Clinically Aligned Geometry Constraints for Robust IVUS Vessel Boundary Segmentation

Intravascular ultrasound (IVUS) lumen and external elastic membrane (EEM) segmentation is important for quantitative coronary plaque burden assessment. Errors in lumen or EEM delineation directly propagate to plaque area, plaque burden and geometric measurements. However, standard methods prioritising overlap scores often suffer from boundary drift and topology errors, leading to inaccurate clinical measurements. We present GeoCat, a geometry-consistent network that processes 5-frame IVUS clips using dual Cartesian-polar encoders with cross-domain attention and temporal fusion. A differentiable geometry consistency loss directly supervises clinically relevant descriptors including diameters, orientations, and cross-sectional areas. The model is trained on 12,242 annotated frames from 146 patients acquired with two commercial IVUS systems. We evaluate performance using both segmentation accuracy and plaque-relevant clinical metrics, including Dice/IoU, boundary measures(95HD (mm), ASSD), topology violation rate, and clinical geometry errors (dmax/dmin, angles, and areas). On our dataset, GeoCat achieves a Dice of 0.93, reduces 95HD to 0.14 mm, and lowers topology violations to 1.0%. Importantly, it significantly improves geometric fidelity, yielding diameter errors of 0.13-0.16 mm and angular errors of ~8 degrees, supporting reliable plaque burden quantification.

NeRD: Neuro-Symbolic Rule Distillation for Efficient Ontology-Grounded Chain-of-Thought in Medical Image Diagnosis

Interpretability is essential for trustworthy medical image diagnosis. However, existing concept-driven interpretable methods have key limitations: Concept Bottleneck Models (CBMs) require scoring all predefined concepts at inference time and for manual intervention, imposing a substantial burden on clinicians, while rationale-based generative approaches often select concepts by class discriminability, which can drift from diagnostic ontologies. To address these issues, we propose Neuro-Symbolic Rule Distillation (NeRD), a framework that produces efficient, ontology-grounded reasoning chains that are sufficient yet non-redundant, without manually crafting diagnostic rules. Experiments on two skin datasets demonstrate strong diagnostic performance and interpretability, and blinded expert evaluation confirms the clinical plausibility of NeRD rationales. Our method further enables a first expert-in-the-loop study for Multimodal Chain-of-Thought-based diagnosis, achieving efficient and effective concept-level intervention.

LLaVA-OneVision-2: Towards Next-Generation Perceptual Intelligence

We introduce LLaVA-OneVision-2 (LLaVA-OV-2), the most capable vision-language model in the LLaVA-OneVision series to date, achieving superior performance across a broad range of multimodal benchmarks. The model builds on a native OneVision-Encoder and incorporates Windowed Attention for efficient local computation while maintaining native resolution. Its key advance is codec-stream tokenization: it treats compressed video as a continuous bit-cost stream, where bit-cost dynamics determine adaptive temporal groups, and motion-residual cues select salient spatial evidence into compact visual canvases. This allocation concentrates a limited token budget on event-bearing content, enabling more stable long-video token compression than fixed groups of pictures. A shared 3D RoPE further places codec canvases, sampled frames, and images in a unified spatiotemporal coordinate system. Furthermore, we build the LLaVA-OV-2 data and training stack around large-scale open supervision: approximately 8M re-captioned video samples for pretraining, a 4M-sample spatial corpus for fine-tuning. We also introduce JumpScore, a temporal-localization benchmark targeting fine-grained grounding in high-frequency, densely repeated motion, a regime underrepresented by existing video evaluations. A standout capability of LLaVA-OV-2 is its unified perception across video understanding, temporal grounding, spatial grounding, and manipulation-trace reasoning. On JumpScore, LLaVA-OneVision-2-8B reaches 74.9 JumpScore mAP, surpassing Qwen3-VL-8B (30.1) by +44.8 points; under matched visual-token budgets on the same benchmark, codec-stream inputs improve temporal grounding over frame sampling by +9.7 points. Across standard benchmarks, LLaVA-OneVision-2-8B further outperforms Qwen3-VL-8B by +4.3 average points on video tasks, +5.3 on spatial tasks, and +15.6 average J&F on tracking tasks.

Beyond Binary Success: A Diagnostic Meta-Evaluation Framework for Fine-Grained Manipulation

Fine-grained manipulation marks a regime where global scene context no longer suffices, and success hinges on the tight coupling of local attribute grounding, high-fidelity spatial perception, and constraint-respecting motor execution. However, current embodied AI benchmarks collapse these capacities into binary success rates, systematically inflating reported capabilities by up to 70% and masking the architectural bottlenecks that impede real-world deployment. We introduce MetaFine, a diagnostic meta-evaluation framework that disentangles manipulation competency along three axes: understanding, perception, and controlled behavior. Built on a compositional task graph, MetaFine absorbs heterogeneous external benchmarks and reconstructs them into diagnostic scenarios of varying complexity under a unified protocol. Evaluating state-of-the-art vision-language-action (VLA) models through this lens exposes severe dimension-specific failures invisible to conventional metrics. Through targeted causal intervention, we identify the visual encoder's ability to preserve local spatial structure as a key bottleneck for fine-grained precision: improving it directly unlocks previously inaccessible manipulation capabilities without modifying downstream policies. MetaFine further supports hybrid real-sim validation, using limited paired real-world rollouts to calibrate scalable simulation-based estimates for more stable physical benchmarking. By shifting evaluation from ranking to diagnosis, MetaFine turns benchmarking into an actionable compass for repairing the layered capacities underlying genuine physical dexterity. The MetaFine framework, benchmarks, and supporting resources will be publicly released at our project page: https://metafine.github.io/.

DermAgent: A Self-Reflective Agentic System for Dermatological Image Analysis with Multi-Tool Reasoning and Traceable Decision-Making

Dermatological diagnosis requires integrating fine-grained visual perception with expert clinical knowledge. Although Multimodal Large Language Models (MLLMs) facilitate interactive medical image analysis, their application in dermatology is hindered by insufficient domain-specific grounding and hallucinations. To address these issues, we propose DermAgent, a collaborative multi-tool agent that orchestrates seven specialized vision and language modules within a Plan-Execute-Reflect framework. DermAgent delivers stepwise, traceable diagnostic reasoning through three core components. First, it employs complementary visual perception tools for comprehensive morphological description, dermoscopic concept annotation, and disease diagnosis. Second, to overcome the lack of domain prior, a dual-modality retrieval module anchors every prediction in external evidence by cross-referencing 413,210 diagnosed image cases and 3,199 clinical guideline chunks. To further mitigate hallucinations, a deterministic critic module conducts strict post-hoc auditing via confidence, coverage, and conflict gates, automatically detecting inter-source disagreements to trigger targeted self-correction. Extensive experiments on five dermatology benchmarks demonstrate that DermAgent consistently outperforms state-of-the-art MLLMs and medical agent baselines across zero-shot fine-grained disease diagnosis, concept annotation, and clinical captioning tasks, exceeding GPT-4o by 17.6% in skin disease diagnostic accuracy and 3.15% in captioning ROUGE-L. Our code is available at https://github.com/YizeezLiu/DermAgent.

Fundus Image-based Glaucoma Screening via Retinal Knowledge-Oriented Dynamic Multi-Level Feature Integration

Automated diagnosis based on color fundus photography is essential for large-scale glaucoma screening. However, existing deep learning models are typically data-driven and lack explicit integration of retinal anatomical knowledge, which limits their robustness across heterogeneous clinical datasets. Moreover, pathological cues in fundus images may appear beyond predefined anatomical regions, making fixed-region feature extraction insufficient for reliable diagnosis. To address these challenges, we propose a retinal knowledge-oriented glaucoma screening framework that integrates dynamic multi-scale feature learning with domain-specific retinal priors. The framework adopts a tri-branch structure to capture complementary retinal representations, including global retinal context, structural features of the optic disc/cup, and dynamically localized pathological regions. A Dynamic Window Mechanism is devised to adaptively identify diagnostically informative regions, while a Knowledge-Enhanced Convolutional Attention Module incorporates retinal priors extracted from a pre-trained foundation model to guide attention learning. Extensive experiments on the large-scale AIROGS dataset demonstrate that the proposed method outperforms diverse baselines, achieving an AUC of 98.5% and an accuracy of 94.6%. Additional evaluations on multiple datasets from the SMDG-19 benchmark further confirm its strong cross-domain generalization capability, indicating that knowledge-guided attention combined with adaptive lesion localization can significantly improve the robustness of automated glaucoma screening systems.

Cognitive Pivot Points and Visual Anchoring: Unveiling and Rectifying Hallucinations in Multimodal Reasoning Models

Multimodal Large Reasoning Models (MLRMs) have achieved remarkable strides in visual reasoning through test time compute scaling, yet long chain reasoning remains prone to hallucinations. We identify a concerning phenomenon termed the Reasoning Vision Truth Disconnect (RVTD): hallucinations are strongly correlated with cognitive bifurcation points that often exhibit high entropy states. We attribute this vulnerability to a breakdown in visual semantic anchoring, localized within the network's intermediate layers; specifically, during these high uncertainty transitions, the model fails to query visual evidence, reverting instead to language priors. Consequently, we advocate a shift from solely outcome level supervision to augmenting it with fine grained internal attention guidance. To this end, we propose V-STAR (Visual Structural Training with Attention Reinforcement), a lightweight, holistic training paradigm designed to internalize visually aware reasoning capabilities. Central to our approach is the Hierarchical Visual Attention Reward (HVAR), integrated within the GRPO framework. Upon detecting high entropy states, this mechanism dynamically incentivizes visual attention across critical intermediate layers, thereby anchoring the reasoning process back to the visual input. Furthermore, we introduce the Forced Reflection Mechanism (FRM), a trajectory editing strategy that disrupts cognitive inertia by triggering reflection around high entropy cognitive bifurcation points and encouraging verification of subsequent steps against the visual input, thereby translating external debiasing interventions into an intrinsic capability for hallucination mitigation.

Do No Harm: Exposing Hidden Vulnerabilities of LLMs via Persona-based Client Simulation Attack in Psychological Counseling

The increasing use of large language models (LLMs) in mental healthcare raises safety concerns in high-stakes therapeutic interactions. A key challenge is distinguishing therapeutic empathy from maladaptive validation, where supportive responses may inadvertently reinforce harmful beliefs or behaviors in multi-turn conversations. This risk is largely overlooked by existing red-teaming frameworks, which focus mainly on generic harms or optimization-based attacks. To address this gap, we introduce Personality-based Client Simulation Attack (PCSA), the first red-teaming framework that simulates clients in psychological counseling through coherent, persona-driven client dialogues to expose vulnerabilities in psychological safety alignment. Experiments on seven general and mental health-specialized LLMs show that PCSA substantially outperforms four competitive baselines. Perplexity analysis and human inspection further indicate that PCSA generates more natural and realistic dialogues. Our results reveal that current LLMs remain vulnerable to domain-specific adversarial tactics, providing unauthorized medical advice, reinforcing delusions, and implicitly encouraging risky actions.

MuSEAgent: A Multimodal Reasoning Agent with Stateful Experiences

Research agents have recently achieved significant progress in information seeking and synthesis across heterogeneous textual and visual sources. In this paper, we introduce MuSEAgent, a multimodal reasoning agent that enhances decision-making by extending the capabilities of research agents to discover and leverage stateful experiences. Rather than relying on trajectory-level retrieval, we propose a stateful experience learning paradigm that abstracts interaction data into atomic decision experiences through hindsight reasoning. These experiences are organized into a quality-filtered experience bank that supports policy-driven experience retrieval at inference time. Specifically, MuSEAgent enables adaptive experience exploitation through complementary wide- and deep-search strategies, allowing the agent to dynamically retrieve multimodal guidance across diverse compositional semantic viewpoints. Extensive experiments demonstrate that MuSEAgent consistently outperforms strong trajectory-level experience retrieval baselines on both fine-grained visual perception and complex multimodal reasoning tasks. These results validate the effectiveness of stateful experience modeling in improving multimodal agent reasoning.

Project Imaging-X: A Survey of 1000+ Open-Access Medical Imaging Datasets for Foundation Model Development

Foundation models have demonstrated remarkable success across diverse domains and tasks, primarily due to the thrive of large-scale, diverse, and high-quality datasets. However, in the field of medical imaging, the curation and assembling of such medical datasets are highly challenging due to the reliance on clinical expertise and strict ethical and privacy constraints, resulting in a scarcity of large-scale unified medical datasets and hindering the development of powerful medical foundation models. In this work, we present the largest survey to date of medical image datasets, covering over 1,000 open-access datasets with a systematic catalog of their modalities, tasks, anatomies, annotations, limitations, and potential for integration. Our analysis exposes a landscape that is modest in scale, fragmented across narrowly scoped tasks, and unevenly distributed across organs and modalities, which in turn limits the utility of existing medical image datasets for developing versatile and robust medical foundation models. To turn fragmentation into scale, we propose a metadata-driven fusion paradigm (MDFP) that integrates public datasets with shared modalities or tasks, thereby transforming multiple small data silos into larger, more coherent resources. Building on MDFP, we release an interactive discovery portal that enables end-to-end, automated medical image dataset integration, and compile all surveyed datasets into a unified, structured table that clearly summarizes their key characteristics and provides reference links, offering the community an accessible and comprehensive repository. By charting the current terrain and offering a principled path to dataset consolidation, our survey provides a practical roadmap for scaling medical imaging corpora, supporting faster data discovery, more principled dataset creation, and more capable medical foundation models.