Trust It or Not: Confidence-Guided Automatic Radiology Report Generation

Medical imaging plays a pivotal role in diagnosis and treatment in clinical practice. Inspired by the significant progress in automatic image captioning, various deep learning (DL)-based methods have been proposed to generate radiology reports for medical images. Despite promising results, previous works overlook the uncertainties of their models and are thus unable to provide clinicians with the reliability/confidence of the generated radiology reports to assist their decision-making. In this paper, we propose a novel method to explicitly quantify both the visual uncertainty and the textual uncertainty for DL-based radiology report generation. Such multi-modal uncertainties can sufficiently capture the model confidence degree at both the report level and the sentence level, and thus they are further leveraged to weight the losses for more comprehensive model optimization. Experimental results have demonstrated that the proposed method for model uncertainty characterization and estimation can produce more reliable confidence scores for radiology report generation, and the modified loss function, which takes into account the uncertainties, leads to better model performance on two public radiology report datasets. In addition, the quality of the automatically generated reports was manually evaluated by human raters and the results also indicate that the proposed uncertainties can reflect the variance of clinical diagnosis.