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Med-Scout: Curing MLLMs' Geometric Blindness in Medical Perception via Geometry-Aware RL Post-Training

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Despite recent Multimodal Large Language Models (MLLMs)' linguistic prowess in medical diagnosis, we find even state-of-the-art MLLMs suffer from a critical perceptual deficit: geometric blindness. This failure to ground outputs in objective geometric constraints leads to plausible yet factually incorrect hallucinations, rooted in training paradigms that prioritize linguistic fluency over geometric fidelity. This paper introduces Med-Scout, a novel framework that "cures" this blindness via Reinforcement Learning (RL) that leverages the intrinsic geometric logic latent within unlabeled medical images. Instead of relying on costly expert annotations, Med-Scout derives verifiable supervision signals through three strategic proxy tasks: Hierarchical Scale Localization, Topological Jigsaw Reconstruction, and Anomaly Consistency Detection. To rigorously quantify this deficit, we present Med-Scout-Bench, a new benchmark specifically designed to evaluate geometric perception. Extensive evaluations show that Med-Scout significantly mitigates geometric blindness, outperforming leading proprietary and open-source MLLMs by over 40% on our benchmark. Furthermore, this enhanced geometric perception generalizes to broader medical understanding, achieving superior results on radiological and comprehensive medical VQA tasks.

Anglin Liu, Ruichao Chen, Yi Lu, Hongxia Xu, Jintai Chen• 2026

Related benchmarks

TaskDatasetResultRank
Medical Visual Question AnsweringSlake
Accuracy83
134
Medical Visual Question AnsweringVQA-RAD
Accuracy71
106
Medical Visual Question AnsweringPMC-VQA
Accuracy57.4
44
Medical Visual Question AnsweringMedXpertQA
Accuracy30.8
19
Medical Visual Question AnsweringOmniMedVQA
Accuracy81.9
18
Medical Multimodal Geometric PerceptionMed-Scout-Bench
Task A Score94.4
15
Medical Report GenerationMIMIC-CXR
ROUGE-L31.4
15
Medical Visual Question AnsweringRadImageNet-VQA
Accuracy64
15
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