MIRA: Evaluating Multimodal AI on Complex Clinical Reasoning in Interventional Radiology

Abstract We present MIRA (Multimodal Interventional RAdiology evaluation), a comprehensive benchmark for evaluating large multimodal models in expert-level interventional radiology tasks requiring specialized domain knowledge and advanced visual reasoning capabilities. Unlike existing medical benchmarks that primarily provide binary labels without contextual depth, MIRA offers diverse question formats, including open-ended, closed-ended, single-choice, and multiple-choice categories, each accompanied by detailed expert-validated explanations. The benchmark incorporates approximately 184K high-quality medical images spanning multiple imaging modalities with 1.2M meticulously generated question-answer pairs across various anatomical regions. These pairs were created through a sophisticated cascade methodology involving expert interventional radiologists at both the data collection and validation stages. Our comprehensive evaluation, encompassing zero-shot testing and fine-tuning experiments of large multimodal models, revealing significant performance gaps between AI systems and human specialists. Fine-tuning experiments demonstrate substantial improvements, with models achieving up to 0.80 accuracy on single-choice questions. MIRA establishes a challenging benchmark that suggests promising directions for developing specialized clinical AI systems for interventional radiology.