Radiology Report Generation (RRG) is an important research topic for relieving radiologist' heavy workload. Existing RRG models mainly rely on supervised fine-tuning (SFT) based on different model architectures using data pairs of radiological images and corresponding radiologist-annotated reports. Recent research has shifted focus to post-training improvements, aligning RRG model outputs with human preferences using reinforcement learning (RL). However, the limited data coverage of high-quality annotated data poses risks of overfitting and generalization. This paper proposes a novel Online Iterative Self-Alignment (OISA) method for RRG that consists of four stages: self-generation of diverse data, self-evaluation for multi-objective preference data,self-alignment for multi-objective optimization and self-iteration for further improvement. Our approach allows for generating varied reports tailored to specific clinical objectives, enhancing the overall performance of the RRG model iteratively. Unlike existing methods, our frame-work significantly increases data quality and optimizes performance through iterative multi-objective optimization. Experimental results demonstrate that our method surpasses previous approaches, achieving state-of-the-art performance across multiple evaluation metrics.

The current gold standard for evaluating generated chest x-ray (CXR) reports is through radiologist annotations. However, this process can be extremely time-consuming and costly, especially when evaluating large numbers of reports. In this work, we present FineRad-Score, a Large Language Model (LLM)-based automated evaluation metric for generated CXR reports. Given a candidate report and a ground-truth report, FineRadScore gives the minimum number of line-by-line corrections required to go from the candidate to the ground-truth report. Additionally, FineRadScore provides an error severity rating with each correction and generates comments explaining why the correction was needed. We demonstrate that FineRadScore's corrections and error severity scores align with radiologist opinions. We also show that, when used to judge the quality of the report as a whole, FineRadScore aligns with radiologists as well as current state-of-the-art automated CXR evaluation metrics. Finally, we analyze FineRadScore's shortcomings to provide suggestions for future improvements. Code to run FineRadScore can be found here.

We propose a new automated evaluation metric for machine-generated radiology reports using the successful COMET architecture adapted for the radiology domain. We train and publish four medically-oriented model checkpoints, including one trained on RadGraph, a radiology knowledge graph. Our results show that our metric correlates moderately to high with established metrics such as BERTscore, BLEU, and CheXbert scores. Furthermore, we demonstrate that one of our checkpoints exhibits a high correlation with human judgment, as assessed using the publicly available annotations of six board-certified radiologists, using a set of 200 reports. We also performed our own analysis gathering annotations with two radiologists on a collection of 100 reports. The results indicate the potential effectiveness of our method as a radiology-specific evaluation metric. The code, data, and model checkpoints to reproduce our findings will be publicly available.

We present a radiology-specific multimodal model for the task for generating radiological reports from chest X-rays (CXRs). Our work builds on the idea that large language model(s) can be equipped with multimodal capabilities through alignment with pre-trained vision encoders. On natural images, this has been shown to allow multimodal models to gain image understanding and description capabilities. Our proposed model (MAIRA-1) leverages a CXR-specific image encoder in conjunction with a fine-tuned large language model based on Vicuna-7B, and text-based data augmentation, to produce reports with state-of-the-art quality. In particular, MAIRA-1 significantly improves on the radiologist-aligned RadCliQ metric and across all lexical metrics considered. Manual review of model outputs demonstrates promising fluency and accuracy of generated reports while uncovering failure modes not captured by existing evaluation practices. More information and resources can be found on the project website: https://aka.ms/maira.