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arXiv · 2512.11060

Synthetic Vasculature and Pathology Enhance Vision-Language Model Reasoning

Chenjun Li·Cheng Wan·Laurin Lux·Alexander Berger·Richard B. Rosen·Martin J. Menten·Johannes C. Paetzold
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Abstract

Vision-Language Models (VLMs) offer a promising path toward interpretable medical diagnosis by allowing users to ask about clinical explanations alongside predictions and across different modalities. However, training VLMs for detailed reasoning requires large-scale image-text datasets. In many specialized domains, for example in reading Optical Coherence Tomography Angiography (OCTA) images, such precise text with grounded description of pathologies is scarce or even non-existent. To overcome this bottleneck, we introduce Synthetic Vasculature Reasoning (SVR), a framework that controllably synthesizes images and corresponding text, specifically: realistic retinal vasculature with Diabetic Retinopathy (DR) features: capillary dropout, microaneurysms, neovascularization, and tortuosity, while automatically generating granular reasoning texts. Based on this we curate OCTA-100K-SVR, an OCTA image-reasoning dataset with 100,000 pairs. Our experiments show that a general-purpose VLM (Qwen3-VL-8b) trained on the dataset achieves a zero-shot balanced classification accuracy of 89.67% on real OCTA images, outperforming supervised baselines. Through human expert evaluation we also demonstrate that it significantly enhances explanation quality and pathology localization on clinical data.

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Chenjun Li, Cheng Wan, Laurin Lux, Alexander Berger, Richard B. Rosen, Martin J. Menten, Johannes C. Paetzold. 2025-12-11. Synthetic Vasculature and Pathology Enhance Vision-Language Model Reasoning. https://arxiv.org/abs/2512.11060

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