UCSF-PDGM-VQA: Visual Question Answering dataset for brain tumor MRI interpretation

Abstract: Brain tumor diagnosis is largely dependent on Magnetic Resonance Imaging (MRI) evaluation, which requires radiologists to synthesize thousands of images across multiple 3D sequences and longitudinal studies. This process requires advanced neuro-radiology training, poses substantial cognitive load, and is highly time-consuming. Despite increasing demands in radiology, this expertise is difficult to scale, straining the current health systems. Vision-LLMs (VLMs) provide an opportunity to reduce this burden through a semi-automated, interactive interpretation of complex brain MRIs. However, they are currently underutilized in neuro-oncology due to a lack of specialized benchmarks for evaluating them. We introduce a clinically relevant visual question answering (VQA) benchmark -- the UCSF-PDGM-VQA dataset -- consisting of 2,387 QA pairs from 473 glioma-related MRI studies in the public UCSF-PDGM dataset. We further establish a performance baseline for six state-of-the-art vision-LLMs (VLMs) and one LLM on this dataset. We find that current models are incapable of effectively processing multi-sequence, 3-dimensional MRI scans, thus resulting in a suppression of visual features and over-reliance on language priors, causing modality collapse. These findings underscore a critical deficiency in current model reliability and safety within clinical settings, necessitating the development of robust, domain-specific VLMs.