arXiv:2504.18453cs.AIcs.CL2025-04被引 1

让AI像放射科医生一样推理,生成可验证的报告。

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

  • 用思维链和强化学习训练模型,让报告连接影像发现与解剖位置。
  • 在公开数据集上,报告质量比顶尖方法提升7%(METEOR/ROUGE-L)。
  • 适合需要可解释性与临床可信度的医学AI应用,如辅助诊断。

放射科报告生成对效率至关重要,但现有模型缺乏专家式的结构化推理,难以建立临床信任与可解释性,因无法将视觉发现与精确解剖位置关联。本文提出BoxMed-RL,一种开创性的统一训练框架,用于生成空间可验证且可解释的放射科报告。基于大型视觉语言模型,该框架通过两个集成阶段实现:(1) 预训练阶段,首先通过思维链监督优化模型,使其内化放射科医生的工作流程;随后采用空间可验证的强化学习,使医疗发现与边界框对齐;(2) 下游适配阶段,冻结预训练权重,仅训练下游适配器以确保报告流畅且临床可信。该框架精准模拟放射科医生工作流程,强制模型将高层医学概念与明确解剖证据关联。在公开数据集上的大量实验表明,BoxMed-RL在METEOR与ROUGE-L指标上平均提升7%,在大语言模型评估指标上平均提升5%,进一步证明其生成高质量放射科报告的鲁棒性。

原文摘要 · Abstract (English)

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.

医学AI可解释性强化学习报告生成

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