Abstract:While Vision-Language Models (VLMs) show great promise in volumetric medical report generation, they frequently suffer from visual hallucinations and a lack of grounding in 3D CT data. Current Supervised Fine-Tuning (SFT) and Reinforcement Learning (RL) strategies typically optimize text fidelity alone, essentially rewarding correct diagnoses derived from language priors rather than genuine visual perception. To address this, we propose cross-view aligned Evidence-driven Multimodal Reinforcement Learning (Evidence-MRL, noted as E-MRL), a reliable RL reasoning framework that formulates the generation process as a Markov Decision Process of "diagnosis-localization-verification". Unlike standard approaches, our model is explicitly trained to identify a "key evidence slice" alongside the global diagnostic report, grounding its findings in verifiable visual evidence. Crucially, we introduce a novel cross-view consistency reward, which validates the semantic alignment between the golden-standard report and a local visual re-query of the selected key slice, providing additional rewards for correctly-localized reasoning. Experiments on large-scale 3D CT tumor datasets demonstrate that E-MRL significantly reduces hallucinations and improves diagnostic accuracy compared to SFT and RL baselines, offering a clinically interpretable solution for visually-grounded and tumor analysis.
Abstract:Electroencephalogram (EEG) decoding is a critical component of medical diagnostics, rehabilitation engineering, and brain-computer interfaces. However, contemporary decoding methodologies remain heavily dependent on task-specific datasets to train specialized neural network architectures. Consequently, limited data availability impedes the development of generalizable large brain decoding models. In this work, we propose a paradigm shift from conventional signal-based decoding by leveraging large-scale vision-language models (VLMs) to analyze EEG waveform plots. By converting multivariate EEG signals into stacked waveform images and integrating neuroscience domain expertise into textual prompts, we demonstrate that foundational VLMs can effectively differentiate between different patterns in the human brain. To address the inherent non-stationarity of EEG signals, we introduce a Retrieval-Augmented In-Context Learning (RAICL) approach, which dynamically selects the most representative and relevant few-shot examples to condition the autoregressive outputs of the VLM. Experiments on EEG-based seizure detection indicate that state-of-the-art VLMs under RAICL achieved better or comparable performance with traditional time series based approaches. These findings suggest a new direction in physiological signal processing that effectively bridges the modalities of vision, language, and neural activities. Furthermore, the utilization of off-the-shelf VLMs, without the need for retraining or downstream architecture construction, offers a readily deployable solution for clinical applications.