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.
By Zanting Ye, Shengyuan Liu, Xin Liu, Chenhui Wang, Zhisong Wang, Jiashuai Liu, Zipei Wang, Cheng Wang, Wentao Pan, Mengjie Fang, Di Dong, Mohammad Salmanpour, Arman Rahmim, Yu Gu, Yong Xia, Hongming Shan, Yixuan Yuan, Yefeng Zheng, Lijun Lu
SurgRAW introduces a multi‑agent, chain‑of‑thought workflow for robotic surgical video analysis, leveraging a new SurgCoTBench benchmark with 14,256 QA pairs across five surgical tasks. The system uses an orchestrator to split scene understanding into two reasoning streams, panel‑discussion‑style collaboration among task‑specific agents, and retrieval‑augmented generation to incorporate surgical knowledge. Experiments show SurgRAW outperforms mainstream vision‑language models and a supervised baseline by 14.61% accuracy.
By Chang Han Low, Ziyue Wang, Tianyi Zhang, Zhu Zhuo, Zhitao Zeng, Evangelos B. Mazomenos, Yueming Jin
Large language model (LLM) agents are beginning to automate machine learning engineering (MLE) by coupling planning, code execution, debugging, and empirical feedback. Translating this capability to medical imaging remains difficult because each task imposes modality-specific experimentation and strict requirements for validation protocols and prediction artifacts.
nnFoundation introduces complementary convolutional and transformer-based 3D foundation models for radiology, trained on 2.1 million CT, MRI, and PET volumes from 125 datasets. The models are evaluated on 108 tasks—including segmentation, detection, classification, report generation, and image retrieval—under domain shift, low-data, and low-compute scenarios, consistently outperforming prior 3D foundation models and training from scratch. Performance varies by task type, with convolutional models excelling at spatially localized tasks and transformer models at global semantic reasoning, and dynamic alignment with dataset characteristics further enhances transferability.
By Constantin Ulrich Harsy, Tassilo Wald, Karol Gotkowski, Yannick Kirchhoff, Marcel Knopp, Maximilian Rokuss, Elisa Stegmeier, Philipp Schader, Dasha Trofimova, Raphael Stock, Kim-Celine Kahl, Stephen Schaumann, Selen Erkan, David Zimmerer, Stefan Denner, Moritz Langenberg, Sebastian Ziegler, Katharina Eckstein, Maximilian Fischer, Jonathan Suprijadi, B\'alint Kov\'acs, Benjamin Hamm, Anand Deshpande, Dimitrios Bounias, Nico Disch, Shuhan Xiao, Jessica K\"achele, Jan Sellner, Rajesh Baidya, Jeremias Traub, Lars Kr\"amer, Maximilian Zenk, Tim R\"adsch, Stefan Dvoretskii, Robin Peretzke, Jonathan Deissler, Alexandra Ertl, Partha Ghosh, Kris Dreher, Stefan Dinkelacker, Annika Reinke, Evangelia Christodoulou, Numan Saeed, Yoland Savriama, Santiago Estrada, David K\"ugler, Laura Alexandra Daza Barragan, Cristina Isabel Gonzalez Osorio, Jan Peeken, Michael Baumgartner, Marvin Teichmann, Guillaume Chabin, Matthias Kirchler, Valentin Koch, for the ALFA study, Markus Hohenhaus, Dimitri Koslov, Nina Decker, Mohammad Yaqub, Arnd Heuser, Martin Reuter, Julia A. Schnabel, Tobias Heimann, Florin Ghesu, Paul Brachmann, Claus P. Heu{\ss}el, Alexander Radbruch, Gianluca Brugnara, Aditya Rastogi, Martha Foltyn-Dumitru, Heinz-Peter Schlemmer, Ignaz Reicht, Julius C. Holzschuh, Michael Bach, Bram Stieltjes, Kai Schlamp, Lena Maier-Hein, Marco Nolden, Ralf Floca, Paul F. J\"ager, Philipp Vollmuth, Fabian Isensee, Klaus H. Maier-Hein
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...
By Xiaohong Liu, Guoxing Yang, Yulin Luo, Jiaji Mao, Xiang Zhang, Haibo Wang, Zhiyang He, Ming Gao, Shanghang Zhang, Jun Shen, Guangyu Wang
arXiv:2607. 10522v1 Announce Type: cross Abstract: Large language model (LLM) agents are beginning to automate machine learning engineering (MLE) by coupling planning, code execution, debugging, and empirical feedback.
By Shengyuan Liu, Jia-Xuan Jiang, Boyun Zheng, Cheng Wang, Zipei Wang, Wentao Pan, Hongtao Wu, Houwen Peng, Yu Gu, Lichao Sun, Yixuan Yuan
arXiv:2606.27264v3 Announce Type: replace
Abstract: Reasoning in multimodal large language models (MLLMs) has shown strong promise in medical imaging. However, this reasoning is usually free-form tex...
By Hashmat Shadab Malik, Anees Ur Rehman Hashmi, Numan Saeed, Muzammal Naseer, Salman Khan, Christoph Lippert
MedVA is an end‑to‑end neuro‑symbolic agentic system designed to streamline medical volume visualization. It combines a neuro‑symbolic intent formulation agent that refines natural‑language requests with symbolic reasoning, a multi‑model ROI identification agent that uses pretrained medical segmentation models to locate specified regions, and an objective‑driven visualization optimization agent that evaluates ROI visibility using a volume‑based objective. Extensive evaluations and a formative user study demonstrate the system’s effectiveness and high usability across users with varying expertise.
By Haill An, Suhyeon Kim, Minjun Kang, Eunwoo Lee, Bin Sheng, Lei Bi, Younhyun Jung
arXiv:2601.09879v2 Announce Type: replace-cross
Abstract: Recent progress in medical vision-language models (VLMs) has achieved strong performance on image-level text-centric tasks such as report gen...
By Yang Xing, Jiong Wu, Savas Ozdemir, Ying Zhang, Yang Yang, Wei Shao, Kuang Gong
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: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.
By Hangjie Yuan, Yichen Qian, Zhiwei Tang, Xianzhe Xu, Lirong Wu, Sicheng Yang, Jinwang Wang, Pengju Wang, Zhitao Zeng, Yizeng Han, Yan Xing, Shengxuan Luo, Tao Feng, Qing Xie, Weigen Yao, Yi Yang, Zuozhu Liu, Jiasheng Tang, Shaocheng Wang, Jitao Wang, Jiahong Dong, Weihua Chen, Feng Xu, Fan Wang
arXiv:2609.39566v1 Announce Type: new
Abstract: Foundation models can serve as clinical agents through tool-use harnesses. However, conventional medical benchmarks assess reasoning over preselected e...
By Minye Shao, Chaohui Yu, Yixuan Wu, Fan Wang, Ling Shao, Yang Long