MIRA: Medical Image Reflection for Agentic Diagnosis
This work addresses the limitations of existing medical vision-language agents, which often invoke diagnostic tools indiscriminately, thereby introducing noisy or misleading evidence due to a lack of validation regarding tool necessity and evidential consistency. To overcome this, the authors propose a novel diagnostic framework endowed with autonomous evidence-seeking and reflective verification capabilities. The framework dynamically orchestrates image processing and web-search tools while evaluating the relevance and consistency of retrieved evidence. A two-stage training strategy is employed: first, high-quality fine-tuning trajectories are generated via tool-augmented Monte Carlo tree search; second, an online reflection-based evolutionary mechanism refines decision-making through self-correction and adaptation. Evaluated across nine medical visual reasoning benchmarks, the method achieves an average score of 64.73—outperforming Qwen3-VL-8B by 7.44 points—with a valid tool invocation rate of 73.8% and a harmful judgment rate reduced to 1.6%.