Yunyi Liu

Yunyi Liu, Zhanyu Wang, Dong Xu et al.

Medical Visual Question Answering (VQA) systems play a supporting role to understand clinic-relevant information carried by medical images. The questions to a medical image include two categories: close-end (such as Yes/No question) and open-end. To obtain answers, the majority of the existing medical VQA methods relies on classification approaches, while a few works attempt to use generation approaches or a mixture of the two. The classification approaches are relatively simple but perform poorly on long open-end questions. To bridge this gap, in this paper, we propose a new Transformer based framework for medical VQA (named as Q2ATransformer), which integrates the advantages of both the classification and the generation approaches and provides a unified treatment for the close-end and open-end questions. Specifically, we introduce an additional Transformer decoder with a set of learnable candidate answer embeddings to query the existence of each answer class to a given image-question pair. Through the Transformer attention, the candidate answer embeddings interact with the fused features of the image-question pair to make the decision. In this way, despite being a classification-based approach, our method provides a mechanism to interact with the answer information for prediction like the generation-based approaches. On the other hand, by classification, we mitigate the task difficulty by reducing the search space of answers. Our method achieves new state-of-the-art performance on two medical VQA benchmarks. Especially, for the open-end questions, we achieve 79.19% on VQA-RAD and 54.85% on PathVQA, with 16.09% and 41.45% absolute improvements, respectively.

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.

Yingshu Li, Zhanyu Wang, Yunyi Liu et al.

Harnessing the robust capabilities of Large Language Models (LLMs) for narrative generation, logical reasoning, and common-sense knowledge integration, this study delves into utilizing LLMs to enhance automated radiology report generation (R2Gen). Despite the wealth of knowledge within LLMs, efficiently triggering relevant knowledge within these large models for specific tasks like R2Gen poses a critical research challenge. This paper presents KARGEN, a Knowledge-enhanced Automated radiology Report GENeration framework based on LLMs. Utilizing a frozen LLM to generate reports, the framework integrates a knowledge graph to unlock chest disease-related knowledge within the LLM to enhance the clinical utility of generated reports. This is achieved by leveraging the knowledge graph to distill disease-related features in a designed way. Since a radiology report encompasses both normal and disease-related findings, the extracted graph-enhanced disease-related features are integrated with regional image features, attending to both aspects. We explore two fusion methods to automatically prioritize and select the most relevant features. The fused features are employed by LLM to generate reports that are more sensitive to diseases and of improved quality. Our approach demonstrates promising results on the MIMIC-CXR and IU-Xray datasets.

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.

Jiawei Zhang, Jun Li, Reachsak Ly et al.

For structural health monitoring, continuous and automatic crack detection has been a challenging problem. This study is conducted to propose a framework of automatic crack segmentation from high-resolution images containing crack information about steel box girders of bridges. Considering the multi-scale feature of cracks, convolutional neural network architecture of Feature Pyramid Networks (FPN) for crack detection is proposed. As for input, 120 raw images are processed via two approaches (shrinking the size of images and splitting images into sub-images). Then, models with the proposed structure of FPN for crack detection are developed. The result shows all developed models can automatically detect the cracks at the raw images. By shrinking the images, the computation efficiency is improved without decreasing accuracy. Because of the separable characteristic of crack, models using the splitting method provide more accurate crack segmentations than models using the resizing method. Therefore, for high-resolution images, the FPN structure coupled with the splitting method is an promising solution for the crack segmentation and detection.

Erjian Guo, Zhen Zhao, Zicheng Wang et al.

Medical Visual Question Answering (Med-VQA) systems benefit the interpretation of medical images containing critical clinical information. However, the challenge of noisy labels and limited high-quality datasets remains underexplored. To address this, we establish the first benchmark for noisy labels in Med-VQA by simulating human mislabeling with semantically designed noise types. More importantly, we introduce the DiN framework, which leverages a diffusion model to handle noisy labels in Med-VQA. Unlike the dominant classification-based VQA approaches that directly predict answers, our Answer Diffuser (AD) module employs a coarse-to-fine process, refining answer candidates with a diffusion model for improved accuracy. The Answer Condition Generator (ACG) further enhances this process by generating task-specific conditional information via integrating answer embeddings with fused image-question features. To address label noise, our Noisy Label Refinement(NLR) module introduces a robust loss function and dynamic answer adjustment to further boost the performance of the AD module.

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.

Shaoyang Zhou, Yingshu Li, Yunyi Liu et al.

Chest Xray imaging is a widely used diagnostic tool in modern medicine, and its high utilization creates substantial workloads for radiologists. To alleviate this burden, vision language models are increasingly applied to automate Chest Xray radiology report generation (CXRRRG), aiming for clinically accurate descriptions while reducing manual effort. Conventional approaches, however, typically rely on single images, failing to capture the longitudinal context necessary for producing clinically faithful comparison statements. Recently, growing attention has been directed toward incorporating longitudinal data into CXR RRG, enabling models to leverage historical studies in ways that mirror radiologists diagnostic workflows. Nevertheless, existing surveys primarily address single image CXRRRG and offer limited guidance for longitudinal settings, leaving researchers without a systematic framework for model design. To address this gap, this survey provides the first comprehensive review of longitudinal radiology report generation (LRRG). Specifically, we examine dataset construction strategies, report generation architectures alongside longitudinally tailored designs, and evaluation protocols encompassing both longitudinal specific measures and widely used benchmarks. We further summarize LRRG methods performance, alongside analyses of different ablation studies, which collectively highlight the critical role of longitudinal information and architectural design choices in improving model performance. Finally, we summarize five major limitations of current research and outline promising directions for future development, aiming to lay a foundation for advancing this emerging field.

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.