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Towards Enhancing 3D Spatial Reasoning in Medical Multimodal Large Language Models

Research Multimodal & Generative

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TL;DR — A data-centric method that boosts 3D volumetric medical understanding in multimodal LLMs by synthesizing radiologist-style chain-of-thought reasoning, letting a 2D-pretrained model rival costly native-3D architectures without 3D-specific pretraining.

  • Introduces a large-scale structured reasoning dataset built via a "slice-wise data synthesis paradigm" that decomposes 3D reading into per-slice observations synthesized into an interpretable Chain-of-Thought, mirroring radiologists' diagnostic workflow.
  • The synthesized reasoning enforces clinical principles: sequential spatial tracking, multi-slice spatial awareness for artifact mitigation, and differential exclusion.
  • Instruction-tuning a standard 2D-pretrained MLLM on this data reportedly yields significant gains over the 2D baseline across multiple 3D medical benchmarks and rivals resource-intensive native 3D models.
  • Positioned as avoiding expensive 3D pretraining/annotation; datasets and training workflows are released publicly (GitHub repo linked).

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Towards Enhancing 3D Spatial Reasoning in Medical Multimodal Large Language Models

arXiv cs.CV Zhuoyuan Fu, Zeshang Li, Yiqiong Zhang, Hangui Lin, Yan Shu, Yan Li, Binyang Li, Yaru Zhao 2026-07-15 arXiv:2607.13860
Public signals Semantic Scholar citations 0 · Semantic Scholar influential citations 0
Providers: Hugging Face · N/A OpenAlex · N/A Publisher · N/A Semantic Scholar · Citations 0 · Influential citations 0 X · N/A Fetched 2026-08-01 14:17:38.279754 UTC

TL;DR — A data-centric method that boosts 3D volumetric medical understanding in multimodal LLMs by synthesizing radiologist-style chain-of-thought reasoning, letting a 2D-pretrained model rival costly native-3D architectures without 3D-specific pretraining.

  • Introduces a large-scale structured reasoning dataset built via a "slice-wise data synthesis paradigm" that decomposes 3D reading into per-slice observations synthesized into an interpretable Chain-of-Thought, mirroring radiologists' diagnostic workflow.
  • The synthesized reasoning enforces clinical principles: sequential spatial tracking, multi-slice spatial awareness for artifact mitigation, and differential exclusion.
  • Instruction-tuning a standard 2D-pretrained MLLM on this data reportedly yields significant gains over the 2D baseline across multiple 3D medical benchmarks and rivals resource-intensive native 3D models.
  • Positioned as avoiding expensive 3D pretraining/annotation; datasets and training workflows are released publicly (GitHub repo linked).
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