arXiv — NLP / Computation & Language · · 3 min read

Scalable Training of Spatially Grounded 2D Vision-Language Models for Radiology

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Computer Science > Computer Vision and Pattern Recognition

arXiv:2606.20477 (cs)
[Submitted on 18 Jun 2026]

Title:Scalable Training of Spatially Grounded 2D Vision-Language Models for Radiology

Authors:Yusuf Salcan (1 and 4), Simon Ging (1 and 2), Robin Schirrmeister (3), Philipp Arnold (3), Elmar Kotter (3), Behzad Bozorgtabar (2), Thomas Brox (1) ((1) Computer Vision Group, University of Freiburg, Germany, (2) Adaptive & Agentic AI (A3) Lab, Aarhus University, Denmark, (3) Department of Radiology, Medical Center -- University of Freiburg, Germany, (4) CRIION-AI Lab, Freiburg, Germany)
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Abstract:We study how to train visually grounded vision-language models (VLMs) for radiology without manual spatial annotations. We introduce RefRad2D, a large-scale bilingual (German/English) dataset of 1.2M CT and MR image-text pairs derived from clinical practice, with task-specific VQA and spatial grounding subsets generated automatically via LLM-based curation and automated segmentation. Trained on this data, our model RadGrounder jointly performs report generation, visual question answering, and spatial grounding via bounding-box detection or segmentation. On external VQA benchmarks (Slake, VQA-RAD), RadGrounder achieves competitive results with specialized medical VLMs. Adding our clinical data to the training mixture improves open-ended VQA over fine-tuning on the downstream datasets alone, showing the transferability of our dataset. Crucially, adding grounding supervision does not degrade language quality, enabling spatially verifiable outputs at no cost to VQA performance.
Comments: Accepted for MICCAI 2026. First two authors: equal contribution. Last two authors: equal supervision
Subjects: Computer Vision and Pattern Recognition (cs.CV); Computation and Language (cs.CL); Machine Learning (cs.LG)
Cite as: arXiv:2606.20477 [cs.CV]
  (or arXiv:2606.20477v1 [cs.CV] for this version)
  https://doi.org/10.48550/arXiv.2606.20477
arXiv-issued DOI via DataCite (pending registration)

Submission history

From: Simon Ging [view email]
[v1] Thu, 18 Jun 2026 16:55:26 UTC (1,328 KB)
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