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Concept-Grounded Reasoning with Prompt-Driven Localization for Interpretable Structured Report Generation

Published 16 Sept 2026arXiv:2609.15334

data quality89

Updated 7 h ago · first seen 15 Sept 2026

paper_01M2JK0CVYEVY99VDYWGCNPCFX

Abstract

Medical imaging modalities such as ultrasound and X-ray are widely used in clinical practice, where diagnosis follows a structured, evidence-driven workflow aligned with standardized criteria. While multimodal large language models (MLLMs) show promise for automated medical report generation, most existing systems rely on end-to-end multimodal fusion without modeling clinically defined intermediate attributes, leading to limited grounding and interpretability. To address this issue, we propose CORAL (COncept-grounded ReAsoning with Localization), a multimodal framework that integrates spatial grounding and concept-level supervision into a unified reasoning process. CORAL employs a prompt-driven medical segmentation model to localize lesions and predicts multi-class clinical attributes through a Concept Bottleneck module. The resulting textual concept tokens are combined with mask-modulated visual features within an MLLM to enable structured report generation and diagnostic prediction. Experiments on BUS-CoT and IU X-ray datasets demonstrate consistent improvements in diagnostic accuracy, concept consistency, and report quality over strong general-purpose and medical MLLMs, indicating that concept-grounded reasoning better aligns generation with clinical decision processes.

Authors

Authors 9

Adrian WellerHongbin LinHualiang WangJuangui XuLehan WangLijie HuWeiyang LiuXiaomeng LiXinyue Xu

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arXiv (Atom API + RSS)rss.arxiv.org/rss/cs.CV feedT1· Official7 h ago4
arXiv (Atom API + RSS)rss.arxiv.org/rss/cs.AI feedT1· Official7 h ago5
arXiv (Atom API + RSS)rss.arxiv.org/rss/cs.LG feedT1· Official7 h ago4

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