Metrics that matter: Evaluating image quality metrics for medical image generation

Evaluating generative models for synthetic medical imaging is crucial yet challenging, especially given the high standards of fidelity, anatomical accuracy, and safety required for clinical applications. Standard evaluation of generated images often relies on no-reference image quality metrics when ground truth images are unavailable, but their reliability in this complex domain is not well established. This study comprehensively assesses commonly used no-reference image quality metrics using brain MRI data, including tumour and vascular images, providing a representative exemplar for the field. We systematically evaluate metric sensitivity to a range of challenges, including noise, distribution shifts, and, critically, localised morphological alterations designed to mimic clinically relevant inaccuracies. We then compare these metric scores against model performance on a relevant downstream segmentation task, analysing results across both controlled image perturbations and outputs from different generative model architectures. Our findings reveal significant limitations: many widely-used no-reference image quality metrics correlate poorly with downstream task suitability and exhibit a profound insensitivity to localised anatomical details crucial for clinical validity. Furthermore, these metrics can yield misleading scores regarding distribution shifts, e.g. data memorisation. This reveals the risk of misjudging model readiness, potentially leading to the deployment of flawed tools that could compromise patient safety. We conclude that ensuring generative models are truly fit for clinical purpose requires a multifaceted validation framework, integrating performance on relevant downstream tasks with the cautious interpretation of carefully selected no-reference image quality metrics.

PiCo: Enhancing Text-Image Alignment with Improved Noise Selection and Precise Mask Control in Diffusion Models

Advanced diffusion models have made notable progress in text-to-image compositional generation. However, it is still a challenge for existing models to achieve text-image alignment when confronted with complex text prompts. In this work, we highlight two factors that affect this alignment: the quality of the randomly initialized noise and the reliability of the generated controlling mask. We then propose PiCo (Pick-and-Control), a novel training-free approach with two key components to tackle these two factors. First, we develop a noise selection module to assess the quality of the random noise and determine whether the noise is suitable for the target text. A fast sampling strategy is utilized to ensure efficiency in the noise selection stage. Second, we introduce a referring mask module to generate pixel-level masks and to precisely modulate the cross-attention maps. The referring mask is applied to the standard diffusion process to guide the reasonable interaction between text and image features. Extensive experiments have been conducted to verify the effectiveness of PiCo in liberating users from the tedious process of random generation and in enhancing the text-image alignment for diverse text descriptions.

RESAnything: Attribute Prompting for Arbitrary Referring Segmentation

We present an open-vocabulary and zero-shot method for arbitrary referring expression segmentation (RES), targeting input expressions that are more general than what prior works were designed to handle. Specifically, our inputs encompass both object- and part-level labels as well as implicit references pointing to properties or qualities of object/part function, design, style, material, etc. Our model, coined RESAnything, leverages Chain-of-Thoughts (CoT) reasoning, where the key idea is attribute prompting. We generate detailed descriptions of object/part attributes including shape, color, and location for potential segment proposals through systematic prompting of a large language model (LLM), where the proposals are produced by a foundational image segmentation model. Our approach encourages deep reasoning about object or part attributes related to function, style, design, etc., enabling the system to handle implicit queries without any part annotations for training or fine-tuning. As the first zero-shot and LLM-based RES method, RESAnything achieves clearly superior performance among zero-shot methods on traditional RES benchmarks and significantly outperforms existing methods on challenging scenarios involving implicit queries and complex part-level relations. Finally, we contribute a new benchmark dataset to offer ~3K carefully curated RES instances to assess part-level, arbitrary RES solutions.

Augmenting Perceptual Super-Resolution via Image Quality Predictors

Super-resolution (SR), a classical inverse problem in computer vision, is inherently ill-posed, inducing a distribution of plausible solutions for every input. However, the desired result is not simply the expectation of this distribution, which is the blurry image obtained by minimizing pixelwise error, but rather the sample with the highest image quality. A variety of techniques, from perceptual metrics to adversarial losses, are employed to this end. In this work, we explore an alternative: utilizing powerful non-reference image quality assessment (NR-IQA) models in the SR context. We begin with a comprehensive analysis of NR-IQA metrics on human-derived SR data, identifying both the accuracy (human alignment) and complementarity of different metrics. Then, we explore two methods of applying NR-IQA models to SR learning: (i) altering data sampling, by building on an existing multi-ground-truth SR framework, and (ii) directly optimizing a differentiable quality score. Our results demonstrate a more human-centric perception-distortion tradeoff, focusing less on non-perceptual pixel-wise distortion, instead improving the balance between perceptual fidelity and human-tuned NR-IQA measures.

VIST-GPT: Ushering in the Era of Visual Storytelling with LLMs?

Visual storytelling is an interdisciplinary field combining computer vision and natural language processing to generate cohesive narratives from sequences of images. This paper presents a novel approach that leverages recent advancements in multimodal models, specifically adapting transformer-based architectures and large multimodal models, for the visual storytelling task. Leveraging the large-scale Visual Storytelling (VIST) dataset, our VIST-GPT model produces visually grounded, contextually appropriate narratives. We address the limitations of traditional evaluation metrics, such as BLEU, METEOR, ROUGE, and CIDEr, which are not suitable for this task. Instead, we utilize RoViST and GROOVIST, novel reference-free metrics designed to assess visual storytelling, focusing on visual grounding, coherence, and non-redundancy. These metrics provide a more nuanced evaluation of narrative quality, aligning closely with human judgment.

DVLTA-VQA: Decoupled Vision-Language Modeling with Text-Guided Adaptation for Blind Video Quality Assessment

Inspired by the dual-stream theory of the human visual system (HVS) - where the ventral stream is responsible for object recognition and detail analysis, while the dorsal stream focuses on spatial relationships and motion perception - an increasing number of video quality assessment (VQA) works built upon this framework are proposed. Recent advancements in large multi-modal models, notably Contrastive Language-Image Pretraining (CLIP), have motivated researchers to incorporate CLIP into dual-stream-based VQA methods. This integration aims to harness the model's superior semantic understanding capabilities to replicate the object recognition and detail analysis in ventral stream, as well as spatial relationship analysis in dorsal stream. However, CLIP is originally designed for images and lacks the ability to capture temporal and motion information inherent in videos. %Furthermore, existing feature fusion strategies in no-reference video quality assessment (NR-VQA) often rely on fixed weighting schemes, which fail to adaptively adjust feature importance. To address the limitation, this paper propose a Decoupled Vision-Language Modeling with Text-Guided Adaptation for Blind Video Quality Assessment (DVLTA-VQA), which decouples CLIP's visual and textual components, and integrates them into different stages of the NR-VQA pipeline.

Content-Distortion High-Order Interaction for Blind Image Quality Assessment

The content and distortion are widely recognized as the two primary factors affecting the visual quality of an image. While existing No-Reference Image Quality Assessment (NR-IQA) methods have modeled these factors, they fail to capture the complex interactions between content and distortions. This shortfall impairs their ability to accurately perceive quality. To confront this, we analyze the key properties required for interaction modeling and propose a robust NR-IQA approach termed CoDI-IQA (Content-Distortion high-order Interaction for NR-IQA), which aggregates local distortion and global content features within a hierarchical interaction framework. Specifically, a Progressive Perception Interaction Module (PPIM) is proposed to explicitly simulate how content and distortions independently and jointly influence image quality. By integrating internal interaction, coarse interaction, and fine interaction, it achieves high-order interaction modeling that allows the model to properly represent the underlying interaction patterns. To ensure sufficient interaction, multiple PPIMs are employed to hierarchically fuse multi-level content and distortion features at different granularities. We also tailor a training strategy suited for CoDI-IQA to maintain interaction stability. Extensive experiments demonstrate that the proposed method notably outperforms the state-of-the-art methods in terms of prediction accuracy, data efficiency, and generalization ability.

CamMimic: Zero-Shot Image To Camera Motion Personalized Video Generation Using Diffusion Models

We introduce CamMimic, an innovative algorithm tailored for dynamic video editing needs. It is designed to seamlessly transfer the camera motion observed in a given reference video onto any scene of the user's choice in a zero-shot manner without requiring any additional data. Our algorithm achieves this using a two-phase strategy by leveraging a text-to-video diffusion model. In the first phase, we develop a multi-concept learning method using a combination of LoRA layers and an orthogonality loss to capture and understand the underlying spatial-temporal characteristics of the reference video as well as the spatial features of the user's desired scene. The second phase proposes a unique homography-based refinement strategy to enhance the temporal and spatial alignment of the generated video. We demonstrate the efficacy of our method through experiments conducted on a dataset containing combinations of diverse scenes and reference videos containing a variety of camera motions. In the absence of an established metric for assessing camera motion transfer between unrelated scenes, we propose CameraScore, a novel metric that utilizes homography representations to measure camera motion similarity between the reference and generated videos. Extensive quantitative and qualitative evaluations demonstrate that our approach generates high-quality, motion-enhanced videos. Additionally, a user study reveals that 70.31% of participants preferred our method for scene preservation, while 90.45% favored it for motion transfer. We hope this work lays the foundation for future advancements in camera motion transfer across different scenes.

Exploring Semantic Feature Discrimination for Perceptual Image Super-Resolution and Opinion-Unaware No-Reference Image Quality Assessment

Generative Adversarial Networks (GANs) have been widely applied to image super-resolution (SR) to enhance the perceptual quality. However, most existing GAN-based SR methods typically perform coarse-grained discrimination directly on images and ignore the semantic information of images, making it challenging for the super resolution networks (SRN) to learn fine-grained and semantic-related texture details. To alleviate this issue, we propose a semantic feature discrimination method, SFD, for perceptual SR. Specifically, we first design a feature discriminator (Feat-D), to discriminate the pixel-wise middle semantic features from CLIP, aligning the feature distributions of SR images with that of high-quality images. Additionally, we propose a text-guided discrimination method (TG-D) by introducing learnable prompt pairs (LPP) in an adversarial manner to perform discrimination on the more abstract output feature of CLIP, further enhancing the discriminative ability of our method. With both Feat-D and TG-D, our SFD can effectively distinguish between the semantic feature distributions of low-quality and high-quality images, encouraging SRN to generate more realistic and semantic-relevant textures. Furthermore, based on the trained Feat-D and LPP, we propose a novel opinion-unaware no-reference image quality assessment (OU NR-IQA) method, SFD-IQA, greatly improving OU NR-IQA performance without any additional targeted training. Extensive experiments on classical SISR, real-world SISR, and OU NR-IQA tasks demonstrate the effectiveness of our proposed methods.

WoundAmbit: Bridging State-of-the-Art Semantic Segmentation and Real-World Wound Care

Chronic wounds affect a large population, particularly the elderly and diabetic patients, who often exhibit limited mobility and co-existing health conditions. Automated wound monitoring via mobile image capture can reduce in-person physician visits by enabling remote tracking of wound size. Semantic segmentation is key to this process, yet wound segmentation remains underrepresented in medical imaging research. To address this, we benchmark state-of-the-art deep learning models from general-purpose vision, medical imaging, and top methods from public wound challenges. For fair comparison, we standardize training, data augmentation, and evaluation, conducting cross-validationto minimize partitioning bias. We also assess real-world deployment aspects, including generalization to an out-of-distribution wound dataset, computational efficiency, and interpretability. Additionally, we propose a reference object-based approach to convert AI-generated masks into clinically relevant wound size estimates, and evaluate this, along with mask quality, for the best models based on physician assessments. Overall, the transformer-based TransNeXt showed the highest levels of generalizability. Despite variations in inference times, all models processed at least one image per second on the CPU, which is deemed adequate for the intended application. Interpretability analysis typically revealed prominent activations in wound regions, emphasizing focus on clinically relevant features. Expert evaluation showed high mask approval for all analyzed models, with VWFormer and ConvNeXtS backbone performing the best. Size retrieval accuracy was similar across models, and predictions closely matched expert annotations. Finally, we demonstrate how our AI-driven wound size estimation framework, WoundAmbit, can be integrated into a custom telehealth system. Our code will be made available on GitHub upon publication.