MATEX: Multi-scale Attention and Text-guided Explainability of Medical Vision-Language Models

We introduce MATEX (Multi-scale Attention and Text-guided Explainability), a novel framework that advances interpretability in medical vision-language models by incorporating anatomically informed spatial reasoning. MATEX synergistically combines multi-layer attention rollout, text-guided spatial priors, and layer consistency analysis to produce precise, stable, and clinically meaningful gradient attribution maps. By addressing key limitations of prior methods, such as spatial imprecision, lack of anatomical grounding, and limited attention granularity, MATEX enables more faithful and interpretable model explanations. Evaluated on the MS-CXR dataset, MATEX outperforms the state-of-the-art M2IB approach in both spatial precision and alignment with expert-annotated findings. These results highlight MATEX's potential to enhance trust and transparency in radiological AI applications.

Clinical Knowledge Graph Construction and Evaluation with Multi-LLMs via Retrieval-Augmented Generation

Large language models (LLMs) offer new opportunities for constructing knowledge graphs (KGs) from unstructured clinical narratives. However, existing approaches often rely on structured inputs and lack robust validation of factual accuracy and semantic consistency, limitations that are especially problematic in oncology. We introduce an end-to-end framework for clinical KG construction and evaluation directly from free text using multi-agent prompting and a schema-constrained Retrieval-Augmented Generation (KG-RAG) strategy. Our pipeline integrates (1) prompt-driven entity, attribute, and relation extraction; (2) entropy-based uncertainty scoring; (3) ontology-aligned RDF/OWL schema generation; and (4) multi-LLM consensus validation for hallucination detection and semantic refinement. Beyond static graph construction, the framework supports continuous refinement and self-supervised evaluation, enabling iterative improvement of graph quality. Applied to two oncology cohorts (PDAC and BRCA), our method produces interpretable, SPARQL-compatible, and clinically grounded knowledge graphs without relying on gold-standard annotations. Experimental results demonstrate consistent gains in precision, relevance, and ontology compliance over baseline methods.