Radiology report generation from longitudinal medical data is critical for assessing disease progression and automating diagnostic workflows. While recent methods incorporate longitudinal information, they primarily rely on multimodal feature fusion, with limited capacity for explicit disease evolution modeling and temporal reasoning. To address this, we propose MARE, an end-to-end framework that formulates longitudinal radiology report generation as a multimodal analogical reasoning task. Inspired by the Abduction–Mapping–Induction paradigm, MARE models latent relational structures underlying disease evolution by aligning lesion-level visual features across time and mapping them to the textual domain for temporally coherent and clinically meaningful report generation. To mitigate the spatial misalignment caused by patient positioning or imaging variation, we introduce an Adaptive Region Alignment (ARA) module for robust temporal correspondence. Additionally, we design Dual Evolution Consistency (DEC) losses to regularize analogical reasoning by enforcing temporal coherence in both visual and textual evolution paths. Extensive experiments on the Longitudinal-MIMIC dataset demonstrate that MARE significantly outperforms state-of-the-art baselines across both natural language generation and clinical effectiveness metrics, highlighting the value of structured analogical reasoning for disease evolution-aware report generation.

Multimodal Large Language Models (MLLMs) possess extensive knowledge and strong reasoning capabilities, achieving remarkable performance in knowledge-based visual question answering, significantly surpassing traditional small-scale Vision-Language Models (VLMs). However, the distinct training paradigms of MLLMs and small-scale VLMs result in misaligned feature representation spaces and divergent answer prediction distributions. To bridge this gap, we propose a novel end-to-end large-small model synergy framework, where small VLMs and MLLMs collaborate via synergistic optimization of shared objectives while maintaining their co-evolving complementary specializations. Specifically, multimodal fine-grained heuristics are extracted from well-tuned small VLMs and subsequently projected into the textual space of MLLMs through dedicated visual and textual collaboration modules. This enables cross-modal guidance for both visual and textual inputs. Finally, a dual-objective synergy loss promotes alignment toward shared goals, while a visual discrepancy loss preserves specialization diversity. Extensive experiments demonstrate that our framework achieves state-of-the-art performance on both the OK-VQA and A-OKVQA benchmarks.

Considerable performance gains have been achieved for knowledge-based visual question answering due to the visual-language pre-training models with pre-training-then-fine-tuning paradigm. However, because the targets of the pre-training and fine-tuning stages are different, there is an evident barrier that prevents the cross-modal comprehension ability developed in the pre-training stage from fully endowing the fine-tuning task. To break this barrier, in this paper, we propose a novel hybrid prompting model for knowledge-based VQA, which inherits and incorporates the pre-training and fine-tuning tasks with a shared objective. Specifically, based on static declaration prompt, we construct a consistent goal with the fine-tuning via masked language modeling to inherit capabilities of pre-training task, while selecting the top-t relevant knowledge in a dense retrieval manner. Additionally, a dynamic knowledge prompt is learned from retrieved knowledge, which not only alleviates the length constraint on inputs for visual-language pre-trained models but also assists in providing answer features via fine-tuning. Combining and unifying the aims of the two stages could fully exploit the abilities of pre-training and fine-tuning to predict answer. We evaluate the proposed model on the OKVQA dataset, and the result shows that our model outperforms the state-of-the-art methods based on visual-language pre-training models with a noticeable performance gap and even exceeds the large-scale language model of GPT-3, which proves the benefits of the hybrid prompts and the advantages of unifying pre-training to fine-tuning.