The article reviews how multimodal large language models (MLLMs) are expanding radiology AI beyond image‑specific tasks to multimodal reasoning, yet volumetric radiology poses a representational challenge because clinical interpretation needs full 3‑D spatial context and quantitative data. It surveys over 200 studies, categorizing advances in volumetric representation, multimodal understanding, and agentic orchestration, and introduces a Claim‑Design‑Validation framework to align technical, workflow, and clinical claims. The review emphasizes that native volumetric modeling and agentic capabilities must match spatial, quantitative, contextual, and workflow demands, and that clinical credibility hinges on faithful 3‑D representation, traceable behavior, proper validation, and defined human oversight.
arXiv:2409.16183v2 Announce Type: replace Abstract: Radiology is a vital and complex component of modern clinical workflow and covers many tasks. Recently, vision-language (VL) foundation models in m...
arXiv:2608. 12689v1 Announce Type: cross Abstract: Multi-parametric magnetic resonance imaging (mpMRI) is a cornerstone for brain tumor diagnosis and treatment, yet current AI models face critical limitations: their lack of natural language interaction and interpretability impedes spatial information integration and cross-modal reasoning required clinically.
arXiv:2607. 24743v1 Announce Type: cross Abstract: Multimodal large language models (MLLMs) hold immense potential to revolutionize clinical practice, yet deploying them in the medical domain is fundamentally a vision-centric challenge: models must absorb knowledge from heterogeneous 2D and 3D medical images, and evaluation protocols must align with radiologists' clinical practice and provide an accurate, fine-grained and factualness-driven assessment.
Multimodal large language models (MLLMs) hold immense potential to revolutionize clinical practice, yet deploying them in the medical domain is fundamentally a vision-centric challenge: models must absorb knowledge from heterogeneous 2D and 3D medical images, and evaluation protocols must align with radiologists' clinical practice and provide an accurate, fine-grained and factualness-driven assessment. In this paper, we introduce ClinFusion, a vision-centric MLLM designed for holistic medical understanding that systematically addresses these limitations.
arXiv:2506. 00633v3 Announce Type: replace-cross Abstract: Generating semantically controllable 3D CT volumes from radiology reports requires more than a rich text encoder, it requires vision-language alignment grounded in volumetric space.
arXiv:2607. 14116v1 Announce Type: cross Abstract: Free-form radiology reports contain rich clinical descriptions, yet converting them for reliable segmentation remains challenging due to the inherent variability of natural language.
The paper introduces MedREAL, a unified framework that aligns linguistic reasoning with spatial grounding for medical visual question answering and segmentation. MedREAL employs Seg Anchored Reasoning Pooling (SARP) to extract semantic evidence from segmentation tokens and a Reasoning-to-Visual (R2V) fusion mechanism to integrate these features into a segmentation pipeline. Using the newly created MedRAVS-13K dataset, MedREAL achieves superior performance, reporting 68.49% gIoU and 70.47% cIoU, and generates evidence masks that consistently match textual diagnoses.
arXiv:2606. 28556v1 Announce Type: new Abstract: Recent advances in large language models and vision-language models have enabled reasoning over multimodal data, offering opportunities for clinical applications such as decision support and triaging.
The paper introduces UR$^{2}$-MLLM, an uncertainty‑aware multimodal large language model that dynamically revisits uncertain image regions during radiology report generation. It incorporates an uncertainty perception module trained on a specialized dataset, builds a multimodal reasoning trajectory with a detect‑and‑copy mechanism to guide revisits, and refines this behavior using a visual grounding reward via reinforcement learning. Experiments on MIMIC‑CXR and IU‑Xray demonstrate state‑of‑the‑art performance, underscoring the importance of visual revisit reasoning for reliable, clinically aligned reports.
arXiv:2608. 08135v1 Announce Type: cross Abstract: Cross-modality medical image translation can reduce the burden of multi-modal acquisitions, yet the field remains constrained by two coupled limitations: methods operate on 2D slices or 3D patches rather than whole volumes, and train a separate model for each translation task.
arXiv:2608. 03890v1 Announce Type: cross Abstract: A clinically useful chest X-ray system must go beyond fluent report generation: it should classify findings with tunable decision thresholds, localize them spatially, and derive the anatomical measurements upon which many diagnoses depend.
arXiv:2608.22323v1 Announce Type: new Abstract: The application of Large Language Models (LLMs) to diagnostic decision-making has garnered growing interest. However, existing benchmarks largely focus...