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Scientific image manipulation in biomedical publications poses a growing threat to research integrity and reproducibility. Unlike natural image forensics, biomedical forgery detection is uniquely challenging due to domain-specific artifacts, complex textures, and unstructured figure layouts. We present the first vision-language guided framework for both generating and detecting biomedical image forgeries. By combining diffusion-based synthesis with vision-language prompting, our method enables realistic and semantically controlled manipulations—including duplication, splicing, and region removal—across diverse biomedical modalities. We introduce Rescind, a large-scale benchmark featuring fine-grained annotations and modality-specific splits, and propose Integscan, a structured state-space modeling framework that integrates attention-enhanced visual encoding with prompt-conditioned semantic alignment for precise forgery localization. To ensure semantic fidelity, we incorporate a VLM-based verification loop that filters generated forgeries based on consistency with intended prompts. Extensive experiments on Rescind and existing benchmarks demonstrate that Integscan achieves state-of-the-art performance in both detection and localization, establishing a strong foundation for automated scientific integrity analysis.
