arXiv:2603.05860cs.AIcs.CV2026-03被引 4

让医疗影像智能体自主发现并升级工具链,提升诊断适应性。

Evolving Medical Imaging Agents via Experience-driven Self-skill Discovery

  • 从真实诊疗轨迹中自动挖掘高效多步工具组合,形成可复用的新工具。
  • 在多个医学影像任务上,多步决策准确率显著优于现有方法。
  • 适合需要持续进化、应对复杂临床场景的智能诊断系统研发者。

临床影像解读本质上是多步骤、工具导向的过程:医生通过视觉证据与患者信息的迭代结合,量化发现结果,并经由一系列专业流程逐步修正判断。尽管基于大模型的智能体有望协调此类异构医疗工具,但现有系统在部署后将工具集和调用策略视为静态,面对真实世界中的领域迁移、任务变化和诊断需求演进时极易失效,常需耗费大量成本进行手动重构。本文提出MACRO——一种经验驱动自演化、具备增强记忆的医疗智能体,实现从静态工具组合到动态工具发现的转变。该智能体从已验证的执行轨迹中自主识别高频有效的多步工具序列,将其合成可复用的复合工具,并注册为新的高层次原语,持续扩展其行为能力。轻量级图像特征记忆库将工具选择锚定于视觉-临床上下文,结合类似GRPO的训练循环,强化对新发现复合工具的可靠调用,实现低监督下的闭环自我优化。在多种医学影像数据集与任务上的大量实验表明,自主复合工具发现显著提升了多步编排准确率与跨域泛化能力,优于强基线及最新前沿代理方法,弥合了僵化静态工具使用与自适应、情境感知的临床智能辅助之间的差距。代码将在接受后公开。

原文摘要 · Abstract (English)

Clinical image interpretation is inherently multi-step and tool-centric: clinicians iteratively combine visual evidence with patient context, quantify findings, and refine their decisions through a sequence of specialized procedures. While LLM-based agents promise to orchestrate such heterogeneous medical tools, existing systems treat tool sets and invocation strategies as static after deployment. This design is brittle under real-world domain shifts, across tasks, and evolving diagnostic requirements, where predefined tool chains frequently degrade and demand costly manual re-design. We propose MACRO, a self-evolving, experience-augmented medical agent that shifts from static tool composition to experience-driven tool discovery. From verified execution trajectories, the agent autonomously identifies recurring effective multi-step tool sequences, synthesizes them into reusable composite tools, and registers these as new high-level primitives that continuously expand its behavioral repertoire. A lightweight image-feature memory grounds tool selection in a visual-clinical context, while a GRPO-like training loop reinforces reliable invocation of discovered composites, enabling closed-loop self-improvement with minimal supervision. Extensive experiments across diverse medical imaging datasets and tasks demonstrate that autonomous composite tool discovery consistently improves multi-step orchestration accuracy and cross-domain generalization over strong baselines and recent state-of-the-art agentic methods, bridging the gap between brittle static tool use and adaptive, context-aware clinical AI assistance. Code will be available upon acceptance.

医疗AI智能体自演化

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