Anatomical Region-Guided Contrastive Decoding: A Plug-and-Play Strategy for Mitigating Hallucinations in Medical VLMs

Fuente: arXiv
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Auteurs principaux: Liang, Xiao, Liu, Chenxi, Ma, Zhi, Wang, Di, Jing, Bin, Wang, Quan, Shi, Yuanyuan
Format: Preprint
Publié: 2025
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author Liang, Xiao
Liu, Chenxi
Ma, Zhi
Wang, Di
Jing, Bin
Wang, Quan
Shi, Yuanyuan
author_facet Liang, Xiao
Liu, Chenxi
Ma, Zhi
Wang, Di
Jing, Bin
Wang, Quan
Shi, Yuanyuan
contents Medical Vision-Language Models (MedVLMs) show immense promise in clinical applicability. However, their reliability is hindered by hallucinations, where models often fail to derive answers from visual evidence, instead relying on learned textual priors. Existing mitigation strategies for MedVLMs have distinct limitations: training-based methods rely on costly expert annotations, limiting scalability, while training-free interventions like contrastive decoding, though data-efficient, apply a global, untargeted correction whose effects in complex real-world clinical settings can be unreliable. To address these challenges, we introduce Anatomical Region-Guided Contrastive Decoding (ARCD), a plug-and-play strategy that mitigates hallucinations by providing targeted, region-specific guidance. Our module leverages an anatomical mask to direct a three-tiered contrastive decoding process. By dynamically re-weighting at the token, attention, and logits levels, it verifiably steers the model's focus onto specified regions, reinforcing anatomical understanding and suppressing factually incorrect outputs. Extensive experiments across diverse datasets, including chest X-ray, CT, brain MRI, and ocular ultrasound, demonstrate our method's effectiveness in improving regional understanding, reducing hallucinations, and enhancing overall diagnostic accuracy.
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id arxiv_https___arxiv_org_abs_2512_17189
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publishDate 2025
record_format arxiv
spellingShingle Anatomical Region-Guided Contrastive Decoding: A Plug-and-Play Strategy for Mitigating Hallucinations in Medical VLMs
Liang, Xiao
Liu, Chenxi
Ma, Zhi
Wang, Di
Jing, Bin
Wang, Quan
Shi, Yuanyuan
Computer Vision and Pattern Recognition
Medical Vision-Language Models (MedVLMs) show immense promise in clinical applicability. However, their reliability is hindered by hallucinations, where models often fail to derive answers from visual evidence, instead relying on learned textual priors. Existing mitigation strategies for MedVLMs have distinct limitations: training-based methods rely on costly expert annotations, limiting scalability, while training-free interventions like contrastive decoding, though data-efficient, apply a global, untargeted correction whose effects in complex real-world clinical settings can be unreliable. To address these challenges, we introduce Anatomical Region-Guided Contrastive Decoding (ARCD), a plug-and-play strategy that mitigates hallucinations by providing targeted, region-specific guidance. Our module leverages an anatomical mask to direct a three-tiered contrastive decoding process. By dynamically re-weighting at the token, attention, and logits levels, it verifiably steers the model's focus onto specified regions, reinforcing anatomical understanding and suppressing factually incorrect outputs. Extensive experiments across diverse datasets, including chest X-ray, CT, brain MRI, and ocular ultrasound, demonstrate our method's effectiveness in improving regional understanding, reducing hallucinations, and enhancing overall diagnostic accuracy.
title Anatomical Region-Guided Contrastive Decoding: A Plug-and-Play Strategy for Mitigating Hallucinations in Medical VLMs
topic Computer Vision and Pattern Recognition
url https://arxiv.org/abs/2512.17189