Yunyi Liu

Yingshu Li, Yunyi Liu, Zhanyu Wang et al.

This work conducts an evaluation of GPT-4V's multimodal capability for medical image analysis, with a focus on three representative tasks of radiology report generation, medical visual question answering, and medical visual grounding. For the evaluation, a set of prompts is designed for each task to induce the corresponding capability of GPT-4V to produce sufficiently good outputs. Three evaluation ways including quantitative analysis, human evaluation, and case study are employed to achieve an in-depth and extensive evaluation. Our evaluation shows that GPT-4V excels in understanding medical images and is able to generate high-quality radiology reports and effectively answer questions about medical images. Meanwhile, it is found that its performance for medical visual grounding needs to be substantially improved. In addition, we observe the discrepancy between the evaluation outcome from quantitative analysis and that from human evaluation. This discrepancy suggests the limitations of conventional metrics in assessing the performance of large language models like GPT-4V and the necessity of developing new metrics for automatic quantitative analysis.

Yunyi Liu, Zhanyu Wang, Yingshu Li et al.

In recent years, automated radiology report generation has experienced significant growth. This paper introduces MRScore, an automatic evaluation metric tailored for radiology report generation by leveraging Large Language Models (LLMs). Conventional NLG (natural language generation) metrics like BLEU are inadequate for accurately assessing the generated radiology reports, as systematically demonstrated by our observations within this paper. To address this challenge, we collaborated with radiologists to develop a framework that guides LLMs for radiology report evaluation, ensuring alignment with human analysis. Our framework includes two key components: i) utilizing GPT to generate large amounts of training data, i.e., reports with different qualities, and ii) pairing GPT-generated reports as accepted and rejected samples and training LLMs to produce MRScore as the model reward. Our experiments demonstrate MRScore's higher correlation with human judgments and superior performance in model selection compared to traditional metrics. Our code and datasets will be available on GitHub.

Yingshu Li, Yunyi Liu, Lingqiao Liu et al.

Evaluating automatically generated radiology reports remains a fundamental challenge due to the lack of clinically grounded, interpretable, and fine-grained metrics. Existing methods either produce coarse overall scores or rely on opaque black-box models, limiting their usefulness in real-world clinical workflows. We introduce RadReason, a novel evaluation framework for radiology reports that not only outputs fine-grained sub-scores across six clinically defined error types, but also produces human-readable justifications that explain the rationale behind each score. Our method builds on Group Relative Policy Optimization and incorporates two key innovations: (1) Sub-score Dynamic Weighting, which adaptively prioritizes clinically challenging error types based on live F1 statistics; and (2) Majority-Guided Advantage Scaling, which adjusts policy gradient updates based on prompt difficulty derived from sub-score agreement. Together, these components enable more stable optimization and better alignment with expert clinical judgment. Experiments on the ReXVal benchmark show that RadReason surpasses all prior offline metrics and achieves parity with GPT-4-based evaluations, while remaining explainable, cost-efficient, and suitable for clinical deployment. Code will be released upon publication.

Yingshu Li, Yunyi Liu, Zhanyu Wang et al.

Radiology report generation (RRG) for diagnostic images, such as chest X-rays, plays a pivotal role in both clinical practice and AI. Traditional free-text reports suffer from redundancy and inconsistent language, complicating the extraction of critical clinical details. Structured radiology report generation (S-RRG) offers a promising solution by organizing information into standardized, concise formats. However, existing approaches often rely on classification or visual question answering (VQA) pipelines that require predefined label sets and produce only fragmented outputs. Template-based approaches, which generate reports by replacing keywords within fixed sentence patterns, further compromise expressiveness and often omit clinically important details. In this work, we present a novel approach to S-RRG that includes dataset construction, model training, and the introduction of a new evaluation framework. We first create a robust chest X-ray dataset (MIMIC-STRUC) that includes disease names, severity levels, probabilities, and anatomical locations, ensuring that the dataset is both clinically relevant and well-structured. We train an LLM-based model to generate standardized, high-quality reports. To assess the generated reports, we propose a specialized evaluation metric (S-Score) that not only measures disease prediction accuracy but also evaluates the precision of disease-specific details, thus offering a clinically meaningful metric for report quality that focuses on elements critical to clinical decision-making and demonstrates a stronger alignment with human assessments. Our approach highlights the effectiveness of structured reports and the importance of a tailored evaluation metric for S-RRG, providing a more clinically relevant measure of report quality.

Yunyi Liu, Yingshu Li, Zhanyu Wang et al.

Automated radiology report generation (R2Gen) has advanced significantly, introducing challenges in accurate evaluation due to its complexity. Traditional metrics often fall short by relying on rigid word-matching or focusing only on pathological entities, leading to inconsistencies with human assessments. To bridge this gap, we introduce ReFINE, an automatic evaluation metric designed specifically for R2Gen. Our metric utilizes a reward model, guided by our margin-based reward enforcement loss, along with a tailored training data design that enables customization of evaluation criteria to suit user-defined needs. It not only scores reports according to user-specified criteria but also provides detailed sub-scores, enhancing interpretability and allowing users to adjust the criteria between different aspects of reports. Leveraging GPT-4, we designed an easy-to-use data generation pipeline, enabling us to produce extensive training data based on two distinct scoring systems, each containing reports of varying quality along with corresponding scores. These GPT-generated reports are then paired as accepted and rejected samples through our pairing rule to train an LLM towards our fine-grained reward model, which assigns higher rewards to the report with high quality. Our reward-control loss enables this model to simultaneously output multiple individual rewards corresponding to the number of evaluation criteria, with their summation as our final ReFINE. Our experiments demonstrate ReFINE's heightened correlation with human judgments and superior performance in model selection compared to traditional metrics. Notably, our model provides both an overall score and individual scores for each evaluation item, enhancing interpretability. We also demonstrate its flexible training across various evaluation systems.