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Zuozhu Liu

Publications and source records attributed to Zuozhu Liu.

At least 19 recordsLinked to original sources
arXiv2026

CDEG: Learning Decision-Critical Evidence for Long-Horizon Diagnostic Agents

Unlike static medical question answering, long-horizon diagnosis captures the sequential nature of clinical practice: evidence is progressively acquired, integrated, and evaluated over multiple rounds of interaction before reaching a final diagnosis. However, existing doctor agents often fail when critical evidence is either not acquired or not adequately incorporated into diagnostic reasoning. Recent agentic approaches attempt to address these failures by reusing historical trajectories or distilled memories. But their diagnostic gains remain constrained because such experience may contain noisy or incidental information and is typically reused without validating which evidence actually drives diagnostic decisions. To address this limitation, we introduce CDEG, a graph-based framework that learns reusable decision-critical evidence from historical diagnostic trajectories. CDEG contrasts successful and failed trajectories from the same case to identify candidate evidence, validates their diagnostic impact through controlled counterfactual interventions, and organizes the resulting diagnosis--evidence--action relations into a structured graph. During inference, CDEG tracks the evolving patient evidence state to retrieve relevant diagnostic relations and selectively guide missing evidence acquisition or overlooked evidence reappraisal. Across in-domain and out-of-distribution benchmarks with multiple doctor agent backbones, CDEG consistently improves diagnostic performance, achieving up to an 11.5% accuracy gain over vanilla agents. These results demonstrate that reliable long-horizon diagnosis requires moving beyond trajectory-level experience reuse toward evidence-level learning of the factors that truly shape clinical decisions.

cs.AI↗
arXiv2026

DentAgent: Evidence-Centric Multi-Agent Coordination for Multimodal Dental Reasoning

Oral diseases affect billions of people worldwide, underscoring a pressing need for accurate and reliable dental assessment that integrates heterogeneous evidence from domain knowledge, radiographs, intraoral photographs, and 3D dental data. Most existing dental AI systems remain modality- or task-specific. Although recent vision-language models support flexible dental question answering, directly generated response leaves evidence implicit and untraceable. To address these limitations, we introduce DentAgent, an evidence-centric multi-agent framework, in which the Orchestrator coordinate five specialized agents spanning various modalities. Each specialist utilizes domain tools to convert observations into structured evidence records. The Evidence Blackboard manages these records as a shared evidence state, tracking coverage, gaps, and conflicts before response generation. This standardized evidence representation integrates isolated dental capabilities into a unified agentic workflow. Across four benchmarks, DentAgent demonstrates leading performance, even surpassing the senior specialists by 17.3 percentage points on multi-label diagnosis, which supports its value for broadly applicable and traceable multimodal dental reasoning, and highlights its potential as a technical foundation for population oral health assessment and management.

cs.AI↗
arXiv2026

MedUAG: Unified Understanding and Generation for Medical Multimodal Models

Recent Multimodal Large Language Models (MLLMs) are rapidly evolving into unified understanding and generation (UAG) frameworks. However, extending these unified paradigms to the medical domain is hindered by: the absence of comprehensive training and evaluation benchmarks, and the lack of broadly validated unified medical model. To address these gaps, we present a comprehensive foundation for medical UAG. First, we construct MedUAGCorpus, the largest unified medical understanding and generation dataset to date, comprising over 6 million instances across 14 imaging modalities. Second, we introduce MedUAGBench, a systematic benchmark that expands medical generation evaluation to 12 diverse tasks under standardized protocols. Finally, leveraging these resources, we develop MedUAG, an end-to-end trained unified medical model. Extensive experiments demonstrate that MedUAG achieves strong performance across a wide array of understanding and generation tasks, establishing a competitive baseline and paving the way for next-generation medical multimodal systems.

cs.CL↗
arXiv2026

MedUP: Awakening Unified Understanding and Perception in Medical Vision-Language Models

Medical Vision-Language Models (Med-VLMs) excel at verbalizing visual content, yet precise visual perception, segmentation, and grounding remain challenging. Existing approaches either verbalize regions as coordinate strings or rely on external modules that decouple perception from understanding, creating representation gaps for region-language alignment. We present MedUP, a Med-VLM that natively unifies perception and understanding within a shared token space. At its core lies UniMedTok, a region tokenizer that encodes masks as discrete tokens in the LLM vocabulary, enabling the model to seamlessly interleave mask tokens with text. We curate UniMed-Train, a 1.84M-instance corpus spanning text-guided segmentation, region-grounded understanding, medical VQA and CoT-based segmentation, and introduce UniMed-Bench for unified evaluation. Extensive experiments show that MedUP outperforms native, agentic, and dual-decoder Med-VLMs across all tasks while remaining competitive with specialist segmentors, demonstrating the strong potential of unified understanding and perception modeling.

cs.CV↗
arXiv2026

FUSEP: A Multi-Center Benchmark for Diverse Tasks in Early Pregnancy Fetal Ultrasound Screening

A large number of infants with congenital anomalies are born each year globally, especially in areas with underdeveloped medical resources. Currently, fetal ultrasound screening is the most common modality for early pregnancy anatomy detection. This modality can detect anomalies earlier and provide opportune treatment advice. However, the lack of an ultrasound dataset on early fetal gestation has slowed down the development of automated assisted diagnosis. In this work, we present a benchmark dataset for Fetal Ultrasound Screening in Early Pregnancy to facilitate intelligent ultrasound examination and assisted diagnosis called FUSEP. Our dataset consists of two ultrasound views recommended by the international guideline, i.e., Crown-rump Length (CRL) and Nuchal Translucency (NT) views in three hospitals, totaling 4,017 ultrasound images, with 45,820 box-level expert-level annotations. Our dataset and baseline present the following three contributions: 1) Our medical experts annotated a total of 14 key anatomical structures in two views using a box-level format; 2) Our data is collected extensively from different sonographers, devices, scanning angles, hospitals, etc; 3) We report the performance of the semi-supervised learning, fully supervised learning, unsupervised domain adaptation (UDA), and source-free UDA in ultrasound images multi-object detection. To the best of our knowledge, this is the first publicly available dataset and benchmark for fetal early pregnancy ultrasound screening. We believe that FUSEP and benchmark can contribute to the medical community in the development of multiple tasks such as standard plane recognition, quality control on ultrasound images, automated assisted diagnostics in early fetal pregnancy, medical multi-object detection, domain adaptation for object detection, etc.

cs.CV↗
arXiv2026

ClinFusion: A Vision-Centric Multimodal LLM System for Holistic Medical Understanding

Multimodal large language models (MLLMs) hold immense potential to revolutionize clinical practice, yet deploying them in the medical domain is fundamentally a vision-centric challenge: models must absorb knowledge from heterogeneous 2D and 3D medical images, and evaluation protocols must align with radiologists' clinical practice and provide an accurate, fine-grained and factualness-driven assessment. In this paper, we introduce ClinFusion, a vision-centric MLLM designed for holistic medical understanding that systematically addresses these limitations. We propose a compositional and cascaded vision encoder architecture featuring a Cascade Spatial-Aware Locality Fusion operator that unifies diverse 2D and native 3D medical image understanding within a fused encoder. We further introduce a vision-grounded evaluation framework, including MedIF-Bench for instruction-following assessment and a region-of-interest-grounded method for clinically aligned and factualness-driven report generation evaluation. We show that ClinFusion sets a new state-of-the-art across a comprehensive suite of 2D and 3D multimodal medical benchmarks---spanning visual question answering, report generation, and instruction following---as well as textual medical tasks, outperforming leading open-source medical MLLMs (\textit{e.g.}, Hulu-Med, Lingshu) on 20 out of 24 benchmarks and demonstrating multimodal capabilities better than powerful proprietary models such as GPT-5.2 and Gemini-3-Flash on 13 out of 16 benchmarks, and can be further augmented with agentic tool use for retrieval-augmented and tool-assisted clinical workflows. A blinded evaluation by board-certified radiologists confirms that ClinFusion produces the highest-ranked reports, and validates our RoI-grounded metric as achieving the strongest correlation with expert judgment among all automatic evaluation metrics examined.

cs.CV↗
arXiv2026

LongMedBench: Benchmarking Medical Agents for Long-Horizon Clinical Decision-Making

In this work, we introduce LongMedBench, a real-world EHR-based benchmark for long-horizon clinical decision-making. Prior evaluations of LLM-based medical agents have largely emphasized short-context knowledge QA and tool use. However, real-world medical care is inherently longitudinal, and clinicians must aggregate evidence across repeated visits, tests, and evolving treatments. Therefore, long-horizon interaction is essential for realistic assessment. LongMedBench is constructed via a reproducible pipeline that integrates MIMIC-IV admission records and clinical notes into time-series event streams and long-context memory datasets, enabling long-horizon, multi-session interactions between agents and a clinical environment. It comprises 335 patients, with 19.72 inpatient visits per patient on average and 44.91 medical events per visit. Guided by the long-horizon decision process, we propose an evaluation taxonomy with three suites: fact-based QA, temporal reasoning, and long-horizon decision-making. This taxonomy measures how agents understand and leverage historical patient information over extended horizons. Our experiments show that while recent LLMs can make good use of explicit timestamps, they have challenges in implicit time inference; The RAG and agent memory system can improve the performance of information retrieval tasks, but the performance of decision-making tasks is highly dependent on the model's immediate context.

cs.AI↗
arXiv2026

MedStreamBench: A Time-Aware Benchmark for Streaming and Proactive Medical Video Understanding

Existing medical video benchmarks primarily evaluate whether a model produces the correct answer, but rarely assess whether it answers at the right time. In real clinical settings, AI systems must decide not only what to predict, but also when to answer, defer judgment, or proactively raise alerts. This creates a critical gap between benchmark evaluation and deployment requirements. We present MedStreamBench, a benchmark for time-aware medical video understanding. MedStreamBench integrates 22 medical datasets and 5,419 QA instances across four temporal settings: retrospective, present, future, and proactive. Unlike conventional benchmarks that assume full-video access, MedStreamBench restricts models to temporally bounded evidence windows and supports both single-turn and streaming evaluation. We further introduce a proactive monitoring setting that requires models to determine whether and when clinically relevant alerts should be triggered. Beyond answer correctness, MedStreamBench evaluates temporal behavior through responsiveness and post-evidence stability. Experiments on leading general-purpose and medical vision-language models reveal a substantial gap between offline recognition and temporally grounded decision-making, with performance dropping markedly in streaming and proactive settings. Our benchmark is available at https://huggingface.co/datasets/Venn2024/MedStreamBench.

cs.CV↗
arXiv2026

AtomiMed: Hierarchical Atomic Fact-Checking for Universal Clinical-Aware Medical Report Evaluation

Traditional metrics for Medical Report Generation (MRG) predominantly rely on surface-level n-gram overlap, which fails to capture clinical factual accuracy and often overlooks catastrophic diagnostic errors. We address this fundamental limitation by proposing \textbf{AtomiMed}, a universal, modality-agnostic evaluation framework that decomposes complex medical narratives into a standardized, multi-level hierarchy of Atomic Clinical Facts, encompassing Disease-level entities and Attribute-level descriptors, including location, morphology, and severity. By implementing an Agentic Cross-Verification loop between ground-truth and predicted reports, AtomiMed simulates a multi-radiologist peer-review process to verify clinical consistency, thus enabling the decoupled assessment of diagnostic detection and descriptive accuracy. To facilitate standardized evaluation, we introduce \textbf{MRGEvalKit}, an open-source toolkit for automated hierarchical extraction, and curate \textbf{OmniMRG-Bench}, a comprehensive multi-modal benchmark covering X-ray, CT, MRI, and Ultrasound. Extensive experiments on multiple expert-annotated reader studies demonstrate that AtomiMed achieves significantly higher correlation with human radiologist judgment compared to traditional and model-based metrics. Our code are release at https://github.com/Venn2336/MRGEvalkit

cs.CE↗
arXiv2026

BioMedVR: Confusion-Aware Mixture-of-Prompt Experts for Biomedical Visual Reprogramming

Recent advances in vision-language models (VLMs) such as CLIP have demonstrated strong generalization across natural-image domains. However, adapting these models to biomedical imaging is non-trivial: full-model fine-tuning is computationally expensive, while medical data are often scarce and exhibit subtle, fine-grained inter-class differences, making parameter-efficient adaptation particularly critical. Visual Reprogramming (VR) offers a parameter-efficient alternative by injecting learnable perturbations into the input space, but existing VR approaches for VLMs mainly focus on positive class prompts and overlook confusing negatives, leading to miscalibrated predictions in fine-grained medical scenarios. We present BioMedVR, the first VR-based framework for biomedical imaging, enabling few-shot adaptation of pretrained VLMs through compact learnable VR modules. To mitigate class confusion, we introduce a Confusion Minimization Mechanism that leverages LLM-generated confusion-aware attributes together with a Confusion-Suppression Loss to explicitly reduce false-positive alignment. Moreover, the designed Mixture-of-Prompt Experts combines a positive expert for main-class discrimination and a negative expert for confusion suppression, balanced via adaptive gating. Extensive experiments on 18 datasets, including 11 biomedical datasets and 7 natural image benchmarks, demonstrate that BioMedVR achieves superior accuracy and generalization, effectively bridging VR and VLMs in biomedical domains.

cs.CV↗
arXiv2026

VideoWeaver: Evaluating and Evolving Skills for Agentic Long Video Generation

Recent agent frameworks such as Claude Code, Codex, and OpenClaw are strong at tool use and orchestration, but whether they can handle long video generation, a long-horizon multimodal task, remains underexplored. Unlike earlier video agents whose pipeline is handcrafted, these frameworks can build and refine their own workflows. We introduce VideoWeaver, an agent harness and benchmark that evaluates and evolves skills for long video generation, where an agent turns a single instruction into a long video by composing foundation skills into its own workflow rather than following a predefined pipeline. The benchmark has 16 task categories and 285 cases, with references spanning text, image, audio, video, and their combinations. Because errors can arise at any stage and not just in the final video, we propose an agent-as-judge that inspects both the execution trace and the final video, grounding its scores in evidence such as metadata and intermediate files. Using this feedback, we further design a skill evolution algorithm that refines and merges the agent's skills. Across multiple frameworks and models, we find that an explicit composition skill improves the generation process over using foundation skills alone, that skill evolution further improves output quality, and that performance varies notably across harness and model choices. The proposed agent-as-judge also aligns well with human judgments, especially on process metrics. Code and dataset is available at https://github.com/JianhuiWei7/VideoWeaver

cs.CV↗
arXiv2026

Med-R2: An Adversarial Benchmark for Evidence-Grounded Reasoning in Medical VLMs

Vision-language models have demonstrated impressive capabilities in general medical visual question answering, yet due to limited interpretability, it remains unclear whether their predictions reflect evidence-grounded clinical reasoning or reliance on spurious priors. We introduce Med-R2 Bench, a hierarchical benchmark aligned with the clinical workflow to evaluate adversarial robustness with visual grounding. We design stepwise QA tasks to assess whether reasoning chains are strictly grounded in visual evidence across the four clinical stages, and employ adversarial perturbations to test robustness against misleading cues. Med-R2 comprises 42,432 images, 31 task categories, and 110,406 QA pairs. Evaluation across 14 VLMs reveals a sequential performance degradation along the four-stage clinical workflow. Adversarial experiments show that models rely heavily on correct prompts to guess answers. Even when provided with explicit visual cues, the models struggle to accurately align textual descriptions. Finally, we demonstrate stepwise fine-tuning using our hierarchical data significantly improves reasoning robustness, highlighting its potential to drive future improvements in evidence-based medical AI.

cs.CV↗
arXiv2026

How Far Are Video Models from True Multimodal Reasoning?

Despite remarkable progress toward general-purpose video models, a critical question remains unanswered: how far are these models from achieving true multimodal reasoning? Existing benchmarks fail to address this question rigorously, as they remain constrained by straightforward task designs and fragmented evaluation metrics that neglect complex multimodal reasoning. To bridge this gap, we introduce CLVG-Bench, an evaluation framework designed to probe video models' zero-shot reasoning capabilities via Context Learning in Video Generation. CLVG-Bench comprises more than 1,000 high-quality, manually annotated metadata across 6 categories and 47 subcategories, covering complex scenarios including physical simulation, logical reasoning, and interactive contexts. To enable rigorous and scalable assessment, we further propose an Adaptive Video Evaluator (AVE) that aligns with human expert perception using minimal annotations, delivering interpretable textual feedback across diverse video context tasks. Extensive experiments reveal a striking answer to our central question: while state-of-the-art (SOTA) video models, such as Seedance 2.0, demonstrate competence on certain understanding and reasoning subtasks, they fall substantially short with logically grounded and interactive generation tasks (achieving success rates <25% and ~0%, respectively), exposing multimodal reasoning and physical grounding as critical bottlenecks. By systematically quantifying these limitations, the proposed method provides actionable feedbacks and a clear roadmap toward truly robust, general-purpose video models. CLVG-Bench and code are released here.

cs.CV↗
arXiv2026

PBE-UNet: A light weight Progressive Boundary-Enhanced U-Net with Scale-Aware Aggregation for Ultrasound Image Segmentation

Accurate lesion segmentation in ultrasound images is essential for preventive screening and clinical diagnosis, yet remains challenging due to low contrast, blurry boundaries, and significant scale variations. Although existing deep learning-based methods have achieved remarkable performance, these methods still struggle with scale variations and indistinct tumor boundaries. To address these challenges, we propose a progressive boundary enhanced U-Net (PBE-UNet). Specially, we first introduce a scale-aware aggregation module (SAAM) that dynamically adjusts its receptive field to capture robust multi-scale contextual information. Then, we propose a boundary-guided feature enhancement (BGFE) module to enhance the feature representations. We find that there are large gaps between the narrow boundary and the wide segmentation error areas. Unlike existing methods that treat boundaries as static masks, the BGFE module progressively expands the narrow boundary prediction into broader spatial attention maps. Thus, broader spatial attention maps could effectively cover the wider segmentation error regions and enhance the model's focus on these challenging areas. We conduct expensive experiments on four benchmark ultrasound datasets, BUSI, Dataset B, TN3K, and BP. The experimental results how that our proposed PBE-UNet outperforms state-of-the-art ultrasound image segmentation methods. The code is at https://github.com/cruelMouth/PBE-UNet.

cs.CV↗
arXiv2026

BiasIG: Benchmarking Multi-dimensional Social Biases in Text-to-Image Models

Text-to-Image (T2I) generative models have revolutionized content creation, yet they inherently risk amplifying societal biases. While sociological research provides systematic classifications of bias, existing T2I benchmarks largely conflate these nuances or focus narrowly on occupational stereotypes, leaving the multi-dimensional nature of generative bias inadequately measured. In this paper, we introduce BiasIG, a unified benchmark that quantifies social biases across a curated dataset of 47,040 prompts. Grounded in sociological and machine ethics frameworks, BiasIG disentangles biases across 4 dimensions to enable fine-grained diagnosis. To facilitate scalable and reliable evaluation, we propose a fully automated pipeline powered by a fine-tuned multi-modal large language model, achieving high alignment accuracy comparable to human experts. Extensive experiments on 8 T2I models and 3 debiasing methods not only validate BiasIG as a robust diagnostic tool, but also reveal critical insights: interventions on protected attributes often trigger unintended confounding effects on unrelated demographics, and debiasing methods exhibit a persistent tendency toward discrimination rather than mere ignorance. Our work advocates for a precise, taxonomy-driven approach to fairness in AIGC, providing a theoretical framework for using BiasIG's metrics as feedback signals in future closed-loop mitigation. The benchmark is openly available at https://github.com/Astarojth/BiasIG.

cs.CY↗
arXiv2026

Optimsyn: Influence-Guided Rubrics Optimization for Synthetic Data Generation

Large language models (LLMs) achieve strong downstream performance largely due to abundant supervised fine-tuning (SFT) data. However, high-quality SFT data in knowledge-intensive domains such as humanities, social sciences, medicine, law, and finance is scarce because expert curation is expensive, privacy constraints are strict, and label consistency is hard to ensure. Recent work uses synthetic data, typically by prompting a generator over domain documents and filtering outputs with handcrafted rubrics. Yet rubric design is expert-dependent, transfers poorly across domains, and is often optimized through a brittle heuristic loop of writing rubrics, synthesizing data, training, inspecting results, and manually guessing revisions. This process lacks reliable quantitative feedback about how a rubric affects downstream performance. We propose evaluating synthetic data by its training utility on the target model and using this signal to guide data generation. Inspired by influence estimation, we adopt an optimizer-aware estimator that uses gradient information to quantify each synthetic sample's contribution to a target model's objective on specific tasks. Our analysis shows that even when synthetic and real samples are close in embedding space, their influence on learning can differ substantially. Based on this insight, we propose an optimization-based framework that adapts rubrics using target-model feedback. We provide lightweight guiding text and use a rubric-specialized model to generate task-conditioned rubrics. Influence score is used as the reward to optimize the rubric generator with reinforcement learning. Experiments across domains, target models, and data generators show consistent improvements and strong generalization without task-specific tuning.

cs.CL↗
arXiv2026

HICT: High-precision 3D CBCT reconstruction from a single X-ray

Accurate 3D dental imaging is vital for diagnosis and treatment planning, yet CBCT's high radiation dose and cost limit its accessibility. Reconstructing 3D volumes from a single low-dose panoramic X-ray is a promising alternative but remains challenging due to geometric inconsistencies and limited accuracy. We propose HiCT, a two-stage framework that first generates geometrically consistent multi-view projections from a single panoramic image using a video diffusion model, and then reconstructs high-fidelity CBCT from the projections using a ray-based dynamic attention network and an X-ray sampling strategy. To support this, we built XCT, a large-scale dataset combining public CBCT data with 500 paired PX-CBCT cases. Extensive experiments show that HiCT achieves state-of-the-art performance, delivering accurate and geometrically consistent reconstructions for clinical use.

cs.CV↗
arXiv2026

Scaling Video Pretraining for Surgical Foundation Models

Surgical video understanding is essential for computer-assisted interventions, yet existing surgical foundation models remain constrained by limited data scale, procedural diversity, and inconsistent evaluation, often lacking a reproducible training pipeline. We propose SurgRec, a scalable and reproducible pretraining recipe for surgical video understanding, instantiated with two variants: SurgRec-MAE and SurgRec-JEPA. We curate a large multi-source corpus of 10,535 videos and 214.5M frames spanning endoscopy, laparoscopy, cataract, and robotic surgery. Building on this corpus, we develop a unified pretraining pipeline with balanced sampling and standardize a reproducible benchmark across 16 downstream datasets and four clinical domains with consistent data splits. Across extensive comparisons against SSL baselines and vision-language models, SurgRec consistently achieves superior performance across downstream datasets. In contrast, VLMs prove unreliable for fine-grained temporal recognition, exhibiting both performance gaps and sensitivity to prompt phrasing. Our work provides a reproducible, scalable foundation for the community to build more general surgical video models. All code, models, and data will be publicly released.

cs.CV↗