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Policy Split: Incentivizing Dual-Mode Exploration in LLM Reinforcement with Dual-Mode Entropy Regularization METER: Evaluating Multi-Level Contextual Causal Reasoning in Large Language Models Think Before you Write: QA-Guided Reasoning for Character Descriptions in Books METRO: Towards Strategy Induction from Expert Dialogue Transcripts for Non-collaborative Dialogues Retrieval as Generation: A Unified Framework with Self-Triggered Information Planning Do LLMs Know Tool Irrelevance? Demystifying Structural Alignment Bias in Tool Invocations Enhancing Multimodal Large Language Models for Ancient Chinese Character Evolution Analysis via Glyph-Driven Fine-Tuning Exploring Knowledge Conflicts for Faithful LLM Reasoning: Benchmark and Method CocoaBench: Evaluating Unified Digital Agents in the Wild MathAgent: Adversarial Evolution of Constraint Graphs for Mathematical Reasoning Data Synthesis Efficient Training for Cross-lingual Speech Language Models Shared Emotion Geometry Across Small Language Models: A Cross-Architecture Study of Representation, Behavior, and Methodological Confounds A Systematic Analysis of the Impact of Persona Steering on LLM Capabilities Uncertainty-Aware Web-Conditioned Scientific Fact-Checking When Valid Signals Fail: Regime Boundaries Between LLM Features and RL Trading Policies When Verification Fails: How Compositionally Infeasible Claims Escape Rejection Mem$^2$Evolve: Towards Self-Evolving Agents via Co-Evolutionary Capability Expansion and Experience Distillation AOP-Smart: A RAG-Enhanced Large Language Model Framework for Adverse Outcome Pathway Analysis Advancing Polish Language Modeling through Tokenizer Optimization in the Bielik v3 7B and 11B Series TInR: Exploring Tool-Internalized Reasoning in Large Language Models Do BERT Embeddings Encode Narrative Dimensions? A Token-Level Probing Analysis of Time, Space, Causality, and Character in Fiction Generating Multiple-Choice Knowledge Questions with Interpretable Difficulty Estimation using Knowledge Graphs and Large Language Models Deep-Reporter: Deep Research for Grounded Multimodal Long-Form Generation Too Nice to Tell the Truth: Quantifying Agreeableness-Driven Sycophancy in Role-Playing Language Models Learning and Enforcing Context-Sensitive Control for LLMs Efficient Process Reward Modeling via Contrastive Mutual Information Computational Lesions in Multilingual Language Models Separate Shared and Language-specific Brain Alignment Bridging Linguistic Gaps: Cross-Lingual Mapping in Pre-Training and Dataset for Enhanced Multilingual LLM Performance Early Decisions Matter: Proximity Bias and Initial Trajectory Shaping in Non-Autoregressive Diffusion Language Models LLMs Should Incorporate Explicit Mechanisms for Human Empathy
Look-Closer-Then-Diagnose: Confidence-Aware Ultrasound VQ...
Yue Zhou, Erxuan Wu, Yikang Sun, Hongjoo Lee, Yuan Bi, Huixiong · 2026-05-21 · via cs.AI updates on arXiv.org

Vision-Language Models (VLMs) have significantly advanced medical visual question answering, yet their performance in ultrasound remains suboptimal. In clinical practice, sonographers explicitly focus on lesion regions to formulate reports, though diagnostic interpretations sometimes vary due to inherent subjectivity. However, existing VLMs are not explicitly structured to interactively zoom into lesions prior to diagnosis; moreover, they typically treat annotations as unbiased ground truths, failing to account for their inherent subjectivity and ambiguity. In this paper, we propose a framework specifically designed to consider the sonographer's cognitive workflow. We first introduce a structured Zoom-then-Diagnose paradigm, which replicates the interactive search process to enable lesion-focused reasoning. Furthermore, within the Group Relative Policy Optimization (GRPO) framework, we introduce an uncertainty-aware reward derived from stochastic group-wise rollouts to estimate prediction consistency as a proxy for model confidence. Together, these two components encourage the model to reinforce accurate predictions on clear cases while remaining cautious under ambiguity. Experiments across liver, breast, and thyroid datasets show that our framework improves lesion localization by 39.3\%, demonstrating that our model has learned the ability to actively look closer and diagnose.