MedImageOSWorld: Benchmarking GUI Agents for Medical Image Consoles

Ziyang Long, Xinqi Li, Lujing Xing, Hsin-Jung Yang

Graphical consoles offer a practical interface for medical acquisition assistance, allowing agents to work through the controls and visual feedback used by human operators. Reliable assistance requires linking on-screen anatomy to acquisition decisions that determine what image evidence becomes available next. We introduce MedImageOSWorld, a benchmark for evaluating this capability in simulated CT, MR, and ultrasound consoles. Using screenshots and mouse-and-keyboard actions, agents configure protocols, plan acquisitions, inspect the resulting images, and make corrective adjustments across seven capability levels, from console operation to feedback-driven control. Evaluation combines task-specific workflow checks with hidden anatomical ground truth to assess procedural completion and acquisition outcomes separately. A common evaluation protocol specifies episode conditions and interaction budgets, while recorded trajectories support analysis of how agents observe, act, and respond to acquisition feedback. Across eleven open-weight agents, success rates range from 3.0 to 25.0 on a 0-100 scale while workflow-progress rates reach 21.5-74.5: agents complete much of the console…