Volumetric Radiology AI in the Era of Multimodal Large Language Models

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.

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• llms
• agents
• multimodal
• safety