Accurately grounding regions of interest (ROIs) is critical for diagnosis and treatment planning in medical imaging. While multimodal large language models (MLLMs) combine visual perception with natural language, current medical-grounding pipelines still rely on supervised fine-tuning with explicit spatial hints, making them ill-equipped to handle the implicit queries common in clinical practice. This work makes three core contributions. We first define Unified Medical Reasoning Grounding (UMRG), a novel vision-language task that demands clinical reasoning and pixel-level grounding. Second, we release U-MRG-14K, a dataset of 14K samples featuring pixel-level masks alongside implicit clinical queries and reasoning traces, spanning 10 modalities, 15 super-categories, and 108 specific categories. Finally, we introduce MedReasoner, a modular framework that distinctly separates reasoning from segmentation: an MLLM reasoner is optimized with reinforcement learning, while a frozen segmentation expert converts spatial prompts into masks, with alignment achieved through format and accuracy rewards. MedReasoner achieves state-of-the-art performance on U-MRG-14K and demonstrates strong generalization to unseen clinical queries, underscoring the significant promise of reinforcement learning for interpretable medical grounding.

Large language models (LLMs) have shown considerable promise in clinical natural language processing, yet few domain-specific datasets exist to rigorously evaluate their performance on radiology tasks. In this work, we introduce an annotated corpus of 6,393 radiology reports from 586 patients, each labeled for follow-up imaging status, to support the development and benchmarking of follow-up adherence detection systems. Using this corpus, we systematically compared traditional machine-learning classifiers, including logistic regression (LR), support vector machines (SVM), Longformer, and a fully fine-tuned Llama3-8B-Instruct, with recent generative LLMs. To evaluate generative LLMs, we tested GPT-4o and the open-source GPT-OSS-20B under two configurations: a baseline (Base) and a task-optimized (Advanced) setting that focused inputs on metadata, recommendation sentences, and their surrounding context. A refined prompt for GPT-OSS-20B further improved reasoning accuracy. Performance was assessed using precision, recall, and F1 scores with 95% confidence intervals estimated via non-parametric bootstrapping. Inter-annotator agreement was high (F1 = 0.846). GPT-4o (Advanced) achieved the best performance (F1 = 0.832), followed closely by GPT-OSS-20B (Advanced; F1 = 0.828). LR and SVM also performed strongly (F1 = 0.776 and 0.775), underscoring that while LLMs approach human-level agreement through prompt optimization, interpretable and resource-efficient models remain valuable baselines.

Recent advances in multimodal large language models have enabled unified processing of visual and textual inputs, offering promising applications in general-purpose medical AI. However, their ability to generalize compositionally across unseen combinations of imaging modality, anatomy, and task type remains underexplored. We introduce CrossMed, a benchmark designed to evaluate compositional generalization (CG) in medical multimodal LLMs using a structured Modality-Anatomy-Task (MAT) schema. CrossMed reformulates four public datasets, CheXpert (X-ray classification), SIIM-ACR (X-ray segmentation), BraTS 2020 (MRI classification and segmentation), and MosMedData (CT classification) into a unified visual question answering (VQA) format, resulting in 20,200 multiple-choice QA instances. We evaluate two open-source multimodal LLMs, LLaVA-Vicuna-7B and Qwen2-VL-7B, on both Related and Unrelated MAT splits, as well as a zero-overlap setting where test triplets share no Modality, Anatomy, or Task with the training data. Models trained on Related splits achieve 83.2 percent classification accuracy and 0.75 segmentation cIoU, while performance drops significantly under Unrelated and zero-overlap conditions, demonstrating the benchmark difficulty. We also show cross-task transfer, where segmentation performance improves by 7 percent cIoU even when trained using classification-only data. Traditional models (ResNet-50 and U-Net) show modest gains, confirming the broad utility of the MAT framework, while multimodal LLMs uniquely excel at compositional generalization. CrossMed provides a rigorous testbed for evaluating zero-shot, cross-task, and modality-agnostic generalization in medical vision-language models.

Medical image grounding aims to align natural language phrases with specific regions in medical images, serving as a foundational task for intelligent diagnosis, visual question answering (VQA), and automated report generation (MRG). However, existing research is constrained by limited modality coverage, coarse-grained annotations, and the absence of a unified, generalizable grounding framework. To address these challenges, we construct a large-scale medical grounding dataset Med-GLIP-5M comprising over 5.3 million region-level annotations across seven imaging modalities, covering diverse anatomical structures and pathological findings. The dataset supports both segmentation and grounding tasks with hierarchical region labels, ranging from organ-level boundaries to fine-grained lesions. Based on this foundation, we propose Med-GLIP, a modality-aware grounding framework trained on Med-GLIP-5M. Rather than relying on explicitly designed expert modules, Med-GLIP implicitly acquires hierarchical semantic understanding from diverse training data -- enabling it to recognize multi-granularity structures, such as distinguishing lungs from pneumonia lesions. Extensive experiments demonstrate that Med-GLIP consistently outperforms state-of-the-art baselines across multiple grounding benchmarks. Furthermore, integrating its spatial outputs into downstream tasks, including medical VQA and report generation, leads to substantial performance gains. Our dataset will be released soon.

Efficient analysis and processing of dental images are crucial for dentists to achieve accurate diagnosis and optimal treatment planning. However, dental imaging inherently poses several challenges, such as low contrast, metallic artifacts, and variations in projection angles. Combined with the subjectivity arising from differences in clinicians' expertise, manual interpretation often proves time-consuming and prone to inconsistency. Artificial intelligence (AI)-based automated dental image analysis (DIA) offers a promising solution to these issues and has become an integral part of computer-aided dental diagnosis and treatment. Among various AI technologies, deep learning (DL) stands out as the most widely applied and influential approach due to its superior feature extraction and representation capabilities. To comprehensively summarize recent progress in this field, we focus on the two fundamental aspects of DL research-datasets and models. In this paper, we systematically review 260 studies on DL applications in DIA, including 49 papers on publicly available dental datasets and 211 papers on DL-based algorithms. We first introduce the basic concepts of dental imaging and summarize the characteristics and acquisition methods of existing datasets. Then, we present the foundational techniques of DL and categorize relevant models and algorithms according to different DIA tasks, analyzing their network architectures, optimization strategies, training methods, and performance. Furthermore, we summarize commonly used training and evaluation metrics in the DIA domain. Finally, we discuss the current challenges of existing research and outline potential future directions. We hope that this work provides a valuable and systematic reference for researchers in this field. All supplementary materials and detailed comparison tables will be made publicly available on GitHub.

Imaging technologies are fundamental to biomedical research and modern medicine, requiring analysis of high-resolution images across various modalities. While multimodal large language models (MLLMs) show promise for biomedical image analysis, most are designed for low-resolution images from general-purpose datasets, risking critical information loss. We investigate how image resolution affects MLLM performance in biomedical applications and demonstrate that: (1) native-resolution training and inference significantly improve performance across multiple tasks, (2) misalignment between training and inference resolutions severely degrades performance, and (3) mixed-resolution training effectively mitigates misalignment and balances computational constraints with performance requirements. Based on these findings, we recommend prioritizing native-resolution inference and mixed-resolution datasets to optimize biomedical MLLMs for transformative impact in scientific research and clinical applications.

Mammography, the current standard for breast cancer screening, has reduced sensitivity in women with dense breast tissue, contributing to missed or delayed diagnoses. Thermalytix, an AI-based thermal imaging modality, captures functional vascular and metabolic cues that may complement mammographic structural data. This study investigates whether a breast density-informed multi-modal AI framework can improve cancer detection by dynamically selecting the appropriate imaging modality based on breast tissue composition. A total of 324 women underwent both mammography and thermal imaging. Mammography images were analyzed using a multi-view deep learning model, while Thermalytix assessed thermal images through vascular and thermal radiomics. The proposed framework utilized Mammography AI for fatty breasts and Thermalytix AI for dense breasts, optimizing predictions based on tissue type. This multi-modal AI framework achieved a sensitivity of 94.55% (95% CI: 88.54-100) and specificity of 79.93% (95% CI: 75.14-84.71), outperforming standalone mammography AI (sensitivity 81.82%, specificity 86.25%) and Thermalytix AI (sensitivity 92.73%, specificity 75.46%). Importantly, the sensitivity of Mammography dropped significantly in dense breasts (67.86%) versus fatty breasts (96.30%), whereas Thermalytix AI maintained high and consistent sensitivity in both (92.59% and 92.86%, respectively). This demonstrates that a density-informed multi-modal AI framework can overcome key limitations of unimodal screening and deliver high performance across diverse breast compositions. The proposed framework is interpretable, low-cost, and easily deployable, offering a practical path to improving breast cancer screening outcomes in both high-resource and resource-limited settings.

The rapid advancement of artificial intelligence (AI) in healthcare imaging has revolutionized diagnostic medicine and clinical decision-making processes. This work presents an intelligent multimodal framework for medical image analysis that leverages Vision-Language Models (VLMs) in healthcare diagnostics. The framework integrates Google Gemini 2.5 Flash for automated tumor detection and clinical report generation across multiple imaging modalities including CT, MRI, X-ray, and Ultrasound. The system combines visual feature extraction with natural language processing to enable contextual image interpretation, incorporating coordinate verification mechanisms and probabilistic Gaussian modeling for anomaly distribution. Multi-layered visualization techniques generate detailed medical illustrations, overlay comparisons, and statistical representations to enhance clinical confidence, with location measurement achieving 80 pixels average deviation. Result processing utilizes precise prompt engineering and textual analysis to extract structured clinical information while maintaining interpretability. Experimental evaluations demonstrated high performance in anomaly detection across multiple modalities. The system features a user-friendly Gradio interface for clinical workflow integration and demonstrates zero-shot learning capabilities to reduce dependence on large datasets. This framework represents a significant advancement in automated diagnostic support and radiological workflow efficiency, though clinical validation and multi-center evaluation are necessary prior to widespread adoption.

Deep learning for medical imaging is hampered by task-specific models that lack generalizability and prognostic capabilities, while existing'universal' approaches suffer from simplistic conditioning and poor medical semantic understanding. T o address these limitations, we introduce DuPLUS, a deep learning framework for efficient multi-modal medical image analysis. DuPLUS introduces a novel vision-language framework that leverages hierarchical semantic prompts for fine-grained control over the analysis task, a capability absent in prior universal models. T o enable extensibility to other medical tasks, it includes a hierarchical, text-controlled architecture driven by a unique dual-prompt mechanism. F or segmentation, DuPLUS is able to generalize across three imaging modalities, ten different anatomically various medical datasets, encompassing more than 30 organs and tumor types. It outperforms the state-of-the-art task-specific and universal models on 8 out of 10 datasets. W e demonstrate extensibility of its text-controlled architecture by seamless integration of electronic health record (EHR) data for prognosis prediction, and on a head and neck cancer dataset, DuPLUS achieved a Concordance Index (CI) of 0.69. Parameter-efficient fine-tuning enables rapid adaptation to new tasks and modalities from varying centers, establishing DuPLUS as a versatile and clinically relevant solution for medical image analysis. The code for this work is made available at: https: //anonymous.4open.science/r/DuPLUS-6C52

Aims Late diagnosis of Oral Squamous Cell Carcinoma (OSCC) contributes significantly to its high global mortality rate, with over 50\% of cases detected at advanced stages and a 5-year survival rate below 50\% according to WHO statistics. This study aims to improve early detection of OSCC by developing a multimodal deep learning framework that integrates clinical, radiological, and histopathological images using a weighted ensemble of DenseNet-121 convolutional neural networks (CNNs). Material and Methods A retrospective study was conducted using publicly available datasets representing three distinct medical imaging modalities. Each modality-specific dataset was used to train a DenseNet-121 CNN via transfer learning. Augmentation and modality-specific preprocessing were applied to increase robustness. Predictions were fused using a validation-weighted ensemble strategy. Evaluation was performed using accuracy, precision, recall, F1-score. Results High validation accuracy was achieved for radiological (100\%) and histopathological (95.12\%) modalities, with clinical images performing lower (63.10\%) due to visual heterogeneity. The ensemble model demonstrated improved diagnostic robustness with an overall accuracy of 84.58\% on a multimodal validation dataset of 55 samples. Conclusion The multimodal ensemble framework bridges gaps in the current diagnostic workflow by offering a non-invasive, AI-assisted triage tool that enhances early identification of high-risk lesions. It supports clinicians in decision-making, aligning with global oncology guidelines to reduce diagnostic delays and improve patient outcomes.