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Oct 16

Language Models that Play Chess and Explain Their Moves

Modern chess engines are silent experts: they play at a superhuman level, but do not offer explanations for their play. On the other hand, language models (LMs) can generate plausible-sounding explanations, but their weak playing strength limits the utility of their explanations. We introduce Queen, a 4B-parameter chess-language model that can explain its moves and plans while playing at the level of a typical Grandmaster. Our novel framework enables domain-specific reasoning through complementary components: an encoder-decoder architecture and an iterative distillation algorithm. This architecture integrates a silent expert chess encoder with an instruction-tuned LM through cross-attention, which we train via a question-answering curriculum to extract chess concepts from the encoder's representations. Building on this domain-adapted model, we iteratively improve its explanations with a natural-language analog of the Bellman update: the model analyzes the positions after its top candidate moves and consolidates them into an explanation of the current position, which is then distilled back into the model. Over seven iterations, our model gains over 900 Elo points (1782 to 2697), substantially surpassing all frontier models on both playing strength and puzzle accuracy, despite containing three orders of magnitude fewer parameters. Furthermore, LM-based evaluations show that our explanations are fluent and approach GPT-5.6-Sol (high) in coherence. The generality of our architecture and training procedure suggests a recipe for applying language models to domains where silent expert encoders are available, like games, robotics, and computer use.

  • 3 authors
·
Oct 1 3

Grounded Chess Reasoning in Language Models via Master Distillation

Language models often lack grounded reasoning capabilities in specialized domains where training data is scarce but bespoke systems excel. We introduce a general framework for distilling expert system reasoning into natural language chain-of-thought explanations, enabling compact models to acquire domain expertise and the ability to generate faithful, grounded explanations. Rather than distilling only final outputs, we capture the full reasoning process, transforming opaque expert computations into transparent, step-by-step explanations. We demonstrate this approach in chess, a canonical reasoning domain where language models continue to underperform. Our 4B parameter model, C1, advances from a near-zero baseline to 48.1% accuracy, outperforming all open-source models and most frontier proprietary systems. Notably, C1 surpasses its distillation teacher and generates solutions in two orders of magnitude fewer tokens than baselines. Unlike prior neural chess approaches that predict only best moves, C1 generates explainable solutions revealing strategic reasoning. Our pipeline combines supervised fine-tuning and reinforcement learning with theme-balanced data sampling for comprehensive tactical coverage. Master Distillation demonstrates how to inject expert-level knowledge into compact models for under-optimized domains, offering a recipe for unlocking RLVR where LLMs lack sufficient base capabilities.

  • 7 authors
·
Mar 19

ChessQA: Evaluating Large Language Models for Chess Understanding

Chess provides an ideal testbed for evaluating the reasoning, modeling, and abstraction capabilities of large language models (LLMs), as it has well-defined structure and objective ground truth while admitting a wide spectrum of skill levels. However, existing evaluations of LLM ability in chess are ad hoc and narrow in scope, making it difficult to accurately measure LLM chess understanding and how it varies with scale, post-training methodologies, or architecture choices. We present ChessQA, a comprehensive benchmark that assesses LLM chess understanding across five task categories (Structural, Motifs, Short Tactics, Position Judgment, and Semantic), which approximately correspond to the ascending abstractions that players master as they accumulate chess knowledge, from understanding basic rules and learning tactical motifs to correctly calculating tactics, evaluating positions, and semantically describing high-level concepts. In this way, ChessQA captures a more comprehensive picture of chess ability and understanding, going significantly beyond the simple move quality evaluations done previously, and offers a controlled, consistent setting for diagnosis and comparison. Furthermore, ChessQA is inherently dynamic, with prompts, answer keys, and construction scripts that can evolve as models improve. Evaluating a range of contemporary LLMs, we find persistent weaknesses across all five categories and provide results and error analyses by category. We will release the code, periodically refreshed datasets, and a public leaderboard to support further research.

  • 3 authors
·
Oct 27, 2025

UniMaia: Steering Chess Policies with Language for Human-like Play

Recent advances in large language models have enabled natural language to serve as a flexible interface for controlling complex systems, but often at the cost of large-scale multimodal training or weakened domain-specific inductive biases. In structured decision-making domains such as chess, specialized policy networks achieve strong performance but lack semantic controllability, while prompt-conditioned language models are more flexible yet typically exhibit weaker domain grounding. We propose UniMaia, a framework for prompt-conditioned policy modulation that adapts a frozen Lc0-based chess policy network using a parameter-efficient text encoder and a ControlNet-style conditioning mechanism. UniMaia enables semantic control over gameplay, including opening selection and player strength, while preserving the pretrained policy representations. We further introduce UniMaia-Aux, which incorporates auxiliary temporal conditioning and behavioral prediction objectives. To support this work, we construct a large-scale metadata-augmented Lichess dataset, develop a semi-automated prompt-generation pipeline, and introduce benchmarks spanning both prompt-conditioned and metadata-conditioned settings. UniMaia achieves state-of-the-art expected accuracy on several prompt-conditioned benchmarks and competitive top-move accuracy on general instruction-following tasks, while remaining competitive with dedicated metadata-conditioned approaches on human move prediction benchmarks. UniMaia-Aux further improves expected accuracy and behavioral modeling across several evaluation settings, with modest trade-offs in top-move accuracy. Overall, our results demonstrate that prompt-conditioned control of domain-specific policy networks is feasible without end-to-end multimodal training, while highlighting trade-offs between controllability and predictive performance.

  • 2 authors
·
May 25

Benchmarking Prompt Optimization of Large Language Models With Chess

Evaluating large language models becomes increasingly challenging as their capabilities advance: benchmarks can saturate, public test sets risk contamination, and assessing harder tasks can require expensive grading or execution infrastructure. These challenges are amplified in automatic prompt optimization (APO), where evaluation is repeated throughout the search for better prompts. Studying APO therefore requires a benchmark that is cheap and deterministic to score, hard enough to leave room for improvement, and renewable as models evolve. We introduce a chess benchmark built from 1,118 Lichess puzzles to study APO for frozen LLMs: we optimize their prompts without updating their model weights. Chess combines inexpensive exact-match scoring, engine-based evaluation of alternative moves, and a renewable supply of problems with adjustable difficulty. Unlike evaluations that report only success on isolated test items, the benchmark also connects puzzle-solving gains to short game-play rollouts within the same domain. We use it to evaluate six APO algorithms on eight target models, measuring not only baseline strength but also how much each model responds to optimization and whether optimized prompts transfer across models and to game play. Chess is thus a well-suited benchmark for APO: it is (i) challenging, as even the strongest evaluated model, Gemini 3.5 Flash (used as the meta-model), solves only about 55\% of puzzles; (ii) discriminative, revealing gains, unchanged performance, and regressions across methods and models; (iii) renewable, with fresh puzzles to reduce contamination risk and adjustable difficulty to maintain headroom as models improve; and (iv) affordable, as the complete study runs for around \$800. We release the puzzles, optimization and evaluation code, and dataset-renewal scripts (https://github.com/imec-ailabs/Automatic-Prompt-Optimization-with-Chess).

  • 7 authors
·
Sep 29

Language Models are Few-Shot Learners

Recent work has demonstrated substantial gains on many NLP tasks and benchmarks by pre-training on a large corpus of text followed by fine-tuning on a specific task. While typically task-agnostic in architecture, this method still requires task-specific fine-tuning datasets of thousands or tens of thousands of examples. By contrast, humans can generally perform a new language task from only a few examples or from simple instructions - something which current NLP systems still largely struggle to do. Here we show that scaling up language models greatly improves task-agnostic, few-shot performance, sometimes even reaching competitiveness with prior state-of-the-art fine-tuning approaches. Specifically, we train GPT-3, an autoregressive language model with 175 billion parameters, 10x more than any previous non-sparse language model, and test its performance in the few-shot setting. For all tasks, GPT-3 is applied without any gradient updates or fine-tuning, with tasks and few-shot demonstrations specified purely via text interaction with the model. GPT-3 achieves strong performance on many NLP datasets, including translation, question-answering, and cloze tasks, as well as several tasks that require on-the-fly reasoning or domain adaptation, such as unscrambling words, using a novel word in a sentence, or performing 3-digit arithmetic. At the same time, we also identify some datasets where GPT-3's few-shot learning still struggles, as well as some datasets where GPT-3 faces methodological issues related to training on large web corpora. Finally, we find that GPT-3 can generate samples of news articles which human evaluators have difficulty distinguishing from articles written by humans. We discuss broader societal impacts of this finding and of GPT-3 in general.

  • 31 authors
·
May 28, 2020 1

Evaluating Language Models' Evaluations of Games

Reasoning is not just about solving problems -- it is also about evaluating which problems are worth solving at all. Evaluations of artificial intelligence (AI) systems primarily focused on problem solving, historically by studying how models play games such as chess and Go. In this paper, we advocate for a new paradigm that assesses AI systems' evaluation of games. First, we introduce a formalism for evaluating such evaluations. We then leverage a large-scale dataset of over 100 novel board games and over 450 human judgments to compare evaluations produced by modern language and reasoning models against those of people and symbolic computational agents. We consider two kinds of evaluative queries: assessing the payoff (or fairness) and the funness of games. These queries span two dimensions relevant to the design of evaluations of AI evaluations: how complex a query is to compute and how difficult a query is to quantify. Our results show that reasoning models are generally more aligned to people in their evaluations of games than non-reasoning language models. However, we observe a non-monotonic relationship: as models get closer to game-theoretic optimal, their fit to human data weakens. We also observe more "jaggedness" across models for assessing funness, in line with the greater difficulty of quantifying this query. Across queries and games, reasoning models show highly variable and unpredictable resource usage when assessing queries, pointing to the importance of imbuing more resource-rational meta-reasoning in language and reasoning models.

  • 12 authors
·
Oct 12, 2025 2

Mastering Board Games by External and Internal Planning with Language Models

While large language models perform well on a range of complex tasks (e.g., text generation, question answering, summarization), robust multi-step planning and reasoning remains a considerable challenge for them. In this paper we show that search-based planning can significantly improve LLMs' playing strength across several board games (Chess, Fischer Random / Chess960, Connect Four, and Hex). We introduce, compare and contrast two major approaches: In external search, the model guides Monte Carlo Tree Search (MCTS) rollouts and evaluations without calls to an external engine, and in internal search, the model directly generates in-context a linearized tree of potential futures and a resulting final choice. Both build on a language model pre-trained on relevant domain knowledge, capturing the transition and value functions across these games. We find that our pre-training method minimizes hallucinations, as our model is highly accurate regarding state prediction and legal moves. Additionally, both internal and external search indeed improve win-rates against state-of-the-art bots, even reaching Grandmaster-level performance in chess while operating on a similar move count search budget per decision as human Grandmasters. The way we combine search with domain knowledge is not specific to board games, suggesting direct extensions into more general language model inference and training techniques.

  • 16 authors
·
Dec 2, 2024

Can Large Language Models Master Complex Card Games?

Complex games have long been an important benchmark for testing the progress of artificial intelligence algorithms. AlphaGo, AlphaZero, and MuZero have defeated top human players in Go and Chess, garnering widespread societal attention towards artificial intelligence. Concurrently, large language models (LLMs) have exhibited remarkable capabilities across various tasks, raising the question of whether LLMs can achieve similar success in complex games. In this paper, we explore the potential of LLMs in mastering complex card games. We systematically assess the learning capabilities of LLMs across eight diverse card games, evaluating the impact of fine-tuning on high-quality gameplay data, and examining the models' ability to retain general capabilities while mastering these games. Our findings indicate that: (1) LLMs can approach the performance of strong game AIs through supervised fine-tuning on high-quality data, (2) LLMs can achieve a certain level of proficiency in multiple complex card games simultaneously, with performance augmentation for games with similar rules and conflicts for dissimilar ones, and (3) LLMs experience a decline in general capabilities when mastering complex games, but this decline can be mitigated by integrating a certain amount of general instruction data. The evaluation results demonstrate strong learning ability and versatility of LLMs. The code is available at https://github.com/THUDM/LLM4CardGame

  • 7 authors
·
Sep 1, 2025

Visual Sketchpad: Sketching as a Visual Chain of Thought for Multimodal Language Models

Humans draw to facilitate reasoning: we draw auxiliary lines when solving geometry problems; we mark and circle when reasoning on maps; we use sketches to amplify our ideas and relieve our limited-capacity working memory. However, such actions are missing in current multimodal language models (LMs). Current chain-of-thought and tool-use paradigms only use text as intermediate reasoning steps. In this work, we introduce Sketchpad, a framework that gives multimodal LMs a visual sketchpad and tools to draw on the sketchpad. The LM conducts planning and reasoning according to the visual artifacts it has drawn. Different from prior work, which uses text-to-image models to enable LMs to draw, Sketchpad enables LMs to draw with lines, boxes, marks, etc., which is closer to human sketching and better facilitates reasoning. Sketchpad can also use specialist vision models during the sketching process (e.g., draw bounding boxes with object detection models, draw masks with segmentation models), to further enhance visual perception and reasoning. We experiment with a wide range of math tasks (including geometry, functions, graphs, and chess) and complex visual reasoning tasks. Sketchpad substantially improves performance on all tasks over strong base models with no sketching, yielding an average gain of 12.7% on math tasks, and 8.6% on vision tasks. GPT-4o with Sketchpad sets a new state of the art on all tasks, including V*Bench (80.3%), BLINK spatial reasoning (83.9%), and visual correspondence (80.8%). All codes and data are in https://visualsketchpad.github.io/.

  • 8 authors
·
Jun 13, 2024 1

CHESS: Optimizing LLM Inference via Channel-Wise Thresholding and Selective Sparsification

Deploying large language models (LLMs) on edge devices presents significant challenges due to the substantial computational overhead and memory requirements. Activation sparsification can mitigate these challenges by reducing the number of activated neurons during inference. Existing methods typically employ thresholding-based sparsification based on the statistics of activation tensors. However, these methods do not explicitly model the impact of activation sparsification on performance, leading to suboptimal performance degradation. To address this issue, this paper reformulates the activation sparsification problem by introducing a new objective that optimizes the sparsification decisions. Building on this reformulation, we propose CHESS, a general activation sparsification approach via CHannel-wise thrEsholding and Selective Sparsification. First, channel-wise thresholding assigns a unique threshold to each activation channel in the feed-forward network (FFN) layers. Then, selective sparsification involves applying thresholding-based activation sparsification to specific layers within the attention modules. Finally, we detail the implementation of sparse kernels to accelerate LLM inference. Experimental results demonstrate that the proposed CHESS achieves lower performance degradation over 8 downstream tasks while activating fewer parameters compared to existing methods, thus speeding up the LLM inference by up to 1.27x.

  • 5 authors
·
Sep 2, 2024

Xiangqi-R1: Enhancing Spatial Strategic Reasoning in LLMs for Chinese Chess via Reinforcement Learning

Game playing has long served as a fundamental benchmark for evaluating Artificial General Intelligence (AGI). While Large Language Models (LLMs) have demonstrated impressive capabilities in general reasoning, their effectiveness in spatial strategic reasoning, which is critical for complex and fully observable board games, remains insufficiently explored. In this work, we adopt Chinese Chess (Xiangqi) as a challenging and rich testbed due to its intricate rules and spatial complexity. To advance LLMs' strategic competence in such environments, we propose a training framework tailored to Xiangqi, built upon a large-scale dataset of five million board-move pairs enhanced with expert annotations and engine evaluations. Building on this foundation, we introduce Xiangqi-R1, a 7B-parameter model trained in multi-stage manner: (1) fine-tuning for legal move prediction to capture basic spatial rules, (2) incorporating strategic annotations to improve decision-making, and (3) applying reinforcement learning via Group Relative Policy Optimization (GRPO) with multi-dimensional reward signals to enhance reasoning stability. Our Experimental results indicate that, despite their size and power, general-purpose LLMs struggle to achieve satisfactory performance in these tasks. Compared to general-purpose LLMs, Xiangqi-R1 greatly advances with an 18% rise in move legality and a 22% boost in analysis accuracy. Our results point to a promising path for creating general strategic intelligence in spatially complex areas.

  • 6 authors
·
Jul 16, 2025

Exploring Collaboration between a language and a non-language agent

LLMs are increasingly deployed as orchestrators that coordinate specialized subagents to solve complex tasks through natural language. However, in many important domains like game playing and robotics, the strongest available agents are not language models. Integrating non-language agents with LLMs would require verbalization: compressing their rich continuous representations into sparse textual summaries at each interaction step. To study whether verbalization constitutes a bottleneck, we introduce LLAMIA-Bench, a suite of six diverse collaborative chess tasks spanning three facets: behavioral imitation, state assessment, and natural-language explanation. Each task instantiates a well-established chess problem that neither the LLM nor the chess engine can solve alone. To solve LLM collaboration with non-language agents, we introduce latent state internalization, which projects the subagent's continuous representations directly into the LLM's token stream as learned state tokens, with dynamic re-encoding as actions advance the environment state. Comparing internalization to verbalized integration, our experiments reveal a consistent verbalization debt: the performance gap widens throughout training and persists as the LLM scales from 4B to 14B parameters. A single 14B model, LLAMIA, trained with latent state internalization, matches or exceeds task specialists and frontier models including GPT-5.1 with tool access across all benchmark tasks, and generalizes out-of-distribution where task-specific finetunes collapse

adobe Adobe
·
Sep 1 2

Implicit Search via Discrete Diffusion: A Study on Chess

In the post-AlphaGo era, there has been a renewed interest in search techniques such as Monte Carlo Tree Search (MCTS), particularly in their application to Large Language Models (LLMs). This renewed attention is driven by the recognition that current next-token prediction models often lack the ability for long-term planning. Is it possible to instill search-like abilities within the models to enhance their planning abilities without relying on explicit search? We propose DiffuSearch , a model that does implicit search by looking into the future world via discrete diffusion modeling. We instantiate DiffuSearch on a classical board game, Chess, where explicit search is known to be essential. Through extensive controlled experiments, we show DiffuSearch outperforms both the searchless and explicit search-enhanced policies. Specifically, DiffuSearch outperforms the one-step policy by 19.2% and the MCTS-enhanced policy by 14% on action accuracy. Furthermore, DiffuSearch demonstrates a notable 30% enhancement in puzzle-solving abilities compared to explicit search-based policies, along with a significant 540 Elo increase in game-playing strength assessment. These results indicate that implicit search via discrete diffusion is a viable alternative to explicit search over a one-step policy. All codes are publicly available at https://github.com/HKUNLP/DiffuSearch{https://github.com/HKUNLP/DiffuSearch}.

  • 7 authors
·
Feb 27, 2025

The Weight of Silence: A Causal Case for Weights Over the Scratchpad in Latent Chess Reasoning

Latent, or silent, reasoning lets language models carry out intermediate computation in continuous vector space instead of words, and is widely assumed to function as an internal scratchpad the model consults during inference. Whether that assumption survives reinforcement learning has not been tested directly: existing causal analyses of latent reasoning are confined to math and logic tasks, comparing reliance on thoughts within one checkpoint, never before and after RL. We train a chess-playing model through a staged latent-reasoning curriculum followed by reinforcement learning, and find legality climbs monotonically to 61% (from a 48% pre-RL baseline) while checkmate confabulation is eliminated entirely. To locate this gain, we run a six-condition causal intervention suite on the same model before and after RL: substituting or noising the thought vectors leaves performance unchanged, ablating them costs only mild degradation, and only exact-zero vectors cause collapse. This robustness gap is itself the finding: under exact-zero corruption, legality collapses to 1% pre-RL versus 9% post-RL, a gap that survives correction across the full battery. A 10x-larger replication of the post-RL checkpoint's own battery confirms this: removing the thoughts, with or without restoring sequence length, also reaches significance; substitution and noise remain indistinguishable from baseline. RL appears to add robustness to disruption, not reliance on thought content. These results push back against the field's default assumption that latent thoughts function as an actively consulted inference-time scratchpad, and instead indicate latent reasoning's principal effect here is shaping the model's parameters during training. We also demonstrate a working RL gain in chess, where multiple groups report the same latent-reasoning-plus-RL recipe failing to improve accuracy over SFT.

  • 1 authors
·
Jul 26

Weak-to-Strong Generalization: Eliciting Strong Capabilities With Weak Supervision

Widely used alignment techniques, such as reinforcement learning from human feedback (RLHF), rely on the ability of humans to supervise model behavior - for example, to evaluate whether a model faithfully followed instructions or generated safe outputs. However, future superhuman models will behave in complex ways too difficult for humans to reliably evaluate; humans will only be able to weakly supervise superhuman models. We study an analogy to this problem: can weak model supervision elicit the full capabilities of a much stronger model? We test this using a range of pretrained language models in the GPT-4 family on natural language processing (NLP), chess, and reward modeling tasks. We find that when we naively finetune strong pretrained models on labels generated by a weak model, they consistently perform better than their weak supervisors, a phenomenon we call weak-to-strong generalization. However, we are still far from recovering the full capabilities of strong models with naive finetuning alone, suggesting that techniques like RLHF may scale poorly to superhuman models without further work. We find that simple methods can often significantly improve weak-to-strong generalization: for example, when finetuning GPT-4 with a GPT-2-level supervisor and an auxiliary confidence loss, we can recover close to GPT-3.5-level performance on NLP tasks. Our results suggest that it is feasible to make empirical progress today on a fundamental challenge of aligning superhuman models.

  • 12 authors
·
Dec 14, 2023 1

Understanding Reasoning from Pretraining to Post-Training

Reinforcement learning (RL) has become central to improving large language models (LLMs) on complex reasoning tasks, yet RL post-training is largely studied in isolation from the pretraining that precedes it. As a result, two basic questions remain open: (1) how do pretraining choices (model size, data) shape the returns to RL compute, and (2) what does RL actually do to the model? These questions are difficult to study in the standard LLM setting: pretraining corpora are vast and uncontrolled, making it hard to attribute behaviors to pretraining versus RL, and systematic compute sweeps across both stages are prohibitively expensive. To address these challenges, we use chess as a controlled testbed for studying reasoning across the full pretraining-to-post-training pipeline. We follow the standard LLM training pipeline by pretraining language models from 5M to 1B parameters on human chess games, supervised fine-tuning on synthetic reasoning traces, and running RL on chess puzzles with verifiable rewards. Using this framework, we find that the post-RL performance at given RL compute level is well-predicted from the pretraining loss, and slope of the RL reward curves improves approximately linearly with the pretraining tokens. Beyond scaling, we find that RL does not simply sharpen the SFT policy: on easy puzzles it amplifies correct moves the SFT policy already preferred, while on hard puzzles it surfaces correct moves that were nearly absent under SFT. We further test whether our findings transfer beyond chess by training a 1B language model on math-domain text, where the same predictive pattern emerges: longer-pretrained checkpoints reach higher post-RL performance and improve faster under RL. In sum, we provide a quantitative account of the pretraining-to-RL interface and a controlled testbed for studying the science of reasoning across the full pretraining-to-post-training pipeline.

  • 7 authors
·
Jul 16 2

Mixture of Experts Made Intrinsically Interpretable

Neurons in large language models often exhibit polysemanticity, simultaneously encoding multiple unrelated concepts and obscuring interpretability. Instead of relying on post-hoc methods, we present MoE-X, a Mixture-of-Experts (MoE) language model designed to be intrinsically interpretable. Our approach is motivated by the observation that, in language models, wider networks with sparse activations are more likely to capture interpretable factors. However, directly training such large sparse networks is computationally prohibitive. MoE architectures offer a scalable alternative by activating only a subset of experts for any given input, inherently aligning with interpretability objectives. In MoE-X, we establish this connection by rewriting the MoE layer as an equivalent sparse, large MLP. This approach enables efficient scaling of the hidden size while maintaining sparsity. To further enhance interpretability, we enforce sparse activation within each expert and redesign the routing mechanism to prioritize experts with the highest activation sparsity. These designs ensure that only the most salient features are routed and processed by the experts. We evaluate MoE-X on chess and natural language tasks, showing that it achieves performance comparable to dense models while significantly improving interpretability. MoE-X achieves a perplexity better than GPT-2, with interpretability surpassing even sparse autoencoder (SAE)-based approaches.

  • 7 authors
·
Mar 5, 2025 2

Verification of the Implicit World Model in a Generative Model via Adversarial Sequences

Generative sequence models are typically trained on sample sequences from natural or formal languages. It is a crucial question whether -- or to what extent -- sample-based training is able to capture the true structure of these languages, often referred to as the ``world model''. Theoretical results indicate that we can hope for soundness at best, that is, generating valid sequences, but not necessarily all of them. However, it is still important to have practical tools that are able to verify whether a given sequence model is sound. In this study, we focus on chess, as it is a domain that provides enough complexity while having a simple rule-based world model. We propose adversarial sequence generation for verifying the soundness of the sequence model. Our adversaries generate valid sequences so as to force the sequence model to generate an invalid next move prediction. Apart from the falsification of soundness, this method is also suitable for a more fine-grained analysis of the failure modes and the effects of different choices during training. To demonstrate this, we propose a number of methods for adversarial sequence generation and evaluate the approach on a large set of chess models. We train models on random as well as high-quality chess games, using several training recipes. We find that none of the models are sound, but some training techniques and dataset choices are able to improve soundness remarkably. We also investigate the potential application of board state probes in both our training and attack methods. Our findings indicate that the extracted board states have no causal role in next token prediction in most of the models.

  • 2 authors
·
Feb 5

Chessformer: A Unified Architecture for Chess Modeling

Chess has long served as a canonical testbed for artificial intelligence, but modeling approaches for its central tasks have diverged. Maximizing playing strength, predicting human play, and enabling interpretability are typically solved with disparate architectures, and these designs are often misaligned with the geometry of the domain. This raises the natural question of whether these objectives require separate modeling paradigms, or if there exists a single architecture that supports them simultaneously. We introduce Chessformer, a unified architecture that advances the state of the art on all three central goals in chess modeling. Chessformer is an encoder-only transformer that represents board squares as tokens, augments self-attention with a novel dynamic positional encoding called Geometric Attention Bias (GAB) that adapts to domain-specific geometry, and predicts actions with an attention-based source-destination policy head. We evaluate Chessformer on each front. First, we develop \maiathree, a family of models for human move prediction that reaches 57.1\% move-matching accuracy, significantly surpassing the previous state of the art with fewer than a quarter of the parameters. Second, we integrate Chessformer into Leela Chess Zero, a leading open-source engine, adding over 100 Elo of playing strength and resulting in tournament victories over Stockfish in major computer chess competitions. Third, we show that Chessformer's square-token design makes attention patterns and activations directly attributable to board squares, enabling granular interpretability analyses that prior architectures do not naturally support. More broadly, our results demonstrate that aligning a model's tokenization, positional encoding, and output design with the underlying structure of a domain can yield simultaneous gains in performance, human compatibility, and interpretability.

  • 5 authors
·
May 17

Maia-2: A Unified Model for Human-AI Alignment in Chess

There are an increasing number of domains in which artificial intelligence (AI) systems both surpass human ability and accurately model human behavior. This introduces the possibility of algorithmically-informed teaching in these domains through more relatable AI partners and deeper insights into human decision-making. Critical to achieving this goal, however, is coherently modeling human behavior at various skill levels. Chess is an ideal model system for conducting research into this kind of human-AI alignment, with its rich history as a pivotal testbed for AI research, mature superhuman AI systems like AlphaZero, and precise measurements of skill via chess rating systems. Previous work in modeling human decision-making in chess uses completely independent models to capture human style at different skill levels, meaning they lack coherence in their ability to adapt to the full spectrum of human improvement and are ultimately limited in their effectiveness as AI partners and teaching tools. In this work, we propose a unified modeling approach for human-AI alignment in chess that coherently captures human style across different skill levels and directly captures how people improve. Recognizing the complex, non-linear nature of human learning, we introduce a skill-aware attention mechanism to dynamically integrate players' strengths with encoded chess positions, enabling our model to be sensitive to evolving player skill. Our experimental results demonstrate that this unified framework significantly enhances the alignment between AI and human players across a diverse range of expertise levels, paving the way for deeper insights into human decision-making and AI-guided teaching tools.

  • 6 authors
·
Oct 30, 2024

Code World Models for General Game Playing

Large Language Models (LLMs) reasoning abilities are increasingly being applied to classical board and card games, but the dominant approach -- involving prompting for direct move generation -- has significant drawbacks. It relies on the model's implicit fragile pattern-matching capabilities, leading to frequent illegal moves and strategically shallow play. Here we introduce an alternative approach: We use the LLM to translate natural language rules and game trajectories into a formal, executable world model represented as Python code. This generated model -- comprising functions for state transition, legal move enumeration, and termination checks -- serves as a verifiable simulation engine for high-performance planning algorithms like Monte Carlo tree search (MCTS). In addition, we prompt the LLM to generate heuristic value functions (to make MCTS more efficient), and inference functions (to estimate hidden states in imperfect information games). Our method offers three distinct advantages compared to directly using the LLM as a policy: (1) Verifiability: The generated CWM serves as a formal specification of the game's rules, allowing planners to algorithmically enumerate valid actions and avoid illegal moves, contingent on the correctness of the synthesized model; (2) Strategic Depth: We combine LLM semantic understanding with the deep search power of classical planners; and (3) Generalization: We direct the LLM to focus on the meta-task of data-to-code translation, enabling it to adapt to new games more easily. We evaluate our agent on 10 different games, of which 4 are novel and created for this paper. 5 of the games are fully observed (perfect information), and 5 are partially observed (imperfect information). We find that our method outperforms or matches Gemini 2.5 Pro in 9 out of the 10 considered games.

  • 16 authors
·
Oct 5, 2025

CheXGround: Anatomical Region Tokens for Grounded Longitudinal Chest X-ray Interpretation

Recent radiology multi-modal language models have made substantial progress in chest X-ray report generation, visual question answering, and temporal reasoning. While longitudinal chest X-ray interpretation compares sequential examinations to describe change, visual grounding aims to connect clinical language with localized image evidence. Although longitudinal modeling and visual grounding have each advanced radiology language models, how localized visual evidence can support longitudinal interpretation remains under-explored. We introduce CheXGround, a region-grounded longitudinal chest X-ray language model that represents paired studies through corresponding anatomical regions. CheXGround extracts anatomical regions from current and prior radiographs, encodes them as temporally enhanced Region-of-Interest (ROI) tokens, and combines them with global temporal image context during generation. To connect these region tokens with clinical text, we propose Temporal Region--Phrase Alignment, a pretraining objective that aligns temporal anatomical representations with localized report phrases. We evaluate CheXGround on single-study and longitudinal Visual Question Answering (VQA), longitudinal findings generation, temporal grounded VQA, and anatomical grounding. Across these tasks, CheXGround improves clinical language quality, temporal reasoning, and localization accuracy over recent baselines. Our results suggest that organizing longitudinal evidence at the anatomical level is a strong representation for grounded radiology language modeling. Project page: https://adonaydem.github.io/chexground-website

  • 7 authors
·
Aug 30

The Consensus Game: Language Model Generation via Equilibrium Search

When applied to question answering and other text generation tasks, language models (LMs) may be queried generatively (by sampling answers from their output distribution) or discriminatively (by using them to score or rank a set of candidate outputs). These procedures sometimes yield very different predictions. How do we reconcile mutually incompatible scoring procedures to obtain coherent LM predictions? We introduce a new, a training-free, game-theoretic procedure for language model decoding. Our approach casts language model decoding as a regularized imperfect-information sequential signaling game - which we term the CONSENSUS GAME - in which a GENERATOR seeks to communicate an abstract correctness parameter using natural language sentences to a DISCRIMINATOR. We develop computational procedures for finding approximate equilibria of this game, resulting in a decoding algorithm we call EQUILIBRIUM-RANKING. Applied to a large number of tasks (including reading comprehension, commonsense reasoning, mathematical problem-solving, and dialog), EQUILIBRIUM-RANKING consistently, and sometimes substantially, improves performance over existing LM decoding procedures - on multiple benchmarks, we observe that applying EQUILIBRIUM-RANKING to LLaMA-7B outperforms the much larger LLaMA-65B and PaLM-540B models. These results highlight the promise of game-theoretic tools for addressing fundamental challenges of truthfulness and consistency in LMs.

  • 4 authors
·
Oct 13, 2023 3

Aligning Superhuman AI with Human Behavior: Chess as a Model System

As artificial intelligence becomes increasingly intelligent---in some cases, achieving superhuman performance---there is growing potential for humans to learn from and collaborate with algorithms. However, the ways in which AI systems approach problems are often different from the ways people do, and thus may be uninterpretable and hard to learn from. A crucial step in bridging this gap between human and artificial intelligence is modeling the granular actions that constitute human behavior, rather than simply matching aggregate human performance. We pursue this goal in a model system with a long history in artificial intelligence: chess. The aggregate performance of a chess player unfolds as they make decisions over the course of a game. The hundreds of millions of games played online by players at every skill level form a rich source of data in which these decisions, and their exact context, are recorded in minute detail. Applying existing chess engines to this data, including an open-source implementation of AlphaZero, we find that they do not predict human moves well. We develop and introduce Maia, a customized version of Alpha-Zero trained on human chess games, that predicts human moves at a much higher accuracy than existing engines, and can achieve maximum accuracy when predicting decisions made by players at a specific skill level in a tuneable way. For a dual task of predicting whether a human will make a large mistake on the next move, we develop a deep neural network that significantly outperforms competitive baselines. Taken together, our results suggest that there is substantial promise in designing artificial intelligence systems with human collaboration in mind by first accurately modeling granular human decision-making.

  • 4 authors
·
Jun 2, 2020

Skill Issue: Are Skills Language-Invariant in LLMs?

Large language models access knowledge inconsistently across languages, but to what extent do they differ in their skill sets when interacting with different languages? This work quantifies cross-lingual skill inconsistency orthogonally from knowledge and general benchmark performance. We do this via multilingual self-play: two instances of the same model compete in a text-based game, each interacting through a different language interface. Since the model, opponent, rules, state space, and available actions remain fixed, this setting isolates the effect of language on the model's realized behavior. We build a multilingual extension to TextArena and evaluate three open-weight models across eight languages and six games covering spatial reasoning, imperfect information, resource allocation, and repeated interaction. We find that the same model can exhibit markedly different playing strength across languages, with systematic variation in win--loss margins, invalid actions, and strategic tendencies. Detailed analyses reveal language-specific failures in spatial reasoning, card-conditioned decisions, and optimal move selection. In some settings, changing only the intermediate reasoning language recovers much of the lost performance, suggesting that language can affect different stages of the decision process. These results show that skill discrepancies are a measurable major roadblock in the development of truly multilingual models. Better understanding these discrepancies can help us design models that perform more equitably across languages.

The-CoLab CoLab Lab
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Aug 25 2

From Natural Language to Extensive-Form Game Representations

We introduce a framework for translating game descriptions in natural language into extensive-form representations in game theory, leveraging Large Language Models (LLMs) and in-context learning. Given the varying levels of strategic complexity in games, such as perfect versus imperfect information, directly applying in-context learning would be insufficient. To address this, we introduce a two-stage framework with specialized modules to enhance in-context learning, enabling it to divide and conquer the problem effectively. In the first stage, we tackle the challenge of imperfect information by developing a module that identifies information sets along and the corresponding partial tree structure. With this information, the second stage leverages in-context learning alongside a self-debugging module to produce a complete extensive-form game tree represented using pygambit, the Python API of a recognized game-theoretic analysis tool called Gambit. Using this python representation enables the automation of tasks such as computing Nash equilibria directly from natural language descriptions. We evaluate the performance of the full framework, as well as its individual components, using various LLMs on games with different levels of strategic complexity. Our experimental results show that the framework significantly outperforms baseline models in generating accurate extensive-form games, with each module playing a critical role in its success.

  • 3 authors
·
Jan 28, 2025

Enhancing Chess Reinforcement Learning with Graph Representation

Mastering games is a hard task, as games can be extremely complex, and still fundamentally different in structure from one another. While the AlphaZero algorithm has demonstrated an impressive ability to learn the rules and strategy of a large variety of games, ranging from Go and Chess, to Atari games, its reliance on extensive computational resources and rigid Convolutional Neural Network (CNN) architecture limits its adaptability and scalability. A model trained to play on a 19times 19 Go board cannot be used to play on a smaller 13times 13 board, despite the similarity between the two Go variants. In this paper, we focus on Chess, and explore using a more generic Graph-based Representation of a game state, rather than a grid-based one, to introduce a more general architecture based on Graph Neural Networks (GNN). We also expand the classical Graph Attention Network (GAT) layer to incorporate edge-features, to naturally provide a generic policy output format. Our experiments, performed on smaller networks than the initial AlphaZero paper, show that this new architecture outperforms previous architectures with a similar number of parameters, being able to increase playing strength an order of magnitude faster. We also show that the model, when trained on a smaller 5times 5 variant of chess, is able to be quickly fine-tuned to play on regular 8times 8 chess, suggesting that this approach yields promising generalization abilities. Our code is available at https://github.com/akulen/AlphaGateau.

  • 2 authors
·
Oct 30, 2024

Evaluating Language Models for Mathematics through Interactions

The standard methodology of evaluating large language models (LLMs) based on static pairs of inputs and outputs is insufficient for developing assistants: this kind of assessments fails to take into account the essential interactive element in their deployment, and therefore limits how we understand language model capabilities. We introduce CheckMate, an adaptable prototype platform for humans to interact with and evaluate LLMs. We conduct a study with CheckMate to evaluate three language models~(InstructGPT, ChatGPT, and GPT-4) as assistants in proving undergraduate-level mathematics, with a mixed cohort of participants from undergraduate students to professors of mathematics. We release the resulting interaction and rating dataset, MathConverse. By analysing MathConverse, we derive a preliminary taxonomy of human behaviours and uncover that despite a generally positive correlation, there are notable instances of divergence between correctness and perceived helpfulness in LLM generations, amongst other findings. Further, we identify useful scenarios and existing issues of GPT-4 in mathematical reasoning through a series of case studies contributed by expert mathematicians. We conclude with actionable takeaways for ML practitioners and mathematicians: models which communicate uncertainty, respond well to user corrections, are more interpretable and concise may constitute better assistants; interactive evaluation is a promising way to continually navigate the capability of these models; humans should be aware of language models' algebraic fallibility, and for that reason discern where they should be used.

  • 14 authors
·
Jun 2, 2023

CheXanatomy: Anatomy-Aware Vision-Language Modeling for Chest Radiographs

Vision-language models (VLMs) pretrained on large-scale image-text pairs demonstrate strong image-level understanding, but are primarily optimized for global alignment and do not explicitly encode fine-grained anatomical structure, limiting their suitability for spatially precise tasks such as segmentation. We introduce CheXanatomy, a framework that integrates explicit anatomical knowledge into a pretrained VLM through autoregressive token-space supervision. Instead of adding task-specific decoder heads, the model is trained to generate anatomical segmentation masks via next-token prediction. To enable scalable supervision, we synthesize realistic chest radiographs from CT volumes and forward-project CT segmentation labels to obtain anatomically consistent 2D masks. We evaluate the approach on synthetic and real chest radiographs against a U-Net baseline, including ablations on model scale, input resolution, and vision encoder fine-tuning. Autoregressive anatomical supervision achieves performance comparable to specialized convolutional models in-distribution and demonstrates improved geometric robustness under domain shift to real CXR data. In addition, anatomy-pretrained models exhibit improved sample efficiency when adapting to novel localization tasks under limited supervision. Larger models and higher input image resolution improve performance, while vision encoder fine-tuning has limited effect. These results show that embedding anatomical structure directly into the generative objective promotes spatially grounded representations and supports anatomy-aware medical vision-language modeling.

  • 3 authors
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Jun 24

Rethinking Visual Attribution for Chest X-ray Reasoning in Large Vision Language Models

Large Vision Language Models (LVLMs) show promise in medical applications, but their inability to faithfully ground responses in visual evidence raises serious concerns about clinical trustworthiness. While visual attribution methods are widely used to explain LVLM predictions, whether these explanations actually reflect the visual evidence underlying the model's decision is largely unverified, since ground-truth annotations for internal model reasoning are typically unavailable. We address this question for chest X-ray (CXR) reasoning by developing a causal evaluation framework that retains only CXR-VQA samples for which the expert-annotated region is verified, via counterfactual editing, to be causally responsible for the model's prediction. Using this framework across 11 attribution methods, six open-source LVLMs, and two output modes (direct answer and step-by-step reasoning), we find that existing attribution methods often fail to identify the evidence used by LVLMs. To address this failure, we propose MedFocus, a concept-based attribution method that localizes clinically meaningful anatomical regions via unbalanced optimal transport and measures their causal effect on model outputs through targeted interventions. MedFocus produces spatial, concept-level, and token-level attributions and substantially outperforms prior methods, taking a step toward more trustworthy attribution for medical LVLMs. Our data and code are available at https://github.com/gzxiong/medfocus/.

  • 5 authors
·
May 18 1

XrayGPT: Chest Radiographs Summarization using Medical Vision-Language Models

The latest breakthroughs in large vision-language models, such as Bard and GPT-4, have showcased extraordinary abilities in performing a wide range of tasks. Such models are trained on massive datasets comprising billions of public image-text pairs with diverse tasks. However, their performance on task-specific domains, such as radiology, is still under-investigated and potentially limited due to a lack of sophistication in understanding biomedical images. On the other hand, conversational medical models have exhibited remarkable success but have mainly focused on text-based analysis. In this paper, we introduce XrayGPT, a novel conversational medical vision-language model that can analyze and answer open-ended questions about chest radiographs. Specifically, we align both medical visual encoder (MedClip) with a fine-tuned large language model (Vicuna), using a simple linear transformation. This alignment enables our model to possess exceptional visual conversation abilities, grounded in a deep understanding of radiographs and medical domain knowledge. To enhance the performance of LLMs in the medical context, we generate ~217k interactive and high-quality summaries from free-text radiology reports. These summaries serve to enhance the performance of LLMs through the fine-tuning process. Our approach opens up new avenues the research for advancing the automated analysis of chest radiographs. Our open-source demos, models, and instruction sets are available at: https://github.com/mbzuai-oryx/XrayGPT.

  • 8 authors
·
Jun 13, 2023

CAPTOR: a vision-language foundation model for Chest-Abdomen-Pelvis Oncologic CT

Purpose : To develop and evaluate CAPTOR, a deep-learning vision-language foundation model for oncologic chest-abdomen-pelvis (CAP) CT interpretation. Materials & Methods : CAPTOR (Chest-Abdomen-Pelvis foundaTion model for Oncologic Radiology) is a contrastive vision-language model, trained using a pretraining strategy for oncologic CAP CT (in single- or multiple-series acquisitions), on a multicenter retrospective dataset from North America, Europe and Asia, predominantly from tumor lesion examinations. CAPTOR was compared with state-of-the-art CT foundation models on three downstream tasks: disease detection, survival prediction using TumorImagingBench and image retrieval. Classification and retrieval were both evaluated on held-out internal and public test sets, stratified by anatomical coverage and indication. Bootstrap resampling was used to estimate confidence intervals, and pairwise comparisons were performed using permutation tests. Results : CAPTOR was trained and tested on 25,512 and 10,794 CT-report pairs respectively. TumorImagingBench datasets comprised between 134 and 421 studies each. CAPTOR outperformed all baseline models, on the classification task, on the CAP subset (AUC 0.767, 95%CI: 0.734-0.793, vs. 0.695, 95%CI: 0.645-0.736 for the next-best, p<0.001) and oncologic subset (AUC 0.784, 95%CI: 0.759-0.805, vs. 0.734, 95%CI: 0.703-0.767 p<0.001), ranked first on three of the four oncologic prognostic benchmarks, and achieved superior retrieval performance on CAP and oncologic subsets. Conclusion : A foundation model trained on oncology-enriched CAP CT data outperformed relevant state-of-the-art models in its target clinical context, underscoring the importance of clinically aligned pretraining. We release our preprocessing, training and inference code : https://github.com/Guerbet-AI/CAPTOR and model weights : https://huggingface.co/Guerbet-AI/CAPTOR

  • 6 authors
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Oct 8

ViX-Ray: A Vietnamese Chest X-Ray Dataset for Vision-Language Models

Vietnamese medical research has become an increasingly vital domain, particularly with the rise of intelligent technologies aimed at reducing time and resource burdens in clinical diagnosis. Recent advances in vision-language models (VLMs), such as Gemini and GPT-4V, have sparked a growing interest in applying AI to healthcare. However, most existing VLMs lack exposure to Vietnamese medical data, limiting their ability to generate accurate and contextually appropriate diagnostic outputs for Vietnamese patients. To address this challenge, we introduce ViX-Ray, a novel dataset comprising 5,400 Vietnamese chest X-ray images annotated with expert-written findings and impressions from physicians at a major Vietnamese hospital. We analyze linguistic patterns within the dataset, including the frequency of mentioned body parts and diagnoses, to identify domain-specific linguistic characteristics of Vietnamese radiology reports. Furthermore, we fine-tune five state-of-the-art open-source VLMs on ViX-Ray and compare their performance to leading proprietary models, GPT-4V and Gemini. Our results show that while several models generate outputs partially aligned with clinical ground truths, they often suffer from low precision and excessive hallucination, especially in impression generation. These findings not only demonstrate the complexity and challenge of our dataset but also establish ViX-Ray as a valuable benchmark for evaluating and advancing vision-language models in the Vietnamese clinical domain.

  • 7 authors
·
Mar 15

A Reasoning-Enabled Vision-Language Foundation Model for Chest X-ray Interpretation

Chest X-rays (CXRs) are among the most frequently performed imaging examinations worldwide, yet rising imaging volumes increase radiologist workload and the risk of diagnostic errors. Although artificial intelligence (AI) systems have shown promise for CXR interpretation, most generate only final predictions, without making explicit how visual evidence is translated into radiographic findings and diagnostic predictions. We present CheXOne, a reasoning-enabled vision-language model for CXR interpretation. CheXOne jointly generates diagnostic predictions and explicit, clinically grounded reasoning traces that connect visual evidence, radiographic findings, and these predictions. The model is trained on 14.7 million instruction and reasoning samples curated from 30 public datasets spanning 36 CXR interpretation tasks, using a two-stage framework that combines instruction tuning with reinforcement learning to improve reasoning quality. We evaluate CheXOne in zero-shot settings across visual question answering, report generation, visual grounding and reasoning assessment, covering 17 evaluation settings. CheXOne outperforms existing medical and general-domain foundation models and achieves strong performance on independent public benchmarks. A clinical reader study demonstrates that CheXOne-drafted reports are comparable to or better than resident-written reports in 55% of cases, while effectively addressing clinical indications and enhancing both report writing and CXR interpretation efficiency. Further analyses involving radiologists reveal that the generated reasoning traces show high clinical factuality and provide causal support for the final predictions, offering a plausible explanation for the performance gains. These results suggest that explicit reasoning can improve model performance, interpretability and clinical utility in AI-assisted CXR interpretation.

  • 22 authors
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Apr 1

X-Ray-CoT: Interpretable Chest X-ray Diagnosis with Vision-Language Models via Chain-of-Thought Reasoning

Chest X-ray imaging is crucial for diagnosing pulmonary and cardiac diseases, yet its interpretation demands extensive clinical experience and suffers from inter-observer variability. While deep learning models offer high diagnostic accuracy, their black-box nature hinders clinical adoption in high-stakes medical settings. To address this, we propose X-Ray-CoT (Chest X-Ray Chain-of-Thought), a novel framework leveraging Vision-Language Large Models (LVLMs) for intelligent chest X-ray diagnosis and interpretable report generation. X-Ray-CoT simulates human radiologists' "chain-of-thought" by first extracting multi-modal features and visual concepts, then employing an LLM-based component with a structured Chain-of-Thought prompting strategy to reason and produce detailed natural language diagnostic reports. Evaluated on the CORDA dataset, X-Ray-CoT achieves competitive quantitative performance, with a Balanced Accuracy of 80.52% and F1 score of 78.65% for disease diagnosis, slightly surpassing existing black-box models. Crucially, it uniquely generates high-quality, explainable reports, as validated by preliminary human evaluations. Our ablation studies confirm the integral role of each proposed component, highlighting the necessity of multi-modal fusion and CoT reasoning for robust and transparent medical AI. This work represents a significant step towards trustworthy and clinically actionable AI systems in medical imaging.

  • 3 authors
·
Aug 17, 2025

CXR-LLaVA: Multimodal Large Language Model for Interpreting Chest X-ray Images

Purpose: Recent advancements in large language models (LLMs) have expanded their capabilities in a multimodal fashion, potentially replicating the image interpretation of human radiologists. This study aimed to develop open-source multimodal large language model for interpreting chest X-ray images (CXR-LLaVA). We also examined the effect of prompt engineering and model parameters such as temperature and nucleus sampling. Materials and Methods: For training, we collected 659,287 publicly available CXRs: 417,336 CXRs had labels for certain radiographic abnormalities (dataset 1); 241,951 CXRs provided free-text radiology reports (dataset 2). After pre-training the Resnet50 as an image encoder, the contrastive language-image pre-training was used to align CXRs and corresponding radiographic abnormalities. Then, the Large Language Model Meta AI-2 was fine-tuned using dataset 2, which were refined using GPT-4, with generating various question answering scenarios. The code can be found at https://github.com/ECOFRI/CXR_LLaVA. Results: In the test set, we observed that the model's performance fluctuated based on its parameters. On average, it achieved F1 score of 0.34 for five pathologic findings (atelectasis, cardiomegaly, consolidation, edema, and pleural effusion), which was improved to 0.46 through prompt engineering. In the independent set, the model achieved an average F1 score of 0.30 for the same pathologic findings. Notably, for the pediatric chest radiograph dataset, which was unseen during training, the model differentiated abnormal radiographs with an F1 score ranging from 0.84 to 0.85. Conclusion: CXR-LLaVA demonstrates promising potential in CXR interpretation. Both prompt engineering and model parameter adjustments can play pivotal roles in interpreting CXRs.

  • 4 authors
·
Oct 22, 2023

Human-aligned Chess with a Bit of Search

Chess has long been a testbed for AI's quest to match human intelligence, and in recent years, chess AI systems have surpassed the strongest humans at the game. However, these systems are not human-aligned; they are unable to match the skill levels of all human partners or model human-like behaviors beyond piece movement. In this paper, we introduce Allie, a chess-playing AI designed to bridge the gap between artificial and human intelligence in this classic game. Allie is trained on log sequences of real chess games to model the behaviors of human chess players across the skill spectrum, including non-move behaviors such as pondering times and resignations In offline evaluations, we find that Allie exhibits humanlike behavior: it outperforms the existing state-of-the-art in human chess move prediction and "ponders" at critical positions. The model learns to reliably assign reward at each game state, which can be used at inference as a reward function in a novel time-adaptive Monte-Carlo tree search (MCTS) procedure, where the amount of search depends on how long humans would think in the same positions. Adaptive search enables remarkable skill calibration; in a large-scale online evaluation against players with ratings from 1000 to 2600 Elo, our adaptive search method leads to a skill gap of only 49 Elo on average, substantially outperforming search-free and standard MCTS baselines. Against grandmaster-level (2500 Elo) opponents, Allie with adaptive search exhibits the strength of a fellow grandmaster, all while learning exclusively from humans.

  • 5 authors
·
Oct 3, 2024

TMGBench: A Systematic Game Benchmark for Evaluating Strategic Reasoning Abilities of LLMs

The rapid advancement of large language models (LLMs) has accelerated their application in reasoning, with strategic reasoning drawing increasing attention. To evaluate LLMs' strategic reasoning capabilities, game theory, with its concise structure, has become a preferred approach. However, current research focuses on a limited selection of games, resulting in low coverage. Classic game scenarios risk data leakage, and existing benchmarks often lack extensibility, making them inadequate for evaluating state-of-the-art models. To address these challenges, we propose TMGBench, a benchmark with comprehensive game type coverage, novel scenarios, and flexible organization. Specifically, we incorporate all 144 game types summarized by the Robinson-Goforth topology of 2x2 games, constructed as classic games. We also employ synthetic data generation to create diverse, higher-quality scenarios through topic guidance and human inspection, referred to as story-based games. Lastly, we provide a sustainable framework for increasingly powerful LLMs by treating these games as atomic units and organizing them into more complex forms via sequential, parallel, and nested structures. Our comprehensive evaluation of mainstream LLMs covers tests on rational reasoning, robustness, Theory-of-Mind (ToM), and reasoning in complex forms. Results reveal flaws in accuracy, consistency, and varying mastery of ToM. Additionally, o1-mini, OpenAI's latest reasoning model, achieved accuracy rates of 66.6%, 60.0%, and 70.0% on sequential, parallel, and nested games, highlighting TMGBench's challenges.

  • 6 authors
·
Oct 14, 2024

BoardgameQA: A Dataset for Natural Language Reasoning with Contradictory Information

Automated reasoning with unstructured natural text is a key requirement for many potential applications of NLP and for developing robust AI systems. Recently, Language Models (LMs) have demonstrated complex reasoning capacities even without any finetuning. However, existing evaluation for automated reasoning assumes access to a consistent and coherent set of information over which models reason. When reasoning in the real-world, the available information is frequently inconsistent or contradictory, and therefore models need to be equipped with a strategy to resolve such conflicts when they arise. One widely-applicable way of resolving conflicts is to impose preferences over information sources (e.g., based on source credibility or information recency) and adopt the source with higher preference. In this paper, we formulate the problem of reasoning with contradictory information guided by preferences over sources as the classical problem of defeasible reasoning, and develop a dataset called BoardgameQA for measuring the reasoning capacity of LMs in this setting. BoardgameQA also incorporates reasoning with implicit background knowledge, to better reflect reasoning problems in downstream applications. We benchmark various LMs on BoardgameQA and the results reveal a significant gap in the reasoning capacity of state-of-the-art LMs on this problem, showing that reasoning with conflicting information does not surface out-of-the-box in LMs. While performance can be improved with finetuning, it nevertheless remains poor.

  • 7 authors
·
Jun 13, 2023

Cross-modal linkage risk in clinical vision-language models

Vision-language models (VLMs) trained on paired chest radiographs and radiology reports learn a shared embedding space that can preserve instance-level image-report correspondence. This poses a privacy risk in settings where radiographs and reports are deliberately kept separate after acquisition, such as image-only data sharing or access-controlled reports, because a de-identified image may be re-linked to its original narrative report through cosine similarity alone. We formalized this as image-to-report retrieval and used public paired cohorts, in which the true pairing is known by design, as ground-truth benchmarks to audit the risk rather than as the privacy scenario. Evaluating VLMs of increasing clinical specialization on 406,241 paired examples from 126,804 patients across MIMIC-CXR (43,793 held-out pairs) and external CheXpert Plus (29,296 pairs), we found that re-linkage rose systematically with specialization: the strongest VLM retrieved the correct report at 15 times chance at a candidate pool of N = 100, 50 times chance at N = 10,000, and well above chance at full-database scale. The signal persisted under pathology-matched hard negatives that removed disease-label shortcuts, indicating correspondence beyond broad diagnostic categories. To reduce it without retraining, we froze both encoders and applied differentially private optimization only to the projection heads defining the alignment layer (epsilon = 0.34, delta = 6x10-6). This reduced Recall@1 by 61.8% at N = 10,000 on MIMIC-CXR and transferred to CheXpert Plus without retraining, while image-side utility was largely preserved: macro AUROC for linear-probe classification across 14 labels shifted only from 79.63% to 79.43%. Targeted DP finetuning of the shared alignment layer can substantially reduce cross-modal re-linkage without materially degrading the image representations that make these models clinically useful.

  • 4 authors
·
May 31

RadVLM: A Multitask Conversational Vision-Language Model for Radiology

The widespread use of chest X-rays (CXRs), coupled with a shortage of radiologists, has driven growing interest in automated CXR analysis and AI-assisted reporting. While existing vision-language models (VLMs) show promise in specific tasks such as report generation or abnormality detection, they often lack support for interactive diagnostic capabilities. In this work we present RadVLM, a compact, multitask conversational foundation model designed for CXR interpretation. To this end, we curate a large-scale instruction dataset comprising over 1 million image-instruction pairs containing both single-turn tasks -- such as report generation, abnormality classification, and visual grounding -- and multi-turn, multi-task conversational interactions. After fine-tuning RadVLM on this instruction dataset, we evaluate it across different tasks along with re-implemented baseline VLMs. Our results show that RadVLM achieves state-of-the-art performance in conversational capabilities and visual grounding while remaining competitive in other radiology tasks. Ablation studies further highlight the benefit of joint training across multiple tasks, particularly for scenarios with limited annotated data. Together, these findings highlight the potential of RadVLM as a clinically relevant AI assistant, providing structured CXR interpretation and conversational capabilities to support more effective and accessible diagnostic workflows.

  • 15 authors
·
Feb 5, 2025

Dia-LLaMA: Towards Large Language Model-driven CT Report Generation

Medical report generation has achieved remarkable advancements yet has still been faced with several challenges. First, the inherent imbalance in the distribution of normal and abnormal cases may lead models to exhibit a biased focus on normal samples, resulting in unreliable diagnoses. Second, the frequent occurrence of common template sentences in the reports may overwhelm the critical abnormal information. Moreover, existing works focus on 2D chest X-rays, leaving CT report generation underexplored due to the high-dimensional nature of CT images and the limited availability of CT-report pairs. Recently, LLM has shown a great ability to generate reliable answers with appropriate prompts, which shed light on addressing the aforementioned challenges. In this paper, we propose Dia-LLaMA, a framework to adapt the LLaMA2-7B for CT report generation by incorporating diagnostic information as guidance prompts. Considering the high dimension of CT, we leverage a pre-trained ViT3D with perceiver to extract the visual information. To tailor the LLM for report generation and emphasize abnormality, we extract additional diagnostic information by referring to a disease prototype memory bank, which is updated during training to capture common disease representations. Furthermore, we introduce disease-aware attention to enable the model to adjust attention for different diseases. Experiments on the chest CT dataset demonstrated that our proposed method outperformed previous methods and achieved state-of-the-art on both clinical efficacy performance and natural language generation metrics. The code will be made publically available.

  • 4 authors
·
Mar 24, 2024

Development of a Large-scale Dataset of Chest Computed Tomography Reports in Japanese and a High-performance Finding Classification Model

Background: Recent advances in large language models highlight the need for high-quality multilingual medical datasets. While Japan leads globally in CT scanner deployment and utilization, the lack of large-scale Japanese radiology datasets has hindered the development of specialized language models for medical imaging analysis. Objective: To develop a comprehensive Japanese CT report dataset through machine translation and establish a specialized language model for structured finding classification. Additionally, to create a rigorously validated evaluation dataset through expert radiologist review. Methods: We translated the CT-RATE dataset (24,283 CT reports from 21,304 patients) into Japanese using GPT-4o mini. The training dataset consisted of 22,778 machine-translated reports, while the validation dataset included 150 radiologist-revised reports. We developed CT-BERT-JPN based on "tohoku-nlp/bert-base-japanese-v3" architecture for extracting 18 structured findings from Japanese radiology reports. Results: Translation metrics showed strong performance with BLEU scores of 0.731 and 0.690, and ROUGE scores ranging from 0.770 to 0.876 for Findings and from 0.748 to 0.857 for Impression sections. CT-BERT-JPN demonstrated superior performance compared to GPT-4o in 11 out of 18 conditions, including lymphadenopathy (+14.2%), interlobular septal thickening (+10.9%), and atelectasis (+7.4%). The model maintained F1 scores exceeding 0.95 in 14 out of 18 conditions and achieved perfect scores in four conditions. Conclusions: Our study establishes a robust Japanese CT report dataset and demonstrates the effectiveness of a specialized language model for structured finding classification. The hybrid approach of machine translation and expert validation enables the creation of large-scale medical datasets while maintaining high quality.

  • 10 authors
·
Dec 20, 2024

Preference Fine-Tuning for Factuality in Chest X-Ray Interpretation Models Without Human Feedback

Radiologists play a crucial role by translating medical images into medical reports. However, the field faces staffing shortages and increasing workloads. While automated approaches using vision-language models (VLMs) show promise as assistants, they require exceptionally high accuracy. Most current VLMs in radiology rely solely on supervised fine-tuning (SFT). Meanwhile, in the general domain, additional preference fine-tuning has become standard practice. The challenge in radiology lies in the prohibitive cost of obtaining radiologist feedback. We propose a scalable automated preference alignment technique for VLMs in radiology, focusing on chest X-ray (CXR) report generation. Our method leverages publicly available datasets with an LLM-as-a-Judge mechanism, eliminating the need for additional expert radiologist feedback. We evaluate and benchmark five direct alignment algorithms (DAAs). Our results show up to a 57.4% improvement in average GREEN scores, a LLM-based metric for evaluating CXR reports, and a 9.2% increase in an average across six metrics (domain specific and general), compared to the SFT baseline. We study reward overoptimization via length exploitation, with reports lengthening by up to 3.2x. To assess a potential alignment tax, we benchmark on six additional diverse tasks, finding no significant degradations. A reader study involving four board-certified radiologists indicates win rates of up to 0.62 over the SFT baseline, while significantly penalizing verbosity. Our analysis provides actionable insights for the development of VLMs in high-stakes fields like radiology.

  • 11 authors
·
Oct 9, 2024

Extracting and Encoding: Leveraging Large Language Models and Medical Knowledge to Enhance Radiological Text Representation

Advancing representation learning in specialized fields like medicine remains challenging due to the scarcity of expert annotations for text and images. To tackle this issue, we present a novel two-stage framework designed to extract high-quality factual statements from free-text radiology reports in order to improve the representations of text encoders and, consequently, their performance on various downstream tasks. In the first stage, we propose a Fact Extractor that leverages large language models (LLMs) to identify factual statements from well-curated domain-specific datasets. In the second stage, we introduce a Fact Encoder (CXRFE) based on a BERT model fine-tuned with objective functions designed to improve its representations using the extracted factual data. Our framework also includes a new embedding-based metric (CXRFEScore) for evaluating chest X-ray text generation systems, leveraging both stages of our approach. Extensive evaluations show that our fact extractor and encoder outperform current state-of-the-art methods in tasks such as sentence ranking, natural language inference, and label extraction from radiology reports. Additionally, our metric proves to be more robust and effective than existing metrics commonly used in the radiology report generation literature. The code of this project is available at https://github.com/PabloMessina/CXR-Fact-Encoder.

  • 5 authors
·
Jul 1, 2024

CheXagent: Towards a Foundation Model for Chest X-Ray Interpretation

Chest X-rays (CXRs) are the most frequently performed imaging test in clinical practice. Recent advances in the development of vision-language foundation models (FMs) give rise to the possibility of performing automated CXR interpretation, which can assist physicians with clinical decision-making and improve patient outcomes. However, developing FMs that can accurately interpret CXRs is challenging due to the (1) limited availability of large-scale vision-language datasets in the medical image domain, (2) lack of vision and language encoders that can capture the complexities of medical data, and (3) absence of evaluation frameworks for benchmarking the abilities of FMs on CXR interpretation. In this work, we address these challenges by first introducing CheXinstruct - a large-scale instruction-tuning dataset curated from 28 publicly-available datasets. We then present CheXagent - an instruction-tuned FM capable of analyzing and summarizing CXRs. To build CheXagent, we design a clinical large language model (LLM) for parsing radiology reports, a vision encoder for representing CXR images, and a network to bridge the vision and language modalities. Finally, we introduce CheXbench - a novel benchmark designed to systematically evaluate FMs across 8 clinically-relevant CXR interpretation tasks. Extensive quantitative evaluations and qualitative reviews with five expert radiologists demonstrate that CheXagent outperforms previously-developed general- and medical-domain FMs on CheXbench tasks. Furthermore, in an effort to improve model transparency, we perform a fairness evaluation across factors of sex, race and age to highlight potential performance disparities. Our project is at https://stanford-aimi.github.io/chexagent.html.

  • 17 authors
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Jan 22, 2024 2

Standardizing Longitudinal Radiology Report Evaluation via Large Language Model Annotation

Longitudinal information in radiology reports refers to the sequential tracking of findings across multiple examinations over time, which is crucial for monitoring disease progression and guiding clinical decisions. Many recent automated radiology report generation methods are designed to capture longitudinal information; however, validating their performance is challenging. There is no proper tool to consistently label temporal changes in both ground-truth and model-generated texts for meaningful comparisons. Large language models (LLMs) offer a promising annotation alternative, as they are capable of capturing nuanced linguistic patterns and semantic similarities without extensive manual intervention. They also adapt well to new contexts. In this study, we therefore propose an LLM-based pipeline to automatically annotate longitudinal information in radiology reports. The pipeline first identifies sentences containing relevant information and then extracts the progression of diseases. We evaluate and compare five mainstream LLMs on these two tasks using 500 manually annotated reports. Considering both efficiency and performance, Qwen2.5-32B was subsequently selected and used to annotate another 95,169 reports from the public MIMIC-CXR dataset. Our Qwen2.5-32B-annotated dataset provided us with a standardized benchmark for evaluating report generation models. Using this new benchmark, we assessed seven state-of-the-art report generation models. Our LLM-based annotation method outperforms existing annotation solutions, achieving 11.3\% and 5.3\% higher F1-scores for longitudinal information detection and disease tracking, respectively. The source code is available at https://github.com/wxinyi1996/Standardizing-Longitudinal-Chest-X-ray-Report-Evaluation-via-Large-Language-Model-Annotation.git.

  • 4 authors
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Aug 29

NV-Reason-CT: 3D Visual Language Model for CT Analysis

We present NV-Reason-CT, a generative vision--language model for chest and abdominal CT combining native 3D visual encoding with radiologist-guided reasoning. The model couples a native 3D vision transformer with a language model, passing all visual tokens and their explicit 3D coordinates into language decoding without further spatial token merging. This retains volumetric spatial information within the vision encoder and through the language model's positional encoding during joint processing with text. We train on a curated corpus of approximately 550,000 multimodal instruction examples from 70,111 unique CT image inputs, combining standardized reports, abnormality-focused and anatomy-specific questions, multi-turn interactions, and radiologist-authored reasoning from recorded and transcribed expert CT interpretations. Expert annotations provide direct supervision and guide additional report-grounded synthetic reasoning. End-to-end supervised fine-tuning (SFT) is followed by Group Relative Policy Optimization (GRPO), with verifiable rewards over chest and abdominal abnormality sets. The model supports abnormality classification, report generation, and interactive reasoning with reviewable observations, differential diagnoses, and uncertainty. Evaluation spans public CT benchmarks and a held-out NIH cohort. On CT-RATE, NV-Reason-CT achieves a macro-F1 of 0.614 and macro-AUROC of 0.871 without a task-specific classification head; generated reports achieve a report-derived macro-F1 of 0.592. In a preliminary study with expert radiologists, AI-assisted review received favorable confidence ratings and was associated with a 50% reduction in average reported interpretation and reporting time. We release the model and training code to support reproducible research on explainable AI for volumetric medical imaging.

  • 16 authors
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Sep 22

RadGenome-Chest CT: A Grounded Vision-Language Dataset for Chest CT Analysis

Developing generalist foundation model has recently attracted tremendous attention among researchers in the field of AI for Medicine (AI4Medicine). A pivotal insight in developing these models is their reliance on dataset scaling, which emphasizes the requirements on developing open-source medical image datasets that incorporate diverse supervision signals across various imaging modalities. In this paper, we introduce RadGenome-Chest CT, a comprehensive, large-scale, region-guided 3D chest CT interpretation dataset based on CT-RATE. Specifically, we leverage the latest powerful universal segmentation and large language models, to extend the original datasets (over 25,692 non-contrast 3D chest CT volume and reports from 20,000 patients) from the following aspects: (i) organ-level segmentation masks covering 197 categories, which provide intermediate reasoning visual clues for interpretation; (ii) 665 K multi-granularity grounded reports, where each sentence of the report is linked to the corresponding anatomical region of CT volume in the form of a segmentation mask; (iii) 1.3 M grounded VQA pairs, where questions and answers are all linked with reference segmentation masks, enabling models to associate visual evidence with textual explanations. All grounded reports and VQA pairs in the validation set have gone through manual verification to ensure dataset quality. We believe that RadGenome-Chest CT can significantly advance the development of multimodal medical foundation models, by training to generate texts based on given segmentation regions, which is unattainable with previous relevant datasets. We will release all segmentation masks, grounded reports, and VQA pairs to facilitate further research and development in this field.

  • 7 authors
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Apr 25, 2024

Retrieval-augmented in-context learning for multimodal large language models in disease classification

Objectives: We aim to dynamically retrieve informative demonstrations, enhancing in-context learning in multimodal large language models (MLLMs) for disease classification. Methods: We propose a Retrieval-Augmented In-Context Learning (RAICL) framework, which integrates retrieval-augmented generation (RAG) and in-context learning (ICL) to adaptively select demonstrations with similar disease patterns, enabling more effective ICL in MLLMs. Specifically, RAICL examines embeddings from diverse encoders, including ResNet, BERT, BioBERT, and ClinicalBERT, to retrieve appropriate demonstrations, and constructs conversational prompts optimized for ICL. We evaluated the framework on two real-world multi-modal datasets (TCGA and IU Chest X-ray), assessing its performance across multiple MLLMs (Qwen, Llava, Gemma), embedding strategies, similarity metrics, and varying numbers of demonstrations. Results: RAICL consistently improved classification performance. Accuracy increased from 0.7854 to 0.8368 on TCGA and from 0.7924 to 0.8658 on IU Chest X-ray. Multi-modal inputs outperformed single-modal ones, with text-only inputs being stronger than images alone. The richness of information embedded in each modality will determine which embedding model can be used to get better results. Few-shot experiments showed that increasing the number of retrieved examples further enhanced performance. Across different similarity metrics, Euclidean distance achieved the highest accuracy while cosine similarity yielded better macro-F1 scores. RAICL demonstrated consistent improvements across various MLLMs, confirming its robustness and versatility. Conclusions: RAICL provides an efficient and scalable approach to enhance in-context learning in MLLMs for multimodal disease classification.

  • 9 authors
·
May 4, 2025

CheXmix: Unified Generative Pretraining for Vision Language Models in Medical Imaging

Recent medical multimodal foundation models are built as multimodal LLMs (MLLMs) by connecting a CLIP-pretrained vision encoder to an LLM using LLaVA-style finetuning. This two-stage, decoupled approach introduces a projection layer that can distort visual features. This is especially concerning in medical imaging where subtle cues are essential for accurate diagnoses. In contrast, early-fusion generative approaches such as Chameleon eliminate the projection bottleneck by processing image and text tokens within a single unified sequence, enabling joint representation learning that leverages the inductive priors of language models. We present CheXmix, a unified early-fusion generative model trained on a large corpus of chest X-rays paired with radiology reports. We expand on Chameleon's autoregressive framework by introducing a two-stage multimodal generative pretraining strategy that combines the representational strengths of masked autoencoders with MLLMs. The resulting models are highly flexible, supporting both discriminative and generative tasks at both coarse and fine-grained scales. Our approach outperforms well-established generative models across all masking ratios by 6.0% and surpasses CheXagent by 8.6% on AUROC at high image masking ratios on the CheXpert classification task. We further inpaint images over 51.0% better than text-only generative models and outperform CheXagent by 45% on the GREEN metric for radiology report generation. These results demonstrate that CheXmix captures fine-grained information across a broad spectrum of chest X-ray tasks. Our code is at: https://github.com/StanfordMIMI/CheXmix.

  • 11 authors
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Apr 23

Med-AR: Autoregressive Vision-Language Pretraining for Long-Tailed Chest X-Ray Classification and Uncertainty-Aware Evaluation

Long-tailed chest X-ray classification requires visual representations that capture both common abnormalities and subtle, infrequent findings. We propose Med-AR-8B and Med-AR-2B, two radiology-native autoregressive vision-language models pretrained with structured reports, abnormality-focused text, and region annotations. We evaluate the transfer of their visual encoders to multi-label classification against contrastive, self-supervised, and supervised pretrained encoders, including Med-CLIP, CheXFound, EVA-Base, ARK, and BioViL-T, using a common ML-Decoder classification head. To assess fine-grained recognition, we also construct LLM-expanded, report-derived label sets for MIMIC-CXR and CheXpert. Across PadChest, MIMIC-CXR, and CheXpert, Med-AR-8B outperforms Med-CLIP in mean AUROC and AUPRC for head, medium, and tail findings. On MIMIC-CXR, it increases tail-label mean AUPRC from 0.1033 to 0.1441. Med-AR-2B achieves the strongest discrimination results on PadChest. Across the broader encoder comparison, a Med-AR variant achieves the highest mean AUROC and AUPRC in every reported prevalence group on each public dataset. Both Med-AR variants also achieve lower excess area under the risk-coverage curve than Med-CLIP on all three public datasets, indicating improved selective-prediction performance under the evaluated protocol. Internal results are metric-dependent, with Med-CLIP retaining advantages in overall and tail AUPRC and in selective prediction. These findings establish Med-AR as a strong pretraining recipe for long-tailed chest X-ray classification on the evaluated public benchmarks and demonstrate the value of assessing discrimination and selective prediction together.

  • 6 authors
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Sep 23

SentZero: An Enhanced Sentence-Centric Vision-Language Pretraining for Multi-Task Zero-Shot Chest X-Ray Analysis

Vision-language (VL) pretraining using paired chest X-ray (CXR) images and radiology reports has shown strong potential for medical image understanding. However, existing methods often remain dependent on task-specific finetuning because radiology reports are lengthy, clinically dense, and difficult to align with simple zero-shot prompts. Recent sentence-level approaches partially address this limitation using clinical phrases extracted by large language models (LLMs), but they largely overlook the intrinsic characteristics of radiology discourse. In particular, limited positive-pair diversity constrains further gains, while clinically equivalent sentences frequently recur across patients, creating false negatives in contrastive learning. To address these issues, we propose SentZero, an enhanced sentence-centric VL pretraining framework for zero-shot, multi-task CXR analysis. SentZero introduces LLM-based abstract-level sentence structuring and mapping to expand positive-pair diversity, together with an additional loss term to mitigate false negatives. We further introduce sentence-conditioned residual modulation of visual embeddings, enabling visual features to adapt to the semantic characteristics of each input sentence. Across diverse downstream tasks and datasets, SentZero improves zero-shot generalization and outperforms prior multi-task zero-shot methods.

  • 4 authors
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Sep 27 1

ARC-CT: Anatomy-Routed Contrastive Vision-Language Learning for 3D Chest CT

Contrastive vision-language learning uses paired chest CT volumes and radiology reports to learn abnormality classifiers without manually annotated labels. However, two characteristics of chest CT challenge conventional global contrastive learning. First, many critical abnormalities are small or anatomically localized, and pooling an en- tire volume into a single embedding may dilute their visual evidence. Second, the standard contrastive objective treats every other scan in a batch as a negative. Because many chest CTs share abnormalities, this objective incorrectly pushes co-positive pairs apart. We propose Anatomy-Routed Contrastive Learning for 3D Chest CT (ARC-CT), a region-aware framework that addresses these limitations using only la- bels extracted from reports by an LLM, with no manual annotations or bounding boxes. ARC-CT combines three components: (1) an Anato- myQFormer localizing evidence via queries constrained by automatically generated organ masks; (2) a label-Jaccard soft InfoNCE objective in- tegrating the standard one-hot target with the label-set overlap of each pair, which reduces false-negative penalties between studies that share clinical findings; and (3) an organ-level alignment loss connecting mask- pooled visual features to organ-specific report text extracted offline with a large language model. ARC-CT achieves a 0.86 mask-free macro AUC across 18 abnormalities using a compact 3D ResNet-18 backbone. Over- all, ARC-CT outperforms both comparable efficient baselines and sev- eral larger transformer models. Our code and weights are available at https://github.com/arc-ct/arc-ct.

  • 4 authors
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Aug 27