In addition, we provide a new dataset for evaluating metrics.

X-ray image-based medical report generation (MRG) is a pivotal area in artificial intelligence that can significantly reduce diagnostic burdens for clinicians and patient wait times. Existing MRG models predominantly rely on Large Language Models (LLMs) to improve report generation, with limited exploration of pre-trained vision foundation models or advanced fine-tuning techniques. Mainstream frameworks either avoid fine-tuning or utilize simplistic methods like LoRA, often neglecting the potential of enhancing cross-attention mechanisms. Additionally, while Transformer-based models dominate vision-language tasks, non-Transformer architectures, such as the Mamba network, remain underex-plored for medical report generation, presenting a promising avenue for future research. In this paper, we propose EMRRG, a novel X-ray report generation framework that fine-tunes pre-trained Mamba networks using parameter-efficient methods. Specifically, X-ray images are divided into patches, tokenized, and processed by an SSM-based vision backbone for feature extraction, with Partial LoRA yielding optimal performance. An LLM with a hybrid decoder generates the medical report, enabling end-to-end training and achieving strong results on benchmark datasets. Extensive experiments on three widely used benchmark datasets fully validated the effectiveness of our proposed strategies for the X-ray MRG.

In addition, we provide a new dataset for evaluating metrics.

The increasing prevalence of retinal diseases poses a significant challenge to the healthcare system, as the demand for ophthalmologists surpasses the available workforce. This imbalance creates a bottleneck in diagnosis and treatment, potentially delaying critical care. Traditional methods of generating medical reports from retinal images rely on manual interpretation, which is time-consuming and prone to errors, further straining ophthalmologists' limited resources. This thesis investigates the potential of Artificial Intelligence (AI) to automate medical report generation for retinal images. AI can quickly analyze large volumes of image data, identifying subtle patterns essential for accurate diagnosis. By automating this process, AI systems can greatly enhance the efficiency of retinal disease diagnosis, reducing doctors' workloads and enabling them to focus on more complex cases. The proposed AI-based methods address key challenges in automated report generation: (1) A multi-modal deep learning approach captures interactions between textual keywords and retinal images, resulting in more comprehensive medical reports; (2) Improved methods for medical keyword representation enhance the system's ability to capture nuances in medical terminology; (3) Strategies to overcome RNN-based models' limitations, particularly in capturing long-range dependencies within medical descriptions; (4) Techniques to enhance the interpretability of the AI-based report generation system, fostering trust and acceptance in clinical practice. These methods are rigorously evaluated using various metrics and achieve state-of-the-art performance. This thesis demonstrates AI's potential to revolutionize retinal disease diagnosis by automating medical report generation, ultimately improving clinical efficiency, diagnostic accuracy, and patient care.

X-ray medical report generation is one of the important applications of artificial intelligence in healthcare. With the support of large foundation models, the quality of medical report generation has significantly improved. However, challenges such as hallucination and weak disease diagnostic capability still persist. In this paper, we first construct a large-scale multi-modal medical knowledge graph (termed M3KG) based on the ground truth medical report using the GPT-4o. It contains 2477 entities, 3 kinds of relations, 37424 triples, and 6943 disease-aware vision tokens for the CheXpert Plus dataset. Then, we sample it to obtain multi-granularity semantic graphs and use an R-GCN encoder for feature extraction. For the input X-ray image, we adopt the Swin-Transformer to extract the vision features and interact with the knowledge using cross-attention. The vision tokens are fed into a Q-former and retrieved the disease-aware vision tokens using another cross-attention. Finally, we adopt the large language model to map the semantic knowledge graph, input X-ray image, and disease-aware vision tokens into language descriptions. Extensive experiments on multiple datasets fully validated the effectiveness of our proposed knowledge graph and X-ray report generation framework. The source code of this paper will be released on https://github.com/Event-AHU/Medical_Image_Analysis.

LLMs have demonstrated significant potential in Medical Report Generation (MRG), yet their development requires large amounts of medical image-report pairs, which are commonly scattered across multiple centers. Centralizing these data is exceptionally challenging due to privacy regulations, thereby impeding model development and broader adoption of LLM-driven MRG models. To address this challenge, we present FedMRG, the first framework that leverages Federated Learning (FL) to enable privacy-preserving, multi-center development of LLM-driven MRG models, specifically designed to overcome the critical challenge of communication-efficient LLM training under multi-modal data heterogeneity. To start with, our framework tackles the fundamental challenge of communication overhead in FL-LLM tuning by employing low-rank factorization to efficiently decompose parameter updates, significantly reducing gradient transmission costs and making LLM-driven MRG feasible in bandwidth-constrained FL settings. Furthermore, we observed the dual heterogeneity in MRG under the FL scenario: varying image characteristics across medical centers, as well as diverse reporting styles and terminology preferences. To address this, we further enhance FedMRG with (1) client-aware contrastive learning in the MRG encoder, coupled with diagnosis-driven prompts, which capture both globally generalizable and locally distinctive features while maintaining diagnostic accuracy; and (2) a dual-adapter mutual boosting mechanism in the MRG decoder that harmonizes generic and specialized adapters to address variations in reporting styles and terminology. Through extensive evaluation of our established FL-MRG benchmark, we demonstrate the generalizability and adaptability of FedMRG, underscoring its potential in harnessing multi-center data and generating clinically accurate reports while maintaining communication efficiency.

Automated radiology report generation holds significant potential to reduce radiologists' workload and enhance diagnostic accuracy. However, generating precise and clinically meaningful reports from chest radiographs remains challenging due to the complexity of medical language and the need for contextual understanding. Existing models often struggle with maintaining both accuracy and contextual relevance. In this paper, we present LLaMA-XR, a novel framework that integrates LLaMA 3.1 with DenseNet-121-based image embeddings and Quantized Low-Rank Adaptation (QLoRA) fine-tuning. LLaMA-XR achieves improved coherence and clinical accuracy while maintaining computational efficiency. This efficiency is driven by an optimization strategy that enhances parameter utilization and reduces memory overhead, enabling faster report generation with lower computational resource demands. Extensive experiments conducted on the IU X-ray benchmark dataset demonstrate that LLaMA-XR outperforms a range of state-of-the-art methods. Our model achieves a ROUGE-L score of 0.433 and a METEOR score of 0.336, establishing new performance benchmarks in the domain. These results underscore LLaMA-XR's potential as an effective and efficient AI system for automated radiology reporting, offering enhanced clinical utility and reliability.

Medical Large Vision-Language Models (Med-LVLMs) have been widely adopted for medical report generation. Despite Med-LVLMs producing state-of-the-art performance, they exhibit a bias toward predicting all findings as normal, leading to reports that overlook critical abnormalities. Furthermore, these models often fail to provide comprehensive descriptions of radiologically relevant regions necessary for accurate diagnosis. To address these challenges, we proposeMedical Report Generation Agents (MRGAgents), a novel multi-agent framework that fine-tunes specialized agents for different disease categories. By curating subsets of the IU X-ray and MIMIC-CXR datasets to train disease-specific agents, MRGAgents generates reports that more effectively balance normal and abnormal findings while ensuring a comprehensive description of clinically relevant regions. Our experiments demonstrate that MRGAgents outperformed the state-of-the-art, improving both report comprehensiveness and diagnostic utility.