arXiv:2507.06992cs.CVcs.AI2025-07被引 9

用医学概念对齐提升大模型生成放射科报告的准确性

MCA-RG: Enhancing LLMs with Medical Concept Alignment for Radiology Report Generation

  • 构建病理与解剖概念库,对齐视觉特征与医学概念
  • 在MIMIC-CXR和CheXpert Plus上超越现有方法
  • 适合医疗AI研发及临床辅助报告系统开发者

尽管大型语言模型在放射科报告生成(RRG)方面取得显著进展,但临床应用仍面临挑战,主要源于难以准确将病灶和解剖特征映射到对应的文本描述。此外,语义无关的特征提取也阻碍了诊断报告的生成。为此,我们提出医学概念对齐的放射科报告生成框架(MCA-RG),通过显式对齐视觉特征与医学概念来增强报告生成过程。MCA-RG使用两个精心构建的概念库:包含病灶知识的病理概念库和包含解剖描述的解剖概念库。视觉特征被对齐至这些医学概念并进行针对性增强。我们进一步提出基于解剖的对比学习方法以提升解剖特征泛化能力,并采用匹配损失强化病灶特征,优先关注临床相关区域。同时引入特征门控机制过滤低质量概念特征。最终,视觉特征与具体医学概念对应,并用于指导报告生成。在两个公开基准数据集MIMIC-CXR和CheXpert Plus上的实验表明,MCA-RG表现优异,验证了其在放射科报告生成中的有效性。

原文摘要 · Abstract (English)

Despite significant advancements in adapting Large Language Models (LLMs) for radiology report generation (RRG), clinical adoption remains challenging due to difficulties in accurately mapping pathological and anatomical features to their corresponding text descriptions. Additionally, semantic agnostic feature extraction further hampers the generation of accurate diagnostic reports. To address these challenges, we introduce Medical Concept Aligned Radiology Report Generation (MCA-RG), a knowledge-driven framework that explicitly aligns visual features with distinct medical concepts to enhance the report generation process. MCA-RG utilizes two curated concept banks: a pathology bank containing lesion-related knowledge, and an anatomy bank with anatomical descriptions. The visual features are aligned with these medical concepts and undergo tailored enhancement. We further propose an anatomy-based contrastive learning procedure to improve the generalization of anatomical features, coupled with a matching loss for pathological features to prioritize clinically relevant regions. Additionally, a feature gating mechanism is employed to filter out low-quality concept features. Finally, the visual features are corresponding to individual medical concepts, and are leveraged to guide the report generation process. Experiments on two public benchmarks (MIMIC-CXR and CheXpert Plus) demonstrate that MCA-RG achieves superior performance, highlighting its effectiveness in radiology report generation.

放射科报告大模型医学对齐概念增强

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