# CAS-IQA: Teaching Vision-Language Models for Synthetic Angiography Quality Assessment

arXiv: https://arxiv.org/abs/2505.17619 · HTML: https://mlsanity.com/paper/2505.17619/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 23 of its 34 references that are in the map.
- First posted on arXiv 23 May 2025.

## Builds on (most cited first, 23 of 23)

- [Attention Is All You Need](https://mlsanity.com/paper/1706.03762/) (2017)
- [High-Resolution Image Synthesis with Latent Diffusion Models](https://mlsanity.com/paper/2112.10752/) (2021)
- [LoRA: Low-Rank Adaptation of Large Language Models](https://mlsanity.com/paper/2106.09685/) (2021)
- [Visual Instruction Tuning](https://mlsanity.com/paper/2304.08485/) (2023)
- [MMBench: Is Your Multi-modal Model an All-around Player?](https://mlsanity.com/paper/2307.06281/) (2023)
- [Contrastive Learning for Unpaired Image-to-Image Translation](https://mlsanity.com/paper/2007.15651/) (2020)
- [ILVR: Conditioning Method for Denoising Diffusion Probabilistic Models](https://mlsanity.com/paper/2108.02938/) (2021)
- [mPLUG-Owl2: Revolutionizing Multi-modal Large Language Model with Modality Collaboration](https://mlsanity.com/paper/2311.04257/) (2023)
- [MANIQA: Multi-dimension Attention Network for No-Reference Image Quality Assessment](https://mlsanity.com/paper/2204.08958/) (2022)
- [Q-Align: Teaching LMMs for Visual Scoring via Discrete Text-Defined Levels](https://mlsanity.com/paper/2312.17090/) (2023)
- [KonIQ-10k: An ecologically valid database for deep learning of blind image quality assessment](https://mlsanity.com/paper/1910.06180/) (2019)
- [Blind Image Quality Assessment Using A Deep Bilinear Convolutional Neural Network](https://mlsanity.com/paper/1907.02665/) (2019)
- [EGSDE: Unpaired Image-to-Image Translation via Energy-Guided Stochastic Differential Equations](https://mlsanity.com/paper/2207.06635/) (2022)
- [Q-Instruct: Improving Low-level Visual Abilities for Multi-modality Foundation Models](https://mlsanity.com/paper/2311.06783/) (2023)
- [AGIQA-3K: An Open Database for AI-Generated Image Quality Assessment](https://mlsanity.com/paper/2306.04717/) (2023)
- [Teaching Large Language Models to Regress Accurate Image Quality Scores using Score Distribution](https://mlsanity.com/paper/2501.11561/) (2025)
- [AttentionGAN: Unpaired Image-to-Image Translation using Attention-Guided Generative Adversarial Networks](https://mlsanity.com/paper/1911.11897/) (2019)
- [Attentions Help CNNs See Better: Attention-based Hybrid Image Quality Assessment Network](https://mlsanity.com/paper/2204.10485/) (2022)
- [AIGIQA-20K: A Large Database for AI-Generated Image Quality Assessment](https://mlsanity.com/paper/2404.03407/) (2024)
- [FINECAPTION: Compositional Image Captioning Focusing on Wherever You Want at Any Granularity](https://mlsanity.com/paper/2411.15411/) (2024)
- [Large Multi-modality Model Assisted AI-Generated Image Quality Assessment](https://mlsanity.com/paper/2404.17762/) (2024)
- [CADICA: a new dataset for coronary artery disease detection by using invasive coronary angiography](https://mlsanity.com/paper/2402.00570/) (2024)
- [CAS-GAN for Contrast-free Angiography Synthesis](https://mlsanity.com/paper/2410.08490/) (2024)

## Abstract (arXiv)

Synthetic X-ray angiographies generated by modern generative models hold great potential to reduce the use of contrast agents in vascular interventional procedures. However, low-quality synthetic angiographies can significantly increase procedural risk, underscoring the need for reliable image quality assessment (IQA) methods. Existing IQA models, however, fail to leverage auxiliary images as references during evaluation and lack fine-grained, task-specific metrics necessary for clinical relevance. To address these limitations, this paper proposes CAS-IQA, a vision-language model (VLM)-based framework that predicts fine-grained quality scores by effectively incorporating auxiliary information from related images. In the absence of angiography datasets, CAS-3K is constructed, comprising 3,565 synthetic angiographies along with score annotations. To ensure clinically meaningful assessment, three task-specific evaluation metrics are defined. Furthermore, a Multi-path featUre fuSion and rouTing (MUST) module is designed to enhance image representations by adaptively fusing and routing visual tokens to metric-specific branches. Extensive experiments on the CAS-3K dataset demonstrate that CAS-IQA significantly outperforms state-of-the-art IQA methods by a considerable margin.