# KARGEN: Knowledge-enhanced Automated Radiology Report Generation Using Large Language Models

arXiv: https://arxiv.org/abs/2409.05370 · HTML: https://mlsanity.com/paper/2409.05370/

## Key facts

- Cited by 7 papers in the map (data through 14 Oct 2026).
- Placed in Clinical and biomedical applications, one of 17 directions in LLM reasoning.
- Builds on 21 of its 32 references that are in the map.
- First posted on arXiv 9 Sep 2024.

## Placed in

- LLM reasoning / [Clinical and biomedical applications](https://mlsanity.com/lr/clinical-and-biomedical-applications/)

## Builds on (most cited first, 21 of 21)

- [Llama 2: Open Foundation and Fine-Tuned Chat Models](https://mlsanity.com/paper/2307.09288/) (2023)
- [Swin Transformer: Hierarchical Vision Transformer using Shifted Windows](https://mlsanity.com/paper/2103.14030/) (2021)
- [BERTScore: Evaluating Text Generation with BERT](https://mlsanity.com/paper/1904.09675/) (2019)
- [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)
- [MIMIC-CXR-JPG, a large publicly available database of labeled chest radiographs](https://mlsanity.com/paper/1901.07042/) (2019)
- [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)
- [Knowing When to Look: Adaptive Attention via A Visual Sentinel for Image Captioning](https://mlsanity.com/paper/1612.01887/) (2016)
- [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)
- [R2GenGPT: Radiology Report Generation with Frozen LLMs](https://mlsanity.com/paper/2309.09812/) (2023)
- [Knowledge-driven Encode, Retrieve, Paraphrase for Medical Image Report Generation](https://mlsanity.com/paper/1903.10122/) (2019)
- [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)
- [Knowledge Matters: Radiology Report Generation with General and Specific Knowledge](https://mlsanity.com/paper/2112.15009/) (2021)
- [A Medical Semantic-Assisted Transformer for Radiographic Report Generation](https://mlsanity.com/paper/2208.10358/) (2022)
- [Rethinking Medical Report Generation: Disease Revealing Enhancement with Knowledge Graph](https://mlsanity.com/paper/2307.12526/) (2023)

## Built on by (most cited first, 7 of 7)

- [S-RRG-Bench: Structured Radiology Report Generation with Fine-Grained Evaluation Framework](https://mlsanity.com/paper/2508.02082/) (2025)
- [A Review of Longitudinal Radiology Report Generation: Dataset Composition, Methods, and Performance Evaluation](https://mlsanity.com/paper/2510.12444/) (2025)
- [Designing a Robust Radiology Report Generation System](https://mlsanity.com/paper/2411.01153/) (2024)
- [Interactive Segmentation and Report Generation for CT Images](https://mlsanity.com/paper/2503.03294/) (2025)
- [Seeing What Matters: Lesion-Aware High-Resolution Patch Discovery and Fusion for Chest X-ray Report Generation](https://mlsanity.com/paper/2607.06909/) (2026)
- [MAC-RRG: Iterative Multi-Agent Collaboration for X-ray Radiology Report Generation](https://mlsanity.com/paper/2609.26124/) (2026)
- [Pre-training, Reasoning, Benchmarking: X-ray Report Generation on CheXpert Plus Dataset](https://mlsanity.com/paper/2610.08813/) (2026)

## Abstract (arXiv)

Harnessing the robust capabilities of Large Language Models (LLMs) for narrative generation, logical reasoning, and common-sense knowledge integration, this study delves into utilizing LLMs to enhance automated radiology report generation (R2Gen). Despite the wealth of knowledge within LLMs, efficiently triggering relevant knowledge within these large models for specific tasks like R2Gen poses a critical research challenge. This paper presents KARGEN, a Knowledge-enhanced Automated radiology Report GENeration framework based on LLMs. Utilizing a frozen LLM to generate reports, the framework integrates a knowledge graph to unlock chest disease-related knowledge within the LLM to enhance the clinical utility of generated reports. This is achieved by leveraging the knowledge graph to distill disease-related features in a designed way. Since a radiology report encompasses both normal and disease-related findings, the extracted graph-enhanced disease-related features are integrated with regional image features, attending to both aspects. We explore two fusion methods to automatically prioritize and select the most relevant features. The fused features are employed by LLM to generate reports that are more sensitive to diseases and of improved quality. Our approach demonstrates promising results on the MIMIC-CXR and IU-Xray datasets.