MMIR-TCM: Memory-Integrated Multimodal Inference and Retrieval for TCM Clinical Decision Support

Traditional Chinese Medicine (TCM) diagnosis, particularly through tongue inspection, faces persistent challenges in subjectivity and reproducibility. The application of multimodal artificial intelligence to TCM clinical tasks, such as syndrome differentiation and prescription generation, is significantly hampered by the semantic gap between visual tongue features and textual reasoning, as well as the lack of large-scale, standardized datasets. To address these challenges, we introduce MMIR-TCM, a novel framework that emulates the diagnostic process of TCM experts by integrating multimodal large language model(MLLM) with memory-augmented segmentation and retrieval-augmented generation (RAG). Employing a three-stage architecture, MMIR-TCM integrates a training-free Memory-SAM module for robust tongue extraction, a fine-tuned Qwen3-VL model for structured tongue diagnosis generation, and a Qwen3-based RAG component for evidence-grounded clinical decision support generation. The framework was developed and validated using MedTCM, a new large-scale multimodal dataset that we introduce specifically for advanced TCM research. To properly evaluate our framework's clinical accuracy, which existing metrics fail to capture, we also developed TDEU, a domain-specific evaluation metric incorporating semantic understanding and diagnostic importance. Our comprehensive experiments demonstrate that MMIR-TCM significantly outperforms leading models, including GPT-4o and Gemini 2.5 Flash.

StructCore: Structure-Aware Image-Level Scoring for Training-Free Unsupervised Anomaly Detection

Max pooling is the de facto standard for converting anomaly score maps into image-level decisions in memory-bank-based unsupervised anomaly detection (UAD). However, because it relies on a single extreme response, it discards most information about how anomaly evidence is distributed and structured across the image, often causing normal and anomalous scores to overlap. We propose StructCore, a training-free, structure-aware image-level scoring method that goes beyond max pooling. Given an anomaly score map, StructCore computes a low-dimensional structural descriptor phi(S) that captures distributional and spatial characteristics, and refines image-level scoring via a diagonal Mahalanobis calibration estimated from train-good samples, without modifying pixel-level localization. StructCore achieves image-level AUROC scores of 99.6% on MVTec AD and 98.4% on VisA, demonstrating robust image-level anomaly detection by exploiting structural signatures missed by max pooling.

GCR: Geometry-Consistent Routing for Task-Agnostic Continual Anomaly Detection

Feature-based anomaly detection is widely adopted in industrial inspection due to the strong representational power of large pre-trained vision encoders. While most existing methods focus on improving within-category anomaly scoring, practical deployments increasingly require task-agnostic operation under continual category expansion, where the category identity is unknown at test time. In this setting, overall performance is often dominated by expert selection, namely routing an input to an appropriate normality model before any head-specific scoring is applied. However, routing rules that compare head-specific anomaly scores across independently constructed heads are unreliable in practice, as score distributions can differ substantially across categories in scale and tail behavior. We propose GCR, a lightweight mixture-of-experts framework for stabilizing task-agnostic continual anomaly detection through geometry-consistent routing. GCR routes each test image directly in a shared frozen patch-embedding space by minimizing an accumulated nearest-prototype distance to category-specific prototype banks, and then computes anomaly maps only within the routed expert using a standard prototype-based scoring rule. By separating cross-head decision making from within-head anomaly scoring, GCR avoids cross-head score comparability issues without requiring end-to-end representation learning. Experiments on MVTec AD and VisA show that geometry-consistent routing substantially improves routing stability and mitigates continual performance collapse, achieving near-zero forgetting while maintaining competitive detection and localization performance. These results indicate that many failures previously attributed to representation forgetting can instead be explained by decision-rule instability in cross-head routing. Code is available at https://github.com/jw-chae/GCR