DRRG: A Discrete Diffusion Framework for Radiology Report Generation

2026-08-25

AI Summary

本文提出DRRG，一种基于离散扩散框架的放射报告生成方法，通过迭代去噪和临床实体感知掩码提高报告准确性和一致性。

Abstract

Purpose: Automatic radiology report generation (RRG) has been widely explored to improve reporting accuracy and reduce radiologists' workload. Most existing methods rely on autoregressive (AR) frameworks that generate reports token by token and cannot revise earlier content, making them prone to error propagation and inconsistent with the iterative refinement process of radiological reporting. In contrast, discrete diffusion large language models (DLLMs) generate text through iterative denoising, naturally enabling report refinement. However, DLLMs have not been extensively investigated for RRG. In this study, we developed and evaluated a discrete diffusion framework for RRG that enables iterative refinement rather than conventional left-to-right autoregressive decoding. Materials and methods: We developed DRRG, a DLLM-based framework that formulates RRG as iterative masked-token denoising. DRRG incorporates a clinical-entities-aware complementary mask to improve token supervision coverage and emphasize clinically important entities, together with a concept-conditioning module that injects image-derived clinical concepts into visual representations. DRRG was trained and evaluated on MIMIC-CXR and CheXpert Plus. Results: On MIMIC-CXR, DRRG achieved BLEU-4 of 0.210, CheXpert-F1 of 0.549, RadGraph-F1 of 0.281, GREEN of 0.360, and RaTEScore of 0.604, outperforming the compared methods on most reported metrics, despite employing a substantially smaller LLM decoder. On CheXpert Plus, DRRG achieved the highest BLEU-4 (0.119) and CheXpert-F1 (0.347) among the compared methods. Conclusion: Discrete diffusion provides an effective alternative to autoregressive radiology report generation by enabling iterative, bidirectional report refinement. Incorporating clinically focused masking and image-derived concept conditioning improves report quality and clinical consistency.

Problem

• Automatic Radiology Report Generation
• Autoregressive Frameworks
• Error Propagation
• Discrete Diffusion Large Language Models
• Iterative Refinement

Innovation

• discrete diffusion
• iterative refinement
• clinical-entities-aware masking
• concept-conditioning