# ARIVE

Automated chest X-ray reports often read fluently while leaving unclear which image evidence supports which finding. ARIVE interleaves anatomical inspection with diagnostic reasoning before composing the report, trained on 159,416 multimodal chain-of-thought trajectories built from MIMIC-CXR. On MIMIC-CXR and the abnormality-only MIMIC-ABN it scored highest overall on clinical-efficacy measures among the compared models, and in blinded grading of 100 cases its report quality was close to Qwen3.5 (mean 3.47 versus 3.51, against 3.88 for reference reports).

Automated chest X-ray reports often read fluently while leaving unclear which image evidence supports which finding. ARIVE interleaves anatomical inspection with diagnostic reasoning before composing the report, trained on 159,416 multimodal chain-of-thought trajectories built from MIMIC-CXR. On MIMIC-CXR and the abnormality-only MIMIC-ABN it scored highest overall on clinical-efficacy measures among the compared models, and in blinded grading of 100 cases its report quality was close to Qwen3.5 (mean 3.47 versus 3.51, against 3.88 for reference reports).