# FineRadScore: A Radiology Report Line-by-Line Evaluation Technique Generating Corrections with Severity Scores

arXiv: https://arxiv.org/abs/2405.20613 · HTML: https://mlsanity.com/paper/2405.20613/

## Key facts

- Cited by 18 papers in the map (data through 14 Oct 2026).
- Builds on 12 of its 20 references that are in the map.
- First posted on arXiv 31 May 2024.

## Builds on (most cited first, 12 of 12)

- [BERTScore: Evaluating Text Generation with BERT](https://mlsanity.com/paper/1904.09675/) (2019)
- [G-Eval: NLG Evaluation using GPT-4 with Better Human Alignment](https://mlsanity.com/paper/2303.16634/) (2023)
- [MIMIC-CXR-JPG, a large publicly available database of labeled chest radiographs](https://mlsanity.com/paper/1901.07042/) (2019)
- [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)
- [Improving Chest X-Ray Report Generation by Leveraging Warm Starting](https://mlsanity.com/paper/2201.09405/) (2022)
- [MAIRA-1: A specialised large multimodal model for radiology report generation](https://mlsanity.com/paper/2311.13668/) (2023)
- [Improving Radiology Report Generation Systems by Removing Hallucinated References to Non-existent Priors](https://mlsanity.com/paper/2210.06340/) (2022)
- [Multimodal Image-Text Matching Improves Retrieval-based Chest X-Ray Report Generation](https://mlsanity.com/paper/2303.17579/) (2023)
- [Automated Generation of Accurate & Fluent Medical X-ray Reports](https://mlsanity.com/paper/2108.12126/) (2021)
- [A Meta-Evaluation of Faithfulness Metrics for Long-Form Hospital-Course Summarization](https://mlsanity.com/paper/2303.03948/) (2023)
- [Leveraging Professional Radiologists' Expertise to Enhance LLMs' Evaluation for Radiology Reports](https://mlsanity.com/paper/2401.16578/) (2024)

## Built on by (most cited first, 18 of 18)

- [Towards a Holistic Framework for Multimodal Large Language Models in Three-dimensional Brain CT Report Generation](https://mlsanity.com/paper/2407.02235/) (2024)
- [ReXrank: A Public Leaderboard for AI-Powered Radiology Report Generation](https://mlsanity.com/paper/2411.15122/) (2024)
- [RadEval: A framework for radiology text evaluation](https://mlsanity.com/paper/2509.18030/) (2025)
- [ReXErr: Synthesizing Clinically Meaningful Errors in Diagnostic Radiology Reports](https://mlsanity.com/paper/2409.10829/) (2024)
- [CRIMSON: A Clinically-Grounded LLM-Based Metric for Generative Radiology Report Evaluation](https://mlsanity.com/paper/2603.06183/) (2026)
- [Lunguage: A Benchmark for Structured and Sequential Chest X-ray Interpretation](https://mlsanity.com/paper/2505.21190/) (2025)
- [ReEvalMed: Rethinking Medical Report Evaluation by Aligning Metrics with Real-World Clinical Judgment](https://mlsanity.com/paper/2510.00280/) (2025)
- [Uncovering Knowledge Gaps in Radiology Report Generation Models through Knowledge Graphs](https://mlsanity.com/paper/2408.14397/) (2024)
- [ReXamine-Global: A Framework for Uncovering Inconsistencies in Radiology Report Generation Metrics](https://mlsanity.com/paper/2408.16208/) (2024)
- [From large language models to multimodal AI: A scoping review on the potential of generative AI in medicine](https://mlsanity.com/paper/2502.09242/) (2025)
- [CLEAR: A Clinically-Grounded Tabular Framework for Radiology Report Evaluation](https://mlsanity.com/paper/2505.16325/) (2025)
- [MedVAL: Toward Expert-Level Medical Text Validation with Language Models](https://mlsanity.com/paper/2507.03152/) (2025)
- [Clinically Grounded Agent-based Report Evaluation: An Interpretable Metric for Radiology Report Generation](https://mlsanity.com/paper/2508.02808/) (2025)
- [HeadCT-ONE: Enabling Granular and Controllable Automated Evaluation of Head CT Radiology Report Generation](https://mlsanity.com/paper/2409.13038/) (2024)
- [RadReason: Radiology Report Evaluation Metric with Reasons and Sub-Scores](https://mlsanity.com/paper/2508.15464/) (2025)
- [Towards Better Aligned LLM Judges for Radiology Report Evaluation across Modalities and Anatomies](https://mlsanity.com/paper/2604.03376/) (2026)
- [RadMatch: Auditable Radiology Report Evaluation via Finding-Level Matching](https://mlsanity.com/paper/2609.01470/) (2026)
- [Beyond Scalar Scores: Exploring LLM-based Metrics for Clinical Significance Evaluation in Radiology Reports](https://mlsanity.com/paper/2606.18797/) (2026)

## Abstract (arXiv)

The current gold standard for evaluating generated chest x-ray (CXR) reports is through radiologist annotations. However, this process can be extremely time-consuming and costly, especially when evaluating large numbers of reports. In this work, we present FineRadScore, a Large Language Model (LLM)-based automated evaluation metric for generated CXR reports. Given a candidate report and a ground-truth report, FineRadScore gives the minimum number of line-by-line corrections required to go from the candidate to the ground-truth report. Additionally, FineRadScore provides an error severity rating with each correction and generates comments explaining why the correction was needed. We demonstrate that FineRadScore's corrections and error severity scores align with radiologist opinions. We also show that, when used to judge the quality of the report as a whole, FineRadScore aligns with radiologists as well as current state-of-the-art automated CXR evaluation metrics. Finally, we analyze FineRadScore's shortcomings to provide suggestions for future improvements.