# Epistemic-aware Vision-Language Foundation Model for Fetal Ultrasound Interpretation

arXiv: https://arxiv.org/abs/2510.12953 · HTML: https://mlsanity.com/paper/2510.12953/

## Key facts

- Cited by 1 papers in the map (data through 14 Oct 2026).
- Placed in Medical vision-language models, one of 16 directions in Multimodal LLMs / vision-language models.
- Builds on 28 of its 45 references that are in the map.
- First posted on arXiv 14 Oct 2025.

## Placed in

- Multimodal LLMs / vision-language models / [Medical vision-language models](https://mlsanity.com/mllm/medical-vision-language-models/)

## Builds on (most cited first, 28 of 28)

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- [Proximal Policy Optimization Algorithms](https://mlsanity.com/paper/1707.06347/) (2017)
- [DeepSeekMath: Pushing the Limits of Mathematical Reasoning in Open Language Models](https://mlsanity.com/paper/2402.03300/) (2024)
- [Direct Preference Optimization: Your Language Model is Secretly a Reward Model](https://mlsanity.com/paper/2305.18290/) (2023)
- [Qwen2.5-VL Technical Report](https://mlsanity.com/paper/2502.13923/) (2025)
- [Constitutional AI: Harmlessness from AI Feedback](https://mlsanity.com/paper/2212.08073/) (2022)
- [InternVL3: Exploring Advanced Training and Test-Time Recipes for Open-Source Multimodal Models](https://mlsanity.com/paper/2504.10479/) (2025)
- [LLaVA-Med: Training a Large Language-and-Vision Assistant for Biomedicine in One Day](https://mlsanity.com/paper/2306.00890/) (2023)
- [ConvNeXt V2: Co-designing and Scaling ConvNets with Masked Autoencoders](https://mlsanity.com/paper/2301.00808/) (2023)
- [Aligning Large Multimodal Models with Factually Augmented RLHF](https://mlsanity.com/paper/2309.14525/) (2023)
- [LLaVA-NeXT-Interleave: Tackling Multi-image, Video, and 3D in Large Multimodal Models](https://mlsanity.com/paper/2407.07895/) (2024)
- [OpenFlamingo: An Open-Source Framework for Training Large Autoregressive Vision-Language Models](https://mlsanity.com/paper/2308.01390/) (2023)
- [RLHF-V: Towards Trustworthy MLLMs via Behavior Alignment from Fine-grained Correctional Human Feedback](https://mlsanity.com/paper/2312.00849/) (2023)
- [Contrastive Preference Optimization: Pushing the Boundaries of LLM Performance in Machine Translation](https://mlsanity.com/paper/2401.08417/) (2024)
- [Med-Flamingo: a Multimodal Medical Few-shot Learner](https://mlsanity.com/paper/2307.15189/) (2023)
- [Beyond Hallucinations: Enhancing LVLMs through Hallucination-Aware Direct Preference Optimization](https://mlsanity.com/paper/2311.16839/) (2023)
- [BiomedGPT: A Generalist Vision-Language Foundation Model for Diverse Biomedical Tasks](https://mlsanity.com/paper/2305.17100/) (2023)
- [Medical Image Segmentation Review: The success of U-Net](https://mlsanity.com/paper/2211.14830/) (2022)
- [HealthGPT: A Medical Large Vision-Language Model for Unifying Comprehension and Generation via Heterogeneous Knowledge Adaptation](https://mlsanity.com/paper/2502.09838/) (2025)
- [Locate Anything on Earth: Advancing Open-Vocabulary Object Detection for Remote Sensing Community](https://mlsanity.com/paper/2408.09110/) (2024)
- [MIA-DPO: Multi-Image Augmented Direct Preference Optimization For Large Vision-Language Models](https://mlsanity.com/paper/2410.17637/) (2024)
- [A Review on Deep-Learning Algorithms for Fetal Ultrasound-Image Analysis](https://mlsanity.com/paper/2201.12260/) (2022)
- [Interpretable Bilingual Multimodal Large Language Model for Diverse Biomedical Tasks](https://mlsanity.com/paper/2410.18387/) (2024)
- [FetalCLIP: A Visual-Language Foundation Model for Fetal Ultrasound Image Analysis](https://mlsanity.com/paper/2502.14807/) (2025)
- [Evaluating MLLMs with Multimodal Multi-image Reasoning Benchmark](https://mlsanity.com/paper/2506.04280/) (2025)
- [Benchmarking GPT-5 for biomedical natural language processing](https://mlsanity.com/paper/2509.04462/) (2025)

## Built on by (most cited first, 1 of 1)

- [FADA: Accessible fetal ultrasound interpretation and annotation with a selectively distilled unified vision-language model](https://mlsanity.com/paper/2606.11106/) (2026)

## Abstract (arXiv)

Recent medical vision-language models have shown promise on tasks such as VQA, report generation, and anomaly detection. However, most are adapted to structured adult imaging and underperform in fetal ultrasound, which poses challenges of multi-view image reasoning, numerous diseases, and image diversity. To bridge this gap, we introduce FetalMind, a medical AI system tailored to fetal ultrasound for both report generation and diagnosis. Guided by clinical workflow, we propose Salient Epistemic Disentanglement (SED), which injects an expert-curated bipartite graph into the model to decouple view-disease associations and to steer preference selection along clinically faithful steps via reinforcement learning. This design mitigates variability across diseases and heterogeneity across views, reducing learning bottlenecks while aligning the model's inference with obstetric practice. To train FetalMind at scale, we curate FetalSigma-1M dataset, the first large-scale fetal ultrasound report corpus, comprising 20K reports from twelve medical centers, addressing the scarcity of domain data. Extensive experiments show that FetalMind outperforms open- and closed-source baselines across all gestational stages, achieving +14% average gains and +61.2% higher accuracy on critical conditions while remaining efficient, stable, and scalable. Project Page: https://hexiao0275.github.io/FetalMind.