Radiology Report Generation Assists

Report generation drafts findings from scans for radiologists to edit, where missing words harm more than extra words.

Why Does This Exist?

Radiologists dictate hundreds of findings daily while staring at X-rays. Drafting saves keystrokes, but a fluent draft that drops a pneumothorax kills. Input is a scan plus indication; output is findings plus impression for editing, never auto-sign. Fluency scores mislead; clinical recall leads.

Think of It Like This

A scribe drafting minutes for a chair to sign

A scribe drafts meeting minutes noting every vote while the chair corrects and signs. A polished draft missing the key vote fails harder than a clumsy complete one. The chair stays liable either way.

Models are scribes and radiologists are chairs. The analogy stops at liability: signatures stay human by law and practice.

How It Actually Works

An image encoder feeds a language decoder constrained to finding vocabulary. Training weights clinical entities $5$ -fold over filler words. Evaluation counts entity recall for pneumothorax, effusion, and lines plus negation accuracy, not just BLEU. Interfaces show uncertainty and force line-by-line sign-off.

Worked example

A chest film holds a $2$ cm apical pneumothorax plus clear lungs. The draft writes clear lungs correctly but omits the apex line, scoring BLEU $0.72$ yet recall $0/1$ on critical findings. A recall-weighted draft catches the line with extra hedging words, BLEU $0.65$ but critical recall $1/1$ . The lower BLEU draft is the safer one.

Watch Out For

Negation flips from hedging language

No pneumothorax versus possible pneumothorax flips care, but n-gram scores barely move. The symptom is signed errors with high fluency. Score negation separately and highlight no versus possible in review.

The Quick Version

Drafts save dictation but radiologists edit and sign every word.
Missing critical lines fails harder than wordy prose.
Entity recall plus negation beats BLEU for safety.
Do not auto-sign drafts; keep line-by-line verification.
Indication plus comparison films guide what the draft must mention.