MedReasoner: Reinforcement Learning Drives Reasoning Grounding from Clinical Thought to Pixel-Level Precision

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.

DriveRX: A Vision-Language Reasoning Model for Cross-Task Autonomous Driving

Autonomous driving requires real-time, robust reasoning across perception, prediction, planning, and behavior. However, conventional end-to-end models fail to generalize in complex scenarios due to the lack of structured reasoning. Recent vision-language models (VLMs) have been applied to driving tasks, but they typically rely on isolated modules and static supervision, limiting their ability to support multi-stage decision-making. We present AutoDriveRL, a unified training framework that formulates autonomous driving as a structured reasoning process over four core tasks. Each task is independently modeled as a vision-language question-answering problem and optimized using task-specific reward models, enabling fine-grained reinforcement signals at different reasoning stages. Within this framework, we train DriveRX, a cross-task reasoning VLM designed for real-time decision-making. DriveRX achieves strong performance on a public benchmark, outperforming GPT-4o in behavior reasoning and demonstrating robustness under complex or corrupted driving conditions. Our analysis further highlights the impact of vision encoder design and reward-guided reasoning compression. We will release the AutoDriveRL framework and the DriveRX model to support future research.