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Are Vision Language Models Ready for Clinical Diagnosis? A 3D Medical Benchmark for Tumor-centric Visual Question Answering

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arxiv 2505.18915 v1 pith:NVSHMPMN submitted 2025-05-25 cs.CV

classification cs.CV
keywords deeptumorvqareasoningclinicalvisualbenchmarkmedicalmodelsrecognition
verification ladder T0 review T1 audit T2 compute T3 formal
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Vision-Language Models (VLMs) have shown promise in various 2D visual tasks, yet their readiness for 3D clinical diagnosis remains unclear due to stringent demands for recognition precision, reasoning ability, and domain knowledge. To systematically evaluate these dimensions, we present DeepTumorVQA, a diagnostic visual question answering (VQA) benchmark targeting abdominal tumors in CT scans. It comprises 9,262 CT volumes (3.7M slices) from 17 public datasets, with 395K expert-level questions spanning four categories: Recognition, Measurement, Visual Reasoning, and Medical Reasoning. DeepTumorVQA introduces unique challenges, including small tumor detection and clinical reasoning across 3D anatomy. Benchmarking four advanced VLMs (RadFM, M3D, Merlin, CT-CHAT), we find current models perform adequately on measurement tasks but struggle with lesion recognition and reasoning, and are still not meeting clinical needs. Two key insights emerge: (1) large-scale multimodal pretraining plays a crucial role in DeepTumorVQA testing performance, making RadFM stand out among all VLMs. (2) Our dataset exposes critical differences in VLM components, where proper image preprocessing and design of vision modules significantly affect 3D perception. To facilitate medical multimodal research, we have released DeepTumorVQA as a rigorous benchmark: https://github.com/Schuture/DeepTumorVQA.

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Cited by 5 Pith papers

Reviewed papers in the Pith corpus that reference this work. Sorted by Pith novelty score.

  1. Lost in Volume: The CT-SpatialVQA Benchmark for Evaluating Semantic-Spatial Understanding of 3D Medical Vision-Language Models

    cs.CV 2026-05 unverdicted novelty 7.0 of 10

    CT-SpatialVQA benchmark shows 3D medical VLMs achieve only 34% average accuracy on semantic-spatial reasoning tasks in CT volumes, often below random chance.

  2. CXR-ContraBench: Benchmarking Negated-Option Attraction in Medical VLMs

    cs.CV 2026-05 conditional novelty 7.0 of 10

    Medical VLMs frequently select negated options that contradict visible chest X-ray findings, achieving only ~30% accuracy on direct presence probes, but a post-hoc consistency verifier raises accuracy above 95%.

  3. RadThinking: A Dataset for Longitudinal Clinical Reasoning in Radiology

    cs.CV 2026-05 unverdicted novelty 6.0 of 10

    RadThinking releases a large longitudinal CT VQA dataset stratified into foundation perception questions, single-rule reasoning questions, and compositional multi-step chains grounded in clinical reporting standards f...

  4. Lost in Volume: The CT-SpatialVQA Benchmark for Evaluating Semantic-Spatial Understanding of 3D Medical Vision-Language Models

    cs.CV 2026-05 unverdicted novelty 6.0 of 10

    CT-SpatialVQA benchmark reveals that eight 3D medical VLMs achieve only 34% average accuracy on semantic-spatial reasoning tasks from CT data, frequently below random performance.

  5. Beyond Masks: The Case for Medical Image Parsing

    cs.CV 2026-05 unverdicted novelty 5.0 of 10

    Medical image parsing is proposed as the central output for the field instead of masks, with an audit showing that none of eleven representative systems produces a well-formed parse containing attributes, relationship...

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