MRI2Rep: Autoregressive Structured Report Generation for 3D Liver MRI
First end-to-end system for LI-RADS-structured report generation from 3D liver MRI, addressing the underexplored task of automated structured reporting for volumetric medical imaging.
MRI2Rep generates structured reports for 3D liver MRI using an autoregressive framework, achieving 76.0% case-level sensitivity and 29.4% lesion-level F1, outperforming adapted baselines (≤8.3% F1). In a reader study, 70-75% of AI reports were clinically acceptable.
Manual reporting of 3D MRI studies is time-consuming, yet end-to-end structured report generation for 3D liver MRI remains underexplored due to volumetric complexity and scarce paired data. We propose MRI2Rep, an autoregressive framework for liver MRI report generation. From 3,929 real-world MRI-report pairs acquired over a 10-year single-institution cohort, a Report-to-Label Canonicalization (RLC) module converts free-text reports into structured, closed-vocabulary diagnostic sequences without lesion-level annotations. On a held-out test set, MRI2Rep achieves 76.0% case-level sensitivity, 29.4% lesion-level F1, compared with no more than 8.3% for adapted medical vision-language baselines, and 82.4% liver-level accuracy. In a blinded reader study, two radiologists rated 75% and 70% of AI-generated reports as clinically acceptable, compared with 95% and 100% for original reports. Our automated LLM-based judge, LLM-Eval, rated 61.8% of AI-generated reports as acceptable, applying a stricter standard and supporting its use as a conservative proxy. To our knowledge, this is the first end-to-end LI-RADS-structured reporting system for 3D liver MRI.