Reason Like a Radiologist: Chain-of-Thought and Reinforcement Learning for Verifiable Report Generation

Fuente: arXiv
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Autori principali: Jing, Peiyuan, Lee, Kinhei, Zhang, Zhenxuan, Zhou, Huichi, Yuan, Zhengqing, Gao, Zhifan, Zhu, Lei, Papanastasiou, Giorgos, Fang, Yingying, Yang, Guang
Natura: Preprint
Pubblicazione: 2025
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author Jing, Peiyuan
Lee, Kinhei
Zhang, Zhenxuan
Zhou, Huichi
Yuan, Zhengqing
Gao, Zhifan
Zhu, Lei
Papanastasiou, Giorgos
Fang, Yingying
Yang, Guang
author_facet Jing, Peiyuan
Lee, Kinhei
Zhang, Zhenxuan
Zhou, Huichi
Yuan, Zhengqing
Gao, Zhifan
Zhu, Lei
Papanastasiou, Giorgos
Fang, Yingying
Yang, Guang
contents Radiology report generation is critical for efficiency but current models lack the structured reasoning of experts, hindering clinical trust and explainability by failing to link visual findings to precise anatomical locations. This paper introduces BoxMed-RL, a groundbreaking unified training framework for generating spatially verifiable and explainable radiology reports. Built on a large vision-language model, BoxMed-RL revolutionizes report generation through two integrated phases: (1) In the Pretraining Phase, we refine the model via medical concept learning, using Chain-of-Thought supervision to internalize the radiologist-like workflow, followed by spatially verifiable reinforcement, which applies reinforcement learning to align medical findings with bounding boxes. (2) In the Downstream Adapter Phase, we freeze the pretrained weights and train a downstream adapter to ensure fluent and clinically credible reports. This framework precisely mimics radiologists' workflow, compelling the model to connect high-level medical concepts with definitive anatomical evidence. Extensive experiments on public datasets demonstrate that BoxMed-RL achieves an average 7% improvement in both METEOR and ROUGE-L metrics compared to state-of-the-art methods. An average 5% improvement in large language model-based metrics further underscores BoxMed-RL's robustness in generating high-quality radiology reports.
format Preprint
id arxiv_https___arxiv_org_abs_2504_18453
institution arXiv
publishDate 2025
record_format arxiv
spellingShingle Reason Like a Radiologist: Chain-of-Thought and Reinforcement Learning for Verifiable Report Generation
Jing, Peiyuan
Lee, Kinhei
Zhang, Zhenxuan
Zhou, Huichi
Yuan, Zhengqing
Gao, Zhifan
Zhu, Lei
Papanastasiou, Giorgos
Fang, Yingying
Yang, Guang
Artificial Intelligence
Computation and Language
Radiology report generation is critical for efficiency but current models lack the structured reasoning of experts, hindering clinical trust and explainability by failing to link visual findings to precise anatomical locations. This paper introduces BoxMed-RL, a groundbreaking unified training framework for generating spatially verifiable and explainable radiology reports. Built on a large vision-language model, BoxMed-RL revolutionizes report generation through two integrated phases: (1) In the Pretraining Phase, we refine the model via medical concept learning, using Chain-of-Thought supervision to internalize the radiologist-like workflow, followed by spatially verifiable reinforcement, which applies reinforcement learning to align medical findings with bounding boxes. (2) In the Downstream Adapter Phase, we freeze the pretrained weights and train a downstream adapter to ensure fluent and clinically credible reports. This framework precisely mimics radiologists' workflow, compelling the model to connect high-level medical concepts with definitive anatomical evidence. Extensive experiments on public datasets demonstrate that BoxMed-RL achieves an average 7% improvement in both METEOR and ROUGE-L metrics compared to state-of-the-art methods. An average 5% improvement in large language model-based metrics further underscores BoxMed-RL's robustness in generating high-quality radiology reports.
title Reason Like a Radiologist: Chain-of-Thought and Reinforcement Learning for Verifiable Report Generation
topic Artificial Intelligence
Computation and Language
url https://arxiv.org/abs/2504.18453