Medical Image Benchmarks

Latest papers 237

Jul 24, 2026cs.CV

Medical-Checklist: Assessing the Comprehension of Medical Images by Multimodal Models

This paper introduces a new benchmark test, Medical-Checklist, for assessing medical multimodal models. The recent advancements in multimodal models have demonstrated significant potential in the field of medical vision-language tasks. However, it is becoming increasingly clear that evaluating these models' performance, whether they are applied to natural or medical images, is challenging. The critical question is whether the models can accurately understand an input image while associating it with relevant input text. To address this, Medical-Checklist imposes a binary test on the models: they are given an image and two captions, where one is correct and the other incorrect, and the model must select the correct one. The incorrect caption contains a single medical concept (word or phrase) that is inaccurately substituted from the correct caption. Although the task is simple, this simplicity enables the unified assessment of diverse multimodal models designed and learned on different principles. It also enables us to verify whether models correctly understand a wide range of medical concepts across various medical sub-domains. Medical-Checklist is designed to reduce potential biases in data and to enable evaluation of the models' ability to handle out-of-distribution inputs, which were difficult in existing datasets. When evaluating four state-of-the-art medical multimodal models with Medical-Checklist, it was revealed that despite their excellent performance in specific tasks such as Med-VQA, they may not correctly understand images, suggesting a long journey ahead for clinical application. The dataset and code will be made public upon acceptance.
Jul 22, 2026cs.CV

Benchmarking the Domain Gap: Model Selection Instability Under Domain Shift in Video Capsule Endoscopy

Video capsule endoscopy (VCE) classification is typically evaluated within a single dataset, yet clinical deployment demands robustness across acquisition sources, labeling policies, and patient populations. We examine this gap using Kvasir-Capsule, Capsule Vision 2024 (CV2024), and a shared-label subset of Galar. We fine-tune a suite of general-domain pretrained backbones on the official Kvasir-Capsule folds under a standardized protocol and evaluate the same checkpoints on two non-source targets within a documented shared-label decision space. We find that the predictive value of in-domain ranking is target-dependent: Kvasir-Capsule ranking aligns more closely with Galar than with CV2024, while the two non-source targets agree only weakly. Consequently, the strongest in-domain backbone leads on one target yet falls to mid-pack on the other, and no single evaluation target reliably predicts the others. A second CV2024-trained configuration set reproduces this target-dependent instability. We conclude that capsule endoscopy model selection should report cross-target ranking stability rather than peak single-dataset performance.
Jul 22, 2026cs.CV

A Systematic Benchmark of Intensity Normalisation Methods for 3D Knee MRI Segmentation and Cross-Domain Generalisability

Robust out-of-the-box performance is essential for the clinical deployment of deep learning models in medical imaging. An important but underexplored factor affecting model generalisability is intensity normalisation, particularly for magnetic resonance imaging (MRI), where image intensities vary across scanners and protocols. In this study, we systematically compared seven normalisation methods and their impact on the performance of a 3D U-Net model for meniscus segmentation from knee MRI. The methods included standard scaling approaches, histogram-based techniques, and a Gaussian Mixture Model (GMM)-based method. Models were trained on the IWOAI 2019 dataset and evaluated on both internal and external test sets (SKM-TEA) to assess generalisability. Performance was similar internally but differences were significant on external data, with Z-score, Nyúl histogram matching, and CLAHE showing greater robustness than other methods. However, these differences were small compared to the significant performance drop observed between datasets. Overall, while intensity normalisation had a measurable effect on model generalisability, its impact was limited relative to the effects of domain shift, highlighting the need for complementary strategies for robust deployment.
Jul 22, 2026cs.CV

PhenSPINE: A Standardized Benchmark for Spine Pathology Diagnosis

The accurate diagnosis of spinal pathologies depends heavily on radiological interpretation, yet automated systems are hindered by the lack of diverse, high-quality benchmarks. In this study, we present PhenSPINE, a Magnetic Resonance Imaging dataset comprising 16,813 images from 250 patients, curated to facilitate advanced deep learning research. We propose a robust diagnostic benchmark that integrates state-of-theart convolutional backbones with a Positional Encoding mechanism to explicitly model the anatomical context of intervertebral discs. Evaluating across four standard MRI sequences, our experiments demonstrate that the Sagittal T2-weighted sequence offers the most robust diagnostic value, achieving a superior Macro F1-score of 50.31%. We find that multisequence fusion strategies yield inferior performance compared to this single-sequence baseline, as the images across sequences in our dataset are significantly compromised by noise interference from surrounding anatomical regions. This work establishes a robust baseline and offers critical insights into sequence selection for spine analysis.
Jul 21, 2026cs.CV

PathAgentBench: Benchmarking Evidence-Seeking Vision-Language Models on Whole-Slide Pathology Image

Whole-slide image (WSI) diagnosis requires identifying diagnostically relevant regions, examining them across magnifications, and integrating multi-scale evidence. However, most existing pathology benchmarks evaluate models on pre-cropped patches or pre-extracted slide features, leaving their ability to acquire evidence directly from gigapixel WSIs largely untested. We introduce PathAgentBench, a benchmark for evaluating evidence-seeking vision-language models (VLMs) across four complementary capabilities: image-to-text matching for evidence interpretation, text-to-image retrieval for evidence verification, diagnostic-region localization for evidence acquisition, and multi-scale reasoning for evidence integration. The benchmark is organized as a diagnostic tree that links nested regions across magnifications with scale-specific findings and path-level diagnoses. It contains 1,822 TCGA WSIs and 17,135 diagnostic paths annotated by ten board-certified pathologists. An additional private cohort of 190 breast cancer WSIs with detailed annotations is used to evaluate autonomous whole-slide exploration. We evaluate 20 general-purpose, medical, and pathology-specialized models. Leading open-weight models achieve over 93% accuracy in multi-scale reasoning and over 50% accuracy in both cross-modal matching tasks. In contrast, diagnostic-region localization remains challenging: the best text-guided mean intersection-over-union is below 0.09, underperforming a simple center-based heuristic. During autonomous exploration, the unconditional hit rate decreases from 0.522 at low magnification to 0.185 at intermediate magnification and 0.020 at high magnification. These results reveal a pronounced gap between reasoning over curated evidence and acquiring that evidence directly from WSIs. PathAgentBench provides a unified framework for measuring and improving evidence-seeking pathology models.
Jul 21, 2026cs.CV

Local Label-Informed Feature Transfer for Generating Ground-Truth Medical Images: A Comparison of GAN- and Diffusion-Based Approaches

Validating Explainable Artificial Intelligence (XAI) methods in medical imaging requires ground-truth data with known locations of informative features. However, current approaches rely on expert annotations, which are prone to labeling errors, or on hand-crafted artificial perturbations superimposed onto healthy images to mimic lesions or malignant features, which lack clinical realism. We present Local Label-Informed Feature Transfer (LLIFT), a framework for generating semi-synthetic brain magnetic resonance images with realistic lesions placed in user-controlled regions, which does not require pixel-level lesion annotations during training. We implement LLIFT with two generative paradigms: LLIFT-GAN, a custom GAN that learns pathological features from binary class labels alone, and LLIFT-DM, a diffusion-based inpainting pipeline conditioned on bounding-box masks via ControlNet. Both approaches are evaluated on brain magnetic resonance imaging data derived from the Human Connectome Project. In evaluations, both achieve Fréchet Inception Distance scores, with respect to the real pathological distribution, that are comparable to the inter-class reference between healthy and pathological images in the given dataset. Furthermore, qualitative inspection confirms the realism of lesion structures. The resulting benchmark datasets provide spatially controlled ground truth data for evaluating XAI methods in medical imaging.
Jul 20, 2026cs.CL

PathReportEval: A Systematic Benchmark for Pathology Report Generation

Pathology report generation from whole-slide images (WSIs) is a rapidly growing multimodal learning problem, yet progress is difficult to measure because existing studies use heterogeneous datasets, model settings, visual encoders, and evaluation protocols. Moreover, commonly used natural language generation metrics, including BLEU, ROUGE, and METEOR, primarily reward lexical similarity and often fail to detect clinically consequential errors such as omitted diagnoses, hallucinated findings, or discordant tumor attributes. We present a standardized benchmark and evaluation framework for pathology report generation. The benchmark evaluates four representative methods across three datasets (TCGA, HistAI, and REG 2025) using three pathology foundation encoders (CONCHv1.5, UNI2-h, and H-Optimus-1). Our framework standardizes preprocessing, feature extraction, training, decoding, and evaluation, enabling fair comparison across models while providing a modular platform for integrating new methods, datasets, and encoders. A central contribution is the Clinical Report Quality Score (CRQS), a clinically grounded metric for evaluating factual correctness. CRQS maps reference and generated reports into structured clinical attributes and measures four complementary dimensions: clinical fact coverage, key information recall, hallucination rate, and clinical discordance, producing both an overall score and interpretable sub-scores. Experiments demonstrate that conventional language-generation metrics are weakly aligned with clinical correctness and frequently overestimate report quality. In contrast, CRQS reveals clinically meaningful differences between models and encoders that lexical metrics fail to capture. Together, the benchmark, public plug-and-play framework, and CRQS establish a reproducible foundation for rigorous evaluation of pathology report generation.
Jul 20, 2026cs.CV

SAMRI-3D: Adapting SAM2 for 3D MRI Segmentation with Global Volume Tokens

Foundation models such as Segment Anything Model 2 (SAM2) have transformed natural-image and video segmentation, and recent work has begun adapting them to medical imaging. These adaptations, however, are largely general-purpose models that treat MRI as one modality among many; large-scale, MRI-specific modelling and benchmarking remain limited, even though MRI's low soft-tissue contrast leaves many boundaries effectively invisible on individual slices. We present SAMRI-3D, a benchmark and method for 3D MRI segmentation with SAM2. The SAMRI-3D benchmark is the largest MRI-only evaluation to date - 10,392 volumes from 34 datasets (27 public, 7 in-house) spanning 12 anatomical domains and 10+ sequences, with explicit seen/unseen splits. Freezing the image encoder and fine-tuning only the lightweight decoder and memory modules raises mean Dice from 0.58 (zero-shot SAM2) to 0.76, surpassing recent SAM-based medical models (SAMed-2 0.69, Medical-SAM2 0.49, SAM-Med3D 0.37) with strong statistical significance. To target invisible boundaries, we introduce Global Volume Tokens (GVT): persistent memory tokens trained with a Truncated Signed Distance Field (TSDF) reconstruction objective that is discarded at inference (zero added cost). This full model, SAMRI-3D, attains the best accuracy (0.78) and lowest variance across all 34 datasets and, uniquely, shows no drop on 8 held-out datasets (0.79 unseen vs. 0.78 seen); per-sequence analysis confirms the TSDF objective helps most where per-slice contrast is weakest. We will release the benchmark, code, and models in this paper.
Jul 18, 2026cs.CV

Can Multimodal Large Language Models Understand OCT?

Optical coherence tomography (OCT) imaging is essential for the diagnosis and treatment of retinal diseases. Although multimodal large language models (MLLMs) have demonstrated considerable potential in medical image analysis, existing benchmarks largely reduce OCT understanding to coarse-grained disease classification or isolated visual question answering, leaving the complete cognitive process from visual perception to clinical reasoning insufficiently evaluated. To address this limitation, we introduce OCT-Bench, a comprehensive benchmark dedicated to OCT image understanding. OCT-Bench comprises 10,076 high-quality multiple-choice questions constructed from 4,137 OCT images across seven public datasets. Following the real-world clinical interpretation workflow, we establish a hierarchical capability taxonomy consisting of 20 fine-grained tasks across three dimensions: Perception, Cognition, and Reasoning. These tasks cover a broad range of capabilities, including imaging attributes, retinal anatomy, lesion characteristics, spatial relationships, disease assessment, therapeutic decision-making, and prognostic management. We systematically evaluate 20 representative MLLMs, including proprietary models, open-source general-purpose models, and medical-domain models. Experimental results demonstrate that current models remain substantially short of reliable OCT understanding. Moreover, neither medical-domain adaptation nor increased model scale consistently improves performance across capability levels. OCT-Bench enables comprehensive and fine-grained evaluation of MLLMs, providing a foundation for identifying capability bottlenecks and advancing clinically grounded OCT understanding.
Jul 17, 2026cs.CV

Model Merging for Medical LVLMs: A Benchmark and a Winner-Take-All Approach

Large vision-language models (LVLMs) can be adapted to specialized medical imaging tasks via parameter-efficient fine-tuning approaches such as low-rank adaptation (LoRA), leading to a growing ecosystem of expert models tailored to specific imaging modalities and clinical scenarios. However, deploying multiple expert LVLMs in practice incurs substantial computational and operational overhead. Model merging provides a promising solution by consolidating multiple experts into a single model without retraining, yet it remains largely unexplored in the medical domain. In this work, we present the first systematic study of model merging for medical LVLMs. We introduce MergeMedBench, a comprehensive benchmark spanning eight imaging modalities and diverse clinical task types, comprising 16 LoRA fine-tuned models built upon two mainstream architectures. We conduct an extensive evaluation of existing merging methods and further propose winner-take-all, a simple and hyperparameter-free approach that retains only the most dominant parameters across expert models. By preserving the critical parameters that govern model behavior and discarding weaker ones, our method avoids the information dilution inherent in averaging- or alignment-based strategies. Despite its simplicity, winner-take-all consistently outperforms existing approaches, offering both a new perspective on LoRA merging and a strong practical baseline for future research.
Jul 17, 2026cs.CV

Benchmarking MRI Representations for Deep Learning-Based Focal Cortical Dysplasia Segmentation

Focal cortical dysplasia (FCD) is one of the leading structural causes of drug-resistant focal epilepsy, yet its subtle and heterogeneous imaging characteristics make accurate identification and delineation challenging on conventional magnetic resonance imaging (MRI). Although T1-weighted (T1w) and fluid-attenuated inversion recovery (FLAIR) images are routinely acquired for presurgical evaluation, the contribution of different MRI representations to deep learning-based FCD segmentation remains poorly understood. In this study, we present a systematic benchmark of MRI representations for automated FCD segmentation using the nnU-Net framework. A publicly available presurgical MRI dataset comprising 85 FCD subjects and 25 healthy controls was used to evaluate eight input configurations, including conventional MRI contrasts (T1w and FLAIR), ratio-derived representations, and their multimodal combinations. To isolate the effect of MRI representation, all experiments employed identical preprocessing, network architecture, optimization strategy, and five-fold cross-validation. Among the evaluated single-modality representations, FLAIR achieved the strongest overall performance, whereas ratio-derived representations alone were insufficient for reliable identification of subtle FCD. Incorporating ratio-derived representations with conventional T1w and FLAIR images consistently improved lesion delineation, with the four-channel multimodal configuration achieving the highest overall Dice score (0.376), representing a 5.0% relative improvement over the conventional T1w+FLAIR representation. These findings demonstrate that MRI representation design is an important yet underexplored component of deep learning-based FCD segmentation and should be optimized alongside network architecture.
Jul 14, 2026cs.CV

Point Tracking in Surgery--The 2025 Surgical Tattoos in Infrared Challenge (STIRC2025)

Point tracking in surgery is crucial to enable applications in downstream tasks such as segmentation, 3D reconstruction, virtual tissue landmarking, autonomous probe-based scanning, and subtask autonomy. This paper introduces the 2025 iteration of a point tracking challenge to address this, wherein participants submit their algorithms for quantification. Their algorithms are evaluated using a dataset named surgical tattoos in infrared (STIR), with the challenge named the STIR Challenge 2025 (STIRC2025). The STIR Challenge 2025 comprises two quantitative components: accuracy and efficiency. The accuracy component tests the accuracy of algorithms on in vivo and ex vivo sequences. The efficiency component tests algorithm inference latency. The challenge was conducted as a part of MICCAI EndoVis 2025, and seven teams participated in this challenge. In this paper we summarize the challenge results and participant methods. The challenge dataset is available at: https://zenodo.org/records/20191078, and the code for baseline models and metrics calculation is available here: https://github.com/athaddius/STIRMetrics
Jul 14, 2026cs.CV

CRC-HGD: A Histopathological Image Dataset for Grading Colorectal Cancer

Colorectal cancer (CRC) is the third most common cancer worldwide and the second leading cause of cancer-related deaths globally, with approximately 1,926,425 new cases and 904,019 deaths reported in 2022. Accurate histologic grading plays a critical role in prognosis and treatment planning for colorectal adenocarcinoma. In recent years, artificial intelligence and its subcategories, including machine learning and deep learning, have been increasingly employed for automated cancer detection and classification. An appropriate and well-organized dataset is the essential first step to achieve this goal. This paper introduces CRC-HGD, a histopathological microscopy image dataset of 1,914 images obtained from 214 colorectal adenocarcinoma patients (Grade I: 106, Grade II: 75, Grade III: 33). The specimens are H&E-stained colorectal tissue sections acquired at the Poursina Hakim Research Center of Isfahan University of Medical Sciences, Iran, diagnosed between 2014 and 2019, and graded according to the World Health Organization (WHO) criteria into three grades: well-differentiated (Grade I), moderately differentiated (Grade II), and poorly differentiated (Grade III). For each specimen, four magnification levels are provided: 4x, 10x, 20x, and 40x. The dataset is accessible via Mendeley Data (https://doi.org/10.17632/yfp5sfj47m.4) and at http://databiox.com, where the latest version is also available. The distinctive feature of this dataset is the provision of labeled specimens across all three differentiation grades at multiple magnification levels, enabling comprehensive computational analysis of colorectal cancer grading.
Jul 14, 2026cs.CV

Auditing Data Leakage in Whole-Slide Image Multimodal Benchmarks

Recent vision-language models (VLMs) for computational pathology report striking zero-shot performance on whole-slide image (WSI) visual question answering (VQA) benchmarks. We audit these claims and find them fundamentally compromised by data leakage at two hierarchical levels: patient-level leakage, where slides from the same case appear in both training and test folds, and institutional-level leakage, where different cases nonetheless share staining-batch and scanner signatures through a common Tissue Source Site (TSS). By tracing canonical slide, case, and TSS identifiers across major public resources, we document case level train test overlaps of 92.3~100% on TCGA-derived benchmarks, together with near-complete TSS overlap. We further demonstrate that both leakage levels are linearly decodable from foundation-model feature space, that they induce a measurable accuracy gap between leaked and audit-clean cases on a published checkpoint, and that across multiple published WSI VLMs, peak reported accuracies concentrate on the most heavily contaminated benchmarks. Therefore, the current WSI VQA evaluation cannot distinguish genuine multimodal reasoning from nearest-neighbor retrieval over memorized institutional and patient-specific artifacts. Finally, we outline concrete recommendations for contamination-free evaluation. By addressing benchmark construction, provenance disclosure, and automated overlap auditing, we aim to guide future research toward verifiable claims of progress.
Jul 13, 2026cs.CV

A Unified Framework for Comprehensive Cardiac CT Segmentation and Phenotyping: Human-in-the-Loop Data Annotation, Vision Foundation Model Development, Multicenter Evaluation and Clinical Validation

Comprehensive quantification of cardiac structures from computed tomography (CT) remains limited not by data availability but by the scalability of measurements, which makes routine use impractical. Here we present a unified framework for comprehensive cardiac CT segmentation and phenotyping that combines a human-in-the-loop annotation pipeline, a cardiac CT augmentation technique, and a self-supervised foundation model pre-trained on 60,000 unlabeled cardiac CT scans. Using this approach, we assembled the largest and most comprehensive expert-annotated cardiac CT segmentation dataset to date, comprising 1598 cases and 14 distinct cardiac structures (1000 for training, 598 for the external test set). Across five external datasets, the framework segmented all structures more accurately and comprehensively than existing open-source tools. Self-supervised pre-training improved labeling efficiency, with the most significant gains observed during external evaluation in the low-data regime. Benchmarking across convolutional, transformer, and state-space architectures showed comparable performance, indicating that data quality and pre-training, rather than architecture, drove accuracy. The framework was scaled to population-level phenotyping, with segmented anatomy that carries functionally relevant information about ventricular function and disease severity beyond demographic variables. By openly releasing the largest dataset with human labels, code, model weights, a CT augmentation library, and software, this work provides a reproducible foundation for opportunistic cardiac phenotyping from routinely acquired CT scans.
Jul 11, 2026cs.CV

Benchmarking the Robustness of Foundation Models for Mammography under Domain Shift

Foundation models are increasingly used as image feature extractors for mammography, but their robustness under external domain shift remains unclear. We benchmark 15 foundation-model backbones across breast density, BI-RADS severity, and cancer status using a unified frozen-backbone linear-probe protocol, training on 3 source datasets and evaluating on 12 task-compatible out-of-distribution (OOD) datasets after label harmonization. Mammography-specific vision-language models (Mammo-FM and MaMA) provide the strongest mean OOD performance, but robustness is not explained by mammography exposure alone. DINOv3 remains a competitive vision-only baseline, and mammography-adapted pretraining does not consistently improve generalization. Dataset-level analysis further shows that even leading models show heterogeneous performance across datasets. Feature-space inspection reveals that useful representations can preserve clinical signal while retaining dataset and acquisition structure. These findings highlight dataset-level OOD evaluation as a central criterion for assessing mammography representations. Our code is publicly available: https://github.com/biomedia-mira/mammo-ood.
Jul 9, 2026cs.CV

Attribute Retrieving for Open-Vocabulary Endoscopic Compositional Referring Segmentation

Referring Image Segmentation (RIS) aims to segment image regions specified by natural language, enabling fine-grained and controllable visual understanding. Extending RIS to endoscopic imagery, however, presents unique challenges, including scarce high-quality annotations and complex, domain-specific image-text relationships. Although recent vision-language models demonstrate strong cross-domain alignment, they often fail to capture fine-grained textual cues in endoscopic settings, resulting in suboptimal performance and limited generalization. To address these challenges, we introduce ReferEndoscopy, a large-scale benchmark for RIS in the endoscopy field. Building on this dataset, we propose the Attribute Retrieval-based Endoscopic-RIS (AR-ERIS) framework for open-vocabulary endoscopic compositional referring segmentation. AR-ERIS leverages attribute retrieval for open-vocabulary endoscopic compositional referring segmentation and is pretrained on the curated ReferEndoscopy dataset, achieving state-of-the-art performance with strong generalization across both simulated and real-world endoscopic data. The dataset and code will be publicly released upon completion of the review process.
Jul 9, 2026cs.CV

Benchmark Evaluation of Feredated Learning on Multi-organ Images

The privacy requirements of medical data and its substantial variations across organs and modalities hinder the clinical implementation of medical AI. Federated learning (FL) is a feasible approach to overcome these challenges. Due to the continuous emergence of FL algorithms and the highly heterogeneous nature of medical data, objectively evaluating their performance in real-world clinical settings remains difficult. Therefore, a comprehensive federated medical imaging benchmark, serving as a unified evaluation standard, is crucial for advancing the technology toward reliable clinical application. Existing federated medical imaging benchmarks have not yet adequately incorporated state-of-the-art algorithms, are limited to data from single organs or modalities, and overly emphasize model accuracy, making it difficult to comprehensively assess the overall efficacy of FL in real-world medical environments. To address these challenges, we developed the MobenFL benchmark. This benchmark integrates 20 cutting-edge FL algorithms and 22 medical imaging datasets, covering 12 critical organs across the human body, surpassing existing benchmark in breadth. In terms of evaluation dimensions, MobenFL not only assesses performance but also systematically incorporates key metrics such as algorithmic efficiency and privacy protection capabilities. Additionally, it conducts specialized evaluations for complex real-world clinical scenarios involving different diseases, devices, and imaging modalities, thereby providing a comprehensive and in-depth evaluation framework for the clinical application of FL in the medical field.
Jul 9, 2026cs.CV

Metrics or Mirage? An Audit of Evaluation Inconsistencies in Colonoscopy Polyp Segmentation Benchmarks

Progress in colonoscopy polyp segmentation is routinely reported through leaderboard comparisons on a small set of public benchmarks. We argue that this apparent progress is difficult to verify: a systematic audit of \textbf{27 papers} published between 2015 and 2026 reveals three structural problems in how the community evaluates models. \textbf{First}, 25 of 27 papers \textit{omit the Hausdorff distance}. Hausdorff distance is a boundary-accuracy metric with direct clinical relevance for detecting flat or small polyps, and is a standard in radiotherapy segmentation. \textbf{Second}, at least five \textit{incompatible train/test split protocols} co-exist across papers reporting results on the same two datasets (Kvasir-SEG and CVC-ClinicDB), making published Dice scores non-comparable even when they appear in the same leaderboard column. \textbf{Third}, 26 of 27 papers make \textit{performance claims without any statistical significance test}. Strikingly, four papers published \emph{after} the Metrics Reloaded framework~\cite{metricsreloaded2024} (Maier-Hein et al., \textit{Nature Methods} 2024) perpetuate these same problems, suggesting that general-purpose metric guidance has not yet reached the colonoscopy sub-community. To show these problems are not merely cosmetic, we re-evaluate five representative models under three controlled protocols with a single uniform scorer, and find that the reported metric conceals large boundary and recall failures, that the ``best'' model changes with the metric, and that near-tied rankings reverse across random splits. We propose a five-point \textbf{Polyp Segmentation Reporting Checklist}~(PSRC) as a lightweight, domain-adapted corrective.
Jul 8, 2026cs.CV

MedPMC: A Systematic Framework for Scaling High-Fidelity Medical Multimodal Data for Foundation Models

Medicine is inherently multimodal, requiring clinicians to synthesize information across diverse data streams. Yet the development of multimodal foundation models is constrained by limited access to large-scale, high-quality clinical data. Although PubMed Central (PMC) offers a complementary source of expert-authored image-text data, existing PMC-derived resources remain limited in fidelity, reproducibility, and clinical validation. We introduce MedPMC, an automated, continuously updatable framework that transforms permissively licensed literature into high-fidelity infrastructure for medical multimodal models. Applied to 6.1 million PMC articles, MedPMC curated 11 million medical image-text pairs. Component evaluations showed strong performance for initial screening (F1 = 93.2), multi-panel figure detection (F1 = 96.5), figure separation (mAP = 89.8), caption separation and alignment (F1 = 81.4; ROUGE-L = 85.3), and medical figure classification (F1 = 96.5). Manual review by five annotators, three with medical training, found 95.3% of MedPMC images medically relevant, versus 19.7% in a prior PMC-derived dataset. Across 26 benchmarks spanning 11 specialties, a MedPMC-trained CLIP-style model improved average zero-shot AUC by 7.1 percentage points over the strongest architecture-matched biomedical CLIP baseline despite using fewer than half as many image-text pairs. As the vision encoder in a multimodal large language model, it improved medical visual question-answering by 1.9 and 16.9 percentage points across two benchmarks. In 10,524 Yale New Haven Health System dermatology photographs, it improved morphology-to-image retrieval Recall@5 by 11.7 percentage points. These findings show that high-fidelity literature curation strengthens medical multimodal foundation models across benchmark and clinical settings. We publicly release the framework, corpus, benchmarks, and pretrained models.
Jul 8, 2026cs.CV

Vision Foundation Models in Radiology: A Scoping Review of Data, Methodology, Evaluation and Clinical Translation

Vision foundation models (VFMs) are increasingly being developed for radiological imaging, yet their definition, development and evaluation remain heterogeneous. We conducted a PRISMAScR scoping review of peer-reviewed studies published between January 2017 and March 2026 describing foundation models trained exclusively on radiological imaging data. Sixty-seven studies were included and mapped across three pillars: data scale and heterogeneity, architectural and pretraining scalability, and downstream transferability and generalization. Datasets primarily covered brain MRI, thoracoabdominal CT, and chest X-ray, ranging from fewer than 100,000 samples to multi-million-image cohorts. Transformer-based architectures and self-supervised pretraining predominated, particularly masked image modeling, contrastive learning and multi-stage approaches. Evaluation focused mainly on segmentation and classification, whereas cross-center, cross-scanner, anatomical and modality-shift validation was inconsistently reported. Alignment with FUTURE-AI principles was uneven. Overall, radiology-specific VFMs show promising transferability, but clinical translation remains constrained by limited data representativeness, heterogeneous benchmarks, incomplete reporting and insufficient deployment-oriented evaluation.
Jul 6, 2026cs.AI

Evaluating and Understanding Model Editing for Medical Vision Language Models

Model editing promises a fast, targeted way to correct post-deployment mistakes in medical vision-language models (VLMs) without costly retraining. However, existing multimodal model editing benchmarks focus on general-purpose tasks and do not reflect realistic clinical domain requirements and variability. To address this, we introduce M3Bench, a clinically grounded benchmark for multimodal model editing that evaluates whether an edit remains reliable, precise, and generalizable under the challenges of image and text variation, modality and protocol shifts, clinical knowledge composition, and temporal progression. M3Bench contains 16,276 questions spanning diverse anatomy, modalities, and specialties, and supports both single and sequential edits. By evaluating 4 representative editors across 6 medical and general VLMs, we find that no method excels across all criteria. Gradient-based editors achieve strong transfer but suffer from catastrophic locality violations, whereas memory-based methods preserve locality but lack compositional generality and exhibit high backbone-dependent hyperparameter sensitivity. We further attribute these failures to the latent space geometry of VLMs and how different editing methods shift its landscape. Overall, M3Bench establishes a rigorous clinical stress test for multimodal model editing and offers actionable guidance for safer post-deployment adaptation. The benchmark is publicly available at https://github.com/BioMed-AI-Lab-U-Michgan/M3Bench .
Jul 2, 2026cs.CV

Multimodal Fusion for Fine-Grained Classification of Breast Fibroadenoma and Phyllodes Tumors

Breast fibroadenoma (FA) and phyllodes tumor (PT) are fibroepithelial breast lesions with highly overlapping appearances on B-mode ultrasound, making benign and borderline PT prone to being misclassified as FA and complicating preoperative decision-making. Existing computer-aided diagnosis methods commonly rely on single-modal imaging features and insufficiently exploit complementary clinical and textual information. To address this limitation, we construct the FAPT-M Dataset, a pathology-confirmed multimodal dataset comprising 910 patients with strictly reviewed ultrasound images, structured clinical attributes, and ultrasound diagnostic descriptions. Based on this dataset, we propose a clinically guided multimodal framework that integrates DenseNet-based visual encoding, CLIP-inspired text encoding, and lightweight clinical encoding, and further introduces clinical-conditioned adaptive modulation, cross-modal Transformer fusion, and dual-path representation learning to improve feature alignment and multimodal interaction. Under patient-level five-fold cross-validation, the proposed method achieves an accuracy of 77.64%, F1-score of 73.38%, and AUC of 89.74%, outperforming representative CNN-, Transformer-, and vision-language-based baselines. Ablation studies and class-balanced evaluations further confirm the contribution of three-modality fusion and the key architectural components. Overall, this work provides an effective multimodal approach for fine-grained FA-PT classification and establishes a high-quality benchmark for multimodal breast ultrasound analysis.
Jul 2, 2026cs.CV

Assessing VLM Reliability for Medical Image Quality Evaluation Under Corruption and Bias

Vision-Language Models (VLMs) are increasingly applied in medical tasks such as pathology description, report generation, and visual question answering. Medical Image Quality Assessment (MIQA) supports diagnostic accuracy and patient safety by determining whether images meet the standards required for clinical decision-making. Automating MIQA with VLMs may reduce workload, but their behavior under real-world conditions, where images may be degraded or textual context may affect judgments, should be further explored before deployment. We benchmark VLMs on medical image quality using the MediMeta-C dataset zero-shot across seven corruption types and five severity levels. We evaluate sensitivity to degradation patterns, the effect of corruptions on embedding geometry, and whether textual attributes (demographics, expertise, infrastructure, institution) alter scores. Across 16 VLMs and seven modalities, pixelation produced the largest score reductions (mean -20.58%, up to -34.4% for OCT), whereas brightness had limited effect (-0.81%). Embedding displacement was associated with score changes. Same-family models showed correlations of 0.67-0.83; some produced increases up to +31% for corrupted mammography. Textual attributes affected scores: institutional prestige raised them +17.15%, and equipment age lowered them -14.7%. The largest changes were +95.62% (InternVL-8B) and -37.7% (MedGemma). Current VLMs show limitations for medical image quality assessment. Pixelation, a privacy-preserving transformation, reduces performance, indicating a trade-off between patient privacy and reliability. Sensitivity to contextual metadata indicates limited objectivity and marks metadata as a privacy and bias source. Privacy protection and objective quality assessment are related requirements for use.
Jul 1, 2026cs.CV

EchoRisk: A Multicentre Echocardiography Dataset and Benchmark for Cardio-Oncology

Therapy-induced cardiotoxicity is the leading non-oncological cause of treatment interruption in breast cancer patients, yet early, automated risk stratification from routine cardiac imaging remains an unsolved problem. We present EchoRisk, the first curated, multicentre, longitudinal echocardiography dataset with explicit cardiotoxicity labels, released as the primary technical reference for the EchoRisk-MICCAI 2026 challenge. The dataset comprises 422 patients enrolled in the EU-funded CARDIOCARE prospective study across five European sites, yielding 2,159 echocardiography videos across 1,123 clinical exams acquired at up to five longitudinal timepoints, alongside a dedicated cohort of 280 patients with baseline imaging for early cardiotoxicity prediction. Three clinically grounded tasks are defined: automated estimation of left ventricular ejection fraction from cine video (Task 1), classification of LV dysfunction from longitudinal imaging (Task 2), and early prediction of therapy-induced cardiotoxicity from pre-therapy baseline echocardiography alone (Task 3). For each task we specify the evaluation protocol, primary and secondary metrics, and ranking procedure. We establish baseline performance using an R(2+1)D video backbone with LSTM aggregation trained from Kinetics-400 pretrained weights, demonstrating strong discriminative performance for cardiac functional assessment and LV dysfunction classification, while early cardiotoxicity prediction from a single pre-therapy video remains a significant open problem for the community. The dataset, evaluation code, and baseline implementations are publicly available to serve as a benchmark for further collaboration, comparison, and the creation of task-specific architectures in cardio-oncology.
Jul 1, 2026cs.CV

Foundation Models vs. Radiomics for Lung Computed Tomography: A Benchmark of Feature Extractors, Classification Heads, and Segmentation Choices

Radiomics is the established approach for CT-based lung cancer phenotyping, yet comparisons with foundation models rarely isolate contributions of feature extractor, classification head, and segmentation choice, or test cross-cohort robustness. We benchmark five feature extractors (Curia, Curia-2, DINOv3, Radiomics2D, Radiomics3D), seven classification heads (TabPFN, TabICL, XGBoost, CatBoost, Random Forest, logistic regression, Ridge), and three segmentation regimes on five tasks: tumor volume and stage classification, 2-year survival prediction, histology classification, and age prediction. Models are trained on LUNG1 (n=338) and evaluated on an internal test set (n=84) and the external LUNG2 cohort (n=211), with worst-case cross-cohort performance as the primary metric. The dominant design factor is task-dependent: segmentation drives volume and stage classification, while classifier choice drives survival, histology, and age prediction. Radiomics is competitive for tumor volume, tumor stage and survival (partly due to label-derivation effects for the former); Curia variants reach comparable peak scores for survival; DINOv3 falls slightly short across tasks. Patch and slice aggregation have negligible impact. We recommend Curia with tumor segmentation and a CatBoost head as a safe default, achieving the best mean rank across the three primary clinical tasks, though task-specific selection consistently outperforms any cross-task default. When tumor delineations are unavailable, Curia-2 with lung segmentation and logistic regression offers a competitive alternative. All pipelines use a two-stage design suited to small cohort sizes where end-to-end fine-tuning would risk overfitting.
Jun 29, 2026cs.CV

PGE-SAM: Prompt-Guided Feature Enhancement for Interactive Segmentation under Degradation

Segment Anything Model (SAM) has revolutionized promptable image segmentation with strong zero-shot generalization. However, its performance degrades substantially under real-world imaging artifacts such as noise, blur, and compression. Existing methods restore features globally without focusing on segmentation-relevant regions and neglect SAM's iterative refinement mechanism, leading to suboptimal performance in interactive settings. We propose Prompt-Guided Feature Enhancement SAM (PGE-SAM), a framework that explicitly leverages user prompts and prior mask predictions to spatially guide the feature restoration process toward regions of interest through a Prompt Guidance Generator. To recover fine-grained details lost under degradation, we introduce Multi-Scale Features Interaction to incorporate low-level encoder features, along with a Foreground Reconstruction Loss that restricts feature-level supervision to the segmentation target. Furthermore, we present DM-Seg, a benchmark for interactive segmentation on degraded medical images, spanning multiple imaging modalities with both general and modality-specific degradations at varying severity levels. Extensive experiments demonstrate that PGE-SAM achieves SOTA robustness on both medical and natural image domains across multiple degradation levels, while maintaining generalization to clean images and adding less than one-fifth of the parameters of prior methods.
Jun 29, 2026cs.CV

A Multi Center Breast FNAC Whole-Slide Cytology Dataset for AI-Assisted Patch-Wise Classification Using C1 to C5 Reporting Categories

We present a multi center breast fine needle aspiration cytology (FNAC) dataset designed for patch wise classification using C1 to C5 reporting labels. The prospective dataset includes 321 patients and 470 whole-slide images (WSIs) collected from participating tertiary medical centers in India between May 2023 and March 2026. Slides were stained using Papanicolaou (190 WSIs) or MayGrunwald Giemsa (280 WSIs), scanned on a Hamamatsu NanoZoomer S360 at 40X magnification and 0.25 microns per pixel, and stored directly in NDPI format. Across the 470 WSIs, 446 WSIs contain annotated patch regions, yielding 7,398 PNG image patches with expert-verified C1 to C5 labels. The release includes NDPI WSIs, WSI-level GeoJSON annotation files, extracted patch images, deidentified metadata, a data dictionary, a validation summary, a manifest linking WSIs to Zenodo records, and code for dataset inspection and reuse. The complete dataset is approximately 950 GB and is available through Zenodo.
Jun 29, 2026cs.CV

SHOVIR: A Benchmark for Evaluating Vision Shortcut Learning in Radiology Report Generation

Current evaluation protocols for Vision-Language Models (VLMs) in Radiology Report Generation (RRG) rely on report-level metrics that measure lexical overlap or aggregate clinical correctness. However, such metrics do not test whether individual diagnostic statements stem from the actual pathological evidence visible in the image. This allows models to achieve competitive scores by exploiting learned priors or spurious correlations, a failure mode we refer to as vision shortcut. We introduce SHOVIR, a benchmark for evaluating vision shortcut behavior in RRG. SHOVIR extends two spatially annotated chest X-ray datasets, MIMIC-CXR and PadChest-GR, with per-box CheXpert labels, and defines image-level and disease-level occlusion experiments that contrast baseline performance on clean images against localized, region-specific perturbations. Comparing predictions across these conditions isolates two failure modes at the disease-class level: direct shortcuts, where a finding persists after its visual evidence is removed, and contextual shortcuts, where detection degrades once co-occurring pathologies are occluded despite the target region remaining intact. Benchmarking eight state-of-the-art VLMs, we find that shortcut behavior varies substantially across architectures and datasets. Models achieving the highest baseline report quality do not necessarily rank highest in spatial grounding, revealing that clinically fluent generation can coexist with shallow reliance on visual evidence. These findings expose a blind spot in current RRG evaluation and motivate region-aware assessment protocols.
Jun 29, 2026cs.CV

Cross-Modal Iteration Distillation for Robust IHD Screening: The IDNet Framework and A New Benchmark

Color Fundus Photography (CFP) offers a low-cost and non-invasive route for ischemic heart disease (IHD) screening, but current studies are limited by scarce public benchmarks and ineffective fusion of retinal images with sparse clinical variables. We propose IDNet, a multimodal framework with a Cross-Modal Distillation Aggregator (CDA) that uses learnable queries to sequentially integrate left-eye, right-eye, and clinical features, mitigating the imbalance between high-dimensional visual features and low-dimensional tabular inputs. We also construct a reproducible UK Biobank benchmark with open-source curation and quality-control pipelines, yielding 50,410 images from 25,205 subjects. On this benchmark, IDNet outperforms image-only, clinical-only, and several multimodal baselines, and CDA consistently improves multiple visual encoders as a plug-in fusion module.