MedVol-R1: Reward-Driven Evidence Grounding for Volumetric Reasoning Segmentation 文章

arXiv:2605.26621v1 Announce Type: new Abstract: Volumetric Reasoning Segmentation (VRS) aims to segment a target region in a 3D medical scan from a free-form clinical query, where the referent is often implicit and requires both medical knowledge and volume-grounded reasoning. Existing methods typically rely on specialized segmentation tokens to connect language with mask decoding, but this coupling collapses the decision process into opaque latent representations, limiting interpretability and generalization to diverse narrative expressions. In this paper, we present MedVol-R1, a reinforcement learning-based framework for VRS that explicitly decouples evidence grounding from volumetric delineation: the LVLM grounds clinical reasoning to a verifiable 2D evidence anchor (key axial slice and 2D bounding boxes), which is then propagated into a coherent 3D mask by a frozen MedSAM2 module.