# AutoRad-Lung: A Radiomic-Guided Prompting Autoregressive Vision-Language Model for Lung Nodule Malignancy Prediction

arXiv: https://arxiv.org/abs/2503.20662 · HTML: https://mlsanity.com/paper/2503.20662/

## Key facts

- Cited by 2 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 12 of its 23 references that are in the map.
- First posted on arXiv 26 Mar 2025.

## Placed in

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

## Builds on (most cited first, 12 of 12)

- [Learning Transferable Visual Models From Natural Language Supervision](https://mlsanity.com/paper/2103.00020/) (2021)
- [Language Models are Few-Shot Learners](https://mlsanity.com/paper/2005.14165/) (2020)
- [XLNet: Generalized Autoregressive Pretraining for Language Understanding](https://mlsanity.com/paper/1906.08237/) (2019)
- [Learning to Prompt for Vision-Language Models](https://mlsanity.com/paper/2109.01134/) (2021)
- [Conditional Prompt Learning for Vision-Language Models](https://mlsanity.com/paper/2203.05557/) (2022)
- [Vision-Language Models for Vision Tasks: A Survey](https://mlsanity.com/paper/2304.00685/) (2023)
- [An Introduction to Vision-Language Modeling](https://mlsanity.com/paper/2405.17247/) (2024)
- [Scalable Pre-training of Large Autoregressive Image Models](https://mlsanity.com/paper/2401.08541/) (2024)
- [Multimodal Autoregressive Pre-training of Large Vision Encoders](https://mlsanity.com/paper/2411.14402/) (2024)
- [Advances in Medical Image Analysis with Vision Transformers: A Comprehensive Review](https://mlsanity.com/paper/2301.03505/) (2023)
- [From Hand-Crafted to Deep Learning-based Cancer Radiomics: Challenges and Opportunities](https://mlsanity.com/paper/1808.07954/) (2018)
- [CLIP-Lung: Textual Knowledge-Guided Lung Nodule Malignancy Prediction](https://mlsanity.com/paper/2304.08013/) (2023)

## Built on by (most cited first, 2 of 2)

- [FZ-VLM: A Two Stage Florence-Zephyr Vision Language Model Framework for Pulmonary Nodule Characterization and Clinical Decision Making](https://mlsanity.com/paper/2608.15004/) (2026)
- [Volumetric Radiology AI in the Era of Multimodal Large Language Models](https://mlsanity.com/paper/2608.20549/) (2026)

## Abstract (arXiv)

Lung cancer remains one of the leading causes of cancer-related mortality worldwide. A crucial challenge for early diagnosis is differentiating uncertain cases with similar visual characteristics and closely annotation scores. In clinical practice, radiologists rely on quantitative, hand-crafted Radiomic features extracted from Computed Tomography (CT) images, while recent research has primarily focused on deep learning solutions. More recently, Vision-Language Models (VLMs), particularly Contrastive Language-Image Pre-Training (CLIP)-based models, have gained attention for their ability to integrate textual knowledge into lung cancer diagnosis. While CLIP-Lung models have shown promising results, we identified the following potential limitations: (a) dependence on radiologists' annotated attributes, which are inherently subjective and error-prone, (b) use of textual information only during training, limiting direct applicability at inference, and (c) Convolutional-based vision encoder with randomly initialized weights, which disregards prior knowledge. To address these limitations, we introduce AutoRad-Lung, which couples an autoregressively pre-trained VLM, with prompts generated from hand-crafted Radiomics. AutoRad-Lung uses the vision encoder of the Large-Scale Autoregressive Image Model (AIMv2), pre-trained using a multi-modal autoregressive objective. Given that lung tumors are typically small, irregularly shaped, and visually similar to healthy tissue, AutoRad-Lung offers significant advantages over its CLIP-based counterparts by capturing pixel-level differences. Additionally, we introduce conditional context optimization, which dynamically generates context-specific prompts based on input Radiomics, improving cross-modal alignment.