# NEURAL: Attention-Guided Pruning for Unified Multimodal Resource-Constrained Clinical Evaluation

arXiv: https://arxiv.org/abs/2508.09715 · HTML: https://mlsanity.com/paper/2508.09715/

## Key facts

- Cited by 1 papers in the map (data through 14 Oct 2026).
- Builds on 7 of its 18 references that are in the map.
- First posted on arXiv 13 Aug 2025.

## Builds on (most cited first, 7 of 7)

- [Swin Transformer: Hierarchical Vision Transformer using Shifted Windows](https://mlsanity.com/paper/2103.14030/) (2021)
- [Interactive and Explainable Region-guided Radiology Report Generation](https://mlsanity.com/paper/2304.08295/) (2023)
- [CheXpert Plus: Augmenting a Large Chest X-ray Dataset with Text Radiology Reports, Patient Demographics and Additional Image Formats](https://mlsanity.com/paper/2405.19538/) (2024)
- [Improving Chest X-Ray Report Generation by Leveraging Warm Starting](https://mlsanity.com/paper/2201.09405/) (2022)
- [ATP-LLaVA: Adaptive Token Pruning for Large Vision Language Models](https://mlsanity.com/paper/2412.00447/) (2024)
- [PuMer: Pruning and Merging Tokens for Efficient Vision Language Models](https://mlsanity.com/paper/2305.17530/) (2023)
- [LVPruning: An Effective yet Simple Language-Guided Vision Token Pruning Approach for Multi-modal Large Language Models](https://mlsanity.com/paper/2501.13652/) (2025)

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

- [Less Is More? Selective Visual Attention to High-Importance Regions for Multimodal Radiology Summarization](https://mlsanity.com/paper/2603.29901/) (2026)

## Abstract (arXiv)

The rapid growth of multimodal medical imaging data presents significant storage and transmission challenges, particularly in resource-constrained clinical settings. We propose NEURAL, a novel framework that addresses this by using semantics-guided data compression. Our approach repurposes cross-attention scores between the image and its radiological report from a fine-tuned generative vision-language model to structurally prune chest X-rays, preserving only diagnostically critical regions. This process transforms the image into a highly compressed, graph representation. This unified graph-based representation fuses the pruned visual graph with a knowledge graph derived from the clinical report, creating a universal data structure that simplifies downstream modeling. Validated on the MIMIC-CXR and CheXpert Plus dataset for pneumonia detection, NEURAL achieves a 93.4-97.7% reduction in image data size while maintaining a high diagnostic performance of 0.88-0.95 AUC, outperforming other baseline models that use uncompressed data. By creating a persistent, task-agnostic data asset, NEURAL resolves the trade-off between data size and clinical utility, enabling efficient workflows and teleradiology without sacrificing performance. Our NEURAL code is available at https://github.com/basiralab/NEURAL.