Medical Image Quality Assessment (IQA) serves as a critical safety gate for clinical AI, yet existing approaches rely on scalar metrics that fail to capture the descriptive, expert-like evaluation process central to clinical practice. We introduce MedQ-Bench, a comprehensive benchmark for language-based medical IQA evaluation with MLLMs, establishing a perception--description paradigm across 5 imaging modalities and over 40 quality attributes. The benchmark comprises two complementary tasks: MedQ-Perception probes low-level visual attribute discrimination via 2,600 expert-annotated perceptual queries; MedQ-Description covers both no-reference and comparison description sub-tasks with 708 expert-annotated samples, evaluated through a four-dimensional judging protocol. Comprehensive evaluation of 23 state-of-the-art MLLMs reveals that current models exhibit only preliminary and unstable capabilities, and highlights the urgent need for targeted optimization of MLLMs in medical IQA. Project & Dataset: https://github.com/liujiyaoFDU/MedQ-Bench
Chenglong Ma, Yuanfeng Ji, Junzhi Ning, Jiyao Liu, Yujie Wei, Shaohao Rui, Chaoyang Zhang, Wenjie Li 等 21 位作者
Multimodal medical AI requires a common visual interface for encoding heterogeneous imaging evidence for patient condition modeling. However, existing medical visual tokenizers are often tied to a specific dimension and imaging modality, forcing multimodal systems to rely on fragmented and poorly reusable representations. We introduce MedVTok, a general-purpose visual tokenizer that maps 2D images and 3D volumes from diverse imaging modalities into a unified token space. Building such a tokenizer poses two key challenges: preserving anatomical structure across dimensions and capturing clinical semantics across modalities. To this end, MedVTok introduces (i) slice differential regularization, which explicitly models inter-slice anatomical coherence missing in previous per-pixel/per-voxel supervision, and (ii) multi-expert representation alignment, which integrates knowledge from multiple medical expert encoders while retaining modality-specific complementary knowledge. Trained on 28M images and 70K volumes across 9 imaging modalities, MedVTok supports classification, retrieval, segmentation, synthesis, visual question answering, and medical report generation through a single tokenizer. Across 24 benchmarks, MedVTok achieves state-of-the-art performance, demonstrating a scalable token interface that unifies medical image dimension, modality, and task usage.