#01Aug 21, 2026
cs.CV
Masking Is Not Enough: Generative Restoration for Multimodal De-Identification in Medical AI
Shiva Shrestha, Zongxing Xie, Chen Zhao and 3 more
Medical image-text data can expose protected health information (PHI) through both visible image content as well as accompanying text, creating a barrier to privacy-preserving medical AI systems. This risk is especially prominent in multimodal systems, where images, questions, reports, and clinical context may enter training, evaluation, or inference pipelines. Existing medical vision-language benchmarks primarily emphasize task utility, while de-identification methods are often evaluated separately from downstream reasoning. We introduce ClinX, an end-to-end multimodal PHI sanitization framework for medical image-text data. ClinX detects visible identifiers with optical character recognition (OCR), constructs binary PHI masks, and applies ClinX-PRISM, a no-skip generative restoration module with privacy-oriented post-processing for burned-in identifier suppression. In parallel, text-side PHI is reduced through progressive de-identification levels: regex masking, context-aware masking, and rewrite-based sanitization. We evaluate ClinX in medical visual question answering (MedVQA), jointly measuring PHI leakage and downstream utility across image-side, text-side, and combined de-identification settings. Results show that OCR-only masking is not sufficient as a standalone solution, and restoration-based sanitization better preserves clinically relevant visual context while sharply reducing recoverable PHI.
#02Aug 21, 2026
eess.IV
Toward Vision Language Model-based Assessment of Clinical Quality and Usability of LGE-MR Images for Cardiac Ablation Planning
Bipasha Kundu, Abhishek Chaturvedi, Axel W. E. Wismueller and 2 more
LGE cardiac MRI is widely used for left atrial fibrosis assessment and ablation planning in atrial fibrillation patients as knowledge of fibrotic tissue regions identified from LGE-MRI is critical for catheter ablation. Often, poor quality images used during ablation planning can cause mis-localization of ablation targets, directly impacting procedure safety and outcome. The decision of whether a scan meets the minimum quality threshold for ablation planning is currently made informally by the reviewing radiologist and is not captured by any automated system, yet it is arguably the most safety-critical output of the image quality assessment (IQA) process. However, variations in image quality caused by noise, motion artifacts, and poor boundary definition significantly compromise the reliability of downstream segmentation and clinical decision-making tasks. Manual quality assessment by expert radiologists is subjective and difficult to scale, while existing automated methods produce scalar scores without interpretable clinical reasoning. In this work, we propose a two-stage vision language model (VLM) framework for clinically grounded image quality assessment of left atrial LGE-MRI. In the first stage, a fine-tuned VLM generates structured radiology-style quality reports predicting five radiologist-defined criteria: Noise, Motion Artifact, LA Boundary Accuracy, PV Region Accuracy, and Under-segmentation Severity. In the second stage, a GPT-based reasoning module maps the predicted quality and reports to a structured quality scores and binary clinical usability decision for ablation planning. We curate a dataset of 60 annotated image slice-text pairs from 20 patients and benchmark four state-of-the-art VLM architectures. InternVL2 achieves the highest criterion-level accuracy (Avg ACC=0.65, PLCC=0.79), while DeepSeek achieves perfect clinical usability agreement (Acc=1.00, kappa=1.00).
#03Aug 21, 2026
cs.CV
On the Transferability of Agricultural Weed Detection Under Cross-Field Distribution Shift
Nikhilesh Prabhakar, Pranuthi Tenali, Wilfredo Abudeye Fernandez and 5 more
Accurate agricultural weed detection in real-world field conditions is essential for precision agriculture, enabling targeted intervention and reducing yield loss. Recent work has reported strong detection performance from UAV-based imagery across a range of crops, yet existing approaches evaluate within a single crop and field, leaving practitioners with little evidence that a model trained on one crop will generalize to a new field or crop type. In this work, we characterize where cross-dataset weed-localization performance degrades and which modeling choices recover it, reducing the need to relabel every new deployment field. We introduce a newly collected and annotated UAV image dataset for agricultural weed detection in cotton fields and use it alongside an existing soybean dataset collected under a similar protocol. Using these datasets, we evaluate the performance of several strategies for transferring a detector trained on one crop to another, comparing unsupervised domain adaptive object detection (DAOD) against pretraining on a domain-adjacent source dataset followed by few-shot fine-tuning on the target dataset. Our analysis spans target-domain label budgets from zero to the full target dataset, characterizing the trade-off between adaptation strategy and annotation effort. We find that few-shot fine-tuning with as few as 25 labeled target examples outperforms unsupervised DAOD in our cross-crop comparison, suggesting that source domain selection combined with modest target supervision is more productive than algorithmic sophistication in adaptation.
#04Aug 21, 2026
cs.CV
A Modular Agent for Reliable and Auditable Spatial Relation Verification in CT Scans
Simon Vincent Abel, Heiko Hillenhagen, Michael Götz and 3 more
Reliable spatial understanding is an important prerequisite for future medical vision-language systems that aim to support radiological report generation and structured image understanding. While modern vision-language models (VLMs) show promising performance on many medical imaging tasks, recent evidence suggests they remain weak in controlled spatial reasoning and often fail to reliably ground spatial relations in image evidence. Given that radiological reasoning hinges on understanding the relative positions of anatomical structures and findings, this spatial weakness poses risks to diagnostic accuracy. We present a modular medical imaging agent for binary spatial relation verification in axial CT slices. Instead of directly predicting spatial answers end-to-end, the system decomposes the task into explicit stages: language parsing, anatomical localization, and deterministic geometric verification. Natural-language queries are converted into structured relation tuples, queried organs are localized with a YOLO-based detector, and the final spatial decision is computed from object centers using deterministic geometric rules. We evaluate the approach on the held-out MIRP spatial QA benchmark and compare it against representative end-to-end VLM baselines. The best-performing hybrid configuration reaches 94.1% accuracy and 94.2% F1, outperforming direct Qwen2-VL prompting by 42.5 percentage points in accuracy, while preserving interpretable intermediate representations and auditable reasoning stages. The results suggest that explicit modular spatial verification can serve as a promising building block for future report-oriented medical imaging agents.
#05Aug 21, 2026
cs.CV
Stream3Dv2: Geometric-Semantic Fusion Enhanced Streaming Zero-Shot 3D Scene Understanding
Jie Xu, Na Zhao
Recently, open-vocabulary zero-shot 3D scene understanding using vision foundation models has emerged as a promising alternative to data-intensive supervised methods. However, deploying these models in real-world scenarios is severely hindered by their inability to efficiently handle streaming RGB-D inputs and their inherent vulnerability to noise 2D segmentation masks. To address these critical limitations, we propose Stream3Dv2, a novel training-free framework designed for robust streaming 3D perception. Stream3Dv2 processes sequential data through an original nested local-to-historical architecture, capturing multi-view consistency while circumventing the high computational overhead so as to support timely responses. At its core, we introduce a comprehensive geometric-semantic fusion mechanism that resolves geometric noise and semantic ambiguity by explicitly utilizing semantic guidance and formulating 3D segmentation as solving point-and-set merging and partitioning problems. Furthermore, we present an innovative manifold-distance-based point cloud refinement strategy. This approach leverages local manifold graphs for point-to-manifold optimization that mitigates the boundary delineation failures caused by Euclidean-distance metrics, and employs geometric bounding boxes to dynamically activate and update historical instances for achieving rapid manifold-to-manifold refinement. Extensive experiments on public datasets demonstrate that Stream3Dv2 consistently outperforms existing baselines in foundational open-vocabulary streaming 3D segmentation and detection. Finally, we show that integrating our framework with an LLM-based agent enables advanced language-driven 3D scene understanding, underscoring its potential for open-world embodied intelligence. Code will be updated at https://github.com/SubmissionsIn/Stream3D.