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ABRA: Agent Benchmark for Radiology Applications

Summary

ABRA is a new benchmark for radiology agents that must navigate an OHIF viewer and Orthanc DICOM server via 21 tools. It includes 655 tasks across 8 types and 3 difficulties. Testing 10 models reveals high execution but low outcome rates, with the bottleneck being perception, not tool orchestration.

SourcearXiv Computer VisionAuthor: Bulat Maksudov, Vladislav Kurenkov, Kathleen M. Curran, Alessandra Mileo
ABRA: Agent Benchmark for Radiology Applications
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[2605.11224] ABRA: Agent Benchmark for Radiology Applications

[Submitted on 11 May 2026]

Title:ABRA: Agent Benchmark for Radiology Applications

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Abstract:Existing medical-agent benchmarks deliver imaging as pre-selected samples, never as an environment the agent must navigate. We introduce ABRA, a radiology-agent benchmark in which the agent operates an OHIF viewer and an Orthanc DICOM server through twenty-one function-calling tools that span slice navigation, windowing, series selection, pixel-coordinate annotation, and structured reporting. ABRA contains 655 programmatically generated tasks across three difficulty tiers and eight types (viewer control, metadata QA, vision probe, annotation, longitudinal comparison, BI-RADS reporting, and oracle variants of annotation and BI-RADS reporting), drawn from LIDC-IDRI, Duke Breast Cancer MRI, and NLST New-Lesion LongCT. Each episode is scored along Planning, Execution, and Outcome (Bluethgen et al., 2025) by task-type-specific automatic scorers. Ten current models, five closed-weight and five open-weight, reach at least 89% Execution on real annotation but only 0-25% Outcome; on the paired oracle variant where a simulated detector supplies the finding, Outcome on the same task reaches 69-100% across the models evaluated, localising the bottleneck to perception rather than tool orchestration. Code, task generators, and scorers are released at this https URL

Subjects:

Computer Vision and Pattern Recognition (cs.CV); Artificial Intelligence (cs.AI)

Cite as: arXiv:2605.11224 [cs.CV]

(or arXiv:2605.11224v1 [cs.CV] for this version)

https://doi.org/10.48550/arXiv.2605.11224

arXiv-issued DOI via DataCite (pending registration)

Submission history

From: Bulat Maksudov [view email] [v1] Mon, 11 May 2026 20:34:20 UTC (689 KB)

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Key points and analysis

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Key points

  • ABRA requires agents to directly operate radiology tools, not just process pre-selected images.
  • It contains 655 programmatically generated tasks covering viewer control, metadata QA, annotation, and more.
  • Models achieve 89% execution on real annotation but only 0-25% outcome; oracle variants show 69-100% outcome, indicating a perception bottleneck.

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