IMACT-CXR: An Interactive Multi-Agent Conversational Tutoring System for Chest X-Ray Interpretation

Tuan-Anh Le, Anh Mai Vu, David Yang, Akash Awasthi, Hien Van Nguyen

Abstract: IMACT-CXR is an interactive multi-agent conversational tutor that helps trainees interpret chest X-rays by unifying spatial annotation, gaze analysis, knowledge retrieval, and image-grounded reasoning in a single AutoGen-based workflow [5]. The tutor simultaneously ingests learner bounding boxes, gaze samples, and free-text observations. Specialized agents evaluate localization quality, generate Socratic coaching, retrieve PubMed evidence, suggest similar cases from REFLACX, and trigger NV-Reason-CXR-3B for vision-language reasoning when mastery remains low or the learner explicitly asks. Bayesian Knowledge Tracing (BKT) maintains skill-specific mastery estimates that drive both knowledge reinforcement and case similarity retrieval. A lung-lobe segmentation module derived from a TensorFlow U-Net enables anatomically aware gaze feedback, and safety prompts prevent premature disclosure of ground-truth labels. We describe the system architecture, implementation highlights, and integration with the REFLACX dataset for real DICOM cases. IMACT-CXR demonstrates responsive tutoring flows with bounded latency, precise control over answer leakage, and extensibility toward live residency deployment. Preliminary evaluation shows improved localization and diagnostic reasoning compared to baselines.

External IDs:dblp:conf/isbi/LeVYAN26