# ReX-MLE: The Autonomous Agent Benchmark for Medical Imaging Challenges

arXiv: https://arxiv.org/abs/2512.17838 · HTML: https://mlsanity.com/paper/2512.17838/

## Key facts

- Cited by 3 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 32 of its 51 references that are in the map.
- First posted on arXiv 19 Dec 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 32)

- [Training Verifiers to Solve Math Word Problems](https://mlsanity.com/paper/2110.14168/) (2021)
- [Evaluating Large Language Models Trained on Code](https://mlsanity.com/paper/2107.03374/) (2021)
- [Measuring Mathematical Problem Solving With the MATH Dataset](https://mlsanity.com/paper/2103.03874/) (2021)
- [SWE-bench: Can Language Models Resolve Real-World GitHub Issues?](https://mlsanity.com/paper/2310.06770/) (2023)
- [What Disease does this Patient Have? A Large-scale Open Domain Question Answering Dataset from Medical Exams](https://mlsanity.com/paper/2009.13081/) (2020)
- [MLE-bench: Evaluating Machine Learning Agents on Machine Learning Engineering](https://mlsanity.com/paper/2410.07095/) (2024)
- [Deep Learning for Medical Image Analysis](https://mlsanity.com/paper/1708.08987/) (2017)
- [Accelerating scientific discovery with Co-Scientist](https://mlsanity.com/paper/2502.18864/) (2025)
- [TravelPlanner: A Benchmark for Real-World Planning with Language Agents](https://mlsanity.com/paper/2402.01622/) (2024)
- [CRUXEval: A Benchmark for Code Reasoning, Understanding and Execution](https://mlsanity.com/paper/2401.03065/) (2024)
- [AgentClinic: a multimodal agent benchmark to evaluate AI in simulated clinical environments](https://mlsanity.com/paper/2405.07960/) (2024)
- [MedXpertQA: Benchmarking Expert-Level Medical Reasoning and Understanding](https://mlsanity.com/paper/2501.18362/) (2025)
- [ISLES 2022: A multi-center magnetic resonance imaging stroke lesion segmentation dataset](https://mlsanity.com/paper/2206.06694/) (2022)
- [DISCOVERYWORLD: A Virtual Environment for Developing and Evaluating Automated Scientific Discovery Agents](https://mlsanity.com/paper/2406.06769/) (2024)
- [MATH-Perturb: Benchmarking LLMs' Math Reasoning Abilities against Hard Perturbations](https://mlsanity.com/paper/2502.06453/) (2025)
- [BixBench: a Comprehensive Benchmark for LLM-based Agents in Computational Biology](https://mlsanity.com/paper/2503.00096/) (2025)
- [LLM-SRBench: A New Benchmark for Scientific Equation Discovery with Large Language Models](https://mlsanity.com/paper/2504.10415/) (2025)
- [AI Research Agents for Machine Learning: Search, Exploration, and Generalization in MLE-bench](https://mlsanity.com/paper/2507.02554/) (2025)
- [ML-Bench: Evaluating Large Language Models and Agents for Machine Learning Tasks on Repository-Level Code](https://mlsanity.com/paper/2311.09835/) (2023)
- [ML-Master: Towards AI-for-AI via Integration of Exploration and Reasoning](https://mlsanity.com/paper/2506.16499/) (2025)
- [The TopCoW Challenge -- Topology-Aware Circle of Willis Segmentation for CT and MR Angiography](https://mlsanity.com/paper/2312.17670/) (2023)
- [InternAgent: When Agent Becomes the Scientist -- Building Closed-Loop System from Hypothesis to Verification](https://mlsanity.com/paper/2505.16938/) (2025)
- [SciToolAgent: A Knowledge Graph-Driven Scientific Agent for Multi-Tool Integration](https://mlsanity.com/paper/2507.20280/) (2025)
- [R&D-Agent: An LLM-Agent Framework Towards Autonomous Data Science](https://mlsanity.com/paper/2505.14738/) (2025)
- [Medical Large Language Model Benchmarks Should Prioritize Construct Validity](https://mlsanity.com/paper/2503.10694/) (2025)
- [Why is the winner the best?](https://mlsanity.com/paper/2303.17719/) (2023)
- [AI Scientists Fail Without Strong Implementation Capability](https://mlsanity.com/paper/2506.01372/) (2025)
- [ML-Dev-Bench: Comparative Analysis of AI Agents on ML development workflows](https://mlsanity.com/paper/2502.00964/) (2025)
- [Putnam-AXIOM: A Functional and Static Benchmark for Measuring Higher Level Mathematical Reasoning in LLMs](https://mlsanity.com/paper/2508.08292/) (2025)
- [Practical Window Setting Optimization for Medical Image Deep Learning](https://mlsanity.com/paper/1812.00572/) (2018)

## Built on by (most cited first, 3 of 3)

- [NeuroAgent: LLM Agents for Multimodal Neuroimaging Analysis and Research](https://mlsanity.com/paper/2605.06584/) (2026)
- [Towards Autonomous and Auditable Medical Imaging Model Development](https://mlsanity.com/paper/2607.10522/) (2026)
- [BIABench: Evaluating AI agents on real-world bioimage analysis tasks](https://mlsanity.com/paper/2609.34274/) (2026)

## Abstract (arXiv)

Autonomous coding agents built on large language models (LLMs) can now solve many general software and machine learning tasks, but they remain ineffective on complex, domain-specific scientific problems. Medical imaging is a particularly demanding domain, requiring long training cycles, high-dimensional data handling, and specialized preprocessing and validation pipelines, capabilities not fully measured in existing agent benchmarks. To address this gap, we introduce ReX-MLE, a benchmark of 20 challenges derived from high-impact medical imaging competitions spanning diverse modalities and task types. Unlike prior ML-agent benchmarks, ReX-MLE evaluates full end-to-end workflows, requiring agents to independently manage data preprocessing, model training, and submission under realistic compute and time constraints. Evaluating state-of-the-art agents (AIDE, ML-Master, R&D-Agent) with different LLM backends (GPT-5, Gemini, Claude), we observe a severe performance gap: most submissions rank in the 0th percentile compared to human experts. Failures stem from domain-knowledge and engineering limitations. ReX-MLE exposes these bottlenecks and provides a foundation for developing domain-aware autonomous AI systems.