arXiv:2406.06512v2 Announce Type: replace-cross Abstract: The large volume of abdominal computed tomography (CT) scans coupled with the shortage of radiologists have intensified the need for automated medical image analysis tools. Previous state-of-the-art approaches for automated analysis leverage vision-language models (VLMs) that jointly model images and radiology reports. However, current medical VLMs are generally limited to 2D images and short reports. Here to overcome these shortcomings for abdominal CT interpretation, we introduce Merlin, a 3D VLM that learns from volumetric CT scans, electronic health record data and radiology reports. This approach is enabled by a multistage pretraining framework that does not require additional manual annotations. We trained Merlin using a high-quality clinical dataset of paired CT scans (>6 million images from 15,331 CT scans), diagnosis codes (>1.8 million codes) and radiology reports (>6 million tokens). We comprehensively evaluated Merlin on 6 task types and 752 individual tasks that covered diagnostic, prognostic and quality-related tasks. The non-adapted (off-the-shelf) tasks included zero-shot classification of findings (30 findings), phenotype classification (692 phenotypes) and zero-shot cross-modal retrieval (image-to-findings and image-to-impression). The model-adapted tasks included 5-year chronic disease prediction (6 diseases), radiology report generation and 3D semantic segmentation (20 organs). We validated Merlin at scale, with internal testing on 5,137 CT scans and external testing on 44,098 CT scans from 3 independent sites and 2 public datasets. The results demonstrated high generalization across institutions and anatomies. Merlin outperformed 2D VLMs, CT foundation models and off-the-shelf radiology models. We also release our trained models, code, and dataset, available at: https://github.com/StanfordMIMI/Merlin.

arXiv:2506.07218v3 Announce Type: replace-cross Abstract: Enhancing the multimodal reasoning capabilities of Multimodal Large Language Models (MLLMs) is a challenging task that has attracted increasing attention in the community. Recently, several studies have applied Reinforcement Learning with Verifiable Rewards (RLVR) to the multimodal domain in order to enhance the reasoning abilities of MLLMs. However, these works largely overlook the enhancement of multimodal perception capabilities in MLLMs, which serve as a core prerequisite and foundational component of complex multimodal reasoning. Through McNemar's test, we find that existing RLVR method fails to effectively enhance the multimodal perception capabilities of MLLMs, thereby limiting their further improvement in multimodal reasoning. To address this limitation, we propose Perception-R1, which introduces a novel visual perception reward that explicitly encourages MLLMs to perceive the visual content accurately, thereby can effectively incentivizing both their multimodal perception and reasoning capabilities. Specifically, we first collect textual visual annotations from the CoT trajectories of multimodal problems, which will serve as visual references for reward assignment. During RLVR training, we employ a judging LLM to assess the consistency between the visual annotations and the responses generated by MLLM, and assign the visual perception reward based on these consistency judgments. Extensive experiments on several multimodal reasoning benchmarks demonstrate the effectiveness of our Perception-R1, which achieves state-of-the-art performance on most benchmarks using only 1,442 training data. Our code and dataset will be available at https://github.com/tongxiao2002/Perception-R1.