#01Nov 4, 2026
cs.CV
Trick-or-Treat: Adversarial Evaluation of Multimodal Medical Reasoning with Synthetic Images
Oishi Banerjee, Eujin Lee, Sung Eun Kim and 4 more
We used medical image synthesis to create a challenging multimodal evaluation framework that exposes hallucination behaviors in frontier models. Evaluating multimodal reasoning has historically been difficult because existing medical datasets rarely pair different image modalities, such as radiographs and external clinical photographs. To address this gap, we introduce Trick-or-Treat, an adversarial multimodal medical benchmark that pairs real chest radiographs with synthetic clinical photographs to challenge models' cross-modal reasoning. For each of a wide range of conditions, we created two pairs of images, where the pairs share a single chest radiograph but contain different external photographs. In matched pairs, the chest radiograph and photograph both contain findings suggesting the same disease (e.g., varicella pneumonia suggested by lung opacities and crusted skin lesions seen in chickenpox). In mismatched pairs, the photograph depicts an alternative clinical finding that would not lead to the same unifying diagnosis (e.g. replacing crusted skin lesions with ordinary acne). Synthetic photograph generation allows clinical findings to be varied while the person's features and photographic setting stay consistent, reducing confounding. In an investigation of three frontier models, we found that models hallucinated clinically significant photograph findings in 45-57.5% of mismatched pairs, up from 25-37.5% for the same photographs shown alone. When faced with mismatched pairs, models tended to ignore mismatches and instead hallucinated findings that better matched the radiograph (e.g. misreading acne as crusted skin lesions to justify diagnosing chickenpox). Trick-or-Treat both demonstrates concerning error pattern in frontier models' medical reasoning and provides a proof of concept for the use of synthetic images in adversarial multimodal evaluation.
#02Nov 4, 2026
cs.CV
Procedural Adversarial Learning
Jack Nugent, Jia Deng
For many computer vision tasks, neural networks can be trained to produce a low average error, yet they still fail on seemingly simple scenes. Reducing these failures requires first finding them, but they may not be in a fixed dataset. We study procedural adversarial learning (PAL), a framework of minimax training and adversarial evaluation which searches the input space of a procedural generator for difficult instances. The procedural generator is an interpretable program mapping a low-dimensional vector of control parameters (e.g. layout, lighting, pose) to a rendered image and its label. We introduce the Simple-PAT algorithm, which uses zeroth-order optimization in the procedural generator's parameter space to propose adversarial training samples that are generated on demand. We also create PAL-Dojo, a collection of efficient procedural generators for surface normal estimation, image segmentation, and human pose estimation. Against a cross-model black-box adversary with 50M aggregate queries, Simple-PAT reduces worst-case error by a geometric mean of 3.15x compared to standard training and 2.63x compared to the strongest robust training baseline. Code is available at https://github.com/princeton-vl/procedural-adversarial-learning.
#03Nov 4, 2026
cs.CV
Benchmarking Fine-Grained Visual Reasoning for Remote Sensing in Urban Management
Jiawei Zhang, Rizhao Cai, Dayan Guan
Fine-grained visual reasoning is essential for remote sensing in urban management, yet remains underexplored in the evaluation of multimodal large language models (MLLMs). We introduce UMBench, a fine-grained urban remote sensing benchmark built from unmanned aerial vehicle (UAV) images for multiple urban management tasks such as traffic monitoring, urban construction, environmental quality, and disaster warning. Evaluations on UMBench reveal that current MLLMs often rely on scene-level priors and overlook fine-grained visual evidence. To address this issue, we further propose a novel evidence-first chain-of-thought method that directs models to inspect fine-grained visual evidence in a training-free manner. Experiments show that our method can improve the performance of both open-source and commercial MLLMs on UMBench.
#04Nov 4, 2026
cs.CV
CardioDrift: Automatic Cardiac Motion Tracking on a 3D Atlas Mesh via Shape-aware Coherent Point Drift with Slice Shift Correction
Reza Akbari Movahed, Abuzar Rezaee, Shatha Alamri and 3 more
Automatic cardiac motion tracking from cine cardiac magnetic resonance (CMR) imaging is essential for quantifying myocardial motion abnormalities associated with cardiovascular disease. Existing methods fall into two groups: those that represent motion without anatomical correspondence across subjects and therefore limit inter-subject motion assessment; and those that represent motion with globally corresponding points, which typically require a time-consuming and error-prone semi-automatic step to fit a cardiac atlas to the subject space. To address these limitations, this study proposes CardioDrift, a fully automatic, atlas-based probabilistic framework that represents subject-specific cardiac motion on a 3D atlas mesh with globally corresponding points. The Coherent Point Drift (CPD) formulation is generalised to jointly register the atlas surfaces of multiple cardiac regions to the anatomically corresponding contours extracted from cine CMR segmentation maps throughout the cardiac cycle. Slice-shift correction is embedded in the same probabilistic model, estimating slice-wise translations that suppress the misalignment artefact limiting atlas-fitting accuracy. Evaluation on 1301 randomly selected UK Biobank subjects and the M&M dataset, CardioDrift attains Dice similarity coefficients (DSCs) of $92.23\pm8.70\%$, $82.11\pm7.56\%$, and $88.69\pm4.13\%$ for the left ventricle (LV), myocardium (Myo), and right ventricle (RV), exceeding the strongest baseline on every distance and overlap metric of both datasets.
#05Nov 4, 2026
cs.CV
Dynamical State-Space Diffusion for Spatiotemporal Prediction
Woojun Lee, Hankyeol Kim, Pilsung Kang
Diffusion models for temporal prediction typically corrupt each future frame with independent noise, leaving temporal dependence entirely to the denoiser. We propose Dynamical State-Space Diffusion (DSSD), which learns the temporal structure of the corruption process itself. DSSD builds a temporal kernel from the damped oscillatory modes of a stable diagonal state-space model, whose learned decay rates and frequencies let the corruption capture multiple timescales and oscillatory correlations, while the denoiser architecture remains unchanged. Running this model on a finite clip, however, requires the state before the first frame, which is unobserved; starting from a zero state leaves the early frames with less noise than the diffusion schedule prescribes. We avoid this by using the Cholesky factor of the model's stationary covariance as the temporal operator. We prove that this operator is causal, exactly invertible, keeps each frame's noise variance equal to that of standard diffusion, and reduces to the identity at the clean end of the process, and that it is exactly the Kalman innovations form of the state-space model. The denoiser is trained to predict the temporally correlated noise, and sampling removes and reapplies the temporal mixing at each step. On scientific-field and robot-video datasets, DSSD outperforms diffusion baselines that share its denoiser, and the evolution of its learned modes during training shows that the temporal operator adapts to each dataset.