and achieves state-of-the-art results in lesion tracking, with superior lesion retrieval and segmentation accuracy. LesionLocator not only sets a new benchmark in universal promptable lesion segmentation and automated longitudinal lesion tracking but also provides the first open-access solution of its kind, releasing our synthetic 4D dataset and model to the community, empowering future advancements in medical imaging. Code is available at: www.github.com/MIC-DKFZ/LesionLocator

Existing super-resolution (SR) models primarily focus on restoring local texture details, often neglecting the global semantic information within the scene. This oversight can lead to the omission of crucial semantic details or the introduction of inaccurate textures during the recovery process. In our work, we introduce the Cognitive Super-Resolution (CoSeR) framework, empowering SR models with the capacity to comprehend low-resolution images. We achieve this by marrying image appearance and language understanding to generate a cognitive embedding, which not only activates prior information from large text-to-image diffusion models but also facilitates the generation of high-quality reference images to optimize the SR process. To further improve image fidelity, we propose a novel condition injection scheme called "All-in-Attention", consolidating all conditional information into a single module. Consequently, our method successfully restores semantically correct and photorealistic details, demonstrating state-of-the-art performance across multiple benchmarks. Code: https://github.com/VINHYU/CoSeR

Chest X-ray (CXR) classification in clinical practice is often limited by imperfect supervision, arising from (i) extreme long-tailed multi-label disease distributions and (ii) missing annotations for rare or previously unseen findings. The CXR-LT 2026 challenge addresses these issues on a PadChest-based benchmark with a 36-class label space split into 30 in-distribution classes for training and 6 out-of-distribution (OOD) classes for zero-shot evaluation. We present task-specific solutions tailored to the distinct supervision regimes. For Task 1 (long-tailed multi-label classification), we adopt an imbalance-aware multi-label learning strategy to improve recognition of tail classes while maintaining stable performance on frequent findings. For Task 2 (zero-shot OOD recognition), we propose a prediction approach that produces scores for unseen disease categories without using any supervised labels or examples from the OOD classes during training. Evaluated with macro-averaged mean Average Precision (mAP), our method achieves strong performance on both tasks, ranking first on the public leaderboard of the development phase. Code and pre-trained models are available at https://github.com/hieuphamha19/CXR_LT.

This study investigates the integration of diverse patient data sources into multimodal language models for automated chest X-ray (CXR) report generation. Traditionally, CXR report generation relies solely on CXR images and limited radiology data, overlooking valuable information from patient health records, particularly from emergency departments. Utilising the MIMIC-CXR and MIMIC-IV-ED datasets, we incorporate detailed patient information such as aperiodic vital signs, medications, and clinical history to enhance diagnostic accuracy. We introduce a novel approach to transform these heterogeneous data sources into embeddings that prompt a multimodal language model, significantly enhancing the diagnostic accuracy of generated radiology reports. Our comprehensive evaluation demonstrates the benefits of using a broader set of patient data, underscoring the potential for enhanced diagnostic capabilities and better patient outcomes through the integration of multimodal data in CXR report generation.

Frontier models have demonstrated remarkable capabilities in understanding and reasoning with natural-language text, but they still exhibit major competency gaps in multimodal understanding and reasoning especially in high-value verticals such as biomedicine. Medical imaging report generation is a prominent example. Supervised fine-tuning can substantially improve performance, but they are prone to overfitting to superficial boilerplate patterns. In this paper, we introduce Universal Report Generation (UniRG) as a general framework for medical imaging report generation. By leveraging reinforcement learning as a unifying mechanism to directly optimize for evaluation metrics designed for end applications, UniRG can significantly improve upon supervised fine-tuning and attain durable generalization across diverse institutions and clinical practices. We trained UniRG-CXR on publicly available chest X-ray (CXR) data and conducted a thorough evaluation in CXR report generation with rigorous evaluation scenarios. On the authoritative ReXrank benchmark, UniRG-CXR sets new overall SOTA, outperforming prior state of the art by a wide margin.

Foundation models for medical imaging are typically pretrained on increasingly large datasets, following a "scale-at-all-costs" paradigm. However, this strategy faces two critical challenges: large-scale medical datasets often contain substantial redundancy and severe class imbalance that bias representation learning toward over-represented patterns, and indiscriminate training regardless of heterogeneity in data quality incurs considerable computational inefficiency. Here we demonstrate that active, principled data curation during pretraining can serve as a viable, cost-effective alternative to brute-force dataset enlargement. We introduce CheXficient, a chest X-ray (CXR) foundation model that selectively prioritizes informative training samples. CheXficient is pretrained on only 22.7% of 1,235,004 paired CXR images and reports while consuming under 27.3% of the total compute budget, yet achieving comparable or superior performance to its full-data counterpart and other large-scale pretrained models. We assess CheXficient across 20 individual benchmarks spanning 5 task types, including non-adapted off-the-shelf evaluations (zero-shot findings classification and crossmodal retrieval) and adapted downstream tasks (disease prediction, semantic segmentation, and radiology report generation). Further analyses show that CheXficient systematically prioritizes under-represented training samples, improving generalizability on long-tailed or rare conditions. Overall, our work offers practical insights into the data and computation demands for efficient pretraining and downstream adaptation of medical vision-language foundation models.

Recent progress in Large Vision-Language Models (LVLMs) has enabled promising applications in medical tasks, such as report generation and visual question answering. However, existing benchmarks focus mainly on the final diagnostic answer, offering limited insight into whether models engage in clinically meaningful reasoning. To address this, we present CheXStruct and CXReasonBench, a structured pipeline and benchmark built on the publicly available MIMIC-CXR-JPG dataset. CheXStruct automatically derives a sequence of intermediate reasoning steps directly from chest X-rays, such as segmenting anatomical regions, deriving anatomical landmarks and diagnostic measurements, computing diagnostic indices, and applying clinical thresholds. CXReasonBench leverages this pipeline to evaluate whether models can perform clinically valid reasoning steps and to what extent they can learn from structured guidance, enabling fine-grained and transparent assessment of diagnostic reasoning. The benchmark comprises 18,988 QA pairs across 12 diagnostic tasks and 1,200 cases, each paired with up to 4 visual inputs, and supports multi-path, multi-stage evaluation including visual grounding via anatomical region selection and diagnostic measurements. Even the strongest of 10 evaluated LVLMs struggle with structured reasoning and generalization, often failing to link abstract knowledge with anatomically grounded visual interpretation. The code is available at https://github.com/ttumyche/CXReasonBench

Chest X-ray report generation (CXR-RG) has the potential to substantially alleviate radiologists' workload. However, conventional autoregressive vision--language models (VLMs) suffer from high inference latency due to sequential token decoding. Diffusion-based models offer a promising alternative through parallel generation, but they still require multiple denoising iterations. Compressing multi-step denoising to a single step could further reduce latency, but often degrades textual coherence due to the mean-field bias introduced by token-factorized denoisers. To address this challenge, we propose ECHO, an efficient diffusion-based VLM (dVLM) for chest X-ray report generation. ECHO enables stable one-step-per-block inference via a novel Direct Conditional Distillation (DCD) framework, which mitigates the mean-field limitation by constructing unfactorized supervision from on-policy diffusion trajectories to encode joint token dependencies. In addition, we introduce a Response-Asymmetric Diffusion (RAD) training strategy that further improves training efficiency while maintaining model effectiveness. Extensive experiments demonstrate that ECHO surpasses state-of-the-art autoregressive methods, improving RaTE and SemScore by 64.33\% and 60.58\% respectively, while achieving an 8times inference speedup without compromising clinical accuracy.

With the emergence of large-scale vision language models (VLM), it is now possible to produce realistic-looking radiology reports for chest X-ray images. However, their clinical translation has been hampered by the factual errors and hallucinations in the produced descriptions during inference. In this paper, we present a novel phrase-grounded fact-checking model (FC model) that detects errors in findings and their indicated locations in automatically generated chest radiology reports. Specifically, we simulate the errors in reports through a large synthetic dataset derived by perturbing findings and their locations in ground truth reports to form real and fake findings-location pairs with images. A new multi-label cross-modal contrastive regression network is then trained on this dataset. We present results demonstrating the robustness of our method in terms of accuracy of finding veracity prediction and localization on multiple X-ray datasets. We also show its effectiveness for error detection in reports of SOTA report generators on multiple datasets achieving a concordance correlation coefficient of 0.997 with ground truth-based verification, thus pointing to its utility during clinical inference in radiology workflows.

GUI grounding, the task of identifying a precise location on an interface image from a natural language query, plays a crucial role in enhancing the capabilities of Vision-Language Model (VLM) agents. While general VLMs, such as GPT-4V, demonstrate strong performance across various tasks, their proficiency in GUI grounding remains suboptimal. Recent studies have focused on fine-tuning these models specifically for one-shot GUI grounding, yielding significant improvements over baseline performance. We introduce a visual prompting framework called Iterative Narrowing (IN) to further enhance the performance of both general and fine-tuned models in GUI grounding. For evaluation, we tested our method on a comprehensive benchmark comprising different UI platforms.

The ability of large language models (LLMs) to process visual inputs has given rise to general-purpose vision systems, unifying various vision-language (VL) tasks by instruction tuning. However, due to the enormous diversity in input-output formats in the vision domain, existing general-purpose models fail to successfully integrate segmentation and multi-image inputs with coarse-level tasks into a single framework. In this work, we introduce VistaLLM, a powerful visual system that addresses coarse- and fine-grained VL tasks over single and multiple input images using a unified framework. VistaLLM utilizes an instruction-guided image tokenizer that filters global embeddings using task descriptions to extract compressed and refined features from numerous images. Moreover, VistaLLM employs a gradient-aware adaptive sampling technique to represent binary segmentation masks as sequences, significantly improving over previously used uniform sampling. To bolster the desired capability of VistaLLM, we curate CoinIt, a comprehensive coarse-to-fine instruction tuning dataset with 6.8M samples. We also address the lack of multi-image grounding datasets by introducing a novel task, AttCoSeg (Attribute-level Co-Segmentation), which boosts the model's reasoning and grounding capability over multiple input images. Extensive experiments on a wide range of V- and VL tasks demonstrate the effectiveness of VistaLLM by achieving consistent state-of-the-art performance over strong baselines across all downstream tasks. Our project page can be found at https://shramanpramanick.github.io/VistaLLM/.

Agentic systems offer a potential path to solve complex clinical tasks through collaboration among specialized agents, augmented by tool use and external knowledge bases. Nevertheless, for chest X-ray (CXR) interpretation, prevailing methods remain limited: (i) reasoning is frequently neither clinically interpretable nor aligned with guidelines, reflecting mere aggregation of tool outputs; (ii) multimodal evidence is insufficiently fused, yielding text-only rationales that are not visually grounded; and (iii) systems rarely detect or resolve cross-tool inconsistencies and provide no principled verification mechanisms. To bridge the above gaps, we present RadAgents, a multi-agent framework for CXR interpretation that couples clinical priors with task-aware multimodal reasoning. In addition, we integrate grounding and multimodal retrieval-augmentation to verify and resolve context conflicts, resulting in outputs that are more reliable, transparent, and consistent with clinical practice.

Evaluating whether text-to-image models follow explicit spatial instructions is difficult to automate. Object detectors may miss targets or return multiple plausible detections, and simple geometric tests can become ambiguous in borderline cases. Spatial evaluation is naturally a selective prediction problem, the checker may abstain when evidence is weak and report confidence so that results can be interpreted as a risk coverage tradeoff rather than a single score. We introduce SpatialBench-UC, a small, reproducible benchmark for pairwise spatial relations. The benchmark contains 200 prompts (50 object pairs times 4 relations) grouped into 100 counterfactual pairs obtained by swapping object roles. We release a benchmark package, versioned prompts, pinned configs, per-sample checker outputs, and report tables, enabling reproducible and auditable comparisons across models. We also include a lightweight human audit used to calibrate the checker's abstention margin and confidence threshold. We evaluate three baselines, Stable Diffusion 1.5, SD 1.5 BoxDiff, and SD 1.4 GLIGEN. The checker reports pass rate and coverage as well as conditional pass rates on decided samples. The results show that grounding methods substantially improve both pass rate and coverage, while abstention remains a dominant factor due mainly to missing detections.

Visual agent models for automating human activities on Graphical User Interfaces (GUIs) have emerged as a promising research direction, driven by advances in large Vision Language Models (VLMs). A critical challenge in GUI automation is the precise grounding of interface elements across diverse platforms. Existing vision-only GUI agents directly ground elements from large and cluttered screenshots, requiring them to process substantial irrelevant information that compromises their accuracy. In addition, these approaches typically employ basic cross-entropy loss for learning grounding objectives, which fails to effectively capture grounding quality compared to established object detection metrics like Intersection-over-Union (IoU). To address these issues, we introduce R-VLM, a novel GUI grounding approach that leverages zoomed-in region proposals for precise element localization. We also propose an IoU-aware objective function that facilitates model convergence toward high IoU predictions. Our approach bridges the gap between VLMs and conventional object detection techniques, improving the state-of-the-art grounding accuracy by 13% across diverse GUI platforms on the GUI grounding benchmarks ScreenSpot and AgentStudio. In addition, our R-VLM approach shows 3.2-9.7% absolute accuracy improvements in GUI navigation tasks on the AITW and Mind2Web benchmarks.

3D Visual Grounding (3DVG) seeks to locate target objects in 3D scenes using natural language descriptions, enabling downstream applications such as augmented reality and robotics. Existing approaches typically rely on labeled 3D data and predefined categories, limiting scalability to open-world settings. We present SeeGround, a zero-shot 3DVG framework that leverages 2D Vision-Language Models (VLMs) to bypass the need for 3D-specific training. To bridge the modality gap, we introduce a hybrid input format that pairs query-aligned rendered views with spatially enriched textual descriptions. Our framework incorporates two core components: a Perspective Adaptation Module that dynamically selects optimal viewpoints based on the query, and a Fusion Alignment Module that integrates visual and spatial signals to enhance localization precision. Extensive evaluations on ScanRefer and Nr3D confirm that SeeGround achieves substantial improvements over existing zero-shot baselines -- outperforming them by 7.7% and 7.1%, respectively -- and even rivals fully supervised alternatives, demonstrating strong generalization under challenging conditions.

3D visual grounding (3DVG) aims to localize objects in a 3D scene based on natural language queries. In this work, we explore zero-shot 3DVG from multi-view images alone, without requiring any geometric supervision or object priors. We introduce Z3D, a universal grounding pipeline that flexibly operates on multi-view images while optionally incorporating camera poses and depth maps. We identify key bottlenecks in prior zero-shot methods causing significant performance degradation and address them with (i) a state-of-the-art zero-shot 3D instance segmentation method to generate high-quality 3D bounding box proposals and (ii) advanced reasoning via prompt-based segmentation, which utilizes full capabilities of modern VLMs. Extensive experiments on the ScanRefer and Nr3D benchmarks demonstrate that our approach achieves state-of-the-art performance among zero-shot methods. Code is available at https://github.com/col14m/z3d .

Recent advances in multimodal large language models(MLLMs) have led to remarkable progress in visual grounding, enabling fine-grained cross-modal alignment between textual queries and image regions. However, transferring such capabilities to remote sensing imagery remains challenging, as targets are often extremely small within kilometer-scale scenes, and queries typically involve intricate geospatial relations such as relative positions, spatial hierarchies, or contextual dependencies across distant objects. To address these challenges, we propose GeoViS, a Geospatially Rewarded Visual Search framework that reformulates remote sensing visual grounding as a progressive search-and-reasoning process. Rather than directly predicting the target location in a single step, GeoViS actively explores the global image through a tree-structured sequence of visual cues, integrating multimodal perception, spatial reasoning, and reward-guided exploration to refine geospatial hypotheses iteratively. This design enables the model to detect subtle small-scale targets while maintaining holistic scene awareness. Extensive experiments on five remote sensing grounding benchmarks demonstrate that GeoViS achieves precise geospatial understanding and consistently surpasses existing methods across key visual grounding metrics, highlighting its strong cross-domain generalization and interpretability.

Multiple works have emerged to push the boundaries on multi-modal large language models (MLLMs) towards pixel-level understanding. Such approaches have shown strong performance on benchmarks for referring expression segmentation and grounded conversation generation. The current trend in pixel-level MLLMs is to train with pixel-level grounding supervision on large-scale labelled data. However, we show that such MLLMs when evaluated on recent challenging vision centric benchmarks, exhibit a weak ability in visual question answering. Surprisingly, some of these methods even downgrade the grounding ability of MLLMs that were never trained with such supervision. In this work, we propose two novel challenging benchmarks and show that MLLMs without pixel-level grounding supervision can outperform the state of the art in such tasks when evaluating both the pixel-level grounding and visual question answering. We propose simple baselines to extract the grounding information that can be plugged into any MLLM, which we call as PixFoundation. More importantly, we study the research question of "When does grounding emerge in MLLMs that are not trained with pixel-level grounding supervision?" We show that grounding can coincide with object parts or location/appearance information. Code repository is at https://github.com/MSiam/PixFoundation/.

Gaussian Splatting (GS), a recent technique for converting discrete points into continuous spatial representations, has shown promising results in 3D scene modeling and 2D image super-resolution. In this paper, we explore its untapped potential for image inpainting, which demands both locally coherent pixel synthesis and globally consistent semantic restoration. We propose the first image inpainting framework based on 2D Gaussian Splatting, which encodes incomplete images into a continuous field of 2D Gaussian splat coefficients and reconstructs the final image via a differentiable rasterization process. The continuous rendering paradigm of GS inherently promotes pixel-level coherence in the inpainted results. To improve efficiency and scalability, we introduce a patch-wise rasterization strategy that reduces memory overhead and accelerates inference. For global semantic consistency, we incorporate features from a pretrained DINO model. We observe that DINO's global features are naturally robust to small missing regions and can be effectively adapted to guide semantic alignment in large-mask scenarios, ensuring that the inpainted content remains contextually consistent with the surrounding scene. Extensive experiments on standard benchmarks demonstrate that our method achieves competitive performance in both quantitative metrics and perceptual quality, establishing a new direction for applying Gaussian Splatting to 2D image processing.

Medical image synthesis presents unique challenges due to the inherent complexity and high-resolution details required in clinical contexts. Traditional generative architectures such as Generative Adversarial Networks (GANs) or Variational Auto Encoder (VAEs) have shown great promise for high-resolution image generation but struggle with preserving fine-grained details that are key for accurate diagnosis. To address this issue, we introduce Pixel Perfect MegaMed, the first vision-language foundation model to synthesize images at resolutions of 1024x1024. Our method deploys a multi-scale transformer architecture designed specifically for ultra-high resolution medical image generation, enabling the preservation of both global anatomical context and local image-level details. By leveraging vision-language alignment techniques tailored to medical terminology and imaging modalities, Pixel Perfect MegaMed bridges the gap between textual descriptions and visual representations at unprecedented resolution levels. We apply our model to the CheXpert dataset and demonstrate its ability to generate clinically faithful chest X-rays from text prompts. Beyond visual quality, these high-resolution synthetic images prove valuable for downstream tasks such as classification, showing measurable performance gains when used for data augmentation, particularly in low-data regimes. Our code is accessible through the project website - https://tehraninasab.github.io/pixelperfect-megamed.

Localizing the exact pathological regions in a given medical scan is an important imaging problem that traditionally requires a large amount of bounding box ground truth annotations to be accurately solved. However, there exist alternative, potentially weaker, forms of supervision, such as accompanying free-text reports, which are readily available. The task of performing localization with textual guidance is commonly referred to as phrase grounding. In this work, we use a publicly available Foundation Model, namely the Latent Diffusion Model, to perform this challenging task. This choice is supported by the fact that the Latent Diffusion Model, despite being generative in nature, contains cross-attention mechanisms that implicitly align visual and textual features, thus leading to intermediate representations that are suitable for the task at hand. In addition, we aim to perform this task in a zero-shot manner, i.e., without any training on the target task, meaning that the model's weights remain frozen. To this end, we devise strategies to select features and also refine them via post-processing without extra learnable parameters. We compare our proposed method with state-of-the-art approaches which explicitly enforce image-text alignment in a joint embedding space via contrastive learning. Results on a popular chest X-ray benchmark indicate that our method is competitive with SOTA on different types of pathology, and even outperforms them on average in terms of two metrics (mean IoU and AUC-ROC). Source code will be released upon acceptance at https://github.com/vios-s.

Following the impressive development of LLMs, vision-language alignment in LLMs is actively being researched to enable multimodal reasoning and visual IO. This direction of research is particularly relevant to medical imaging because medical image analysis and generation consist of reasoning based on a combination of visual features and prior knowledge. Many recent works have focused on training adapter networks that serve as an information bridge between image processing networks and LLMs; but presumably, in order to achieve maximum reasoning potential of LLMs on visual information as well, visual and language features should be allowed to interact more freely. This is especially important in the medical domain because understanding and generating medical images such as chest X-rays (CXR) require not only accurate visual and language-based reasoning but also a more intimate mapping between the two modalities. Thus, taking inspiration from previous work on the transformer and VQ-GAN combination for bidirectional image and text generation, we build upon this approach and develop a method for instruction-tuning an LLM pre-trained only on text to gain vision-language capabilities for medical images. Specifically, we leverage a pretrained LLM's existing question-answering and instruction-following abilities to teach it to understand visual inputs by instructing it to answer questions about image inputs and, symmetrically, output both text and image responses appropriate to a given query by tuning the LLM with diverse tasks that encompass image-based text-generation and text-based image-generation. We show that our model, LLM-CXR, trained in this approach shows better image-text alignment in both CXR understanding and generation tasks while being smaller in size compared to previously developed models that perform a narrower range of tasks. The code is at https://github.com/hyn2028/llm-cxr.

With the rapid development of mobile devices, modern widely-used mobile phones typically allow users to capture 4K resolution (i.e., ultra-high-definition) images. However, for image demoireing, a challenging task in low-level vision, existing works are generally carried out on low-resolution or synthetic images. Hence, the effectiveness of these methods on 4K resolution images is still unknown. In this paper, we explore moire pattern removal for ultra-high-definition images. To this end, we propose the first ultra-high-definition demoireing dataset (UHDM), which contains 5,000 real-world 4K resolution image pairs, and conduct a benchmark study on current state-of-the-art methods. Further, we present an efficient baseline model ESDNet for tackling 4K moire images, wherein we build a semantic-aligned scale-aware module to address the scale variation of moire patterns. Extensive experiments manifest the effectiveness of our approach, which outperforms state-of-the-art methods by a large margin while being much more lightweight. Code and dataset are available at https://xinyu-andy.github.io/uhdm-page.

Graphical User Interface (GUI) grounding aims to translate natural language instructions into executable screen coordinates, enabling automated GUI interaction. Nevertheless, incorrect grounding can result in costly, hard-to-reverse actions (e.g., erroneous payment approvals), raising concerns about model reliability. In this paper, we introduce SafeGround, an uncertainty-aware framework for GUI grounding models that enables risk-aware predictions through calibrations before testing. SafeGround leverages a distribution-aware uncertainty quantification method to capture the spatial dispersion of stochastic samples from outputs of any given model. Then, through the calibration process, SafeGround derives a test-time decision threshold with statistically guaranteed false discovery rate (FDR) control. We apply SafeGround on multiple GUI grounding models for the challenging ScreenSpot-Pro benchmark. Experimental results show that our uncertainty measure consistently outperforms existing baselines in distinguishing correct from incorrect predictions, while the calibrated threshold reliably enables rigorous risk control and potentials of substantial system-level accuracy improvements. Across multiple GUI grounding models, SafeGround improves system-level accuracy by up to 5.38% percentage points over Gemini-only inference.

In this work, we address the problem of grounding abnormalities in medical images, where the goal is to localize clinical findings based on textual descriptions. While generalist Vision-Language Models (VLMs) excel in natural grounding tasks, they often struggle in the medical domain due to rare, compositional, and domain-specific terms that are poorly aligned with visual patterns. Specialized medical VLMs address this challenge via large-scale domain pretraining, but at the cost of substantial annotation and computational resources. To overcome these limitations, we propose Knowledge to Sight (K2Sight), a framework that introduces structured semantic supervision by decomposing clinical concepts into interpretable visual attributes, such as shape, density, and anatomical location. These attributes are distilled from domain ontologies and encoded into concise instruction-style prompts, which guide region-text alignment during training. Unlike conventional report-level supervision, our approach explicitly bridges domain knowledge and spatial structure, enabling data-efficient training of compact models. We train compact models with 0.23B and 2B parameters using only 1.5\% of the data required by state-of-the-art medical VLMs. Despite their small size and limited training data, these models achieve performance on par with or better than 7B+ medical VLMs, with up to 9.82\% improvement in mAP_{50}. Code and models: https://lijunrio.github.io/K2Sight/{SOTAPink{https://lijunrio.github.io/K2Sight/}}.

Longitudinal multimodal data, including electronic health records (EHR) and sequential chest X-rays (CXRs), is critical for modeling disease progression, yet remains underutilized due to two key challenges: (1) redundancy in consecutive CXR sequences, where static anatomical regions dominate over clinically-meaningful dynamics, and (2) temporal misalignment between sparse, irregular imaging and continuous EHR data. We introduce DiPro, a novel framework that addresses these challenges through region-aware disentanglement and multi-timescale alignment. First, we disentangle static (anatomy) and dynamic (pathology progression) features in sequential CXRs, prioritizing disease-relevant changes. Second, we hierarchically align these static and dynamic CXR features with asynchronous EHR data via local (pairwise interval-level) and global (full-sequence) synchronization to model coherent progression pathways. Extensive experiments on the MIMIC dataset demonstrate that DiPro could effectively extract temporal clinical dynamics and achieve state-of-the-art performance on both disease progression identification and general ICU prediction tasks.

Answer grounding is the task of locating relevant visual evidence for the Visual Question Answering task. While a wide variety of attention methods have been introduced for this task, they suffer from the following three problems: designs that do not allow the usage of pre-trained networks and do not benefit from large data pre-training, custom designs that are not based on well-grounded previous designs, therefore limiting the learning power of the network, or complicated designs that make it challenging to re-implement or improve them. In this paper, we propose a novel architectural block, which we term Sentence Attention Block, to solve these problems. The proposed block re-calibrates channel-wise image feature-maps by explicitly modeling inter-dependencies between the image feature-maps and sentence embedding. We visually demonstrate how this block filters out irrelevant feature-maps channels based on sentence embedding. We start our design with a well-known attention method, and by making minor modifications, we improve the results to achieve state-of-the-art accuracy. The flexibility of our method makes it easy to use different pre-trained backbone networks, and its simplicity makes it easy to understand and be re-implemented. We demonstrate the effectiveness of our method on the TextVQA-X, VQS, VQA-X, and VizWiz-VQA-Grounding datasets. We perform multiple ablation studies to show the effectiveness of our design choices.

Large Language Models (LLMs) demonstrate strong capabilities in broad knowledge representation, yet they are inherently deficient in pixel-level perceptual understanding. Although the Segment Anything Model (SAM) represents a significant advancement in visual-prompt-driven image segmentation, it exhibits notable limitations in multi-mask prediction and category-specific segmentation tasks, and it cannot integrate all segmentation tasks within a unified model architecture. To address these limitations, we present X-SAM, a streamlined Multimodal Large Language Model (MLLM) framework that extends the segmentation paradigm from segment anything to any segmentation. Specifically, we introduce a novel unified framework that enables more advanced pixel-level perceptual comprehension for MLLMs. Furthermore, we propose a new segmentation task, termed Visual GrounDed (VGD) segmentation, which segments all instance objects with interactive visual prompts and empowers MLLMs with visual grounded, pixel-wise interpretative capabilities. To enable effective training on diverse data sources, we present a unified training strategy that supports co-training across multiple datasets. Experimental results demonstrate that X-SAM achieves state-of-the-art performance on a wide range of image segmentation benchmarks, highlighting its efficiency for multimodal, pixel-level visual understanding. Code is available at https://github.com/wanghao9610/X-SAM.

Automatic radiology report generation is booming due to its huge application potential for the healthcare industry. However, existing computer vision and natural language processing approaches to tackle this problem are limited in two aspects. First, when extracting image features, most of them neglect multi-view reasoning in vision and model single-view structure of medical images, such as space-view or channel-view. However, clinicians rely on multi-view imaging information for comprehensive judgment in daily clinical diagnosis. Second, when generating reports, they overlook context reasoning with multi-modal information and focus on pure textual optimization utilizing retrieval-based methods. We aim to address these two issues by proposing a model that better simulates clinicians' perspectives and generates more accurate reports. Given the above limitation in feature extraction, we propose a Globally-intensive Attention (GIA) module in the medical image encoder to simulate and integrate multi-view vision perception. GIA aims to learn three types of vision perception: depth view, space view, and pixel view. On the other hand, to address the above problem in report generation, we explore how to involve multi-modal signals to generate precisely matched reports, i.e., how to integrate previously predicted words with region-aware visual content in next word prediction. Specifically, we design a Visual Knowledge-guided Decoder (VKGD), which can adaptively consider how much the model needs to rely on visual information and previously predicted text to assist next word prediction. Hence, our final Intensive Vision-guided Network (IVGN) framework includes a GIA-guided Visual Encoder and the VKGD. Experiments on two commonly-used datasets IU X-Ray and MIMIC-CXR demonstrate the superior ability of our method compared with other state-of-the-art approaches.

Pixel-wise predictions are required in a wide variety of tasks such as image restoration, image segmentation, or disparity estimation. Common models involve several stages of data resampling, in which the resolution of feature maps is first reduced to aggregate information and then increased to generate a high-resolution output. Previous works have shown that resampling operations are subject to artifacts such as aliasing. During downsampling, aliases have been shown to compromise the prediction stability of image classifiers. During upsampling, they have been leveraged to detect generated content. Yet, the effect of aliases during upsampling has not yet been discussed w.r.t. the stability and robustness of pixel-wise predictions. While falling under the same term (aliasing), the challenges for correct upsampling in neural networks differ significantly from those during downsampling: when downsampling, some high frequencies can not be correctly represented and have to be removed to avoid aliases. However, when upsampling for pixel-wise predictions, we actually require the model to restore such high frequencies that can not be encoded in lower resolutions. The application of findings from signal processing is therefore a necessary but not a sufficient condition to achieve the desirable output. In contrast, we find that the availability of large spatial context during upsampling allows to provide stable, high-quality pixel-wise predictions, even when fully learning all filter weights.

Deep learning methods have shown outstanding classification accuracy in medical imaging problems, which is largely attributed to the availability of large-scale datasets manually annotated with clean labels. However, given the high cost of such manual annotation, new medical imaging classification problems may need to rely on machine-generated noisy labels extracted from radiology reports. Indeed, many Chest X-ray (CXR) classifiers have already been modelled from datasets with noisy labels, but their training procedure is in general not robust to noisy-label samples, leading to sub-optimal models. Furthermore, CXR datasets are mostly multi-label, so current noisy-label learning methods designed for multi-class problems cannot be easily adapted. In this paper, we propose a new method designed for the noisy multi-label CXR learning, which detects and smoothly re-labels samples from the dataset, which is then used to train common multi-label classifiers. The proposed method optimises a bag of multi-label descriptors (BoMD) to promote their similarity with the semantic descriptors produced by BERT models from the multi-label image annotation. Our experiments on diverse noisy multi-label training sets and clean testing sets show that our model has state-of-the-art accuracy and robustness in many CXR multi-label classification benchmarks.

With the development of multimodal reasoning models, Computer Use Agents (CUAs), akin to Jarvis from "Iron Man", are becoming a reality. GUI grounding is a core component for CUAs to execute actual actions, similar to mechanical control in robotics, and it directly leads to the success or failure of the system. It determines actions such as clicking and typing, as well as related parameters like the coordinates for clicks. Current end-to-end grounding models still achieve less than 65\% accuracy on challenging benchmarks like ScreenSpot-pro and UI-Vision, indicating they are far from being ready for deployment. % , as a single misclick can result in unacceptable consequences. In this work, we conduct an empirical study on the training of grounding models, examining details from data collection to model training. Ultimately, we developed the Phi-Ground model family, which achieves state-of-the-art performance across all five grounding benchmarks for models under 10B parameters in agent settings. In the end-to-end model setting, our model still achieves SOTA results with scores of \textbf{43.2} on ScreenSpot-pro and \textbf{27.2} on UI-Vision. We believe that the various details discussed in this paper, along with our successes and failures, not only clarify the construction of grounding models but also benefit other perception tasks. Project homepage: https://zhangmiaosen2000.github.io/Phi-Ground/{https://zhangmiaosen2000.github.io/Phi-Ground/}

Most advanced visual grounding methods rely on Transformers for visual-linguistic feature fusion. However, these Transformer-based approaches encounter a significant drawback: the computational costs escalate quadratically due to the self-attention mechanism in the Transformer Encoder, particularly when dealing with high-resolution images or long context sentences. This quadratic increase in computational burden restricts the applicability of visual grounding to more intricate scenes, such as conversation-based reasoning segmentation, which involves lengthy language expressions. In this paper, we propose an efficient and effective multi-task visual grounding (EEVG) framework based on Transformer Decoder to address this issue, which reduces the cost in both language and visual aspects. In the language aspect, we employ the Transformer Decoder to fuse visual and linguistic features, where linguistic features are input as memory and visual features as queries. This allows fusion to scale linearly with language expression length. In the visual aspect, we introduce a parameter-free approach to reduce computation by eliminating background visual tokens based on attention scores. We then design a light mask head to directly predict segmentation masks from the remaining sparse feature maps. Extensive results and ablation studies on benchmarks demonstrate the efficiency and effectiveness of our approach. Code is available in https://github.com/chenwei746/EEVG.

Modern deep learning-based inpainting enables realistic local image manipulation, raising critical challenges for reliable detection. However, we observe that current detectors primarily rely on global artifacts that appear as inpainting side effects, rather than on locally synthesized content. We show that this behavior occurs because VAE-based reconstruction induces a subtle but pervasive spectral shift across the entire image, including unedited regions. To isolate this effect, we introduce Inpainting Exchange (INP-X), an operation that restores original pixels outside the edited region while preserving all synthesized content. We create a 90K test dataset including real, inpainted, and exchanged images to evaluate this phenomenon. Under this intervention, pretrained state-of-the-art detectors, including commercial ones, exhibit a dramatic drop in accuracy (e.g., from 91\% to 55\%), frequently approaching chance level. We provide a theoretical analysis linking this behavior to high-frequency attenuation caused by VAE information bottlenecks. Our findings highlight the need for content-aware detection. Indeed, training on our dataset yields better generalization and localization than standard inpainting. Our dataset and code are publicly available at https://github.com/emirhanbilgic/INP-X.

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.

The objective of image super-resolution is to generate clean and high-resolution images from degraded versions. Recent advancements in diffusion modeling have led to the emergence of various image super-resolution techniques that leverage pretrained text-to-image (T2I) models. Nevertheless, due to the prevalent severe degradation in low-resolution images and the inherent characteristics of diffusion models, achieving high-fidelity image restoration remains challenging. Existing methods often exhibit issues including semantic loss, artifacts, and the introduction of spurious content not present in the original image. To tackle this challenge, we propose Cascaded diffusion for Super-Resolution, CasSR , a novel method designed to produce highly detailed and realistic images. In particular, we develop a cascaded controllable diffusion model that aims to optimize the extraction of information from low-resolution images. This model generates a preliminary reference image to facilitate initial information extraction and degradation mitigation. Furthermore, we propose a multi-attention mechanism to enhance the T2I model's capability in maximizing the restoration of the original image content. Through a comprehensive blend of qualitative and quantitative analyses, we substantiate the efficacy and superiority of our approach.

Recent advancements in local Implicit Neural Representation (INR) demonstrate its exceptional capability in handling images at various resolutions. However, frequency discrepancies between high-resolution (HR) and ground-truth images, especially at larger scales, result in significant artifacts and blurring in HR images. This paper introduces Frequency Consistency for Implicit Neural Representation (FreqINR), an innovative Arbitrary-scale Super-resolution method aimed at enhancing detailed textures by ensuring spectral consistency throughout both training and inference. During training, we employ Adaptive Discrete Cosine Transform Frequency Loss (ADFL) to minimize the frequency gap between HR and ground-truth images, utilizing 2-Dimensional DCT bases and focusing dynamically on challenging frequencies. During inference, we extend the receptive field to preserve spectral coherence between low-resolution (LR) and ground-truth images, which is crucial for the model to generate high-frequency details from LR counterparts. Experimental results show that FreqINR, as a lightweight approach, achieves state-of-the-art performance compared to existing Arbitrary-scale Super-resolution methods and offers notable improvements in computational efficiency. The code for our method will be made publicly available.

Implicit Neural Representation (INR) has been successfully employed for Arbitrary-scale Super-Resolution (ASR). However, INR-based models need to query the multi-layer perceptron module numerous times and render a pixel in each query, resulting in insufficient representation capability and computational efficiency. Recently, Gaussian Splatting (GS) has shown its advantages over INR in both visual quality and rendering speed in 3D tasks, which motivates us to explore whether GS can be employed for the ASR task. However, directly applying GS to ASR is exceptionally challenging because the original GS is an optimization-based method through overfitting each single scene, while in ASR we aim to learn a single model that can generalize to different images and scaling factors. We overcome these challenges by developing two novel techniques. Firstly, to generalize GS for ASR, we elaborately design an architecture to predict the corresponding image-conditioned Gaussians of the input low-resolution image in a feed-forward manner. Each Gaussian can fit the shape and direction of an area of complex textures, showing powerful representation capability. Secondly, we implement an efficient differentiable 2D GPU/CUDA-based scale-aware rasterization to render super-resolved images by sampling discrete RGB values from the predicted continuous Gaussians. Via end-to-end training, our optimized network, namely GSASR, can perform ASR for any image and unseen scaling factors. Extensive experiments validate the effectiveness of our proposed method.

This paper introduces Qwen-GUI-3B, a lightweight Vision-Language Model (VLM) specifically designed for Graphical User Interface grounding tasks, achieving performance competitive with significantly larger models. Unlike large-scale VLMs (>7B parameters) that are computationally intensive and impractical for consumer-grade hardware, Qwen-GUI-3B delivers strong grounding accuracy while being fully trainable on a single GPU (RTX 4090). The model incorporates several key innovations: (i) combine cross-platform, multi-resolution dataset of 24K examples from diverse sources including mobile, desktop, and web GUI screenshots to effectively address data scarcity in high-resolution desktop environments; (ii) a two-stage fine-tuning strategy, where initial cross-platform training establishes robust GUI understanding, followed by specialized fine-tuning on high-resolution data to significantly enhance model adaptability; and (iii) data curation and redundancy reduction strategies, demonstrating that randomly sampling a smaller subset with reduced redundancy achieves performance comparable to larger datasets, emphasizing data diversity over sheer volume. Empirical evaluation on standard GUI grounding benchmarks-including ScreenSpot, ScreenSpot-v2, and the challenging ScreenSpot-Pro, highlights Qwen-GUI-3B's exceptional accuracy, achieving 84.9% on ScreenSpot and 86.4% on ScreenSpot-v2, surpassing prior models under 4B parameters. Ablation studies validate the critical role of balanced sampling and two-stage fine-tuning in enhancing robustness, particularly in high-resolution desktop scenarios. The Qwen-GUI-3B is available at: https://github.com/Han1018/Qwen-GUI-3B

Graphical User Interface (GUI) grounding, the task of mapping natural language instructions to precise screen coordinates, is fundamental to autonomous GUI agents. While existing methods achieve strong performance through extensive supervised training or reinforcement learning with labeled rewards, they remain constrained by the cost and availability of pixel-level annotations. We observe that when models generate multiple predictions for the same GUI element, the spatial overlap patterns reveal implicit confidence signals that can guide more accurate localization. Leveraging this insight, we propose GUI-RC (Region Consistency), a test-time scaling method that constructs spatial voting grids from multiple sampled predictions to identify consensus regions where models show highest agreement. Without any training, GUI-RC improves accuracy by 2-3% across various architectures on ScreenSpot benchmarks. We further introduce GUI-RCPO (Region Consistency Policy Optimization), which transforms these consistency patterns into rewards for test-time reinforcement learning. By computing how well each prediction aligns with the collective consensus, GUI-RCPO enables models to iteratively refine their outputs on unlabeled data during inference. Extensive experiments demonstrate the generality of our approach: GUI-RC boosts Qwen2.5-VL-3B-Instruct from 80.11% to 83.57% on ScreenSpot-v2, while GUI-RCPO further improves it to 85.14% through self-supervised optimization. Our approach reveals the untapped potential of test-time scaling and test-time reinforcement learning for GUI grounding, offering a promising path toward more robust and data-efficient GUI agents.

Synthetic medical data generation has opened up new possibilities in the healthcare domain, offering a powerful tool for simulating clinical scenarios, enhancing diagnostic and treatment quality, gaining granular medical knowledge, and accelerating the development of unbiased algorithms. In this context, we present a novel approach called ViewXGen, designed to overcome the limitations of existing methods that rely on general domain pipelines using only radiology reports to generate frontal-view chest X-rays. Our approach takes into consideration the diverse view positions found in the dataset, enabling the generation of chest X-rays with specific views, which marks a significant advancement in the field. To achieve this, we introduce a set of specially designed tokens for each view position, tailoring the generation process to the user's preferences. Furthermore, we leverage multi-view chest X-rays as input, incorporating valuable information from different views within the same study. This integration rectifies potential errors and contributes to faithfully capturing abnormal findings in chest X-ray generation. To validate the effectiveness of our approach, we conducted statistical analyses, evaluating its performance in a clinical efficacy metric on the MIMIC-CXR dataset. Also, human evaluation demonstrates the remarkable capabilities of ViewXGen, particularly in producing realistic view-specific X-rays that closely resemble the original images.

Image inpainting is a fundamental research area between image editing and image generation. Recent state-of-the-art (SOTA) methods have explored novel attention mechanisms, lightweight architectures, and context-aware modeling, demonstrating impressive performance. However, they often struggle with complex structure (e.g., texture, shape, spatial relations) and semantics (e.g., color consistency, object restoration, and logical correctness), leading to artifacts and inappropriate generation. To address this challenge, we design a simple yet effective inpainting paradigm called latent categories guidance, and further propose a diffusion-based model named PixelHacker. Specifically, we first construct a large dataset containing 14 million image-mask pairs by annotating foreground and background (potential 116 and 21 categories, respectively). Then, we encode potential foreground and background representations separately through two fixed-size embeddings, and intermittently inject these features into the denoising process via linear attention. Finally, by pre-training on our dataset and fine-tuning on open-source benchmarks, we obtain PixelHacker. Extensive experiments show that PixelHacker comprehensively outperforms the SOTA on a wide range of datasets (Places2, CelebA-HQ, and FFHQ) and exhibits remarkable consistency in both structure and semantics. Project page at https://hustvl.github.io/PixelHacker.

In this paper, we introduce DRR-RATE, a large-scale synthetic chest X-ray dataset derived from the recently released CT-RATE dataset. DRR-RATE comprises of 50,188 frontal Digitally Reconstructed Radiographs (DRRs) from 21,304 unique patients. Each image is paired with a corresponding radiology text report and binary labels for 18 pathology classes. Given the controllable nature of DRR generation, it facilitates the inclusion of lateral view images and images from any desired viewing position. This opens up avenues for research into new and novel multimodal applications involving paired CT, X-ray images from various views, text, and binary labels. We demonstrate the applicability of DRR-RATE alongside existing large-scale chest X-ray resources, notably the CheXpert dataset and CheXnet model. Experiments demonstrate that CheXnet, when trained and tested on the DRR-RATE dataset, achieves sufficient to high AUC scores for the six common pathologies cited in common literature: Atelectasis, Cardiomegaly, Consolidation, Lung Lesion, Lung Opacity, and Pleural Effusion. Additionally, CheXnet trained on the CheXpert dataset can accurately identify several pathologies, even when operating out of distribution. This confirms that the generated DRR images effectively capture the essential pathology features from CT images. The dataset and labels are publicly accessible at https://huggingface.co/datasets/farrell236/DRR-RATE.

Despite the rapid progress of Multimodal Large Language Models (MLLMs), their ability to perform reliable visual grounding in high-stakes clinical software environments remains underexplored. Existing GUI benchmarks largely focus on isolated, single-step grounding queries, overlooking the sequential, workflow-driven reasoning required in real-world medical interfaces, where tasks evolve across independent steps and dynamic interface states. We introduce MedSPOT, a workflow-aware sequential grounding benchmark for clinical GUI environments. Unlike prior benchmarks that treat grounding as a standalone prediction task, MedSPOT models procedural interaction as a sequence of structured spatial decisions. The benchmark comprises 216 task-driven videos with 597 annotated keyframes, in which each task consists of 2 to 3 interdependent grounding steps within realistic medical workflows. This design captures interface hierarchies, contextual dependencies, and fine-grained spatial precision under evolving conditions. To evaluate procedural robustness, we propose a strict sequential evaluation protocol that terminates task assessment upon the first incorrect grounding prediction, explicitly measuring error propagation in multi-step workflows. We further introduce a comprehensive failure taxonomy, including edge bias, small-target errors, no prediction, near miss, far miss, and toolbar confusion, to enable systematic diagnosis of model behavior in clinical GUI settings. By shifting evaluation from isolated grounding to workflow-aware sequential reasoning, MedSPOT establishes a realistic and safety-critical benchmark for assessing multimodal models in medical software environments. Code and data are available at: https://github.com/Tajamul21/MedSPOT.

In clinical radiology reports, doctors capture important information about the patient's health status. They convey their observations from raw medical imaging data about the inner structures of a patient. As such, formulating reports requires medical experts to possess wide-ranging knowledge about anatomical regions with their normal, healthy appearance as well as the ability to recognize abnormalities. This explicit grasp on both the patient's anatomy and their appearance is missing in current medical image-processing systems as annotations are especially difficult to gather. This renders the models to be narrow experts e.g. for identifying specific diseases. In this work, we recover this missing link by adding human anatomy into the mix and enable the association of content in medical reports to their occurrence in associated imagery (medical phrase grounding). To exploit anatomical structures in this scenario, we present a sophisticated automatic pipeline to gather and integrate human bodily structures from computed tomography datasets, which we incorporate in our PAXRay: A Projected dataset for the segmentation of Anatomical structures in X-Ray data. Our evaluation shows that methods that take advantage of anatomical information benefit heavily in visually grounding radiologists' findings, as our anatomical segmentations allow for up to absolute 50% better grounding results on the OpenI dataset as compared to commonly used region proposals. The PAXRay dataset is available at https://constantinseibold.github.io/paxray/.

One of the primary challenges in brain tumor segmentation arises from the uncertainty of voxels close to tumor boundaries. However, the conventional process of generating ground truth segmentation masks fails to treat such uncertainties properly. Those "hard labels" with 0s and 1s conceptually influenced the majority of prior studies on brain image segmentation. As a result, tumor segmentation is often solved through voxel classification. In this work, we instead view this problem as a voxel-level regression, where the ground truth represents a certainty mapping from any pixel to the border of the tumor. We propose a novel ground truth label transformation, which is based on a signed geodesic transform, to capture the uncertainty in brain tumors' vicinity. We combine this idea with a Focal-like regression L1-loss that enables effective regression learning in high-dimensional output space by appropriately weighting voxels according to their difficulty. We thoroughly conduct an experimental evaluation to validate the components of our proposed method, compare it to a diverse array of state-of-the-art segmentation models, and show that it is architecture-agnostic. The code of our method is made publicly available (https://github.com/Oulu-IMEDS/SiNGR/).

Long-tailed class distributions pose a significant challenge for multi-label chest X-ray (CXR) classification, where rare but clinically important findings are severely underrepresented. In this work, we present a systematic empirical evaluation of loss functions, CNN backbone architectures and post-training strategies on the CXR-LT 2026 benchmark, comprising approximately 143K images with 30 disease labels from PadChest. Our experiments demonstrate that LDAM with deferred re-weighting (LDAM-DRW) consistently outperforms standard BCE and asymmetric losses for rare class recognition. Amongst the architectures evaluated, ConvNeXt-Large achieves the best single-model performance with 0.5220 mAP and 0.3765 F1 on our development set, whilst classifier re-training and test-time augmentation further improve ranking metrics. On the official test leaderboard, our submission achieved 0.3950 mAP, ranking 5th amongst all 68 participating teams with total of 1528 submissions. We provide a candid analysis of the development-to-test performance gap and discuss practical insights for handling class imbalance in clinical imaging settings. Code is available at https://github.com/Nikhil-Rao20/Long_Tail.

Visual grounding aims to identify objects or regions in a scene based on natural language descriptions, essential for spatially aware perception in autonomous driving. However, existing visual grounding tasks typically depend on bounding boxes that often fail to capture fine-grained details. Not all voxels within a bounding box are occupied, resulting in inaccurate object representations. To address this, we introduce a benchmark for 3D occupancy grounding in challenging outdoor scenes. Built on the nuScenes dataset, it integrates natural language with voxel-level occupancy annotations, offering more precise object perception compared to the traditional grounding task. Moreover, we propose GroundingOcc, an end-to-end model designed for 3D occupancy grounding through multi-modal learning. It combines visual, textual, and point cloud features to predict object location and occupancy information from coarse to fine. Specifically, GroundingOcc comprises a multimodal encoder for feature extraction, an occupancy head for voxel-wise predictions, and a grounding head to refine localization. Additionally, a 2D grounding module and a depth estimation module enhance geometric understanding, thereby boosting model performance. Extensive experiments on the benchmark demonstrate that our method outperforms existing baselines on 3D occupancy grounding. The dataset is available at https://github.com/RONINGOD/GroundingOcc.

GUI grounding is a critical component in building capable GUI agents. However, existing grounding benchmarks suffer from significant limitations: they either provide insufficient data volume and narrow domain coverage, or focus excessively on a single platform and require highly specialized domain knowledge. In this work, we present VenusBench-GD, a comprehensive, bilingual benchmark for GUI grounding that spans multiple platforms, enabling hierarchical evaluation for real-word applications. VenusBench-GD contributes as follows: (i) we introduce a large-scale, cross-platform benchmark with extensive coverage of applications, diverse UI elements, and rich annotated data, (ii) we establish a high-quality data construction pipeline for grounding tasks, achieving higher annotation accuracy than existing benchmarks, and (iii) we extend the scope of element grounding by proposing a hierarchical task taxonomy that divides grounding into basic and advanced categories, encompassing six distinct subtasks designed to evaluate models from complementary perspectives. Our experimental findings reveal critical insights: general-purpose multimodal models now match or even surpass specialized GUI models on basic grounding tasks. In contrast, advanced tasks, still favor GUI-specialized models, though they exhibit significant overfitting and poor robustness. These results underscore the necessity of comprehensive, multi-tiered evaluation frameworks.

X-ray is widely applied for transmission imaging due to its stronger penetration than natural light. When rendering novel view X-ray projections, existing methods mainly based on NeRF suffer from long training time and slow inference speed. In this paper, we propose a 3D Gaussian splatting-based framework, namely X-Gaussian, for X-ray novel view synthesis. Firstly, we redesign a radiative Gaussian point cloud model inspired by the isotropic nature of X-ray imaging. Our model excludes the influence of view direction when learning to predict the radiation intensity of 3D points. Based on this model, we develop a Differentiable Radiative Rasterization (DRR) with CUDA implementation. Secondly, we customize an Angle-pose Cuboid Uniform Initialization (ACUI) strategy that directly uses the parameters of the X-ray scanner to compute the camera information and then uniformly samples point positions within a cuboid enclosing the scanned object. Experiments show that our X-Gaussian outperforms state-of-the-art methods by 6.5 dB while enjoying less than 15% training time and over 73x inference speed. The application on sparse-view CT reconstruction also reveals the practical values of our method. Code and models will be publicly available at https://github.com/caiyuanhao1998/X-Gaussian . A video demo of the training process visualization is at https://www.youtube.com/watch?v=gDVf_Ngeghg .