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Main Authors: Wu, Ning, Liu, Rui, Lin, Xinkun, Chen, Weixing, Xiang, Jinxi, Wei, Tao, Yao, Lina, Li, Mingjie
Format: Preprint
Published: 2026
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Online Access:https://arxiv.org/abs/2605.27194
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author Wu, Ning
Liu, Rui
Lin, Xinkun
Chen, Weixing
Xiang, Jinxi
Wei, Tao
Yao, Lina
Li, Mingjie
author_facet Wu, Ning
Liu, Rui
Lin, Xinkun
Chen, Weixing
Xiang, Jinxi
Wei, Tao
Yao, Lina
Li, Mingjie
contents Distilling demonstration effects into hidden-space interventions offers a lightweight alternative to full finetuning. However, existing multimodal variants are mostly evaluated on short-form tasks, where outputs end after a few tokens. Extending these methods to long-form generation exposes a fundamental yet underexamined limitation: token-level distillation implicitly treats all output tokens as equally informative, but long-form outputs are dominated by high-frequency template and grammatical tokens, while the tokens that actually determine output quality are sparsely distributed. In medical report generation (MRG), two such decisive tokens stand out: pathology-related tokens that determine diagnostic content, and the end-of-sequence (EOS) event that determines termination. Both receive insufficient supervision under uniform cross-entropy, and autoregressive decoding further compounds the problem by drifting away from teacher-forced trajectories. We propose DIVE, a frozen-backbone distillation framework that addresses long-form report generation through two complementary mechanisms matched to these failures. Decisive-token supervision restores supervision balance by upweighting the cross-entropy contribution of pathology-related tokens and the EOS event, ensuring that content fidelity and termination are learned during training rather than imposed at decoding time. State-conditioned dynamic steering replaces fixed open-loop residuals with hidden-state-dependent adapters, allowing the injected signal to adapt as decoding drifts. Experiments on MIMIC-CXR and CheXpert Plus with two medical VLM backbones show that DIVE consistently ranks among the strongest methods across lexical and clinical-proxy metrics. Our method achieves the best BLEU-4, ROUGE-L, and RadGraph F1 in all dataset--backbone settings, while remaining competitive on coarse label-level CheXbert F1.
format Preprint
id arxiv_https___arxiv_org_abs_2605_27194
institution arXiv
publishDate 2026
record_format arxiv
spellingShingle Not All Tokens Matter Equally: Dynamic In-context Vector Distillation with Decisive-Token Supervision for Long-form Medical Report Generation
Wu, Ning
Liu, Rui
Lin, Xinkun
Chen, Weixing
Xiang, Jinxi
Wei, Tao
Yao, Lina
Li, Mingjie
Computation and Language
Computer Vision and Pattern Recognition
Machine Learning
Distilling demonstration effects into hidden-space interventions offers a lightweight alternative to full finetuning. However, existing multimodal variants are mostly evaluated on short-form tasks, where outputs end after a few tokens. Extending these methods to long-form generation exposes a fundamental yet underexamined limitation: token-level distillation implicitly treats all output tokens as equally informative, but long-form outputs are dominated by high-frequency template and grammatical tokens, while the tokens that actually determine output quality are sparsely distributed. In medical report generation (MRG), two such decisive tokens stand out: pathology-related tokens that determine diagnostic content, and the end-of-sequence (EOS) event that determines termination. Both receive insufficient supervision under uniform cross-entropy, and autoregressive decoding further compounds the problem by drifting away from teacher-forced trajectories. We propose DIVE, a frozen-backbone distillation framework that addresses long-form report generation through two complementary mechanisms matched to these failures. Decisive-token supervision restores supervision balance by upweighting the cross-entropy contribution of pathology-related tokens and the EOS event, ensuring that content fidelity and termination are learned during training rather than imposed at decoding time. State-conditioned dynamic steering replaces fixed open-loop residuals with hidden-state-dependent adapters, allowing the injected signal to adapt as decoding drifts. Experiments on MIMIC-CXR and CheXpert Plus with two medical VLM backbones show that DIVE consistently ranks among the strongest methods across lexical and clinical-proxy metrics. Our method achieves the best BLEU-4, ROUGE-L, and RadGraph F1 in all dataset--backbone settings, while remaining competitive on coarse label-level CheXbert F1.
title Not All Tokens Matter Equally: Dynamic In-context Vector Distillation with Decisive-Token Supervision for Long-form Medical Report Generation
topic Computation and Language
Computer Vision and Pattern Recognition
Machine Learning
url https://arxiv.org/abs/2605.27194