# Gastric-X: A Multimodal Multi-Phase Benchmark Dataset for Advancing Vision-Language Models in Gastric Cancer Analysis

arXiv: https://arxiv.org/abs/2603.19516 · HTML: https://mlsanity.com/paper/2603.19516/

## Key facts

- Cited by 2 papers in the map (data through 14 Oct 2026).
- Placed in Clinical and biomedical applications, one of 17 directions in LLM reasoning.
- Builds on 50 of its 68 references that are in the map.
- First posted on arXiv 19 Mar 2026.

## Placed in

- LLM reasoning / [Clinical and biomedical applications](https://mlsanity.com/lr/clinical-and-biomedical-applications/)
- Multimodal LLMs / vision-language models / [Medical vision-language models](https://mlsanity.com/mllm/medical-vision-language-models/)

## Builds on (most cited first, 30 of 50)

- [Deep Residual Learning for Image Recognition](https://mlsanity.com/paper/1512.03385/) (2015)
- [Learning Transferable Visual Models From Natural Language Supervision](https://mlsanity.com/paper/2103.00020/) (2021)
- [Microsoft COCO: Common Objects in Context](https://mlsanity.com/paper/1405.0312/) (2014)
- [Swin Transformer: Hierarchical Vision Transformer using Shifted Windows](https://mlsanity.com/paper/2103.14030/) (2021)
- [Faster R-CNN: Towards Real-Time Object Detection with Region Proposal Networks](https://mlsanity.com/paper/1506.01497/) (2015)
- [BLIP-2: Bootstrapping Language-Image Pre-training with Frozen Image Encoders and Large Language Models](https://mlsanity.com/paper/2301.12597/) (2023)
- [Improved Baselines with Visual Instruction Tuning](https://mlsanity.com/paper/2310.03744/) (2023)
- [Flamingo: a Visual Language Model for Few-Shot Learning](https://mlsanity.com/paper/2204.14198/) (2022)
- [BLIP: Bootstrapping Language-Image Pre-training for Unified Vision-Language Understanding and Generation](https://mlsanity.com/paper/2201.12086/) (2022)
- [Scaling Up Visual and Vision-Language Representation Learning With Noisy Text Supervision](https://mlsanity.com/paper/2102.05918/) (2021)
- [Fast R-CNN](https://mlsanity.com/paper/1504.08083/) (2015)
- [Learning to Prompt for Vision-Language Models](https://mlsanity.com/paper/2109.01134/) (2021)
- [Conditional Prompt Learning for Vision-Language Models](https://mlsanity.com/paper/2203.05557/) (2022)
- [CheXpert: A Large Chest Radiograph Dataset with Uncertainty Labels and Expert Comparison](https://mlsanity.com/paper/1901.07031/) (2019)
- [LLaVA-Med: Training a Large Language-and-Vision Assistant for Biomedicine in One Day](https://mlsanity.com/paper/2306.00890/) (2023)
- [CoCa: Contrastive Captioners are Image-Text Foundation Models](https://mlsanity.com/paper/2205.01917/) (2022)
- [A Survey on Deep Learning in Medical Image Analysis](https://mlsanity.com/paper/1702.05747/) (2017)
- [Grounded Language-Image Pre-training](https://mlsanity.com/paper/2112.03857/) (2021)
- [Video Swin Transformer](https://mlsanity.com/paper/2106.13230/) (2021)
- [CLIP-Adapter: Better Vision-Language Models with Feature Adapters](https://mlsanity.com/paper/2110.04544/) (2021)
- [FLAVA: A Foundational Language And Vision Alignment Model](https://mlsanity.com/paper/2112.04482/) (2021)
- [FILIP: Fine-grained Interactive Language-Image Pre-Training](https://mlsanity.com/paper/2111.07783/) (2021)
- [PathVQA: 30000+ Questions for Medical Visual Question Answering](https://mlsanity.com/paper/2003.10286/) (2020)
- [SLAKE: A Semantically-Labeled Knowledge-Enhanced Dataset for Medical Visual Question Answering](https://mlsanity.com/paper/2102.09542/) (2021)
- [Deep Learning for Medical Image Analysis](https://mlsanity.com/paper/1708.08987/) (2017)
- [Med-Flamingo: a Multimodal Medical Few-shot Learner](https://mlsanity.com/paper/2307.15189/) (2023)
- [Med-BERT: pre-trained contextualized embeddings on large-scale structured electronic health records for disease prediction](https://mlsanity.com/paper/2005.12833/) (2020)
- [PMC-VQA: Visual Instruction Tuning for Medical Visual Question Answering](https://mlsanity.com/paper/2305.10415/) (2023)
- [PadChest: A large chest x-ray image dataset with multi-label annotated reports](https://mlsanity.com/paper/1901.07441/) (2019)
- [Generalist Foundation Models from a Multimodal Dataset for 3D Computed Tomography](https://mlsanity.com/paper/2403.17834/) (2024)

## Built on by (most cited first, 2 of 2)

- [When Models Learn to Ask Why: Adaptive Causal Reasoning for Trustworthy Medical Vision-Language Models](https://mlsanity.com/paper/2603.23085/) (2026)
- [Measuring and Improving Complex-Atomic Answer Consistency in Endoscopic VQA](https://mlsanity.com/paper/2607.17834/) (2026)

## Abstract (arXiv)

Recent vision-language models (VLMs) have shown strong generalization and multimodal reasoning abilities in natural domains. However, their application to medical diagnosis remains limited by the lack of comprehensive and structured datasets that capture real clinical workflows. To advance the development of VLMs for clinical applications, particularly in gastric cancer, we introduce Gastric-X, a large-scale multimodal benchmark for gastric cancer analysis providing 1.7K cases. Each case in Gastric-X includes paired resting and dynamic CT scans, endoscopic image, a set of structured biochemical indicators, expert-authored diagnostic notes, and bounding box annotations of tumor regions, reflecting realistic clinical conditions. We systematically examine the capability of recent VLMs on five core tasks: Visual Question Answering (VQA), report generation, cross-modal retrieval, disease classification, and lesion localization. These tasks simulate critical stages of clinical workflow, from visual understanding and reasoning to multimodal decision support. Through this evaluation, we aim not only to assess model performance but also to probe the nature of VLM understanding: Can current VLMs meaningfully correlate biochemical signals with spatial tumor features and textual reports? We envision Gastric-X as a step toward aligning machine intelligence with the cognitive and evidential reasoning processes of physicians, and as a resource to inspire the development of next-generation medical VLMs.