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| Main Authors: | , , , , |
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| Format: | Preprint |
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2026
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| Subjects: | |
| Online Access: | https://arxiv.org/abs/2604.10437 |
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| _version_ | 1866914466379071488 |
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| author | Wang, Chenyu Dai, Weicheng Liu, Han Li, Wenchao Batmanghelich, Kayhan |
| author_facet | Wang, Chenyu Dai, Weicheng Liu, Han Li, Wenchao Batmanghelich, Kayhan |
| contents | Vision--language models (VLMs) for radiology report generation (RRG) can produce long-form chest CT reports from volumetric scans and show strong potential to improve radiology workflow efficiency and consistency. However, existing methods face two key limitations: (i) training supervision is often coarse, aligning a whole CT volume with a full free-text report without explicit alignment for fine-grained attributes or pathology locations; and (ii) evaluation is typically holistic (lexical overlap, entity matching, or LLM-as-a-judge scores) and not diagnostic for spatial grounding. We propose \emph{Discriminative Cue-Prompting with Prompt Dropout (DCP-PD)}, a plug-and-play framework that distills fine-grained cues from free-text reports and uses them to guide report generation while mitigating shortcut reliance via prompt dropout. DCP-PD achieves state-of-the-art performance on CT-RATE, improving macro F1 from $=0.501$ to $0.603$ (20% relative), and substantially boosts out-of-distribution performance on Rad-ChestCT from F1 $=0.266$ to $0.503$ (89% relative). Finally, we introduce a hierarchical, location-aware question-set protocol (presence $\rightarrow$ laterality $\rightarrow$ lobe) to directly assess pathology-location grounding, showing that fine-grained spatial localization remains challenging even for models that score highly on current benchmarks. |
| format | Preprint |
| id |
arxiv_https___arxiv_org_abs_2604_10437 |
| institution | arXiv |
| publishDate | 2026 |
| record_format | arxiv |
| spellingShingle | Enhancing Fine-Grained Spatial Grounding in 3D CT Report Generation via Discriminative Guidance Wang, Chenyu Dai, Weicheng Liu, Han Li, Wenchao Batmanghelich, Kayhan Computer Vision and Pattern Recognition Vision--language models (VLMs) for radiology report generation (RRG) can produce long-form chest CT reports from volumetric scans and show strong potential to improve radiology workflow efficiency and consistency. However, existing methods face two key limitations: (i) training supervision is often coarse, aligning a whole CT volume with a full free-text report without explicit alignment for fine-grained attributes or pathology locations; and (ii) evaluation is typically holistic (lexical overlap, entity matching, or LLM-as-a-judge scores) and not diagnostic for spatial grounding. We propose \emph{Discriminative Cue-Prompting with Prompt Dropout (DCP-PD)}, a plug-and-play framework that distills fine-grained cues from free-text reports and uses them to guide report generation while mitigating shortcut reliance via prompt dropout. DCP-PD achieves state-of-the-art performance on CT-RATE, improving macro F1 from $=0.501$ to $0.603$ (20% relative), and substantially boosts out-of-distribution performance on Rad-ChestCT from F1 $=0.266$ to $0.503$ (89% relative). Finally, we introduce a hierarchical, location-aware question-set protocol (presence $\rightarrow$ laterality $\rightarrow$ lobe) to directly assess pathology-location grounding, showing that fine-grained spatial localization remains challenging even for models that score highly on current benchmarks. |
| title | Enhancing Fine-Grained Spatial Grounding in 3D CT Report Generation via Discriminative Guidance |
| topic | Computer Vision and Pattern Recognition |
| url | https://arxiv.org/abs/2604.10437 |