Autonomous Skeletal Landmark Localization towards Agentic C-Arm Control

Purpose: Automated C-arm positioning ensures timely treatment in patients requiring emergent interventions. When a conventional Deep Learning (DL) approach for C-arm control fails, clinicians must revert to manual operation, resulting in additional delays. Consequently, an agentic C-arm control framework based on multimodal large language models (MLLMs) is highly desirable, as it can incorporate clinician feedback and use reasoning to make adjustments toward more accurate positioning. Skeletal landmark localization is essential for C-arm control, and we investigate adapting MLLMs for autonomous landmark localization. Methods: We used an annotated synthetic X-ray dataset and a real X-ray dataset. Each X-ray in both datasets is paired with several skeletal landmarks. We fine-tuned two MLLMs and tasked them with retrieving the closest landmarks from each X-ray. Quantitative evaluations of landmark localization were performed and compared against a leading DL approach. We further conducted qualitative experiments demonstrating: (1) how an MLLM can correct an initially incorrect prediction through reasoning, and (2) how the MLLM can sequentially navigate the C-arm toward a target location. Results: On both datasets, fine-tuned MLLMs demonstrate competitive performance across all localization tasks when compared with the DL approach. In the qualitative experiments, the MLLMs provide evidence of reasoning and spatial awareness. Conclusion: This study shows that fine-tuned MLLMs achieve accurate skeletal landmark localization and hold promise for agentic autonomous C-arm control. Our code is available athttps://github.com/marszzibros/C-arm-localization-LLMs.git

Turning Generators into Retrievers: Unlocking MLLMs for Natural Language-Guided Geo-Localization

Natural-language Guided Cross-view Geo-localization (NGCG) aims to retrieve geo-tagged satellite imagery using textual descriptions of ground scenes. While recent NGCG methods commonly rely on CLIP-style dual-encoder architectures, they often suffer from weak cross-modal generalization and require complex architectural designs. In contrast, Multimodal Large Language Models (MLLMs) offer powerful semantic reasoning capabilities but are not directly optimized for retrieval tasks. In this work, we present a simple yet effective framework to adapt MLLMs for NGCG via parameter-efficient finetuning. Our approach optimizes latent representations within the MLLM while preserving its pretrained multimodal knowledge, enabling strong cross-modal alignment without redesigning model architectures. Through systematic analysis of diverse variables, from model backbone to feature aggregation, we provide practical and generalizable insights for leveraging MLLMs in NGCG. Our method achieves SOTA on GeoText-1652 with a 12.2% improvement in Text-to-Image Recall@1 and secures top performance in 5 out of 12 subtasks on CVG-Text, all while surpassing baselines with far fewer trainable parameters. These results position MLLMs as a robust foundation for semantic cross-view retrieval and pave the way for MLLM-based NGCG to be adopted as a scalable, powerful alternative to traditional dual-encoder designs. Project page and code are available at https://yuqichen888.github.io/NGCG-MLLMs-web/.

GeoFlow: Real-Time Fine-Grained Cross-View Geolocalization via Iterative Flow Prediction

Accurate and fast localization is vital for safe autonomous navigation in GPS-denied areas. Fine-Grained Cross-View Geolocalization (FG-CVG) aims to estimate the precise 2-Degree-of-Freedom (2-DoF) location of a ground image relative to a satellite image. However, current methods force a difficult trade-off, with high-accuracy models being slow for real-time use. In this paper, we introduce GeoFlow, a new approach that offers a lightweight and highly efficient framework that breaks this accuracy-speed trade-off. Our technique learns a direct probabilistic mapping, predicting the displacement (in distance and direction) required to correct any given location hypothesis. This is complemented by our novel inference algorithm, Iterative Refinement Sampling (IRS). Instead of trusting a single prediction, IRS refines a population of hypotheses, allowing them to iteratively 'flow' from random starting points to a robust, converged consensus. Even its iterative nature, this approach offers flexible inference-time scaling, allowing a direct trade-off between performance and computation without any re-training. Experiments on the KITTI and VIGOR datasets show that GeoFlow achieves state-of-the-art efficiency, running at real-time speeds of 29 FPS while maintaining competitive localization accuracy. This work opens a new path for the development of practical real-time geolocalization systems.

Cross-View Meets Diffusion: Aerial Image Synthesis with Geometry and Text Guidance

Aerial imagery analysis is critical for many research fields. However, obtaining frequent high-quality aerial images is not always accessible due to its high effort and cost requirements. One solution is to use the Ground-to-Aerial (G2A) technique to synthesize aerial images from easily collectible ground images. However, G2A is rarely studied, because of its challenges, including but not limited to, the drastic view changes, occlusion, and range of visibility. In this paper, we present a novel Geometric Preserving Ground-to-Aerial (G2A) image synthesis (GPG2A) model that can generate realistic aerial images from ground images. GPG2A consists of two stages. The first stage predicts the Bird's Eye View (BEV) segmentation (referred to as the BEV layout map) from the ground image. The second stage synthesizes the aerial image from the predicted BEV layout map and text descriptions of the ground image. To train our model, we present a new multi-modal cross-view dataset, namely VIGORv2 which is built upon VIGOR with newly collected aerial images, maps, and text descriptions. Our extensive experiments illustrate that GPG2A synthesizes better geometry-preserved aerial images than existing models. We also present two applications, data augmentation for cross-view geo-localization and sketch-based region search, to further verify the effectiveness of our GPG2A. The code and data will be publicly available.