# Factual Serialization Enhancement: A Key Innovation for Chest X-ray Report Generation

arXiv: https://arxiv.org/abs/2405.09586 · HTML: https://mlsanity.com/paper/2405.09586/

## Key facts

- Cited by 11 papers in the map (data through 14 Oct 2026).
- Builds on 38 of its 68 references that are in the map.
- First posted on arXiv 15 May 2024.

## Builds on (most cited first, 30 of 38)

- [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)
- [Learning Transferable Visual Models From Natural Language Supervision](https://mlsanity.com/paper/2103.00020/) (2021)
- [DistilBERT, a distilled version of BERT: smaller, faster, cheaper and lighter](https://mlsanity.com/paper/1910.01108/) (2019)
- [Billion-scale similarity search with GPUs](https://mlsanity.com/paper/1702.08734/) (2017)
- [Align before Fuse: Vision and Language Representation Learning with Momentum Distillation](https://mlsanity.com/paper/2107.07651/) (2021)
- [CheXpert: A Large Chest Radiograph Dataset with Uncertainty Labels and Expert Comparison](https://mlsanity.com/paper/1901.07031/) (2019)
- [SciBERT: A Pretrained Language Model for Scientific Text](https://mlsanity.com/paper/1903.10676/) (2019)
- [MIMIC-CXR-JPG, a large publicly available database of labeled chest radiographs](https://mlsanity.com/paper/1901.07042/) (2019)
- [MedCLIP: Contrastive Learning from Unpaired Medical Images and Text](https://mlsanity.com/paper/2210.10163/) (2022)
- [Generating Radiology Reports via Memory-driven Transformer](https://mlsanity.com/paper/2010.16056/) (2020)
- [CheXbert: Combining Automatic Labelers and Expert Annotations for Accurate Radiology Report Labeling Using BERT](https://mlsanity.com/paper/2004.09167/) (2020)
- [RadGraph: Extracting Clinical Entities and Relations from Radiology Reports](https://mlsanity.com/paper/2106.14463/) (2021)
- [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)
- [Multi-Granularity Cross-modal Alignment for Generalized Medical Visual Representation Learning](https://mlsanity.com/paper/2210.06044/) (2022)
- [When Radiology Report Generation Meets Knowledge Graph](https://mlsanity.com/paper/2002.08277/) (2020)
- [Interactive and Explainable Region-guided Radiology Report Generation](https://mlsanity.com/paper/2304.08295/) (2023)
- [Knowledge-enhanced Visual-Language Pre-training on Chest Radiology Images](https://mlsanity.com/paper/2302.14042/) (2023)
- [Dynamic Graph Enhanced Contrastive Learning for Chest X-ray Report Generation](https://mlsanity.com/paper/2303.10323/) (2023)
- [METransformer: Radiology Report Generation by Transformer with Multiple Learnable Expert Tokens](https://mlsanity.com/paper/2304.02211/) (2023)
- [Improving Chest X-Ray Report Generation by Leveraging Warm Starting](https://mlsanity.com/paper/2201.09405/) (2022)
- [Improving the Factual Correctness of Radiology Report Generation with Semantic Rewards](https://mlsanity.com/paper/2210.12186/) (2022)
- [Radiology Report Generation with a Learned Knowledge Base and Multi-modal Alignment](https://mlsanity.com/paper/2112.15011/) (2021)
- [Knowledge Matters: Radiology Report Generation with General and Specific Knowledge](https://mlsanity.com/paper/2112.15009/) (2021)
- [KiUT: Knowledge-injected U-Transformer for Radiology Report Generation](https://mlsanity.com/paper/2306.11345/) (2023)
- [Cross-modal Prototype Driven Network for Radiology Report Generation](https://mlsanity.com/paper/2207.04818/) (2022)
- [Align, Reason and Learn: Enhancing Medical Vision-and-Language Pre-training with Knowledge](https://mlsanity.com/paper/2209.07118/) (2022)
- [Multimodal Image-Text Matching Improves Retrieval-based Chest X-Ray Report Generation](https://mlsanity.com/paper/2303.17579/) (2023)
- [Towards Unifying Medical Vision-and-Language Pre-training via Soft Prompts](https://mlsanity.com/paper/2302.08958/) (2023)

## Built on by (most cited first, 11 of 11)

- [Enhanced Contrastive Learning with Multi-view Longitudinal Data for Chest X-ray Report Generation](https://mlsanity.com/paper/2502.20056/) (2025)
- [Fact-Aware Multimodal Retrieval Augmentation for Accurate Medical Radiology Report Generation](https://mlsanity.com/paper/2407.15268/) (2024)
- [UMIT: Unifying Medical Imaging Tasks via Vision-Language Models](https://mlsanity.com/paper/2503.15892/) (2025)
- [PriorRG: Prior-Guided Contrastive Pre-training and Coarse-to-Fine Decoding for Chest X-ray Report Generation](https://mlsanity.com/paper/2508.05353/) (2025)
- [A Multimodal Multi-Agent Framework for Radiology Report Generation](https://mlsanity.com/paper/2505.09787/) (2025)
- [EVOKE: Elevating Chest X-ray Report Generation via Multi-View Contrastive Learning and Patient-Specific Knowledge](https://mlsanity.com/paper/2411.10224/) (2024)
- [Automated Structured Radiology Report Generation with Rich Clinical Context](https://mlsanity.com/paper/2510.00428/) (2025)
- [Discrete Diffusion Models with MLLMs for Unified Medical Multimodal Generation](https://mlsanity.com/paper/2510.06131/) (2025)
- [SURE-Med: Systematic Uncertainty Reduction for Enhanced Reliability in Medical Report Generation](https://mlsanity.com/paper/2508.01693/) (2025)
- [XMedFusion: A Knowledge-Guided Multimodal Perception and Reasoning Framework for Autonomous Medical Systems](https://mlsanity.com/paper/2606.14766/) (2026)
- [CliQ-RRG: Clinical-Knowledge Guided Disease-aware Visual-Textual Alignment for QA-Style Radiology Report Generation](https://mlsanity.com/paper/2610.13059/) (2026)

## Abstract (arXiv)

A radiology report comprises presentation-style vocabulary, which ensures clarity and organization, and factual vocabulary, which provides accurate and objective descriptions based on observable findings. While manually writing these reports is time-consuming and labor-intensive, automatic report generation offers a promising alternative. A critical step in this process is to align radiographs with their corresponding reports. However, existing methods often rely on complete reports for alignment, overlooking the impact of presentation-style vocabulary. To address this issue, we propose FSE, a two-stage Factual Serialization Enhancement method. In Stage 1, we introduce factuality-guided contrastive learning for visual representation by maximizing the semantic correspondence between radiographs and corresponding factual descriptions. In Stage 2, we present evidence-driven report generation that enhances diagnostic accuracy by integrating insights from similar historical cases structured as factual serialization. Experiments on MIMIC-CXR and IU X-ray datasets across specific and general scenarios demonstrate that FSE outperforms state-of-the-art approaches in both natural language generation and clinical efficacy metrics. Ablation studies further emphasize the positive effects of factual serialization in Stage 1 and Stage 2. The code is available at https://github.com/mk-runner/FSE.