AOR: Anatomical Ontology-Guided Reasoning for Medical Large Multimodal Model in Chest X-Ray Interpretation

Qingqiu Li; Zihang Cui; Seongsu Bae; Jilan Xu; Runtian Yuan; Yuejie Zhang; Rui Feng; Quanli Shen; Xiaobo Zhang; Junjun He; Shujun Wang

arXiv · 2505.02830

AOR: Anatomical Ontology-Guided Reasoning for Medical Large Multimodal Model in Chest X-Ray Interpretation

Qingqiu Li·Zihang Cui·Seongsu Bae·Jilan Xu·Runtian Yuan·Yuejie Zhang·Rui Feng·Quanli Shen·Xiaobo Zhang·Junjun He·Shujun Wang

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Abstract

Chest X-rays (CXRs) are the most frequently performed imaging examinations in clinical settings. Recent advancements in Large Multimodal Models (LMMs) have enabled automated CXR interpretation, enhancing diagnostic accuracy and efficiency. However, despite their strong visual understanding, current Medical LMMs (MLMMs) still face two major challenges: (1) Insufficient region-level understanding and interaction, and (2) Limited accuracy and interpretability due to single-step reasoning. In this paper, we empower MLMMs with anatomy-centric reasoning capabilities to enhance their interactivity and explainability. Specifically, we first propose an Anatomical Ontology-Guided Reasoning (AOR) framework, which centers on cross-modal region-level information to facilitate multi-step reasoning. Next, under the guidance of expert physicians, we develop AOR-Instruction, a large instruction dataset for MLMMs training. Our experiments demonstrate AOR's superior performance in both VQA and report generation tasks.

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Qingqiu Li, Zihang Cui, Seongsu Bae, Jilan Xu, Runtian Yuan, Yuejie Zhang, Rui Feng, Quanli Shen, Xiaobo Zhang, Junjun He, Shujun Wang. 2025-05-05. AOR: Anatomical Ontology-Guided Reasoning for Medical Large Multimodal Model in Chest X-Ray Interpretation. https://arxiv.org/abs/2505.02830

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