Image generative models are known to duplicate images from the training data as part of their outputs, which can lead to privacy concerns when used for medical image generation. We propose a calibrated per-sample metric for detecting memorization and duplication of training data. Our metric uses image features extracted using an MRI foundation model, aggregates multi-layer whitened nearest-neighbor similarities, and maps them to a bounded \emph{Overfit/Novelty Index} (ONI) and \emph{Memorization Index} (MI) scores. Across three MRI datasets with controlled duplication percentages and typical image augmentations, our metric robustly detects duplication and provides more consistent metric values across datasets. At the sample level, our metric achieves near-perfect detection of duplicates.

One of the key challenges of modern AI models is ensuring that they provide helpful responses to benign queries while refusing malicious ones. But often, the models are vulnerable to multimodal queries with harmful intent embedded in images. One approach for safety alignment is training with extensive safety datasets at the significant costs in both dataset curation and training. Inference-time alignment mitigates these costs, but introduces two drawbacks: excessive refusals from misclassified benign queries and slower inference speed due to iterative output adjustments. To overcome these limitations, we propose to reformulate queries to strengthen cross-modal attention to safety-critical image regions, enabling accurate risk assessment at the query level. Using the assessed risk, it adaptively steers activations to generate responses that are safe and helpful without overhead from iterative output adjustments. We call this Risk-adaptive Activation Steering (RAS). Extensive experiments across multiple benchmarks on multimodal safety and utility demonstrate that the RAS significantly reduces attack success rates, preserves general task performance, and improves inference speed over prior inference-time defenses.