Papers › V2T-CoT: From Vision to Text Chain-of-Thought for Medical Reasoning and Diagnosis

V2T-CoT: From Vision to Text Chain-of-Thought for Medical Reasoning and Diagnosis

24 Jun 2025arXiv:2506.19610links table onlyarchive 2025-07-28

Yuan Wang, Jiaxiang Liu, Shujian Gao, Bin Feng, Zhihang Tang, Xiaotang Gai, Jian Wu, Zuozhu Liu

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Recent advances in multimodal techniques have led to significant progress in Medical Visual Question Answering (Med-VQA). However, most existing models focus on global image features rather than localizing disease-specific regions crucial for diagnosis. Additionally, current research tends to emphasize answer accuracy at the expense of the reasoning pathway, yet both are crucial for clinical decision-making. To address these challenges, we propose From Vision to Text Chain-of-Thought (V2T-CoT), a novel approach that automates the localization of preference areas within biomedical images and incorporates this localization into region-level pixel attention as knowledge for Vision CoT. By fine-tuning the vision language model on constructed R-Med 39K dataset, V2T-CoT provides definitive medical reasoning paths. V2T-CoT integrates visual grounding with textual rationale generation to establish precise and explainable diagnostic results. Experimental results across four Med-VQA benchmarks demonstrate state-of-the-art performance, achieving substantial improvements in both performance and interpretability.

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