# Exploring Compositional Generalization of Multimodal LLMs for Medical Imaging

arXiv: https://arxiv.org/abs/2412.20070 · HTML: https://mlsanity.com/paper/2412.20070/

## Key facts

- Cited by 1 papers in the map (data through 14 Oct 2026).
- Placed in Medical vision-language models, one of 16 directions in Multimodal LLMs / vision-language models.
- Builds on 41 of its 101 references that are in the map.
- First posted on arXiv 28 Dec 2024.

## Placed in

- Multimodal LLMs / vision-language models / [Medical vision-language models](https://mlsanity.com/mllm/medical-vision-language-models/)

## Builds on (most cited first, 30 of 41)

- [Qwen2-VL: Enhancing Vision-Language Model's Perception of the World at Any Resolution](https://mlsanity.com/paper/2409.12191/) (2024)
- [PaLM-E: An Embodied Multimodal Language Model](https://mlsanity.com/paper/2303.03378/) (2023)
- [LLaVA-Med: Training a Large Language-and-Vision Assistant for Biomedicine in One Day](https://mlsanity.com/paper/2306.00890/) (2023)
- [Kosmos-2: Grounding Multimodal Large Language Models to the World](https://mlsanity.com/paper/2306.14824/) (2023)
- [ChestX-ray8: Hospital-scale Chest X-ray Database and Benchmarks on Weakly-Supervised Classification and Localization of Common Thorax Diseases](https://mlsanity.com/paper/1705.02315/) (2017)
- [Shikra: Unleashing Multimodal LLM's Referential Dialogue Magic](https://mlsanity.com/paper/2306.15195/) (2023)
- [Skin Lesion Analysis Toward Melanoma Detection 2018: A Challenge Hosted by the International Skin Imaging Collaboration (ISIC)](https://mlsanity.com/paper/1902.03368/) (2019)
- [Kvasir-SEG: A Segmented Polyp Dataset](https://mlsanity.com/paper/1911.07069/) (2019)
- [Skin Lesion Analysis Toward Melanoma Detection: A Challenge at the 2017 International Symposium on Biomedical Imaging (ISBI), Hosted by the International Skin Imaging Collaboration (ISIC)](https://mlsanity.com/paper/1710.05006/) (2017)
- [VisionLLM: Large Language Model is also an Open-Ended Decoder for Vision-Centric Tasks](https://mlsanity.com/paper/2305.11175/) (2023)
- [Keystroke Dynamics as Part of Lifelogging](https://mlsanity.com/paper/2010.10144/) (2020)
- [GPT4RoI: Instruction Tuning Large Language Model on Region-of-Interest](https://mlsanity.com/paper/2307.03601/) (2023)
- [COVID-Net: A Tailored Deep Convolutional Neural Network Design for Detection of COVID-19 Cases from Chest X-Ray Images](https://mlsanity.com/paper/2003.09871/) (2020)
- [Capabilities of Gemini Models in Medicine](https://mlsanity.com/paper/2404.18416/) (2024)
- [BCN20000: Dermoscopic Lesions in the Wild](https://mlsanity.com/paper/1908.02288/) (2019)
- [Can AI help in screening Viral and COVID-19 pneumonia?](https://mlsanity.com/paper/2003.13145/) (2020)
- [HuatuoGPT-Vision, Towards Injecting Medical Visual Knowledge into Multimodal LLMs at Scale](https://mlsanity.com/paper/2406.19280/) (2024)
- [Skin Lesion Analysis toward Melanoma Detection: A Challenge at the International Symposium on Biomedical Imaging (ISBI) 2016, hosted by the International Skin Imaging Collaboration (ISIC)](https://mlsanity.com/paper/1605.01397/) (2016)
- [Evaluating Deep Neural Networks Trained on Clinical Images in Dermatology with the Fitzpatrick 17k Dataset](https://mlsanity.com/paper/2104.09957/) (2021)
- [A Patient-Centric Dataset of Images and Metadata for Identifying Melanomas Using Clinical Context](https://mlsanity.com/paper/2008.07360/) (2020)
- [OMG-LLaVA: Bridging Image-level, Object-level, Pixel-level Reasoning and Understanding](https://mlsanity.com/paper/2406.19389/) (2024)
- [PAD-UFES-20: a skin lesion dataset composed of patient data and clinical images collected from smartphones](https://mlsanity.com/paper/2007.00478/) (2020)
- [Why are Visually-Grounded Language Models Bad at Image Classification?](https://mlsanity.com/paper/2405.18415/) (2024)
- [COVID-CT-Dataset: A CT Scan Dataset about COVID-19](https://mlsanity.com/paper/2003.13865/) (2020)
- [Going Deeper through the Gleason Scoring Scale: An Automatic end-to-end System for Histology Prostate Grading and Cribriform Pattern Detection](https://mlsanity.com/paper/2105.10490/) (2021)
- [Reliable Tuberculosis Detection using Chest X-ray with Deep Learning, Segmentation and Visualization](https://mlsanity.com/paper/2007.14895/) (2020)
- [Compositional Generalization for Primitive Substitutions](https://mlsanity.com/paper/1910.02612/) (2019)
- [Hard Sample Aware Noise Robust Learning for Histopathology Image Classification](https://mlsanity.com/paper/2112.03694/) (2021)
- [Compositional Generalization in Unsupervised Compositional Representation Learning: A Study on Disentanglement and Emergent Language](https://mlsanity.com/paper/2210.00482/) (2022)
- [Visual Instruction Tuning with Polite Flamingo](https://mlsanity.com/paper/2307.01003/) (2023)

## Built on by (most cited first, 1 of 1)

- [CrossMed: A Multimodal Cross-Task Benchmark for Compositional Generalization in Medical Imaging](https://mlsanity.com/paper/2511.11034/) (2025)

## Abstract (arXiv)

Medical imaging provides essential visual insights for diagnosis, and multimodal large language models (MLLMs) are increasingly utilized for its analysis due to their strong generalization capabilities; however, the underlying factors driving this generalization remain unclear. Current research suggests that multi-task training outperforms single-task as different tasks can benefit each other, but they often overlook the internal relationships within these tasks. To analyze this phenomenon, we attempted to employ compositional generalization (CG), which refers to the models' ability to understand novel combinations by recombining learned elements, as a guiding framework. Since medical images can be precisely defined by Modality, Anatomical area, and Task, naturally providing an environment for exploring CG, we assembled 106 medical datasets to create Med-MAT for comprehensive experiments. The experiments confirmed that MLLMs can use CG to understand unseen medical images and identified CG as one of the main drivers of the generalization observed in multi-task training. Additionally, further studies demonstrated that CG effectively supports datasets with limited data and confirmed that MLLMs can achieve CG across classification and detection tasks, underscoring its broader generalization potential. Med-MAT is available at https://github.com/FreedomIntelligence/Med-MAT.