Tool-integrated vision-language agents have made remarkable progress on compositional and multi-step visual reasoning. Yet their outputs frequently exhibit unfaithfulness: the stated reasoning path diverges from the computation that actually produced the answer, undermining reliability in safety-critical applications. We present DiffuseAgent-MI, a self-evolving agent whose perceptual grounding is governed by a KL-minimal energy model over feature units, providing a distributional view of visual mechanistic interpretability. The agent learns an energy landscape that softly constrains generated samples to lie near the native prior conditioned on the chosen interpretable unit, closing the gap between the explanation and the internal representation. A verifier then supplies trajectory-level faithfulness rewards, and a repair branch re-conditions the energy when the verifier flags an unfaithful step. On GeoQA, SciVis, VQA-v2 and an in-house multimodal reasoning set, DiffuseAgent-MI improves accuracy by up to 5.1 points over prior self-evolving agents while more than doubling mutual-information faithfulness and human-interpretability agreement. Our analysis shows the energy term and the verifier are complementary: the former guarantees distributional faithfulness, the latter trajectory-level faithfulness, and only their combination closes both gaps.
https://arxiv.org/abs/2608.00540
A 3D CT scan entering a vision-language model produces a long sequence of visual tokens, often thousands to tens of thousands per volume, and this sequence must be compressed before a language model can consume it. Token compression is well studied in general vision, but little of it targets 3D CT specifically. A common baseline is grid average, which pools regular grid cells and can blend distinct anatomy, lesion, and air into one token. We present \textbf{ORCA} (ORgan-Centroid Aggregation), a token compressor for 3D CT. It merges adjacent tokens with organ guidance and adds a sinusoidal encoding of each region's centroid to preserve spatial layout. This preserves the anatomical information a downstream model needs. ORCA is training-free and plug-and-play, producing an adjustable token set without any model change or text query. We evaluate it across two datasets (CT-RATE and Merlin) and five encoders. The evaluation spans two task types: attribute prediction over five families (size, density, location, texture, and disease) and text generation (visual question answering and report generation). At matched token budgets, ORCA improves consistently over existing compression methods. It shrinks the visual context $64\times$ and its KV-cache $50\times$, and is $31\times$ faster to process each volume. Code released at this https URL.
https://arxiv.org/abs/2608.00345
Multi-page document visual question answering requires locating sparse evidence at both the page and region levels. Existing approaches typically emphasize one level over the other: page-centric methods focus on page acquisition, with region operations serving mainly as navigation aids, whereas region-centric methods assume that the relevant pages have already been supplied. Consequently, page and region selection remain disconnected rather than forming successive evidence decisions. We propose HierDoc, a hierarchical evidence-routing framework that formulates long-document evidence acquisition as two-stage set prediction from pages to regions. A page policy selects evidence pages from the full document; these pages are then parsed for semantic elements, after which a region policy selects the elements passed to a downstream answer model. Both answer-agnostic policies are optimized with stage-wise GRPO using granularity-specific structured-set rewards. The answer model receives selected full pages together with selected region crops and OCR or table text, preserving global context while emphasizing fine-grained evidence. Across the evaluated benchmarks, HierDoc achieves state-of-the-art or competitive performance among open-weight systems, improving LongDocURL by 16.87% relative to the strongest reported open-weight baseline. Controlled ablations further show that selected regional evidence improves the page-only system in accuracy and F1 by 5.51% and 4.82%, respectively. These results demonstrate the benefit of organizing coarse page routing and fine-grained region routing as successive, separately optimized stages of a unified evidence-acquisition process.
https://arxiv.org/abs/2607.29638
Infrared vision-language models (IR-VLMs) extend thermal perception to open-vocabulary classification, image captioning, and visual question answering. However, their robustness to structured thermal perturbations and the stability of cross-modal semantic alignment remain insufficiently studied. We propose QR-Structured Thermal Triggers (QR-STT), a stealthy, training-free, black-box framework for targeted semantic steering of IR-VLMs. QR-STT preserves the functional regions of a QR pattern while optimizing its internal modules, each of which is assigned a cold, neutral, or hot thermal state. The framework jointly searches module topology and rendering parameters, including position, scale, rotation, intensity, blur, and roundness. A three-stage gradient-free procedure with greedy module-flip refinement efficiently handles the mixed discrete and continuous search space. The objective promotes alignment with an attacker-selected target, suppresses source-class evidence, and regularizes QR structure and visual similarity. Experiments on multiple CLIP-style encoders show that QR-STT consistently redirects image-text alignment toward chosen concepts while maintaining visual stealth. Perturbations optimized for classification also transfer to image captioning and VQA, causing target-consistent semantic drift in generated outputs. These results identify QR-structured thermal patterns as an interpretable attack surface for language-driven infrared perception and highlight the need for robustness evaluation against structured cross-task semantic attacks.
https://arxiv.org/abs/2607.29445
Vision-language models (VLMs) are increasingly being evaluated for medical imaging, but many available benchmarks emphasize disease classification, report generation, or broad visual question answering rather than the spatial and anatomical reasoning required for radiology. We developed the Spatial Perception and Anatomical Reasoning in Clinical Radiology (SPARC-Rad) Benchmark, a manually curated multimodal benchmark dataset and evaluation pipeline for assessing these capabilities in radiology VLMs. SPARC-Rad includes 300 image-question pairs derived from healthy control imaging studies in The Cancer Imaging Archive (TCIA), spanning CT, MRI, and radiography across the abdomen, chest, breast, neuro, and musculoskeletal categories. Radiology trainees manually designed and annotated questions to evaluate anatomical identification, localization, laterality, regional recognition, device identification, and inter-structure spatial relationships. The evaluation pipeline supports standardized prompting, structured output collection, response normalization, LLM-as-judge grading, human quality review, binary correctness scoring, and subgroup analysis by modality, anatomy, and reasoning type. SPARC-Rad provides a reusable framework for evaluating whether VLMs can provide reasoning for radiologic anatomy as a spatial system, supporting future model development, failure-mode analysis, and pre-deployment assessment.
https://arxiv.org/abs/2608.00100
High-resolution visual question answering (HR-VQA) is often treated as a problem of insufficient evidence acquisition, where failing multimodal large language models must inspect images again through cropping, re-encoding, or multi-round search. We show that this view is incomplete: in many cases, fine-grained evidence has already survived visual encoding and become identifiable and influential within an intermediate-layer routing window, but is later diluted before answer generation. We propose Thinking-Once, a \textbf{training-free, single-visual-pass} evidence-routing method that reconstructs question-conditioned attention at this window, preserves core entity tokens and compact background context, and routes this evidence to later layers without extra visual encoding. Across five base models, Thinking-Once consistently improves or matches the corresponding base setting, increasing the average scores on V$^*$Bench, HRBench-4K, and HRBench-8K by \textit{+3.1}, \textit{+3.0}, and \textit{+2.7} points while reducing the average peak memory by about 4,GB. On Qwen2.5-VL-7B, it improves the three benchmarks by \textit{+9.9}, \textit{+4.6}, and \textit{+5.5} points, raising the cross-benchmark mean from 72.5 to 79.1. With the ZwZ-8B base model, Thinking-Once reaches a mean score of 82.7. Against 11 open-source HR-VQA baselines, it obtains the best or tied-best score on all three benchmark averages and the best overall mean; for example, compared with DeepScan, it reduces V$^*$Bench inference time by \textbf{97.2\%} while improving the cross-benchmark mean from 77.8 to 79.1. These results show that HR-VQA can be improved by routing already encoded evidence rather than repeatedly acquiring new visual inputs. Code is available in the appendix.
https://arxiv.org/abs/2607.27830
In clinical practice, patients often undergo multiple imaging examinations over successive visits, yielding longitudinal data. Modeling such temporal information is crucial for reliable assessment of disease progression and treatment response. However, despite the rapid advancement of multimodal large language models (MLLMs), longitudinal medical visual reasoning remains largely underexplored. To fill this gap, we propose LoMeVQA, a comprehensive benchmark consisting of 206K longitudinal visual question answering (VQA) pairs for temporal medical image analysis. LoMeVQA covers five tasks: progress classification, progress description, progress report generation, differential region grounding, and differential region description. To construct the dataset, we develop an automated pipeline that (1) organizes patient records chronologically, (2) extracts clinically meaningful entities via a medical knowledge graph, and (3) models their temporal evolution to guide large language models in generating high-quality longitudinal VQA pairs. Extensive evaluations demonstrate that both general-purpose and medical-domain MLLMs perform poorly on LoMeVQA, revealing substantial limitations in temporal reasoning. To address these limitations, we introduce MedLong-8B, which achieves state-of-the-art performance across all tasks. Beyond benchmarking, we conduct detailed analyses that uncover key failure modes and shed light on how to improve longitudinal medical visual reasoning. Our data is available at: this https URL
https://arxiv.org/abs/2607.27806
Multi-frame medical VQA appears to reward increasingly complex adaptation: controller-style inference, localization-aware reranking, static hard-negative mixing, and staged continuation all appear plausible from first principles. We test a simpler competing hypothesis on MedFrameQA: methods that remain tightly aligned with the benchmark's final answer objective should be the strongest \emph{robust} adaptation family once evaluation is controlled across fixed splits, matched budgets, repeated seeds, and calibration. We compare controller-based methods, scaffold evolution, static mixed supervision, continuation-heavy variants, and direct answer-only supervised fine-tuning (SFT). The strongest robust family is direct decoder-only answer SFT on MedGemma-1.5-4B. Empirically, this family yields substantial improvements in held-out report accuracy over frozen baselines while remaining remarkably stable across repeated seeds and matched controls, ensuring our claims reflect true family-level robustness rather than an isolated hyperparameter peak. Furthermore, post-hoc calibration effectively repairs confidence estimation without compromising accuracy, and the core approach transfers consistently to secondary backbones like Qwen2.5-VL-3B. The main result is therefore not that a complex auxiliary mechanism wins, but that objective-aligned direct answer SFT is the strongest robust adaptation family we found for MedFrameQA. By establishing this strong, minimalist baseline, we hope to redirect community focus toward fundamentally robust optimization rather than architectural complexity.
https://arxiv.org/abs/2607.27566
Multi-image medical VQA is not merely a prompt-length problem; it is a fundamental challenge of agentic decision-making. Medical vision-language agents must aggregate evidence across ordered images, remain robust to answer-order perturbations, and avoid overfitting to noisy search-time feedback. We study MedFrameQA through a controlled comparison of five inference-time agentic strategies, optimized using the same high-budget ShinkaEvolve configuration and evaluated on a reproducible internal frozen split (1,331 evolution, 665 holdout, 855 final test). Across five independent repeated runs, the strongest method emerges as the simplest robust aggregator: the \textbf{order-vote} policy achieves $57.89 \pm 0.65\%$ final-test accuracy, significantly outperforming the fixed baseline ($52.73 \pm 0.42\%$) and the more complex, albeit brittle, order-rerank variant ($55.79 \pm 0.43\%$). Paired bootstrap analysis confirms these significant gains. Extending the evolutionary search budget from 50 to 100 generations yields no generalization benefit: while holdout performance marginally increases, final-test accuracy drops from $57.89\%$ to $56.02\%$. Our findings suggest that for multi-image medical reasoning, defining the correct agentic decision rule is substantially more impactful than expanding the optimization search budget.
https://arxiv.org/abs/2607.27564
Medical vision-language models (VLMs) generate chain-of-thought (CoT) reasoning before answering clinical questions, but whether this reasoning causally influences predictions remains unclear. We present CoT-Mediate, a behavioral framework that perturbs a single clinically meaningful attribute within a model's own generated reasoning and measures whether the resulting prediction follows the edited reasoning. Our framework combines a dual-arm protocol comparing re-prompted evidence with prefix-forced continuation, together with a provenance-controlled intervention that varies only the attributed source of identical reasoning to disentangle reasoning mediation from sycophancy. We evaluate LLaVA-Med and MedGemma on 1,000 VQA-RAD samples each. Prefix-forced continuation consistently yields higher mediation faithfulness than re-prompting, while the provenance analysis reveals distinct model-specific deference behaviors. Across both models, removing visual evidence increases reliance on injected reasoning, whereas laterality is the least faithfully tracked clinical attribute. These results show that the mechanism used to inject reasoning substantially affects measured faithfulness and that contextual position, rather than stated provenance, is the primary determinant of whether medical VLMs use their generated reasoning.
https://arxiv.org/abs/2607.27304
Gastrointestinal (GI) endoscopic image analysis has shifted from single-label classification toward visual question answering (VQA), where a model must answer free-form clinical questions about an image. While recent vision-language models (VLMs) achieve promising answer accuracy on this task, clinical adoption also requires the model's internal representations to reflect the visual evidence behind its answers. We propose a simple multi-task fine-tuning recipe that constructs auxiliary grounding and description tasks from an existing VQA dataset with minimal additional annotation: expert-annotated polyp masks are reused directly, while a GI-domain pretrained classifier with Grad-CAM localization provides weak supervision for finding categories that lack ground-truth masks. Three small VLM backbones are fine-tuned with low-rank adaptation under matched VQA-only and multi-task recipes on Kvasir-VQA-x1, and we show consistent accuracy gains together with improved implicit alignment between answer tokens and the relevant image region, evaluated on both in-distribution and out-of-distribution data.
https://arxiv.org/abs/2607.27122
Visual-token pruning is usually judged by answer quality at a fixed retention budget. For text-rich multimodal large language models (MLLMs), this protocol can miss a distinct failure: an answer remains correct even when no retained token is locally traceable to the small OCR region that supports it. We turn this blind spot into an evidence-risk audit that couples answer behavior with geometric token-origin provenance, interventions, and realized cost; transparent training-free selectors isolate controlled operating points. On locked image-disjoint confirmation, Qwen Target at 30% retention has observed accuracy 0.786 versus 0.783 for Full (paired image-cluster difference +0.003, 95% CI [-0.014, +0.020]), yet same-budget Target, Random, and Grid retain sharply different positive-support coverage: 0.620, 0.270, and 0.318. Across Qwen3-VL-8B, LLaVA-1.5-7B, and InternVL3.5-8B, matched controls, interventions, detector tests, and external methods reveal model-specific quality-risk-traceability frontiers that accuracy alone does not expose. Materialized prefixes yield up to 4.32x batch-prefill speedup and 76.4% lower incremental peak memory; full-validation TextVQA and DocVQA further show that favorable target-verification points do not imply task-general compression. Visual-token pruning should therefore report surviving spatial provenance and realized cost alongside quality and compression.
https://arxiv.org/abs/2608.00077
Vision-language pre-training (VLP) serves as a cornerstone for medical multimodal representation learning. However, existing medical VLP frameworks are often constrained by the limited context windows and shallow representational capacities of lightweight text encoders when processing lengthy, terminology-dense clinical reports. While integrating medical large language models (LLMs) offers unprecedented clinical reasoning capabilities, it introduces three major bottlenecks: (i) the anisotropic representational collapse of generative LLMs under standard contrastive objectives, (ii) the prohibitive memory overhead of joint end-to-end training with large batch sizes, and (iii) the medical hallucinations induced by vanilla contrastive losses that ignore fine-grained anatomical laterality and negation modifiers. To address these challenges, we propose \textbf{SCALPEL}, a \textbf{S}emantic \textbf{C}ross-modal \textbf{A}lignment framework via \textbf{L}LM-\textbf{P}owered \textbf{E}ncoder \textbf{L}earning. First, Clinical Report Contrastive fine-tuning converts a generative LLM into an isotropic encoder via domain-specific clinical text adaptation. Second, an asymmetric alignment strategy leverages offline feature caching to enable efficient training. Critically, we formulate an Anatomy-Negation Aware Objective that explicitly penalizes mismatched image-text pairs involving laterality confusion or false negations. Extensive experiments across MIMIC-CXR, CheXpert, and IU X-Ray benchmarks demonstrate that SCALPEL achieves state-of-the-art performance in cross-modal retrieval, zero-shot disease classification and medical visual question answering.
https://arxiv.org/abs/2607.26885
Scientific figure comprehension and reasoning using multimodal AI requires integrating visual perception with domain-specific reasoning to extract meaningful knowledge, often not presented in the text of a research publication. The Sci-ImageMiner benchmark dataset, accompanied by a community-driven competition, raises the bar over prior scientific competitions by curating a comprehensive, expert-annotated dataset across four end-to-end complementary tasks. The competition attracted 68 active participants and 1,263 public/private submissions from 9th January 2026 to 8th April 2026. Our results show that state-of-the-art multimodal models perform well on classification and summarization tasks but struggle with data extraction and scientific reasoning, particularly in visual question-answering. These findings reveal key limitations and highlight challenges and opportunities for improving domain-aware multimodal AI systems. Overall, the Sci-ImageMiner benchmark and competition establish a rigorous platform for advancing research in scientific figure comprehension and reasoning and demonstrate the potential of state-of-the-art approaches for a challenging and complex research area.
https://arxiv.org/abs/2607.26848
Self-supervised pretraining is central to 3D medical image analysis, where unlabeled CT volumes are abundant but expert annotations are scarce. Yet existing volumetric encoders often fail to preserve the coarse spatial and geometric structure that downstream reasoning depends on, limiting their performance on organ disentanglement, abnormality detection, and spatial understanding when paired with language models. We introduce Rad-JEPA 3D, a joint-embedding predictive framework that learns volumetric CT representations by predicting the latent features of a complete scan from a masked view. At its core is a hybrid H-Mamba encoder that fuses a Mamba state-space branch, which models inter-slice continuity through sequential scanning, with a grouped-query attention branch, which captures cross-plane spatial context, combined through a lightweight per-token router. To improve the quality of intermediate representations, we further propose Hidden States Orthogonal Regularization (HSOR), which aligns student-teacher hidden states and reduces feature redundancy throughout the encoder. This layer-wise regularization produces more consistent and discriminative volumetric representations, leading to improved performance on organ recognition and spatial reasoning tasks. Pretrained on approximately 120,000 CT scans, Rad-JEPA 3D attains state-of-the-art results despite its compact size: with only 4.0B total parameters, it achieves competitive results with state-of-the-art on closed-ended VQA and the best average spatial-reasoning score on the Spatial-Med benchmark. Ablation studies confirm that the hybrid block and HSOR contribute complementary gains, and that the induced spatial structure can substitute for raw language-model scale on volumetric reasoning tasks.
https://arxiv.org/abs/2607.26196
Ultra-high-resolution (UHR) remote-sensing (RS) imagery provides fine-grained Earth-observation evidence over city-scale scenes, but poses a fundamental challenge for multimodal large language models (MLLMs): task-relevant evidence is often sparse, local, and spatially dispersed across extremely large visual contexts. A natural solution is to equip MLLMs with zoom-in tools for active local inspection. However, through a pilot study on XLRS-Bench, we find that zoom-in is only partially effective: it resolves easy and medium-level tasks with locally recoverable evidence, but saturates on hard cases requiring global search, multi-region comparison, path planning, or dispersed-evidence reasoning. Motivated by this finding, we move beyond single-tool zoom-in and introduce GeoMTVR, a large-scale Geospatial Multi-Tool Visual Reasoning dataset built from wide-area satellite imagery. GeoMTVR contains 13K UHR VQA samples with interleaved reasoning trajectories, diverse visual tool calls, and returned visual observations, enabling models to learn question decomposition, tool selection, regional inspection, object-level grounding, auxiliary visual reasoning, and cross-tool evidence integration. Beyond supervised fine-tuning, we propose a tool-attention-focused reinforcement learning algorithm that concentrates optimization on critical tool-use decisions, including when to invoke tools, which tool to select, where to apply it, and how to interpret tool outputs. By combining SFT on GeoMTVR with our RL algorithm, we develop GeoLens, a multi-tool visual reasoning MLLM for UHR RS. Experiments show that GeoLens consistently outperforms direct reasoning and single-tool zoom-in baselines, achieving stronger accuracy, better evidence grounding, and more efficient tool-use trajectories.
https://arxiv.org/abs/2607.25993
Unifying visual understanding and generation in one model holds immense promise, but remains challenging and expensive due to heavy compute and data demands and conflicts between the visual features needed for these two capabilities. To address these challenges, we present Argus-Unified, a compact, effective and unified multimodal model built with low demand on computation and data. Instead of aligning modalities from scratch, Argus-Unified effectively leverages pretrained vision-language models (VLMs) that provide strong multimodal priors. Specifically, we introduce hybrid visual tokens that preserve continuous tokens for understanding while learning discrete tokens for generation from a frozen unified vision encoder. Our training pipeline includes two stages: the first stage learns a quantizer and image decoder on top of the frozen vision encoder, the second stage trains the LLM initialized from a pretrained VLM for the unified multimodal modeling. Using by far the least amount of data (15.6M) and the lowest cost (~$2,000), we demonstrate that unified multimodal models can be trained economically while achieving strong performance in both understanding and generation. Notably, our model attains state-of-the-art multimodal understanding on GQA, POPE, and VQAv2, and competitive generation quality compared to models with dedicated vision encoders (e.g., Janus, Janus-Pro), all at ~10x lower cost and with ~5x less data. We envision Argus-Unified as a useful baseline that lowers the development barrier for unified models.
https://arxiv.org/abs/2607.25527
Vision--Language Models (VLMs) are increasingly deployed through a model supply chain in which pretrained checkpoints, architecture definitions, text encoders, and exported computation graphs are distributed by third parties and reused across downstream services. This reuse model creates a security-critical trust boundary: VLM deployments inherit not only learned parameters but also executable behavior encoded in shared model artifacts. In this paper, we show that a malicious provider can exploit this trust boundary by embedding architectural backdoors into VLM supply chains through representation steering. Our attack introduces dormant steering logic into the model architecture through a trigger-gated additive modification of an intermediate representation, without poisoning training data, controlling downstream fine-tuning, or modifying prompts at deployment time. When the trigger is absent, the modification reduces to zero and the model follows its normal computation, preserving clean utility. When the trigger is present, a steering direction shifts the internal representation toward an attacker-defined objective. We evaluate the attack across multiple VLM families and downstream tasks, including visual question answering, text-to-image generation, retrieval, and semantic response biasing. The results show that the proposed architectural steering backdoor compromises integrity, safety enforcement, and ranking fairness while preserving normal behavior on clean inputs. We further show that shared VLM artifacts can carry dormant steering logic against downstream services, and we propose an auditing defense that inspects the executable logic distributed with model artifacts rather than only their learned weights.
https://arxiv.org/abs/2607.25479
Knowledge-intensive multimodal question answering (KI-MMQA) sits at the intersection of three expensive primitives: long visual token sequences, dense retrieval over large external corpora, and full cross-modal fusion. Existing systems pay all three costs uniformly per query, even though only a small fraction of visual content and retrieved knowledge is actually relevant to any given question. We introduce SKIP (Salient Knowledge-Injected Pathways), a unified inference architecture that routes computation along sparse pathways jointly conditioned on the question, the image, and a difficulty estimate. SKIP combines question-guided visual token pruning, region-conditional sparse retrieval, bipartite sparse cross-attention, and speculative knowledge verification with an adaptive budget controller that allocates compute proportional to predicted question difficulty. We derive an information-bottleneck bound showing that the optimal visual sparsity rate scales as $O(1/\sqrt{N})$ under realistic question-image mutual-information assumptions, with retained accuracy guarantees. Across five KI-MMQA benchmarks (OK-VQA, A-OKVQA, InfoSeek, Encyclopedic-VQA, and ViQuAE), SKIP matches or exceeds the accuracy of strong dense baselines while using $3.4$--$6.8\times$ fewer FLOPs and $2.7\times$ less end-to-end latency. Code available at: this https URL
https://arxiv.org/abs/2607.25422
Histopathological examination primarily relies on hematoxylin and eosin (H&E) and immunohistochemistry (IHC) staining. Although IHC provides critical molecular information, it is costly and requires specialized expertise. Stain transfer provides an efficient alternative by computationally generating IHC from H&E images, but remains challenged by unified and interpretable modeling for heterogeneous biomarkers under pixel-unaligned supervision. We propose DMCoStain, a novel Data-Model Co-optimization framework for Stain transfer. It iteratively co-refines training data and model capability, improving staining accuracy and interpretability in both pathological and structural consistency. To refine training data in a clinically meaningful manner, it incorporates the Multimodal Expert-Guided Finer Selection (MEGFS) strategy, built upon a pioneering IHC-positive-expression (IPE) vision-language model (VLM) that emulates pathologist reasoning. To support MEGFS, we construct ImmunoInstruction, the first large-scale IPE instruction-following dataset with 150K VQA samples. Extensive experiments on multiple tissues and biomarkers demonstrate that DMCoStain achieves state-of-the-art (SOTA) accuracy. This paradigm offers strong practical value, and MEGFS also functions as a specialized evaluation tool for future model development. Dataset, code, and more details are in this https URL.
https://arxiv.org/abs/2607.25393