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| Main Authors: | , , , , , , |
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| Format: | Preprint |
| Published: |
2026
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| Subjects: | |
| Online Access: | https://arxiv.org/abs/2602.22098 |
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Table of Contents:
- Current medical vision-language models (VLMs) process volumetric brain MRI using 2D slice-based approximations, fragmenting the spatial context required for accurate neuroradiological interpretation. We developed \textbf{Brain3D}, a staged vision-language framework for automated radiology report generation from 3D brain tumor MRI. Our approach inflates a pretrained 2D medical encoder into a native 3D architecture and progressively aligns it with a causal language model through three stages: contrastive grounding, supervised projector warmup, and LoRA-based linguistic specialization. Unlike generalist 3D medical VLMs, \textbf{Brain3D} is tailored to neuroradiology, where hemispheric laterality, tumor infiltration patterns, and anatomical localization are critical. Evaluated on 468 subjects (BraTS pathological cases plus healthy controls), our model achieves a Clinical Pathology F1 of 0.951 versus 0.413 for a strong 2D baseline while maintaining perfect specificity on healthy scans. The staged alignment proves essential: contrastive grounding establishes visual-textual correspondence, projector warmup stabilizes conditioning, and LoRA adaptation shifts output from verbose captions to structured clinical reports\footnote{Our code is publicly available for transparency and reproducibility