# Enhancing 3D Medical Image Understanding with Pretraining Aided by 2D Multimodal Large Language Models

arXiv: https://arxiv.org/abs/2509.09064 · HTML: https://mlsanity.com/paper/2509.09064/

## 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 53 of its 89 references that are in the map.
- First posted on arXiv 11 Sep 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, 30 of 53)

- [Attention Is All You Need](https://mlsanity.com/paper/1706.03762/) (2017)
- [BERT: Pre-training of Deep Bidirectional Transformers for Language Understanding](https://mlsanity.com/paper/1810.04805/) (2018)
- [Learning Transferable Visual Models From Natural Language Supervision](https://mlsanity.com/paper/2103.00020/) (2021)
- [U-Net: Convolutional Networks for Biomedical Image Segmentation](https://mlsanity.com/paper/1505.04597/) (2015)
- [Momentum Contrast for Unsupervised Visual Representation Learning](https://mlsanity.com/paper/1911.05722/) (2019)
- [Masked Autoencoders Are Scalable Vision Learners](https://mlsanity.com/paper/2111.06377/) (2021)
- [End-to-End Object Detection with Transformers](https://mlsanity.com/paper/2005.12872/) (2020)
- [BLIP-2: Bootstrapping Language-Image Pre-training with Frozen Image Encoders and Large Language Models](https://mlsanity.com/paper/2301.12597/) (2023)
- [Bootstrap your own latent: A new approach to self-supervised Learning](https://mlsanity.com/paper/2006.07733/) (2020)
- [Flamingo: a Visual Language Model for Few-Shot Learning](https://mlsanity.com/paper/2204.14198/) (2022)
- [Exploring Simple Siamese Representation Learning](https://mlsanity.com/paper/2011.10566/) (2020)
- [Sinkhorn Distances: Lightspeed Computation of Optimal Transportation Distances](https://mlsanity.com/paper/1306.0895/) (2013)
- [Barlow Twins: Self-Supervised Learning via Redundancy Reduction](https://mlsanity.com/paper/2103.03230/) (2021)
- [Unsupervised Representation Learning by Predicting Image Rotations](https://mlsanity.com/paper/1803.07728/) (2018)
- [SimMIM: A Simple Framework for Masked Image Modeling](https://mlsanity.com/paper/2111.09886/) (2021)
- [UNETR: Transformers for 3D Medical Image Segmentation](https://mlsanity.com/paper/2103.10504/) (2021)
- [Swin UNETR: Swin Transformers for Semantic Segmentation of Brain Tumors in MRI Images](https://mlsanity.com/paper/2201.01266/) (2022)
- [Contrastive Learning of Medical Visual Representations from Paired Images and Text](https://mlsanity.com/paper/2010.00747/) (2020)
- [The Medical Segmentation Decathlon](https://mlsanity.com/paper/2106.05735/) (2021)
- [Masked Feature Prediction for Self-Supervised Visual Pre-Training](https://mlsanity.com/paper/2112.09133/) (2021)
- [MedCLIP: Contrastive Learning from Unpaired Medical Images and Text](https://mlsanity.com/paper/2210.10163/) (2022)
- [Mind the Gap: Understanding the Modality Gap in Multi-modal Contrastive Representation Learning](https://mlsanity.com/paper/2203.02053/) (2022)
- [BiomedCLIP: a multimodal biomedical foundation model pretrained from fifteen million scientific image-text pairs](https://mlsanity.com/paper/2303.00915/) (2023)
- [The Liver Tumor Segmentation Benchmark (LiTS)](https://mlsanity.com/paper/1901.04056/) (2019)
- [MONAI: An open-source framework for deep learning in healthcare](https://mlsanity.com/paper/2211.02701/) (2022)
- [CHAOS Challenge -- Combined (CT-MR) Healthy Abdominal Organ Segmentation](https://mlsanity.com/paper/2001.06535/) (2020)
- [Med3D: Transfer Learning for 3D Medical Image Analysis](https://mlsanity.com/paper/1904.00625/) (2019)
- [Joint Distribution Optimal Transportation for Domain Adaptation](https://mlsanity.com/paper/1705.08848/) (2017)
- [ULIP: Learning a Unified Representation of Language, Images, and Point Clouds for 3D Understanding](https://mlsanity.com/paper/2212.05171/) (2022)
- [AbdomenCT-1K: Is Abdominal Organ Segmentation A Solved Problem?](https://mlsanity.com/paper/2010.14808/) (2020)

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

- [MedInsightBench: Evaluating Medical Analytics Agents Through Multi-Step Insight Discovery in Multimodal Medical Data](https://mlsanity.com/paper/2512.13297/) (2025)

## Abstract (arXiv)

Understanding 3D medical image volumes is critical in the medical field, yet existing 3D medical convolution and transformer-based self-supervised learning (SSL) methods often lack deep semantic comprehension. Recent advancements in multimodal large language models (MLLMs) provide a promising approach to enhance image understanding through text descriptions. To leverage these 2D MLLMs for improved 3D medical image understanding, we propose Med3DInsight, a novel pretraining framework that integrates 3D image encoders with 2D MLLMs via a specially designed plane-slice-aware transformer module. Additionally, our model employs a partial optimal transport based alignment, demonstrating greater tolerance to noise introduced by potential noises in LLM-generated content. Med3DInsight introduces a new paradigm for scalable multimodal 3D medical representation learning without requiring human annotations. Extensive experiments demonstrate our state-of-the-art performance on two downstream tasks, i.e., segmentation and classification, across various public datasets with CT and MRI modalities, outperforming current SSL methods. Med3DInsight can be seamlessly integrated into existing 3D medical image understanding networks, potentially enhancing their performance. Our source code, generated datasets, and pre-trained models will be available at https://github.com/Qybc/Med3DInsight.