# Radiology Report Generation via Multi-objective Preference Optimization

arXiv: https://arxiv.org/abs/2412.08901 · HTML: https://mlsanity.com/paper/2412.08901/

## Key facts

- Cited by 16 papers in the map (data through 14 Oct 2026).
- Builds on 23 of its 34 references that are in the map.
- First posted on arXiv 12 Dec 2024.

## Builds on (most cited first, 23 of 23)

- [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)
- [Domain-Specific Language Model Pretraining for Biomedical Natural Language Processing](https://mlsanity.com/paper/2007.15779/) (2020)
- [MIMIC-CXR-JPG, a large publicly available database of labeled chest radiographs](https://mlsanity.com/paper/1901.07042/) (2019)
- [Self-critical Sequence Training for Image Captioning](https://mlsanity.com/paper/1612.00563/) (2016)
- [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)
- [On the Automatic Generation of Medical Imaging Reports](https://mlsanity.com/paper/1711.08195/) (2017)
- [Cross-modal Memory Networks for Radiology Report Generation](https://mlsanity.com/paper/2204.13258/) (2022)
- [Hybrid Retrieval-Generation Reinforced Agent for Medical Image Report Generation](https://mlsanity.com/paper/1805.08298/) (2018)
- [Improving Factual Completeness and Consistency of Image-to-Text Radiology Report Generation](https://mlsanity.com/paper/2010.10042/) (2020)
- [METransformer: Radiology Report Generation by Transformer with Multiple Learnable Expert Tokens](https://mlsanity.com/paper/2304.02211/) (2023)
- [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)
- [Contrastive Attention for Automatic Chest X-ray Report Generation](https://mlsanity.com/paper/2106.06965/) (2021)
- [Knowledge Matters: Radiology Report Generation with General and Specific Knowledge](https://mlsanity.com/paper/2112.15009/) (2021)
- [AlignTransformer: Hierarchical Alignment of Visual Regions and Disease Tags for Medical Report Generation](https://mlsanity.com/paper/2203.10095/) (2022)
- [A Medical Semantic-Assisted Transformer for Radiographic Report Generation](https://mlsanity.com/paper/2208.10358/) (2022)
- [Variational Topic Inference for Chest X-Ray Report Generation](https://mlsanity.com/paper/2107.07314/) (2021)
- [Forward KL Regularized Preference Optimization for Aligning Diffusion Policies](https://mlsanity.com/paper/2409.05622/) (2024)
- [Regularized Conditional Diffusion Model for Multi-Task Preference Alignment](https://mlsanity.com/paper/2404.04920/) (2024)
- [Unifying Relational Sentence Generation and Retrieval for Medical Image Report Composition](https://mlsanity.com/paper/2101.03287/) (2021)
- [Preference Aligned Diffusion Planner for Quadrupedal Locomotion Control](https://mlsanity.com/paper/2410.13586/) (2024)

## Built on by (most cited first, 16 of 16)

- [PriorRG: Prior-Guided Contrastive Pre-training and Coarse-to-Fine Decoding for Chest X-ray Report Generation](https://mlsanity.com/paper/2508.05353/) (2025)
- [Enhancing Reinforcement Learning for Radiology Report Generation with Evidence-aware Rewards and Self-correcting Preference Learning](https://mlsanity.com/paper/2604.13598/) (2026)
- [Online Iterative Self-Alignment for Radiology Report Generation](https://mlsanity.com/paper/2505.11983/) (2025)
- [Towards Robust Endogenous Reasoning: Unifying Drift Adaptation in Non-Stationary Tuning](https://mlsanity.com/paper/2604.15705/) (2026)
- [AnchorDiff: Topology-Aware Masked Diffusion with Confidence-based Rewriting for Radiology Report Generation](https://mlsanity.com/paper/2605.17071/) (2026)
- [CLARIFID: Improving Radiology Report Generation by Reinforcing Clinically Accurate Impressions and Enforcing Detailed Findings](https://mlsanity.com/paper/2507.17234/) (2025)
- [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)
- [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)
- [PDD-RRG: Posterior Diagnostic Decision for Study-level Radiology Report Generation](https://mlsanity.com/paper/2608.03055/) (2026)
- [Clinically Structured Surrogate Rewards for Post-SFT Medical Image Captioning](https://mlsanity.com/paper/2608.18654/) (2026)
- [TALON: A Temporally Aware Longitudinal Framework for Radiology Report Generation](https://mlsanity.com/paper/2609.20826/) (2026)
- [EviDent-CBCT: Evidence-Bottlenecked Report Generation from Dental CBCT under Non-Exhaustive Report Supervision](https://mlsanity.com/paper/2610.02375/) (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)

Automatic Radiology Report Generation (RRG) is an important topic for alleviating the substantial workload of radiologists. Existing RRG approaches rely on supervised regression based on different architectures or additional knowledge injection,while the generated report may not align optimally with radiologists' preferences. Especially, since the preferences of radiologists are inherently heterogeneous and multidimensional, e.g., some may prioritize report fluency, while others emphasize clinical accuracy. To address this problem,we propose a new RRG method via Multi-objective Preference Optimization (MPO) to align the pre-trained RRG model with multiple human preferences, which can be formulated by multi-dimensional reward functions and optimized by multi-objective reinforcement learning (RL). Specifically, we use a preference vector to represent the weight of preferences and use it as a condition for the RRG model. Then, a linearly weighed reward is obtained via a dot product between the preference vector and multi-dimensional reward. Next,the RRG model is optimized to align with the preference vector by optimizing such a reward via RL. In the training stage,we randomly sample diverse preference vectors from the preference space and align the model by optimizing the weighted multi-objective rewards, which leads to an optimal policy on the entire preference space. When inference,our model can generate reports aligned with specific preferences without further fine-tuning. Extensive experiments on two public datasets show the proposed method can generate reports that cater to different preferences in a single model and achieve state-of-the-art performance.