# MedSG-Bench: A Benchmark for Medical Image Sequences Grounding

arXiv: https://arxiv.org/abs/2505.11852 · HTML: https://mlsanity.com/paper/2505.11852/

## Key facts

- Cited by 8 papers in the map (data through 14 Oct 2026).
- Placed in Clinical and biomedical applications, one of 17 directions in LLM reasoning.
- Builds on 86 of its 147 references that are in the map.
- First posted on arXiv 17 May 2025.

## Placed in

- LLM reasoning / [Clinical and biomedical applications](https://mlsanity.com/lr/clinical-and-biomedical-applications/)
- Multimodal LLMs / vision-language models / [Medical vision-language models](https://mlsanity.com/mllm/medical-vision-language-models/)

## Builds on (most cited first, 30 of 86)

- [GPT-4 Technical Report](https://mlsanity.com/paper/2303.08774/) (2023)
- [Segment Anything](https://mlsanity.com/paper/2304.02643/) (2023)
- [Qwen2.5-VL Technical Report](https://mlsanity.com/paper/2502.13923/) (2025)
- [GPT-4o System Card](https://mlsanity.com/paper/2410.21276/) (2024)
- [Grounding DINO: Marrying DINO with Grounded Pre-Training for Open-Set Object Detection](https://mlsanity.com/paper/2303.05499/) (2023)
- [LLaVA-OneVision: Easy Visual Task Transfer](https://mlsanity.com/paper/2408.03326/) (2024)
- [Visual Genome: Connecting Language and Vision Using Crowdsourced Dense Image Annotations](https://mlsanity.com/paper/1602.07332/) (2016)
- [InternVL: Scaling up Vision Foundation Models and Aligning for Generic Visual-Linguistic Tasks](https://mlsanity.com/paper/2312.14238/) (2023)
- [InternVL3: Exploring Advanced Training and Test-Time Recipes for Open-Source Multimodal Models](https://mlsanity.com/paper/2504.10479/) (2025)
- [Expanding Performance Boundaries of Open-Source Multimodal Models with Model, Data, and Test-Time Scaling](https://mlsanity.com/paper/2412.05271/) (2024)
- [LlamaFactory: Unified Efficient Fine-Tuning of 100+ Language Models](https://mlsanity.com/paper/2403.13372/) (2024)
- [LLaVA-Med: Training a Large Language-and-Vision Assistant for Biomedicine in One Day](https://mlsanity.com/paper/2306.00890/) (2023)
- [Kosmos-2: Grounding Multimodal Large Language Models to the World](https://mlsanity.com/paper/2306.14824/) (2023)
- [MiniCPM-V: A GPT-4V Level MLLM on Your Phone](https://mlsanity.com/paper/2408.01800/) (2024)
- [How Far Are We to GPT-4V? Closing the Gap to Commercial Multimodal Models with Open-Source Suites](https://mlsanity.com/paper/2404.16821/) (2024)
- [Shikra: Unleashing Multimodal LLM's Referential Dialogue Magic](https://mlsanity.com/paper/2306.15195/) (2023)
- [LISA: Reasoning Segmentation via Large Language Model](https://mlsanity.com/paper/2308.00692/) (2023)
- [Skin Lesion Analysis Toward Melanoma Detection 2018: A Challenge Hosted by the International Skin Imaging Collaboration (ISIC)](https://mlsanity.com/paper/1902.03368/) (2019)
- [The Medical Segmentation Decathlon](https://mlsanity.com/paper/2106.05735/) (2021)
- [CutPaste: Self-Supervised Learning for Anomaly Detection and Localization](https://mlsanity.com/paper/2104.04015/) (2021)
- [Identifying the Best Machine Learning Algorithms for Brain Tumor Segmentation, Progression Assessment, and Overall Survival Prediction in the BRATS Challenge](https://mlsanity.com/paper/1811.02629/) (2018)
- [GLaMM: Pixel Grounding Large Multimodal Model](https://mlsanity.com/paper/2311.03356/) (2023)
- [SLAKE: A Semantically-Labeled Knowledge-Enhanced Dataset for Medical Visual Question Answering](https://mlsanity.com/paper/2102.09542/) (2021)
- [A large annotated medical image dataset for the development and evaluation of segmentation algorithms](https://mlsanity.com/paper/1902.09063/) (2019)
- [AMOS: A Large-Scale Abdominal Multi-Organ Benchmark for Versatile Medical Image Segmentation](https://mlsanity.com/paper/2206.08023/) (2022)
- [Making the Most of Text Semantics to Improve Biomedical Vision--Language Processing](https://mlsanity.com/paper/2204.09817/) (2022)
- [PadChest: A large chest x-ray image dataset with multi-label annotated reports](https://mlsanity.com/paper/1901.07441/) (2019)
- [mPLUG-Owl3: Towards Long Image-Sequence Understanding in Multi-Modal Large Language Models](https://mlsanity.com/paper/2408.04840/) (2024)
- [Deep Learning for Segmentation using an Open Large-Scale Dataset in 2D Echocardiography](https://mlsanity.com/paper/1908.06948/) (2019)
- [REFUGE Challenge: A Unified Framework for Evaluating Automated Methods for Glaucoma Assessment from Fundus Photographs](https://mlsanity.com/paper/1910.03667/) (2019)

## Built on by (most cited first, 8 of 8)

- [MedMO: Grounding and Understanding Multimodal Large Language Model for Medical Images](https://mlsanity.com/paper/2602.06965/) (2026)
- [MedGround: Bridging the Evidence Gap in Medical Vision-Language Models with Verified Grounding Data](https://mlsanity.com/paper/2601.06847/) (2026)
- [Pix2Fact: When Vision Is Not Enough -- Benchmarking Fine-Grained VQA with Web Verification on High-Resolution Real-World Scenes](https://mlsanity.com/paper/2602.00593/) (2026)
- [MedSPOT: A Workflow-Aware Sequential Grounding Benchmark for Clinical GUI](https://mlsanity.com/paper/2603.19993/) (2026)
- [NeuroVLM-Bench: Evaluation of Vision-Enabled Large Language Models for Clinical Reasoning in Neurological Disorders](https://mlsanity.com/paper/2603.24846/) (2026)
- [WDFFU-Mamba: A Wavelet-guided Dual-attention Feature Fusion Mamba for Breast Tumor Segmentation in Ultrasound Images](https://mlsanity.com/paper/2512.17278/) (2025)
- [Croissant Tasks: A Metadata Format for Reproducible Machine Learning Evaluations](https://mlsanity.com/paper/2605.29786/) (2026)
- [Generalize LMMs to Versatile Visual Modalities via Fabricated Modality Synthesis](https://mlsanity.com/paper/2607.10308/) (2026)

## Abstract (arXiv)

Visual grounding is essential for precise perception and reasoning in multimodal large language models (MLLMs), especially in medical imaging domains. While existing medical visual grounding benchmarks primarily focus on single-image scenarios, real-world clinical applications often involve sequential images, where accurate lesion localization across different modalities and temporal tracking of disease progression (e.g., pre- vs. post-treatment comparison) require fine-grained cross-image semantic alignment and context-aware reasoning. To remedy the underrepresentation of image sequences in existing medical visual grounding benchmarks, we propose MedSG-Bench, the first benchmark tailored for Medical Image Sequences Grounding. It comprises eight VQA-style tasks, formulated into two paradigms of the grounding tasks, including 1) Image Difference Grounding, which focuses on detecting change regions across images, and 2) Image Consistency Grounding, which emphasizes detection of consistent or shared semantics across sequential images. MedSG-Bench covers 76 public datasets, 10 medical imaging modalities, and a wide spectrum of anatomical structures and diseases, totaling 9,630 question-answer pairs. We benchmark both general-purpose MLLMs (e.g., Qwen2.5-VL) and medical-domain specialized MLLMs (e.g., HuatuoGPT-vision), observing that even the advanced models exhibit substantial limitations in medical sequential grounding tasks. To advance this field, we construct MedSG-188K, a large-scale instruction-tuning dataset tailored for sequential visual grounding, and further develop MedSeq-Grounder, an MLLM designed to facilitate future research on fine-grained understanding across medical sequential images. The benchmark, dataset, and model are available at https://huggingface.co/MedSG-Bench