# RadAgents: Multimodal Agentic Reasoning for Chest X-ray Interpretation with Radiologist-like Workflows

arXiv: https://arxiv.org/abs/2509.20490 · HTML: https://mlsanity.com/paper/2509.20490/

## Key facts

- Cited by 8 papers in the map (data through 14 Oct 2026).
- Placed in Medical and scientific domain agents, one of 16 directions in LLM agents and tool use.
- Builds on 35 of its 48 references that are in the map.
- First posted on arXiv 24 Sep 2025.

## Placed in

- LLM agents and tool use / [Medical and scientific domain agents](https://mlsanity.com/agents/medical-and-scientific-domain-agents/)

## Builds on (most cited first, 30 of 35)

- [GPT-4 Technical Report](https://mlsanity.com/paper/2303.08774/) (2023)
- [ReAct: Synergizing Reasoning and Acting in Language Models](https://mlsanity.com/paper/2210.03629/) (2022)
- [GPT-4o System Card](https://mlsanity.com/paper/2410.21276/) (2024)
- [Lost in the Middle: How Language Models Use Long Contexts](https://mlsanity.com/paper/2307.03172/) (2023)
- [Efficient and robust approximate nearest neighbor search using Hierarchical Navigable Small World graphs](https://mlsanity.com/paper/1603.09320/) (2016)
- [MIMIC-CXR-JPG, a large publicly available database of labeled chest radiographs](https://mlsanity.com/paper/1901.07042/) (2019)
- [Plan-and-Solve Prompting: Improving Zero-Shot Chain-of-Thought Reasoning by Large Language Models](https://mlsanity.com/paper/2305.04091/) (2023)
- [SLAKE: A Semantically-Labeled Knowledge-Enhanced Dataset for Medical Visual Question Answering](https://mlsanity.com/paper/2102.09542/) (2021)
- [MedGemma Technical Report](https://mlsanity.com/paper/2507.05201/) (2025)
- [MLLM-as-a-Judge: Assessing Multimodal LLM-as-a-Judge with Vision-Language Benchmark](https://mlsanity.com/paper/2402.04788/) (2024)
- [Making the Most of Text Semantics to Improve Biomedical Vision--Language Processing](https://mlsanity.com/paper/2204.09817/) (2022)
- [CheXbert: Combining Automatic Labelers and Expert Annotations for Accurate Radiology Report Labeling Using BERT](https://mlsanity.com/paper/2004.09167/) (2020)
- [RadGraph: Extracting Clinical Entities and Relations from Radiology Reports](https://mlsanity.com/paper/2106.14463/) (2021)
- [Towards Generalist Biomedical AI](https://mlsanity.com/paper/2307.14334/) (2023)
- [AgentClinic: a multimodal agent benchmark to evaluate AI in simulated clinical environments](https://mlsanity.com/paper/2405.07960/) (2024)
- [Learning to Exploit Temporal Structure for Biomedical Vision-Language Processing](https://mlsanity.com/paper/2301.04558/) (2023)
- [BiomedGPT: A Generalist Vision-Language Foundation Model for Diverse Biomedical Tasks](https://mlsanity.com/paper/2305.17100/) (2023)
- [Multimodal Chain-of-Thought Reasoning: A Comprehensive Survey](https://mlsanity.com/paper/2503.12605/) (2025)
- [MAIRA-2: Grounded Radiology Report Generation](https://mlsanity.com/paper/2406.04449/) (2024)
- [Exploring scalable medical image encoders beyond text supervision](https://mlsanity.com/paper/2401.10815/) (2024)
- [TorchXRayVision: A library of chest X-ray datasets and models](https://mlsanity.com/paper/2111.00595/) (2021)
- [GREEN: Generative Radiology Report Evaluation and Error Notation](https://mlsanity.com/paper/2405.03595/) (2024)
- [MMedAgent: Learning to Use Medical Tools with Multi-modal Agent](https://mlsanity.com/paper/2407.02483/) (2024)
- [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)
- [More Thinking, Less Seeing? Assessing Amplified Hallucination in Multimodal Reasoning Models](https://mlsanity.com/paper/2505.21523/) (2025)
- [MedRAX: Medical Reasoning Agent for Chest X-ray](https://mlsanity.com/paper/2502.02673/) (2025)
- [OctoTools: An Agentic Framework with Extensible Tools for Complex Reasoning](https://mlsanity.com/paper/2502.11271/) (2025)
- [RaTEScore: A Metric for Radiology Report Generation](https://mlsanity.com/paper/2406.16845/) (2024)
- [VILA-M3: Enhancing Vision-Language Models with Medical Expert Knowledge](https://mlsanity.com/paper/2411.12915/) (2024)
- [Accurate Fine-Grained Segmentation of Human Anatomy in Radiographs via Volumetric Pseudo-Labeling](https://mlsanity.com/paper/2306.03934/) (2023)

## Built on by (most cited first, 8 of 8)

- [The Path to Self-Evolving Clinical Systems: Scaling Medical Agents from Assistance to Autonomy](https://mlsanity.com/paper/2607.11175/) (2026)
- [Unsupervised Deep Generative Models for Anomaly Detection in Neuroimaging: A Systematic Scoping Review](https://mlsanity.com/paper/2510.14462/) (2025)
- [Multi-Modal Multi-Agent Reinforcement Learning for Radiology Report Generation](https://mlsanity.com/paper/2603.16876/) (2026)
- [MedGPT-oss: Training a General-Purpose Vision-Language Model for Biomedicine](https://mlsanity.com/paper/2603.00842/) (2026)
- [Echo-α: Large Agentic Multimodal Reasoning Model for Ultrasound Interpretation](https://mlsanity.com/paper/2604.28011/) (2026)
- [VLM- and LLM-Driven Multi-Agent System for PET Image Denoising](https://mlsanity.com/paper/2608.13791/) (2026)
- [MammoClaw: Towards Skill-Evolving Agent Harness for Breast Cancer Mammography Analysis](https://mlsanity.com/paper/2609.31789/) (2026)
- [From Given to Gathered Evidence: Agentic Learning for Longitudinal Medical Reasoning](https://mlsanity.com/paper/2609.39566/) (2026)

## Abstract (arXiv)

Agentic systems offer a potential path to solve complex clinical tasks through collaboration among specialized agents, augmented by tool use and external knowledge bases. Nevertheless, for chest X-ray (CXR) interpretation, prevailing methods remain limited: (i) reasoning is frequently neither clinically interpretable nor aligned with guidelines, reflecting mere aggregation of tool outputs; (ii) multimodal evidence is insufficiently fused, yielding text-only rationales that are not visually grounded; and (iii) systems rarely detect or resolve cross-tool inconsistencies and provide no principled verification mechanisms. To bridge the above gaps, we present RadAgents, a multi-agent framework that couples clinical priors with task-aware multimodal reasoning and encodes a radiologist-style workflow into a modular, auditable pipeline. In addition, we integrate grounding and multimodal retrieval-augmentation to verify and resolve context conflicts, resulting in outputs that are more reliable, transparent, and consistent with clinical practice.