提升医学报告生成可靠性,系统性降低三类不确定性。
SURE-Med: Systematic Uncertainty Reduction for Enhanced Reliability in Medical Report Generation
- 设计统一框架,分别处理视图、标签分布和上下文三类不确定性。
- 在MIMIC-CXR和IU-Xray上达到当前最佳性能,显著减少幻觉。
- 适合关注医疗AI可信度与临床落地的研究者与开发者。
自动化医学报告生成(MRG)有望减轻放射科医生的繁重工作量,但其临床部署受限于三大不确定因素:视觉不确定性(由噪声或错误的体位标注引发,影响特征提取)、标签分布不确定性(长尾疾病分布导致模型忽视罕见但关键病症),以及上下文不确定性(历史报告未经验证,易引发事实性幻觉)。为应对这些挑战,本文提出SURE-Med统一框架,系统性地从视觉、分布和上下文三个维度降低不确定性。针对视觉不确定性,引入前端感知视图修复重采样模块,修正体位标注错误并自适应选择补充视图中的有效特征;针对标签分布不确定性,提出令牌敏感学习目标,增强对关键诊断句建模,并重新加权低频诊断术语,提升对罕见病的敏感性;针对上下文不确定性,设计上下文证据过滤器,仅采纳与当前图像一致的历史信息,有效抑制幻觉。在MIMIC-CXR和IU-Xray基准上的大量实验表明,SURE-Med表现优于现有方法,通过多模态输入不确定性协同降低,树立了医学报告生成可靠性的新标杆,为可信临床决策支持迈出坚实一步。
原文摘要 · Abstract (English)
Automated medical report generation (MRG) holds great promise for reducing the heavy workload of radiologists. However, its clinical deployment is hindered by three major sources of uncertainty. First, visual uncertainty, caused by noisy or incorrect view annotations, compromises feature extraction. Second, label distribution uncertainty, stemming from long-tailed disease prevalence, biases models against rare but clinically critical conditions. Third, contextual uncertainty, introduced by unverified historical reports, often leads to factual hallucinations. These challenges collectively limit the reliability and clinical trustworthiness of MRG systems. To address these issues, we propose SURE-Med, a unified framework that systematically reduces uncertainty across three critical dimensions: visual, distributional, and contextual. To mitigate visual uncertainty, a Frontal-Aware View Repair Resampling module corrects view annotation errors and adaptively selects informative features from supplementary views. To tackle label distribution uncertainty, we introduce a Token Sensitive Learning objective that enhances the modeling of critical diagnostic sentences while reweighting underrepresented diagnostic terms, thereby improving sensitivity to infrequent conditions. To reduce contextual uncertainty, our Contextual Evidence Filter validates and selectively incorporates prior information that aligns with the current image, effectively suppressing hallucinations. Extensive experiments on the MIMIC-CXR and IU-Xray benchmarks demonstrate that SURE-Med achieves state-of-the-art performance. By holistically reducing uncertainty across multiple input modalities, SURE-Med sets a new benchmark for reliability in medical report generation and offers a robust step toward trustworthy clinical decision support.
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