@inproceedings{chen-etal-2026-unireason,
title = "{U}ni{R}eason-{M}ed: A Shared Grounded Reasoning Interface for 2{D}-to-3{D} Transfer in Medical {VQA}",
author = "Chen, Mengzhuo and
Shu, Yan and
Liu, Chi and
Piao, Hongming and
Wang, Xidong and
Li, Derek and
Dai, Bryan",
editor = "Lee, Hung-Yi and
Dev, Sunipa and
Li, Jessy and
Elliott, Desmond",
booktitle = "Proceedings of the 2026 Conference on Empirical Methods in Natural Language Processing",
month = oct,
year = "2026",
address = "Budapest, Hungary",
publisher = "Association for Computational Linguistics",
url = "https://aclanthology.org/2026.emnlp-main.1567/",
pages = "35710--35724",
ISBN = "979-8-89176-459-0",
abstract = "We study whether grounded reasoning supervision from abundant 2D medical images can improve 3D medical VQA when both input types are aligned through a common reasoning interface. We introduce UniReason-Med, a single-checkpoint framework that processes either a 2D image or a slice-serialized 3D volume at inference time, generating interleaved textual reasoning and localized visual evidence through shared box syntax, region-token injection, and a common grounded reasoning policy. To train this interface, we construct UniMed-CoT, a 220K instruction-tuning dataset with interleaved textual reasoning and grounded visual evidence, including 170K 2D and 50K 3D samples. Through supervised fine-tuning followed by outcome-level reinforcement learning, UniReason-Med learns to generate grounded reasoning traces without IoU/Dice-based localization rewards during RL. Data-mixture and component ablations show that joint 2D+3D grounded supervision substantially improves 3D reasoning over 3D-only training, while grounding and region-token injection consistently benefit both 2D and 3D tasks. These results suggest that a shared grounded reasoning interface can transfer reasoning structure from 2D images to slice-serialized volumetric medical understanding."
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<abstract>We study whether grounded reasoning supervision from abundant 2D medical images can improve 3D medical VQA when both input types are aligned through a common reasoning interface. We introduce UniReason-Med, a single-checkpoint framework that processes either a 2D image or a slice-serialized 3D volume at inference time, generating interleaved textual reasoning and localized visual evidence through shared box syntax, region-token injection, and a common grounded reasoning policy. To train this interface, we construct UniMed-CoT, a 220K instruction-tuning dataset with interleaved textual reasoning and grounded visual evidence, including 170K 2D and 50K 3D samples. Through supervised fine-tuning followed by outcome-level reinforcement learning, UniReason-Med learns to generate grounded reasoning traces without IoU/Dice-based localization rewards during RL. Data-mixture and component ablations show that joint 2D+3D grounded supervision substantially improves 3D reasoning over 3D-only training, while grounding and region-token injection consistently benefit both 2D and 3D tasks. These results suggest that a shared grounded reasoning interface can transfer reasoning structure from 2D images to slice-serialized volumetric medical understanding.</abstract>
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%0 Conference Proceedings
%T UniReason-Med: A Shared Grounded Reasoning Interface for 2D-to-3D Transfer in Medical VQA
%A Chen, Mengzhuo
%A Shu, Yan
%A Liu, Chi
%A Piao, Hongming
%A Wang, Xidong
%A Li, Derek
%A Dai, Bryan
%Y Lee, Hung-Yi
%Y Dev, Sunipa
%Y Li, Jessy
%Y Elliott, Desmond
%S Proceedings of the 2026 Conference on Empirical Methods in Natural Language Processing
%D 2026
%8 October
%I Association for Computational Linguistics
%C Budapest, Hungary
%@ 979-8-89176-459-0
%F chen-etal-2026-unireason
%X We study whether grounded reasoning supervision from abundant 2D medical images can improve 3D medical VQA when both input types are aligned through a common reasoning interface. We introduce UniReason-Med, a single-checkpoint framework that processes either a 2D image or a slice-serialized 3D volume at inference time, generating interleaved textual reasoning and localized visual evidence through shared box syntax, region-token injection, and a common grounded reasoning policy. To train this interface, we construct UniMed-CoT, a 220K instruction-tuning dataset with interleaved textual reasoning and grounded visual evidence, including 170K 2D and 50K 3D samples. Through supervised fine-tuning followed by outcome-level reinforcement learning, UniReason-Med learns to generate grounded reasoning traces without IoU/Dice-based localization rewards during RL. Data-mixture and component ablations show that joint 2D+3D grounded supervision substantially improves 3D reasoning over 3D-only training, while grounding and region-token injection consistently benefit both 2D and 3D tasks. These results suggest that a shared grounded reasoning interface can transfer reasoning structure from 2D images to slice-serialized volumetric medical understanding.
%U https://aclanthology.org/2026.emnlp-main.1567/
%P 35710-35724
Markdown (Informal)
[UniReason-Med: A Shared Grounded Reasoning Interface for 2D-to-3D Transfer in Medical VQA](https://aclanthology.org/2026.emnlp-main.1567/) (Chen et al., EMNLP 2026)
ACL