IMACT-CXR: An Interactive Multi-Agent Conversational Tutoring System for Chest X-Ray Interpretation

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Main Authors: Le, Tuan-Anh, Vu, Anh Mai, Yang, David, Awasthi, Akash, Van Nguyen, Hien
Format: Preprint
Published: 2025
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author Le, Tuan-Anh
Vu, Anh Mai
Yang, David
Awasthi, Akash
Van Nguyen, Hien
author_facet Le, Tuan-Anh
Vu, Anh Mai
Yang, David
Awasthi, Akash
Van Nguyen, Hien
contents IMACT-CXR is an interactive multi-agent conversational tutor that helps trainees interpret chest X-rays by unifying spatial annotation, gaze analysis, knowledge retrieval, and image-grounded reasoning in a single AutoGen-based workflow. The tutor simultaneously ingests learner bounding boxes, gaze samples, and free-text observations. Specialized agents evaluate localization quality, generate Socratic coaching, retrieve PubMed evidence, suggest similar cases from REFLACX, and trigger NV-Reason-CXR-3B for vision-language reasoning when mastery remains low or the learner explicitly asks. Bayesian Knowledge Tracing (BKT) maintains skill-specific mastery estimates that drive both knowledge reinforcement and case similarity retrieval. A lung-lobe segmentation module derived from a TensorFlow U-Net enables anatomically aware gaze feedback, and safety prompts prevent premature disclosure of ground-truth labels. We describe the system architecture, implementation highlights, and integration with the REFLACX dataset for real DICOM cases. IMACT-CXR demonstrates responsive tutoring flows with bounded latency, precise control over answer leakage, and extensibility toward live residency deployment. Preliminary evaluation shows improved localization and diagnostic reasoning compared to baselines.
format Preprint
id arxiv_https___arxiv_org_abs_2511_15825
institution arXiv
publishDate 2025
record_format arxiv
spellingShingle IMACT-CXR: An Interactive Multi-Agent Conversational Tutoring System for Chest X-Ray Interpretation
Le, Tuan-Anh
Vu, Anh Mai
Yang, David
Awasthi, Akash
Van Nguyen, Hien
Artificial Intelligence
IMACT-CXR is an interactive multi-agent conversational tutor that helps trainees interpret chest X-rays by unifying spatial annotation, gaze analysis, knowledge retrieval, and image-grounded reasoning in a single AutoGen-based workflow. The tutor simultaneously ingests learner bounding boxes, gaze samples, and free-text observations. Specialized agents evaluate localization quality, generate Socratic coaching, retrieve PubMed evidence, suggest similar cases from REFLACX, and trigger NV-Reason-CXR-3B for vision-language reasoning when mastery remains low or the learner explicitly asks. Bayesian Knowledge Tracing (BKT) maintains skill-specific mastery estimates that drive both knowledge reinforcement and case similarity retrieval. A lung-lobe segmentation module derived from a TensorFlow U-Net enables anatomically aware gaze feedback, and safety prompts prevent premature disclosure of ground-truth labels. We describe the system architecture, implementation highlights, and integration with the REFLACX dataset for real DICOM cases. IMACT-CXR demonstrates responsive tutoring flows with bounded latency, precise control over answer leakage, and extensibility toward live residency deployment. Preliminary evaluation shows improved localization and diagnostic reasoning compared to baselines.
title IMACT-CXR: An Interactive Multi-Agent Conversational Tutoring System for Chest X-Ray Interpretation
topic Artificial Intelligence
url https://arxiv.org/abs/2511.15825