# DART: Disease-aware Image-Text Alignment and Self-correcting Re-alignment for Trustworthy Radiology Report Generation

arXiv: https://arxiv.org/abs/2504.11786 · HTML: https://mlsanity.com/paper/2504.11786/

## Key facts

- Cited by 9 papers in the map (data through 14 Oct 2026).
- Builds on 34 of its 50 references that are in the map.
- First posted on arXiv 16 Apr 2025.

## Builds on (most cited first, 30 of 34)

- [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)
- [Grad-CAM: Visual Explanations from Deep Networks via Gradient-based Localization](https://mlsanity.com/paper/1610.02391/) (2016)
- [Self-Refine: Iterative Refinement with Self-Feedback](https://mlsanity.com/paper/2303.17651/) (2023)
- [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)
- [Bottom-Up and Top-Down Attention for Image Captioning and Visual Question Answering](https://mlsanity.com/paper/1707.07998/) (2017)
- [Show and Tell: A Neural Image Caption Generator](https://mlsanity.com/paper/1411.4555/) (2014)
- [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)
- [Meshed-Memory Transformer for Image Captioning](https://mlsanity.com/paper/1912.08226/) (2019)
- [Generating Sequences by Learning to Self-Correct](https://mlsanity.com/paper/2211.00053/) (2022)
- [On the Automatic Generation of Medical Imaging Reports](https://mlsanity.com/paper/1711.08195/) (2017)
- [A Comprehensive Survey of Deep Learning for Image Captioning](https://mlsanity.com/paper/1810.04020/) (2018)
- [Cross-Entropy Loss Functions: Theoretical Analysis and Applications](https://mlsanity.com/paper/2304.07288/) (2023)
- [X-Linear Attention Networks for Image Captioning](https://mlsanity.com/paper/2003.14080/) (2020)
- [Corrective Retrieval Augmented Generation](https://mlsanity.com/paper/2401.15884/) (2024)
- [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)
- [Interactive and Explainable Region-guided Radiology Report Generation](https://mlsanity.com/paper/2304.08295/) (2023)
- [Dynamic Graph Enhanced Contrastive Learning for Chest X-ray Report Generation](https://mlsanity.com/paper/2303.10323/) (2023)
- [METransformer: Radiology Report Generation by Transformer with Multiple Learnable Expert Tokens](https://mlsanity.com/paper/2304.02211/) (2023)
- [Competence-based Multimodal Curriculum Learning for Medical Report Generation](https://mlsanity.com/paper/2206.14579/) (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)

## Built on by (most cited first, 9 of 9)

- [Visual Alignment of Medical Vision-Language Models for Grounded Radiology Report Generation](https://mlsanity.com/paper/2512.16201/) (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)
- [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)
- [MonteRET: AI Agent Enhancing Multimodal LLMs with Multi-granularity Knowledge Retrieval for Chest CT Report Generation](https://mlsanity.com/paper/2607.14264/) (2026)
- [RadMatch: Auditable Radiology Report Evaluation via Finding-Level Matching](https://mlsanity.com/paper/2609.01470/) (2026)
- [BUSTR: Descriptor-Aware Vision-Language Learning for Breast Ultrasound Report Generation](https://mlsanity.com/paper/2511.20956/) (2025)
- [DRRG: A Discrete Diffusion Framework for Radiology Report Generation](https://mlsanity.com/paper/2608.24105/) (2026)

## Abstract (arXiv)

The automatic generation of radiology reports has emerged as a promising solution to reduce a time-consuming task and accurately capture critical disease-relevant findings in X-ray images. Previous approaches for radiology report generation have shown impressive performance. However, there remains significant potential to improve accuracy by ensuring that retrieved reports contain disease-relevant findings similar to those in the X-ray images and by refining generated reports. In this study, we propose a Disease-aware image-text Alignment and self-correcting Re-alignment for Trustworthy radiology report generation (DART) framework. In the first stage, we generate initial reports based on image-to-text retrieval with disease-matching, embedding both images and texts in a shared embedding space through contrastive learning. This approach ensures the retrieval of reports with similar disease-relevant findings that closely align with the input X-ray images. In the second stage, we further enhance the initial reports by introducing a self-correction module that re-aligns them with the X-ray images. Our proposed framework achieves state-of-the-art results on two widely used benchmarks, surpassing previous approaches in both report generation and clinical efficacy metrics, thereby enhancing the trustworthiness of radiology reports.