# Improving Factuality of 3D Brain MRI Report Generation with Paired Image-domain Retrieval and Text-domain Augmentation

arXiv: https://arxiv.org/abs/2411.15490 · HTML: https://mlsanity.com/paper/2411.15490/

## Key facts

- Cited by 2 papers in the map (data through 14 Oct 2026).
- Builds on 18 of its 48 references that are in the map.
- First posted on arXiv 23 Nov 2024.

## Builds on (most cited first, 18 of 18)

- [An Image is Worth 16x16 Words: Transformers for Image Recognition at Scale](https://mlsanity.com/paper/2010.11929/) (2020)
- [The Llama 3 Herd of Models](https://mlsanity.com/paper/2407.21783/) (2024)
- [LoRA: Low-Rank Adaptation of Large Language Models](https://mlsanity.com/paper/2106.09685/) (2021)
- [Retrieval-Augmented Generation for Knowledge-Intensive NLP Tasks](https://mlsanity.com/paper/2005.11401/) (2020)
- [Masked Autoencoders Are Scalable Vision Learners](https://mlsanity.com/paper/2111.06377/) (2021)
- [Emerging Properties in Self-Supervised Vision Transformers](https://mlsanity.com/paper/2104.14294/) (2021)
- [On the Opportunities and Risks of Foundation Models](https://mlsanity.com/paper/2108.07258/) (2021)
- [Dense Passage Retrieval for Open-Domain Question Answering](https://mlsanity.com/paper/2004.04906/) (2020)
- [LLaVA-Med: Training a Large Language-and-Vision Assistant for Biomedicine in One Day](https://mlsanity.com/paper/2306.00890/) (2023)
- [Leveraging Passage Retrieval with Generative Models for Open Domain Question Answering](https://mlsanity.com/paper/2007.01282/) (2020)
- [SimMIM: A Simple Framework for Masked Image Modeling](https://mlsanity.com/paper/2111.09886/) (2021)
- [Self-supervised Visual Feature Learning with Deep Neural Networks: A Survey](https://mlsanity.com/paper/1902.06162/) (2019)
- [ISLES 2022: A multi-center magnetic resonance imaging stroke lesion segmentation dataset](https://mlsanity.com/paper/2206.06694/) (2022)
- [Self Pre-training with Masked Autoencoders for Medical Image Classification and Segmentation](https://mlsanity.com/paper/2203.05573/) (2022)
- [CheXtransfer: Performance and Parameter Efficiency of ImageNet Models for Chest X-Ray Interpretation](https://mlsanity.com/paper/2101.06871/) (2021)
- [LLM-CXR: Instruction-Finetuned LLM for CXR Image Understanding and Generation](https://mlsanity.com/paper/2305.11490/) (2023)
- [Integrating uncertainty in deep neural networks for MRI based stroke analysis](https://mlsanity.com/paper/2008.06332/) (2020)
- [Learning Modality Knowledge Alignment for Cross-Modality Transfer](https://mlsanity.com/paper/2406.18864/) (2024)

## Built on by (most cited first, 2 of 2)

- [LoV3D: Grounding Cognitive Prognosis Reasoning in Longitudinal 3D Brain MRI via Regional Volume Assessments](https://mlsanity.com/paper/2603.12071/) (2026)
- [Brain Imaging Foundation Models, Are We There Yet? A Systematic Review of Foundation Models for Brain Imaging and Biomedical Research](https://mlsanity.com/paper/2506.13306/) (2025)

## Abstract (arXiv)

Acute ischemic stroke (AIS) requires time-critical decision-making, where inaccurate interpretation of neuroimaging findings can lead to irreversible disability. Diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) maps from magnetic resonance imaging (MRI) are central to detecting acute infarction, yet generating factually reliable radiology reports directly from 3D MRI remains challenging due to the difficulty of learning robust cross-modal alignments between volumetric images and clinical text. We propose paired image-domain retrieval and text-domain augmentation (PIRTA), a retrieval-augmented generation framework that improves report factuality by avoiding explicit image-text alignment. PIRTA retrieves clinically similar 3D DWI/ADC volumes using a pretrained 3D vision encoder and leverages their paired clinician-authored reports to ground large language model (LLM)-based report generation. Experiments on multi-institutional in-house data, a held-out external privacy-preserving cohort, and the public ISLES benchmark demonstrate that PIRTA achieves strong image-domain retrieval performance and consistently improves ischemic-territory accuracy, a clinically grounded surrogate for report factuality, compared to direct image-to-text baselines. These results indicate that retrieval-grounded generation provides a scalable and reliable paradigm for producing factually consistent radiology reports from complex 3D brain MRI. Source code is available at https://github.com/jhlee0619/PIRTA.