无需训练,用AI代理自动分析脑部MRI,完成从预处理到病灶判断全流程。
Agentic Large Language Models for Training-Free Neuro-Radiological Image Analysis
- 让大模型通过调用外部工具,自主完成医学影像分析任务。
- 在多个模型上验证,能准确分割胶质瘤、脑膜瘤等病灶并进行体积推理。
- 适合医学影像研究者和临床辅助诊断系统开发者使用。
当前先进大语言模型在通用视觉问答中表现优异,但缺乏原生3D空间推理能力,难以直接分析如CT或MRI等体数据。新兴的代理式AI提供新方案:通过调用外部专用工具,使大模型无需内置3D处理能力即可完成复杂任务。本文提出一种无需训练的代理式流程,用于自动化脑部MRI分析。在多个大模型(GPT-5.4、Gemini 3.1 Pro、Claude Sonnet 4.6)上,结合现成领域工具,系统可自主执行端到端工作流,包括预处理(去颅骨、配准)、病灶分割(胶质瘤、脑膜瘤、转移瘤)和体积推理。评估涵盖从单次扫描分析到需多时间点对比的纵向治疗响应评估。通过比较单代理与多代理“领域专家”协作的架构,分析设计影响。为支持未来代理系统的严谨评估,我们发布一个基于公开数据构建的图像-提示-答案数据集。结果表明,代理式AI可通过工具调用,无需训练即可解决复杂的神经放射学图像分析任务。
原文摘要 · Abstract (English)
State-of-the-art large language models (LLMs) show high performance in general visual question answering. However, a fundamental limitation remains: current architectures lack the native 3D spatial reasoning required to directly analyze volumetric medical imaging, such as CT or MRI. Emerging agentic AI offers a new solution, eliminating the need for intrinsic 3D processing by enabling LLMs to orchestrate and leverage specialized external tools. Yet, the feasibility of such agentic frameworks in complex, multi-step radiological workflows remains underexplored. In this work, we present a training-free agentic pipeline for automated brain MRI analysis. Validating our methodology on several LLMs (GPT-5.4, Gemini 3.1 Pro, Claude Sonnet 4.6) with off-the-shelf domain-specific tools, our system autonomously executes complex end-to-end workflows, including preprocessing (skull stripping, registration), pathology segmentation (glioma, meningioma, metastases), and volumetric reasoning. We evaluate our framework across increasingly complex radiological tasks, from single-scan tumor and anatomy analysis to longitudinal response assessment requiring multi-timepoint comparisons. We analyze the impact of architectural design by comparing single-agent models against multi-agent "domain-expert" collaborations. To support rigorous evaluation of future agentic systems, we release a benchmark dataset of image-prompt-answer tuples derived from public data. Our results demonstrate that agentic AI can solve highly neuro-radiological image analysis tasks through tool use without the need for training or fine-tuning.
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