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Aug 3

MedVista3D: Vision-Language Modeling for Reducing Diagnostic Errors in 3D CT Disease Detection, Understanding and Reporting

Radiologic diagnostic errors-under-reading errors, inattentional blindness, and communication failures-remain prevalent in clinical practice. These issues often stem from missed localized abnormalities, limited global context, and variability in report language. These challenges are amplified in 3D imaging, where clinicians must examine hundreds of slices per scan. Addressing them requires systems with precise localized detection, global volume-level reasoning, and semantically consistent natural language reporting. However, existing 3D vision-language models are unable to meet all three needs jointly, lacking local-global understanding for spatial reasoning and struggling with the variability and noise of uncurated radiology reports. We present MedVista3D, a multi-scale semantic-enriched vision-language pretraining framework for 3D CT analysis. To enable joint disease detection and holistic interpretation, MedVista3D performs local and global image-text alignment for fine-grained representation learning within full-volume context. To address report variability, we apply language model rewrites and introduce a Radiology Semantic Matching Bank for semantics-aware alignment. MedVista3D achieves state-of-the-art performance on zero-shot disease classification, report retrieval, and medical visual question answering, while transferring well to organ segmentation and prognosis prediction. Code and datasets will be released.

  • 6 authors
·
Sep 3, 2025 2

PixelEyes: Decoupling Perception and Reasoning for Pinpoint Visual Evidence Seeking

This paper explores multi-turn visual reasoning and observes that MLLMs repeatedly fail to localize the target, leading to long, redundant trajectories. We attribute this failure to the entanglement of reasoning and perception within a single model, the MLLM reasons and localizes simultaneously, and inaccurate localization triggers additional reasoning turns that bloat the trajectory. To solve this problem, we propose PixelEyes, a multi-turn visual reasoning agent that explicitly decouples reasoning from perception, i.e., the reasoner decides what to look for, while a specialized perception tool answers where it is. Specifically, PixelEyes introduces 1) Mask-guided Visual Search. A referring segmentation model is invoked to provide mask-precise localization, freeing the reasoner from the need to compensate for imprecise grounding. 2) Semantic-region Breadth-first Search (BFS). To eliminate redundant loops caused by repeatedly cropping incorrect sub-regions, we organize exploration as a breadth-first search over semantic regions. To internalize these capabilities, we construct the PixelEyes-6K dataset by resynthesizing expert trajectories from existing data. This explicitly embeds our mask-guided search and BFS logic into the model. We further introduce Pinpoint-Bench, a zero-hint visual search benchmark, i.e., no location cues are provided in the question, with instance-level masks and bounding boxes that separate localization failures from reasoning failures, enabling fine-grained analysis of failure modes such as inattentional blindness. Recent state-of-the-art MLLMs and visual reasoning agents leave large headroom on Pinpoint-Bench, demonstrating its quality and difficulty. Code and models are open-sourced.