# Attributed Abnormality Graph Embedding for Clinically Accurate X-Ray Report Generation

arXiv: https://arxiv.org/abs/2207.01208 · HTML: https://mlsanity.com/paper/2207.01208/

## Key facts

- Cited by 17 papers in the map (data through 14 Oct 2026).
- Builds on 36 of its 53 references that are in the map.
- First posted on arXiv 4 Jul 2022.

## Builds on (most cited first, 30 of 36)

- [Attention Is All You Need](https://mlsanity.com/paper/1706.03762/) (2017)
- [Deep Residual Learning for Image Recognition](https://mlsanity.com/paper/1512.03385/) (2015)
- [Graph Attention Networks](https://mlsanity.com/paper/1710.10903/) (2017)
- [Densely Connected Convolutional Networks](https://mlsanity.com/paper/1608.06993/) (2016)
- [Layer Normalization](https://mlsanity.com/paper/1607.06450/) (2016)
- [CIDEr: Consensus-based Image Description Evaluation](https://mlsanity.com/paper/1411.5726/) (2014)
- [Show, Attend and Tell: Neural Image Caption Generation with Visual Attention](https://mlsanity.com/paper/1502.03044/) (2015)
- [CheXpert: A Large Chest Radiograph Dataset with Uncertainty Labels and Expert Comparison](https://mlsanity.com/paper/1901.07031/) (2019)
- [Bottom-Up and Top-Down Attention for Image Captioning and Visual Question Answering](https://mlsanity.com/paper/1707.07998/) (2017)
- [Show and Tell: A Neural Image Caption Generator](https://mlsanity.com/paper/1411.4555/) (2014)
- [Knowledge Graphs](https://mlsanity.com/paper/2003.02320/) (2020)
- [Self-critical Sequence Training for Image Captioning](https://mlsanity.com/paper/1612.00563/) (2016)
- [Generating Radiology Reports via Memory-driven Transformer](https://mlsanity.com/paper/2010.16056/) (2020)
- [Meshed-Memory Transformer for Image Captioning](https://mlsanity.com/paper/1912.08226/) (2019)
- [RadGraph: Extracting Clinical Entities and Relations from Radiology Reports](https://mlsanity.com/paper/2106.14463/) (2021)
- [Image Captioning with Semantic Attention](https://mlsanity.com/paper/1603.03925/) (2016)
- [Knowing When to Look: Adaptive Attention via A Visual Sentinel for Image Captioning](https://mlsanity.com/paper/1612.01887/) (2016)
- [On the Automatic Generation of Medical Imaging Reports](https://mlsanity.com/paper/1711.08195/) (2017)
- [Cross-modal Memory Networks for Radiology Report Generation](https://mlsanity.com/paper/2204.13258/) (2022)
- [Exploring and Distilling Posterior and Prior Knowledge for Radiology Report Generation](https://mlsanity.com/paper/2106.06963/) (2021)
- [When Radiology Report Generation Meets Knowledge Graph](https://mlsanity.com/paper/2002.08277/) (2020)
- [Hybrid Retrieval-Generation Reinforced Agent for Medical Image Report Generation](https://mlsanity.com/paper/1805.08298/) (2018)
- [Improving Factual Completeness and Consistency of Image-to-Text Radiology Report Generation](https://mlsanity.com/paper/2010.10042/) (2020)
- [Clinically Accurate Chest X-Ray Report Generation](https://mlsanity.com/paper/1904.02633/) (2019)
- [A Hierarchical Approach for Generating Descriptive Image Paragraphs](https://mlsanity.com/paper/1611.06607/) (2016)
- [Knowledge-driven Encode, Retrieve, Paraphrase for Medical Image Report Generation](https://mlsanity.com/paper/1903.10122/) (2019)
- [Contrastive Attention for Automatic Chest X-ray Report Generation](https://mlsanity.com/paper/2106.06965/) (2021)
- [AlignTransformer: Hierarchical Alignment of Visual Regions and Disease Tags for Medical Report Generation](https://mlsanity.com/paper/2203.10095/) (2022)
- [Automatic Radiology Report Generation based on Multi-view Image Fusion and Medical Concept Enrichment](https://mlsanity.com/paper/1907.09085/) (2019)
- [Show, Describe and Conclude: On Exploiting the Structure Information of Chest X-Ray Reports](https://mlsanity.com/paper/2004.12274/) (2020)

## Built on by (most cited first, 17 of 17)

- [Automated Radiology Report Generation: A Review of Recent Advances](https://mlsanity.com/paper/2405.10842/) (2024)
- [A Systematic Review of Deep Learning-based Research on Radiology Report Generation](https://mlsanity.com/paper/2311.14199/) (2023)
- [Activating Associative Disease-Aware Vision Token Memory for LLM-Based X-ray Report Generation](https://mlsanity.com/paper/2501.03458/) (2025)
- [Towards Medical Artificial General Intelligence via Knowledge-Enhanced Multimodal Pretraining](https://mlsanity.com/paper/2304.14204/) (2023)
- [A Survey of Medical Vision-and-Language Applications and Their Techniques](https://mlsanity.com/paper/2411.12195/) (2024)
- [PriorRG: Prior-Guided Contrastive Pre-training and Coarse-to-Fine Decoding for Chest X-ray Report Generation](https://mlsanity.com/paper/2508.05353/) (2025)
- [Topicwise Separable Sentence Retrieval for Medical Report Generation](https://mlsanity.com/paper/2405.04175/) (2024)
- [Act Like a Radiologist: Radiology Report Generation across Anatomical Regions](https://mlsanity.com/paper/2305.16685/) (2023)
- [R2GenKG: Hierarchical Multi-modal Knowledge Graph for LLM-based Radiology Report Generation](https://mlsanity.com/paper/2508.03426/) (2025)
- [MRG-R1: Reinforcement Learning for Clinically Aligned Medical Report Generation](https://mlsanity.com/paper/2512.16145/) (2025)
- [Natural Language Generation in Healthcare: A Review of Methods and Applications](https://mlsanity.com/paper/2505.04073/) (2025)
- [Seeing Like Radiologists: Context- and Gaze-Guided Vision-Language Pretraining for Chest X-rays](https://mlsanity.com/paper/2603.26049/) (2026)
- [Semantically Informed Salient Regions Guided Radiology Report Generation](https://mlsanity.com/paper/2507.11015/) (2025)
- [Medical Report Generation: A Hierarchical Task Structure-Based Cross-Modal Causal Intervention Framework](https://mlsanity.com/paper/2511.02271/) (2025)
- [RadHiera: Semantic Hierarchical Reinforcement Learning for Medical Report Generation](https://mlsanity.com/paper/2511.10065/) (2025)
- [LEAD: Layer-wise Expert-aligned Decoding for Faithful Radiology Report Generation](https://mlsanity.com/paper/2602.04617/) (2026)
- [Cross-Modal Clinical Knowledge Integration for Mammography Report Generation](https://mlsanity.com/paper/2605.31093/) (2026)

## Abstract (arXiv)

Automatic generation of medical reports from X-ray images can assist radiologists to perform the time-consuming and yet important reporting task. Yet, achieving clinically accurate generated reports remains challenging. Modeling the underlying abnormalities using the knowledge graph approach has been found promising in enhancing the clinical accuracy. In this paper, we introduce a novel fined-grained knowledge graph structure called an attributed abnormality graph (ATAG). The ATAG consists of interconnected abnormality nodes and attribute nodes, allowing it to better capture the abnormality details. In contrast to the existing methods where the abnormality graph was constructed manually, we propose a methodology to automatically construct the fine-grained graph structure based on annotations, medical reports in X-ray datasets, and the RadLex radiology lexicon. We then learn the ATAG embedding using a deep model with an encoder-decoder architecture for the report generation. In particular, graph attention networks are explored to encode the relationships among the abnormalities and their attributes. A gating mechanism is adopted and integrated with various decoders for the generation. We carry out extensive experiments based on the benchmark datasets, and show that the proposed ATAG-based deep model outperforms the SOTA methods by a large margin and can improve the clinical accuracy of the generated reports.