mlsanityData to 14 Oct 2026

Which Tool Response Should I Trust? Tool-Expertise-Aware Chest X-ray Agent with Multimodal Agentic Learning

arXiv 2602.21517 ↗First posted 25 Feb 2026cs.CVcited by 1

On the map: LLM agents and tool use → Medical and scientific domain agents

Abstract (arXiv)

AI agents with tool-use capabilities show promise for integrating the domain expertise of various tools. In the medical field, however, tools are usually AI models that are inherently error-prone and can produce contradictory responses. Existing research on medical agents lacks sufficient understanding of the tools' realistic reliability and thus cannot effectively resolve tool conflicts. To address this gap, this paper introduces a framework that enables an agent to interact with tools and empirically learn their practical trustworthiness across different types of multimodal queries via agentic learning. As a concrete instantiation, we focus on chest X-ray analysis and present a tool-expertise-aware chest X-ray agent (TEA-CXA). When tool outputs disagree, the agent experimentally accepts or rejects multimodal tool results, receives rewards, and learns which tool to trust for each query type. Importantly, TEA-CXA extends existing codebases for reinforcement learning with multi-turn tool-calling that focus on textual inputs, to support multimodal contexts effectively. In addition, we enhance the codebase for medical use scenarios by supporting multiple tool calls in one turn, parallel tool inference, and multi-image accommodation within a single user query. Our code framework is applicable to general medical research on multi-turn tool-calling reinforcement learning in multimodal settings. Experiments show that TEA-CXA outperforms the state-of-the-art methods and a comprehensive set of baselines. Code will be released.

Key facts. Cited by 1 paper 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 24 of its 31 references that are in the map. First posted on arXiv 25 Feb 2026.

Builds on

24 of 31 references.

Closest ancestors · 7

Same direction, newest first

  1. 2025An Agentic System for Rare Disease Diagnosis with Traceable Reasoning25 Jun
  2. 2025MedOrch: Medical Diagnosis with Tool-Augmented Reasoning Agents for Flexible Extensibility30 May
  3. 2025TxAgent: An AI Agent for Therapeutic Reasoning Across a Universe of Tools14 Mar
  4. 2025MedicalAgentsBench for Complex Medical Reasoning: Comparing Internalized Reasoning Models versus Externalized Agent-based Frameworks10 Mar
  5. 2025PathFinder: A Multi-Modal Multi-Agent System for Medical Diagnostic Decision-Making Applied to Histopathology13 Feb
  6. 2024MMedAgent: Learning to Use Medical Tools with Multi-modal Agent2 Jul
  7. 2024AgentMD: Empowering Language Agents for Risk Prediction with Large-Scale Clinical Tool Learning20 Feb

Other references · 17

  1. 2024DeepSeekMath: Pushing the Limits of Mathematical Reasoning in Open Language Modelscited by 9,379
  2. 2024Qwen2-VL: Enhancing Vision-Language Model's Perception of the World at Any Resolutioncited by 4,234
  3. 2024HybridFlow: A Flexible and Efficient RLHF Frameworkcited by 2,057
  4. 2025Search-R1: Training LLMs to Reason and Leverage Search Engines with Reinforcement Learningcited by 1,444
  5. 2023AgentBench: Evaluating LLMs as Agentscited by 1,267
  6. 2017CheXNet: Radiologist-Level Pneumonia Detection on Chest X-Rays with Deep Learningcited by 461
  7. 2025MedGemma Technical Reportcited by 436
  8. 2025HealthBench: Evaluating Large Language Models Towards Improved Human Healthcited by 429
  9. 2024Reinforcement learningcited by 247
  10. 2025Lingshu: A Generalist Foundation Model for Unified Multimodal Medical Understanding and Reasoningcited by 230
  11. 2021TorchXRayVision: A library of chest X-ray datasets and modelscited by 131
  12. 2024Large Multimodal Agents: A Surveycited by 105
5 more
  1. 2025MedRAX: Medical Reasoning Agent for Chest X-raycited by 70
  2. 2023LLaVA-Interactive: An All-in-One Demo for Image Chat, Segmentation, Generation and Editingcited by 47
  3. 2025CPathAgent: An Agent-based Foundation Model for Interpretable High-Resolution Pathology Image Analysis Mimicking Pathologists' Diagnostic Logiccited by 29
  4. 2025ReXVQA: A Large-scale Visual Question Answering Benchmark for Generalist Chest X-ray Understandingcited by 20
  5. 2025RLFactory: A Plug-and-Play Reinforcement Learning Post-Training Framework for LLM Multi-Turn Tool-Usecited by 20

Built on by

Cited by year (2026 to 14 Oct)

Citing papers per year: 2026: 1.

1 paper.

Similar, not cited

Close in wording, no citation either way

  1. 2026DUCX: Decomposing Unfairness in Tool-Using Chest X-ray Agents
  2. 2025RadAgents: Multimodal Agentic Reasoning for Chest X-ray Interpretation with Radiologist-like Workflows
  3. 2026X-Ragent: Tool-Augmented Reinforcement Learning for Evidence-Grounded Chest X-Ray Reasoning
  4. 2026XrayClaw: Cooperative-Competitive Multi-Agent Alignment for Trustworthy Chest X-ray Diagnosis
  5. 2025PASS: Probabilistic Agentic Supernet Sampling for Interpretable and Adaptive Chest X-Ray Reasoning
  6. 2026Evo-MedAgent: Beyond One-Shot Diagnosis with Agents That Remember, Reflect, and Improve
  7. 2026MedCTA: A Benchmark for Clinical Tool Agents
  8. 2026Multi-Modal Multi-Agent Reinforcement Learning for Radiology Report Generation