# CXPMRG-Bench: Pre-training and Benchmarking for X-ray Medical Report Generation on CheXpert Plus Dataset

arXiv: https://arxiv.org/abs/2410.00379 · HTML: https://mlsanity.com/paper/2410.00379/

## Key facts

- Cited by 35 papers in the map (data through 14 Oct 2026).
- Builds on 77 of its 102 references that are in the map.
- First posted on arXiv 1 Oct 2024.

## Builds on (most cited first, 30 of 77)

- [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)
- [An Image is Worth 16x16 Words: Transformers for Image Recognition at Scale](https://mlsanity.com/paper/2010.11929/) (2020)
- [GPT-4 Technical Report](https://mlsanity.com/paper/2303.08774/) (2023)
- [The Llama 3 Herd of Models](https://mlsanity.com/paper/2407.21783/) (2024)
- [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)
- [Judging LLM-as-a-Judge with MT-Bench and Chatbot Arena](https://mlsanity.com/paper/2306.05685/) (2023)
- [ImageNet Large Scale Visual Recognition Challenge](https://mlsanity.com/paper/1409.0575/) (2014)
- [Masked Autoencoders Are Scalable Vision Learners](https://mlsanity.com/paper/2111.06377/) (2021)
- [Mamba: Linear-Time Sequence Modeling with Selective State Spaces](https://mlsanity.com/paper/2312.00752/) (2023)
- [Qwen Technical Report](https://mlsanity.com/paper/2309.16609/) (2023)
- [InternVL: Scaling up Vision Foundation Models and Aligning for Generic Visual-Linguistic Tasks](https://mlsanity.com/paper/2312.14238/) (2023)
- [Empirical Evaluation of Gated Recurrent Neural Networks on Sequence Modeling](https://mlsanity.com/paper/1412.3555/) (2014)
- [CIDEr: Consensus-based Image Description Evaluation](https://mlsanity.com/paper/1411.5726/) (2014)
- [GLU Variants Improve Transformer](https://mlsanity.com/paper/2002.05202/) (2020)
- [CheXpert: A Large Chest Radiograph Dataset with Uncertainty Labels and Expert Comparison](https://mlsanity.com/paper/1901.07031/) (2019)
- [Transformers are SSMs: Generalized Models and Efficient Algorithms Through Structured State Space Duality](https://mlsanity.com/paper/2405.21060/) (2024)
- [MiniCPM-V: A GPT-4V Level MLLM on Your Phone](https://mlsanity.com/paper/2408.01800/) (2024)
- [Vision Mamba: Efficient Visual Representation Learning with Bidirectional State Space Model](https://mlsanity.com/paper/2401.09417/) (2024)
- [Publicly Available Clinical BERT Embeddings](https://mlsanity.com/paper/1904.03323/) (2019)
- [VMamba: Visual State Space Model](https://mlsanity.com/paper/2401.10166/) (2024)
- [Yi: Open Foundation Models by 01.AI](https://mlsanity.com/paper/2403.04652/) (2024)
- [DeepSeek LLM: Scaling Open-Source Language Models with Longtermism](https://mlsanity.com/paper/2401.02954/) (2024)
- [InternLM2 Technical Report](https://mlsanity.com/paper/2403.17297/) (2024)
- [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)
- [Exploring and Distilling Posterior and Prior Knowledge for Radiology Report Generation](https://mlsanity.com/paper/2106.06963/) (2021)

## Built on by (most cited first, 30 of 35)

- [Towards Better Dental AI: A Multimodal Benchmark and Instruction Dataset for Panoramic X-ray Analysis](https://mlsanity.com/paper/2509.09254/) (2025)
- [Activating Associative Disease-Aware Vision Token Memory for LLM-Based X-ray Report Generation](https://mlsanity.com/paper/2501.03458/) (2025)
- [DrVD-Bench: Do Vision-Language Models Reason Like Human Doctors in Medical Image Diagnosis?](https://mlsanity.com/paper/2505.24173/) (2025)
- [A Disease-Aware Dual-Stage Framework for Chest X-ray Report Generation](https://mlsanity.com/paper/2511.12259/) (2025)
- [MedOpenClaw and MedFlowBench: Auditing Medical Agents in Full-Study Workflows](https://mlsanity.com/paper/2603.24649/) (2026)
- [XrayClaw: Cooperative-Competitive Multi-Agent Alignment for Trustworthy Chest X-ray Diagnosis](https://mlsanity.com/paper/2604.02695/) (2026)
- [Evaluating and Mitigating Bias in AI-Based Medical Text Generation](https://mlsanity.com/paper/2504.17279/) (2025)
- [Walking the Tightrope: Disentangling Beneficial and Detrimental Drifts in Non-Stationary Custom-Tuning](https://mlsanity.com/paper/2505.13081/) (2025)
- [Uncertainty-Driven Expert Control: Enhancing the Reliability of Medical Vision-Language Models](https://mlsanity.com/paper/2507.09209/) (2025)
- [R2GenKG: Hierarchical Multi-modal Knowledge Graph for LLM-based Radiology Report Generation](https://mlsanity.com/paper/2508.03426/) (2025)
- [ESTR-CoT: Towards Explainable and Accurate Event Stream based Scene Text Recognition with Chain-of-Thought Reasoning](https://mlsanity.com/paper/2507.02200/) (2025)
- [EMRRG: Efficient Fine-Tuning Pre-trained X-ray Mamba Networks for Radiology Report Generation](https://mlsanity.com/paper/2510.16776/) (2025)
- [Vision-Language Models for Automated Chest X-ray Interpretation: Leveraging ViT and GPT-2](https://mlsanity.com/paper/2501.12356/) (2025)
- [RadReason: Radiology Report Evaluation Metric with Reasons and Sub-Scores](https://mlsanity.com/paper/2508.15464/) (2025)
- [TextME: Bridging Unseen Modalities Through Text Descriptions](https://mlsanity.com/paper/2602.03098/) (2026)
- [Towards Robust Endogenous Reasoning: Unifying Drift Adaptation in Non-Stationary Tuning](https://mlsanity.com/paper/2604.15705/) (2026)
- [OraPO: Oracle-educated Reinforcement Learning for Data-efficient and Factual Radiology Report Generation](https://mlsanity.com/paper/2509.18600/) (2025)
- [Multi-Modal Multi-Agent Reinforcement Learning for Radiology Report Generation](https://mlsanity.com/paper/2603.16876/) (2026)
- [Seeing Like Radiologists: Context- and Gaze-Guided Vision-Language Pretraining for Chest X-rays](https://mlsanity.com/paper/2603.26049/) (2026)
- [Not All Tokens Matter Equally: Dynamic In-context Vector Distillation with Decisive-Token Supervision for Long-form Medical Report Generation](https://mlsanity.com/paper/2605.27194/) (2026)
- [Seeing What Matters: Lesion-Aware High-Resolution Patch Discovery and Fusion for Chest X-ray Report Generation](https://mlsanity.com/paper/2607.06909/) (2026)
- [SURE-Med: Systematic Uncertainty Reduction for Enhanced Reliability in Medical Report Generation](https://mlsanity.com/paper/2508.01693/) (2025)
- [Benchmark Success, Clinical Failure: When Reinforcement Learning Optimizes for Benchmarks, Not Patients](https://mlsanity.com/paper/2512.23090/) (2025)
- [LEAD: Layer-wise Expert-aligned Decoding for Faithful Radiology Report Generation](https://mlsanity.com/paper/2602.04617/) (2026)
- [Rethinking the Efficiency and Effectiveness of Reinforcement Learning for Radiology Report Generation](https://mlsanity.com/paper/2603.04022/) (2026)
- [Prototype-Based Knowledge Guidance for Fine-Grained Structured Radiology Reporting](https://mlsanity.com/paper/2603.11938/) (2026)
- [Radiology Report Generation for Low-Quality X-Ray Images](https://mlsanity.com/paper/2604.10188/) (2026)
- [REVA-PO: Stabilizing Reinforcement Learning for Chest X-ray Report Generation](https://mlsanity.com/paper/2607.10147/) (2026)
- [TextSLIP: Text Self-Supervised CLIP for Medical Report Generation](https://mlsanity.com/paper/2607.21970/) (2026)
- [DRRG: A Discrete Diffusion Framework for Radiology Report Generation](https://mlsanity.com/paper/2608.24105/) (2026)

## Abstract (arXiv)

X-ray image-based medical report generation (MRG) is a pivotal area in artificial intelligence which can significantly reduce diagnostic burdens and patient wait times. Despite significant progress, we believe that the task has reached a bottleneck due to the limited benchmark datasets and the existing large models' insufficient capability enhancements in this specialized domain. Specifically, the recently released CheXpert Plus dataset lacks comparative evaluation algorithms and their results, providing only the dataset itself. This situation makes the training, evaluation, and comparison of subsequent algorithms challenging. Thus, we conduct a comprehensive benchmarking of existing mainstream X-ray report generation models and large language models (LLMs), on the CheXpert Plus dataset. We believe that the proposed benchmark can provide a solid comparative basis for subsequent algorithms and serve as a guide for researchers to quickly grasp the state-of-the-art models in this field. More importantly, we propose a large model for the X-ray image report generation using a multi-stage pre-training strategy, including self-supervised autoregressive generation and Xray-report contrastive learning, and supervised fine-tuning. Extensive experimental results indicate that the autoregressive pre-training based on Mamba effectively encodes X-ray images, and the image-text contrastive pre-training further aligns the feature spaces, achieving better experimental results. Source code can be found on urlhttps://github.com/Event-AHU/MedicalImageAnalysis.