# MIRNet: Integrating Constrained Graph-Based Reasoning with Pre-training for Diagnostic Medical Imaging

arXiv: https://arxiv.org/abs/2511.10013 · HTML: https://mlsanity.com/paper/2511.10013/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 4 of its 9 references that are in the map.
- First posted on arXiv 13 Nov 2025.

## Builds on (most cited first, 4 of 4)

- [Graph Attention Networks](https://mlsanity.com/paper/1710.10903/) (2017)
- [Masked Autoencoders Are Scalable Vision Learners](https://mlsanity.com/paper/2111.06377/) (2021)
- [Encoder-Decoder with Atrous Separable Convolution for Semantic Image Segmentation](https://mlsanity.com/paper/1802.02611/) (2018)
- [Fast Graph Representation Learning with PyTorch Geometric](https://mlsanity.com/paper/1903.02428/) (2019)

## Abstract (arXiv)

Automated interpretation of medical images demands robust modeling of complex visual-semantic relationships while addressing annotation scarcity, label imbalance, and clinical plausibility constraints. We introduce MIRNet (Medical Image Reasoner Network), a novel framework that integrates self-supervised pre-training with constrained graph-based reasoning. Tongue image diagnosis is a particularly challenging domain that requires fine-grained visual and semantic understanding. Our approach leverages self-supervised masked autoencoder (MAE) to learn transferable visual representations from unlabeled data; employs graph attention networks (GAT) to model label correlations through expert-defined structured graphs; enforces clinical priors via constraint-aware optimization using KL divergence and regularization losses; and mitigates imbalance using asymmetric loss (ASL) and boosting ensembles. To address annotation scarcity, we also introduce TongueAtlas-4K, a comprehensive expert-curated benchmark comprising 4,000 images annotated with 22 diagnostic labels--representing the largest public dataset in tongue analysis. Validation shows our method achieves state-of-the-art performance. While optimized for tongue diagnosis, the framework readily generalizes to broader diagnostic medical imaging tasks.