Songtao Jiang
Publications
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.
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.
From Narrow to Panoramic Vision: Attention-Guided Cold-Start Reshapes Multimodal Reasoning
The cold-start initialization stage plays a pivotal role in training Multimodal Large Reasoning Models (MLRMs), yet its mechanisms remain insufficiently understood. To analyze this stage, we introduce the Visual Attention Score (VAS), an attention-based metric that quantifies how much a model attends to visual tokens. We find that reasoning performance is strongly correlated with VAS (r=0.9616): models with higher VAS achieve substantially stronger multimodal reasoning. Surprisingly, multimodal cold-start fails to elevate VAS, resulting in attention distributions close to the base model, whereas text-only cold-start leads to a clear increase. We term this counter-intuitive phenomenon Lazy Attention Localization. To validate its causal role, we design training-free interventions that directly modulate attention allocation during inference, performance gains of 1$-$2% without any retraining. Building on these insights, we further propose Attention-Guided Visual Anchoring and Reflection (AVAR), a comprehensive cold-start framework that integrates visual-anchored data synthesis, attention-guided objectives, and visual-anchored reward shaping. Applied to Qwen2.5-VL-7B, AVAR achieves an average gain of 7.0% across 7 multimodal reasoning benchmarks. Ablation studies further confirm that each component of AVAR contributes step-wise to the overall gains. The code, data, and models are available at https://github.com/lrlbbzl/Qwen-AVAR.