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paperarXivTrust 82 · PrimaryPublished 8d agoLive · 7d ago

PerFact: Perception-Derived Fact Prompting for 3D Brain MRI Report Generation

Radiology report generation has matured almost entirely on 2D chest radiographs, where the default route to better reports is a larger backbone or a pre-training one on medical data. We revisit that assumption on 3D multi-sequence brain MRI, a volumetric multi-disease regime, and find that the model is not the lever. Zero-shot medical and radiology vision-language models transfer poorly to brain MRI, with chest radiograph specialists failing most conspicuously, and five backbones fine-tuned identically across three model families and an order of magnitude in scale differ only marginally. What

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