@inproceedings{chen-etal-2026-medforge,
    title = "{M}ed{F}orge: Interpretable Medical Deepfake Detection via Forgery-aware Reasoning",
    author = "Chen, Zhihui  and
      He, Kai  and
      Lei, Qingyuan  and
      Pu, Bin  and
      Zhang, Jian  and
      Xu, Yuling  and
      Feng, Mengling",
    editor = "Liakata, Maria  and
      Moreira, Viviane P.  and
      Zhang, Jiajun  and
      Jurgens, David",
    booktitle = "Proceedings of the 64th Annual Meeting of the {A}ssociation for {C}omputational {L}inguistics (Volume 1: Long Papers)",
    month = jul,
    year = "2026",
    address = "San Diego, California, United States",
    publisher = "Association for Computational Linguistics",
    url = "https://preview.aclanthology.org/ingest-acl/2026.acl-long.1177/",
    pages = "25672--25692",
    ISBN = "979-8-89176-390-6",
    abstract = "Text-guided image editors can now manipulate authentic medical scans with high fidelity, enabling lesion implantation/removal that threatens clinical trust and safety. Existing defenses are inadequate for healthcare. Medical detectors are largely black-box, while MLLM-based explainers are typically post-hoc, lack medical expertise, and may hallucinate evidence on ambiguous cases. We present MedForge, a data-and-method solution for pre-hoc, evidence-grounded medical forgery detection. We introduce MedForge-90K, a large-scale benchmark of realistic lesion edits across 19 pathologies with expert-guided reasoning supervision via doctor inspection guidelines and gold edit locations. Building on it, MedForge-Reasoner performs localize-then-analyze reasoning, predicting suspicious regions before producing a verdict, and is further aligned with Forgery-aware GSPO to strengthen grounding and reduce hallucinations. Experiments demonstrate state-of-the-art detection accuracy and trustworthy, expert-aligned explanations."
}