arXiv AI By Haowen Gu, Gensheng Pei, Junzhu Mao, Qiong Wang, Mingwu Ren, Yazhou Yao

From Reasoning to Pixels: Grounded Medical Multimodal LLMs for VQA and Segmentation

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The paper introduces MedREAL, a unified framework that aligns linguistic reasoning with spatial grounding for medical visual question answering and segmentation. MedREAL employs Seg Anchored Reasoning Pooling (SARP) to extract semantic evidence from segmentation tokens and a Reasoning-to-Visual (R2V) fusion mechanism to integrate these features into a segmentation pipeline. Using the newly created MedRAVS-13K dataset, MedREAL achieves superior performance, reporting 68.49% gIoU and 70.47% cIoU, and generates evidence masks that consistently match textual diagnoses.

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