Medical phrase grounding is crucial for identifying relevant regions in medical images based on phrase queries, facilitating accurate image analysis and diagnosis. However, current methods rely on manual extraction of key phrases from medical reports, reducing efficiency and increasing the workload for clinicians. Additionally, the lack of model confidence estimation limits clinical trust and usability. In this paper, we introduce a novel task-Medical Report Grounding (MRG)-which aims to directly identify diagnostic phrases and their corresponding grounding boxes from medical reports in an end-to-end manner. To address this challenge, we propose uMedGround, a a robust and reliable framework that leverages a multimodal large language model to predict diagnostic phrases by embedding a unique token, < $\mathtt {BOX}$BOX >, into the vocabulary to enhance detection capabilities. A vision encoder-decoder processes the embedded token and input image to generate grounding boxes. Critically, uMedGround incorporates an uncertainty-aware prediction model, significantly improving the robustness and reliability of grounding predictions. Experimental results demonstrate that uMedGround outperforms state-of-the-art medical phrase grounding methods and fine-tuned large visual-language models, validating its effectiveness and reliability. This study represents a pioneering exploration of the MRG task, marking the first-ever endeavor in this domain. Additionally, we demonstrate the applicability of uMedGround in medical visual question answering and class-based localization tasks, where it highlights visual evidence aligned with key diagnostic phrases, supporting clinicians in interpreting various types of textual inputs, including free-text reports, visual question answering queries, and class labels.

Medical image segmentation is critical for disease diagnosis and treatment assessment. However, concerns regarding the reliability of segmentation regions persist among clinicians, mainly attributed to the absence of confidence assessment, robustness, and calibration to accuracy. To address this, we introduce deep evidential segmentation model (DEviS), an easily implementable foundational model that seamlessly integrates into various medical image segmentation networks. DEviS not only enhances the calibration and robustness of baseline segmentation accuracy but also provides high-efficiency uncertainty estimation for reliable predictions. By leveraging subjective logic theory, we explicitly model probability and uncertainty for medical image segmentation. Here, the Dirichlet distribution parameterizes the distribution of probabilities for different classes of the segmentation results. To generate calibrated predictions and uncertainty, we develop a trainable calibrated uncertainty penalty. Furthermore, DEviS incorporates an uncertainty-aware filtering (UAF) module, which designs the metric of uncertainty-calibrated error to filter out-of-distribution (OOD) data. We conducted validation studies on publicly available datasets, including ISIC2018, KiTS2021, LiTS2017, and BraTS2019, to assess the accuracy and robustness of different backbone segmentation models enhanced by DEviS, as well as the efficiency and reliability of uncertainty estimation. Additionally, two potential clinical trials were conducted using the UAF module. The clinical application conducted on the Johns Hopkins OCT and Duke OCT-DME datasets demonstrated the effectiveness of the model in filtering OOD data. The second trial evaluated its efficacy in filtering high-quality data on the FIVES datasets. At last, the proposed DEviS method was extended to semi-supervised medical image segmentation, where it exhibited strong robustness under noisy conditions. Our code has been released in https://github.com/Cocofeat/DEviS.