ABRA: Agent Benchmark for Radiology Applications

Radiology, with its heterogeneous modalities, anatomies, and evolving protocols, is a natural yet high-stakes testbed for agentic AI. As LLMs grow more capable and tool ecosystems such as MCP and Agent Skills more complex, their capability boundaries in radiology remain unclear. We introduce RadA-BenchPlat, a two-layer benchmark spanning idealized reasoning and real-world execution: a synthetic layer with 2.2k clinician-verified records, 24.2k QA pairs, and 10 tool categories under diverse availability settings; and a real-environment layer pairing 165 2D/3D cases with executable tools for grounding, diagnosis, and report generation. We find that high completion rates under idealized settings do not carry over to real environments, where the best agents trail their upper bound by approximately 15% and drop to 0.327 on long-chain tasks. Prompting strategies (few-shot exemplars, multi-agent coordination) and AutoTB (on-the-fly synthesis of missing tools) mitigate execution drift and breakdowns in difficult scenarios, lifting execution success to 94.5%, yet remain not fully reliable. Overall, our findings suggest that radiology agents are no longer limited to conceptual demonstrations, but are beginning to show potential for real-world applications. Project repository: https://github.com/MAGIC-AI4Med/RadABench

Autonomous agents are increasingly expected to support end-to-end medical-AI research workflows, moving beyond isolated prediction tasks or short-form clinical question answering. However, existing medical agent benchmarks primarily evaluate final outputs, providing limited visibility into agent behavior within the research process. To address this gap, we present AutoMedBench, a workflow-aware benchmark for autonomous medical-AI research across diverse medical imaging and multimodal inference tasks, organizing agent execution into a unified five-stage workflow (S1-S5): Plan, Setup, Validate, Inference, and Submit. It comprises long-horizon tasks with each run averaging 33 agent turns, spanning five research tracks: segmentation, image enhancement, visual question answering (VQA), report generation, and lesion detection. Each task is evaluated under two difficulty tiers, Lite and Standard, which use the same data and metrics but differ in the amount of task-brief scaffolding, and each run is scored using both final task performance and S1-S5 stage scores, enabling stage-level analysis from the initial task brief to the final submitted artifact. Across thousands of recorded runs, stage-level scoring reveals that Validate is the weakest workflow stage on average, whereas Setup is the strongest, suggesting that current agents are better at making pipelines executable than at verifying their reliability. Post-run error analysis further shows that verification and submission failures dominate tagged errors, accounting for 37.7% and 38.1% of fired codes respectively, whereas task-understanding errors are rare at 0.9%, and runs with one fired error code have a 48% lower overall score than runs with no error code on average.

Automated radiology report generation (RRG) can ease radiologist workload, yet most existing systems produce a report in a single forward pass, with no mechanism to check a claim against the image or revisit a finding once stated. We present CogRad, a cognitively inspired multi-agent framework that structures generation around four stages of a radiologist's reading process. A Scout agent discovers anatomical regions directly from image patches via slot attention and assigns region and disease-level triage scores; an Investigator agent concentrates representational capacity on the regions Scout flags as suspicious; a Writer agent compiles these signals into a disease gated visual prefix for a large language model; and a Verifier agent supervises training with a visual entailment loss and, at inference, re-examines its own draft sentence by sentence, regenerating any report it judges insufficiently grounded. On CheXpert Plus, CogRad attains a BLEU-4 of 0.316 and a CIDEr of 0.322, the best scores among the methods we compare against. On IU X-Ray, it attains a BLEU-4 of 0.201 and a CIDEr of 0.724, leading every baseline on every standard NLG metric. We further evaluate CogRad with RadGraph F1, CheXbert F1, and a hallucination analysis to assess clinical accuracy beyond standard text-overlap metrics, complemented by ablation studies and Grad-CAM-based visualizations that characterize each agent's contribution and the model's visual grounding.