# Boot-and-Feedback Framework for Generalist-Expert Model Collaboration in Breast Ultrasound Diagnosis

arXiv: https://arxiv.org/abs/2608.23974 · HTML: https://mlsanity.com/paper/2608.23974/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 12 of its 25 references that are in the map.
- First posted on arXiv 25 Aug 2026.

## Builds on (most cited first, 12 of 12)

- [Deep Residual Learning for Image Recognition](https://mlsanity.com/paper/1512.03385/) (2015)
- [Language Models are Few-Shot Learners](https://mlsanity.com/paper/2005.14165/) (2020)
- [An Image is Worth 16x16 Words: Transformers for Image Recognition at Scale](https://mlsanity.com/paper/2010.11929/) (2020)
- [Gemini 2.5: Pushing the Frontier with Advanced Reasoning, Multimodality, Long Context, and Next Generation Agentic Capabilities](https://mlsanity.com/paper/2507.06261/) (2025)
- [BiomedCLIP: a multimodal biomedical foundation model pretrained from fifteen million scientific image-text pairs](https://mlsanity.com/paper/2303.00915/) (2023)
- [MedViT: A Robust Vision Transformer for Generalized Medical Image Classification](https://mlsanity.com/paper/2302.09462/) (2023)
- [Generative Speech Recognition Error Correction with Large Language Models and Task-Activating Prompting](https://mlsanity.com/paper/2309.15649/) (2023)
- [MedAlign: A Clinician-Generated Dataset for Instruction Following with Electronic Medical Records](https://mlsanity.com/paper/2308.14089/) (2023)
- [Aligning Human Knowledge with Visual Concepts Towards Explainable Medical Image Classification](https://mlsanity.com/paper/2406.05596/) (2024)
- [HoVer-Trans: Anatomy-aware HoVer-Transformer for ROI-free Breast Cancer Diagnosis in Ultrasound Images](https://mlsanity.com/paper/2205.08390/) (2022)
- [Improving Audio-Visual Speech Recognition by Lip-Subword Correlation Based Visual Pre-training and Cross-Modal Fusion Encoder](https://mlsanity.com/paper/2308.08488/) (2023)
- [CineDub: Scaling End-to-End Video Dubbing to Multi-Speaker Dialogues with Coherent Sound Effects](https://mlsanity.com/paper/2608.15734/) (2026)

## Abstract (arXiv)

Breast ultrasound (BUS) is widely used for breast cancer diagnosis yet remains operator-dependent. While deep learning shows promise, ensuring diagnostic reliability and interpretability is challenging. Recent Multimodal Large Language Models (MLLMs) often generate spurious descriptions due to limited domain knowledge, which mislead downstream expert models and compromise clinical validity. To address these challenges, we propose the Boot-and-Feedback (BooF) model collaboration framework for synergistic MLLM-expert interaction. Specifically, in the Boot Stage, the MLLM is guided by the BI-RADS lexicon and preliminary benign-malignant vision-expert predictions, enabling it to transfer general reasoning to BUS analysis while avoiding hallucinations. Subsequently, the Feedback Stage integrates these descriptions with visual features via a lightweight Attention-Gated Cross-Modality Fusion Module. This allows the expert to leverage textual feedback while adaptively filtering noise. Extensive experiments on multiple BUS datasets demonstrate that BooF substantially outperforms state-of-the-art methods in terms of diagnostic accuracy and interpretability.