Daily Papers

Medical Anomaly Detection (MedAD) presents a significant opportunity to enhance diagnostic accuracy using Large Multimodal Models (LMMs) to interpret and answer questions based on medical images. However, the reliance on Supervised Fine-Tuning (SFT) on simplistic and fragmented datasets has hindered the development of models capable of plausible reasoning and robust multimodal generalization. To overcome this, we introduce MedAD-38K, the first large-scale, multi-modal, and multi-center benchmark for MedAD featuring diagnostic Chain-of-Thought (CoT) annotations alongside structured Visual Question-Answering (VQA) pairs. On this foundation, we propose a two-stage training framework. The first stage, Cognitive Injection, uses SFT to instill foundational medical knowledge and align the model with a structured think-then-answer paradigm. Given that standard policy optimization can produce reasoning that is disconnected from the final answer, the second stage incorporates Consistency Group Relative Policy Optimization (Con-GRPO). This novel algorithm incorporates a crucial consistency reward to ensure the generated reasoning process is relevant and logically coherent with the final diagnosis. Our proposed model, MedAD-R1, achieves state-of-the-art (SOTA) performance on the MedAD-38K benchmark, outperforming strong baselines by more than 10\%. This superior performance stems from its ability to generate transparent and logically consistent reasoning pathways, offering a promising approach to enhancing the trustworthiness and interpretability of AI for clinical decision support.

Developing 3D vision-language models with robust clinical reasoning remains a challenge due to the inherent complexity of volumetric medical imaging, the tendency of models to overfit superficial report patterns, and the lack of interpretability-aware reward designs. In this paper, we propose Med3D-R1, a reinforcement learning framework with a two-stage training process: Supervised Fine-Tuning (SFT) and Reinforcement Learning (RL). During SFT stage, we introduce a residual alignment mechanism to bridge the gap between high-dimensional 3D features and textual embeddings, and an abnormality re-weighting strategy to emphasize clinically informative tokens and reduce structural bias in reports. In RL stage, we redesign the consistency reward to explicitly promote coherent, step-by-step diagnostic reasoning. We evaluate our method on medical multiple-choice visual question answering using two 3D diagnostic benchmarks, CT-RATE and RAD-ChestCT, where our model attains state-of-the-art accuracies of 41.92\% on CT-RATE and 44.99\% on RAD-ChestCT. These results indicate improved abnormality diagnosis and clinical reasoning and outperform prior methods on both benchmarks. Overall, our approach holds promise for enhancing real-world diagnostic workflows by enabling more reliable and transparent 3D medical vision-language systems.

Building general-purpose reasoning models with reinforcement learning (RL) entails substantial cross-domain heterogeneity, including large variation in inference-time response lengths and verification latency. Such variability complicates the RL infrastructure, slows training, and makes training curriculum (e.g., response length extension) and hyperparameter selection challenging. In this work, we propose cascaded domain-wise reinforcement learning (Cascade RL) to develop general-purpose reasoning models, Nemotron-Cascade, capable of operating in both instruct and deep thinking modes. Departing from conventional approaches that blend heterogeneous prompts from different domains, Cascade RL orchestrates sequential, domain-wise RL, reducing engineering complexity and delivering state-of-the-art performance across a wide range of benchmarks. Notably, RLHF for alignment, when used as a pre-step, boosts the model's reasoning ability far beyond mere preference optimization, and subsequent domain-wise RLVR stages rarely degrade the benchmark performance attained in earlier domains and may even improve it (see an illustration in Figure 1). Our 14B model, after RL, outperforms its SFT teacher, DeepSeek-R1-0528, on LiveCodeBench v5/v6/Pro and achieves silver-medal performance in the 2025 International Olympiad in Informatics (IOI). We transparently share our training and data recipes.