MedPrune: Topology-Efficient Multimodal Multi-Agent Communication Evolution for Medical VQA Tasks

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While medical multimodal large language models (Med-MLLMs) advance medical visual question answering (VQA), existing clinical workflow-inspired multi-agent frameworks suffer from interaction patterns and excessive computational overhead caused by redundant communication topologies. In this paper, we propose MedPrune, an efficient medical multimodal multi-agent collaboration framework that dynamically prunes both nodes and edges from the communication topology to enhance reasoning ability and token efficiency. Specifically, we first formulate the diagnostic process as a heterogeneous communication graph, where nodes represent specialist agents from various departments and edges capture intra- and inter-departmental interactions. Building on this graph, we introduce two sparsification mechanisms to enable adaptive collaborative evolution: (1) Heterogeneous Node Sparsification, which eliminates task-irrelevant specialist agents irrelevant to the current multimodal question via reinforcement learning-driven topological optimization, and (2) Heterogeneous Edge Sparsification, which selectively retains only the most diagnostically salient intra- and inter-departmental connections by jointly optimizing task performance and topological complexity. Extensive medical VQA experiments under full-set and few-shot training settings prove MedPrune surpasses multi-agent baselines and boosts token efficiency with strong adversarial robustness.