# ImageDoctor: Diagnosing Text-to-Image Generation via Grounded Image Reasoning

arXiv: https://arxiv.org/abs/2510.01010 · HTML: https://mlsanity.com/paper/2510.01010/

## Key facts

- Cited by 7 papers in the map (data through 14 Oct 2026).
- Placed in Multimodal reasoning, one of 17 directions in LLM reasoning.
- Builds on 34 of its 39 references that are in the map.
- First posted on arXiv 1 Oct 2025.

## Placed in

- LLM reasoning / [Multimodal reasoning](https://mlsanity.com/lr/multimodal-reasoning/)

## Builds on (most cited first, 30 of 34)

- [Deep Residual Learning for Image Recognition](https://mlsanity.com/paper/1512.03385/) (2015)
- [Learning Transferable Visual Models From Natural Language Supervision](https://mlsanity.com/paper/2103.00020/) (2021)
- [Denoising Diffusion Probabilistic Models](https://mlsanity.com/paper/2006.11239/) (2020)
- [High-Resolution Image Synthesis with Latent Diffusion Models](https://mlsanity.com/paper/2112.10752/) (2021)
- [DeepSeekMath: Pushing the Limits of Mathematical Reasoning in Open Language Models](https://mlsanity.com/paper/2402.03300/) (2024)
- [Segment Anything](https://mlsanity.com/paper/2304.02643/) (2023)
- [Photorealistic Text-to-Image Diffusion Models with Deep Language Understanding](https://mlsanity.com/paper/2205.11487/) (2022)
- [Qwen2.5-VL Technical Report](https://mlsanity.com/paper/2502.13923/) (2025)
- [BLIP: Bootstrapping Language-Image Pre-training for Unified Vision-Language Understanding and Generation](https://mlsanity.com/paper/2201.12086/) (2022)
- [Scaling Rectified Flow Transformers for High-Resolution Image Synthesis](https://mlsanity.com/paper/2403.03206/) (2024)
- [Gemini 2.5: Pushing the Frontier with Advanced Reasoning, Multimodality, Long Context, and Next Generation Agentic Capabilities](https://mlsanity.com/paper/2507.06261/) (2025)
- [GLIDE: Towards Photorealistic Image Generation and Editing with Text-Guided Diffusion Models](https://mlsanity.com/paper/2112.10741/) (2021)
- [CLIPScore: A Reference-free Evaluation Metric for Image Captioning](https://mlsanity.com/paper/2104.08718/) (2021)
- [Deep Inside Convolutional Networks: Visualising Image Classification Models and Saliency Maps](https://mlsanity.com/paper/1312.6034/) (2013)
- [ImageReward: Learning and Evaluating Human Preferences for Text-to-Image Generation](https://mlsanity.com/paper/2304.05977/) (2023)
- [Visual Autoregressive Modeling: Scalable Image Generation via Next-Scale Prediction](https://mlsanity.com/paper/2404.02905/) (2024)
- [Diffusion Models in Vision: A Survey](https://mlsanity.com/paper/2209.04747/) (2022)
- [Pick-a-Pic: An Open Dataset of User Preferences for Text-to-Image Generation](https://mlsanity.com/paper/2305.01569/) (2023)
- [Human Preference Score v2: A Solid Benchmark for Evaluating Human Preferences of Text-to-Image Synthesis](https://mlsanity.com/paper/2306.09341/) (2023)
- [Group Sequence Policy Optimization](https://mlsanity.com/paper/2507.18071/) (2025)
- [Show-o: One Single Transformer to Unify Multimodal Understanding and Generation](https://mlsanity.com/paper/2408.12528/) (2024)
- [Flow-GRPO: Training Flow Matching Models via Online RL](https://mlsanity.com/paper/2505.05470/) (2025)
- [TIFA: Accurate and Interpretable Text-to-Image Faithfulness Evaluation with Question Answering](https://mlsanity.com/paper/2303.11897/) (2023)
- [DanceGRPO: Unleashing GRPO on Visual Generation](https://mlsanity.com/paper/2505.07818/) (2025)
- [Human Preference Score: Better Aligning Text-to-Image Models with Human Preference](https://mlsanity.com/paper/2303.14420/) (2023)
- [HPSv3: Towards Wide-Spectrum Human Preference Score](https://mlsanity.com/paper/2508.03789/) (2025)
- [Unified Reward Model for Multimodal Understanding and Generation](https://mlsanity.com/paper/2503.05236/) (2025)
- [Holistic Evaluation of Text-To-Image Models](https://mlsanity.com/paper/2311.04287/) (2023)
- [Rich Human Feedback for Text-to-Image Generation](https://mlsanity.com/paper/2312.10240/) (2023)
- [Can We Generate Images with CoT? Let's Verify and Reinforce Image Generation Step by Step](https://mlsanity.com/paper/2501.13926/) (2025)

## Built on by (most cited first, 7 of 7)

- [Advances in GRPO for Generation Models: A Survey](https://mlsanity.com/paper/2603.06623/) (2026)
- [Where, What, Why, and Importance: Structured Defect Grounding for Text-to-Image Feedback](https://mlsanity.com/paper/2606.06113/) (2026)
- [SpatialFlow-GRPO: Where Spatial Credit Drives Image Editing](https://mlsanity.com/paper/2606.26872/) (2026)
- [Beyond Time Shifts: Adapting Omni-LLM as a Reference-Free Evaluator for Generative Audio-Visual Models](https://mlsanity.com/paper/2607.09091/) (2026)
- [RefReward-SR: LR-Conditioned Reward Modeling for Preference-Aligned Super-Resolution](https://mlsanity.com/paper/2603.24198/) (2026)
- [Diffuse AI Control on Fuzzy Tasks](https://mlsanity.com/paper/2606.08892/) (2026)
- [VIEScore2: Unified Image Evaluation with Spatially Grounded Explanations](https://mlsanity.com/paper/2610.00994/) (2026)

## Abstract (arXiv)

The rapid advancement of text-to-image (T2I) models has increased the need for reliable human preference modeling, a demand further amplified by recent progress in reinforcement learning for preference alignment. However, existing approaches typically quantify the quality of a generated image using a single scalar, limiting their ability to provide comprehensive and interpretable feedback on image quality. To address this, we introduce ImageDoctor, a unified multi-aspect T2I model evaluation framework that assesses image quality across four complementary dimensions: plausibility, semantic alignment, aesthetics, and overall quality. ImageDoctor also provides pixel-level flaw indicators in the form of heatmaps, which highlight misaligned or implausible regions, and can be used as a dense reward for T2I model preference alignment. Inspired by the diagnostic process, we improve the detail sensitivity and reasoning capability of ImageDoctor by introducing a "look-think-predict" paradigm, where the model first localizes potential flaws, then generates reasoning, and finally concludes the evaluation with quantitative scores. Built on top of a vision-language model and trained through a combination of supervised fine-tuning and reinforcement learning, ImageDoctor demonstrates strong alignment with human preference across multiple datasets, establishing its effectiveness as an evaluation metric. Furthermore, when used as a reward model for preference tuning, ImageDoctor significantly improves generation quality -- achieving an improvement of 10% over scalar-based reward models.