# A Disease-Aware Dual-Stage Framework for Chest X-ray Report Generation

arXiv: https://arxiv.org/abs/2511.12259 · HTML: https://mlsanity.com/paper/2511.12259/

## Key facts

- Cited by 5 papers in the map (data through 14 Oct 2026).
- Builds on 38 of its 51 references that are in the map.
- First posted on arXiv 15 Nov 2025.

## Builds on (most cited first, 30 of 38)

- [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)
- [PyTorch: An Imperative Style, High-Performance Deep Learning Library](https://mlsanity.com/paper/1912.01703/) (2019)
- [Masked Autoencoders Are Scalable Vision Learners](https://mlsanity.com/paper/2111.06377/) (2021)
- [SGDR: Stochastic Gradient Descent with Warm Restarts](https://mlsanity.com/paper/1608.03983/) (2016)
- [Mamba: Linear-Time Sequence Modeling with Selective State Spaces](https://mlsanity.com/paper/2312.00752/) (2023)
- [CIDEr: Consensus-based Image Description Evaluation](https://mlsanity.com/paper/1411.5726/) (2014)
- [CheXpert: A Large Chest Radiograph Dataset with Uncertainty Labels and Expert Comparison](https://mlsanity.com/paper/1901.07031/) (2019)
- [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)
- [Evaluation: from precision, recall and F-measure to ROC, informedness, markedness and correlation](https://mlsanity.com/paper/2010.16061/) (2020)
- [Generating Radiology Reports via Memory-driven Transformer](https://mlsanity.com/paper/2010.16056/) (2020)
- [RadGraph: Extracting Clinical Entities and Relations from Radiology Reports](https://mlsanity.com/paper/2106.14463/) (2021)
- [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)
- [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)
- [R2GenGPT: Radiology Report Generation with Frozen LLMs](https://mlsanity.com/paper/2309.09812/) (2023)
- [CheXpert Plus: Augmenting a Large Chest X-ray Dataset with Text Radiology Reports, Patient Demographics and Additional Image Formats](https://mlsanity.com/paper/2405.19538/) (2024)
- [METransformer: Radiology Report Generation by Transformer with Multiple Learnable Expert Tokens](https://mlsanity.com/paper/2304.02211/) (2023)
- [PromptMRG: Diagnosis-Driven Prompts for Medical Report Generation](https://mlsanity.com/paper/2308.12604/) (2023)
- [CXR-CLIP: Toward Large Scale Chest X-ray Language-Image Pre-training](https://mlsanity.com/paper/2310.13292/) (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)
- [AlignTransformer: Hierarchical Alignment of Visual Regions and Disease Tags for Medical Report Generation](https://mlsanity.com/paper/2203.10095/) (2022)
- [Cross-modal Prototype Driven Network for Radiology Report Generation](https://mlsanity.com/paper/2207.04818/) (2022)
- [A Medical Semantic-Assisted Transformer for Radiographic Report Generation](https://mlsanity.com/paper/2208.10358/) (2022)
- [ORGAN: Observation-Guided Radiology Report Generation via Tree Reasoning](https://mlsanity.com/paper/2306.06466/) (2023)
- [Weakly Supervised Contrastive Learning for Chest X-Ray Report Generation](https://mlsanity.com/paper/2109.12242/) (2021)

## Built on by (most cited first, 5 of 5)

- [CLIP-Guided Unsupervised Semantic-Aware Exposure Correction](https://mlsanity.com/paper/2601.19129/) (2026)
- [MAC-RRG: Iterative Multi-Agent Collaboration for X-ray Radiology Report Generation](https://mlsanity.com/paper/2609.26124/) (2026)
- [Diagnosis-Conditioned Spatial Gating and Decoder-Level Supervised Contrastive Learning for Radiology Report Generation](https://mlsanity.com/paper/2610.04159/) (2026)
- [Homogeneous Semantic Alignment and Hierarchical Expert Routing for Radiology Report Generation](https://mlsanity.com/paper/2610.04499/) (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)

Radiology report generation from chest X-rays is an important task in artificial intelligence with the potential to greatly reduce radiologists' workload and shorten patient wait times. Despite recent advances, existing approaches often lack sufficient disease-awareness in visual representations and adequate vision-language alignment to meet the specialized requirements of medical image analysis. As a result, these models usually overlook critical pathological features on chest X-rays and struggle to generate clinically accurate reports. To address these limitations, we propose a novel dual-stage disease-aware framework for chest X-ray report generation. In Stage~1, our model learns Disease-Aware Semantic Tokens (DASTs) corresponding to specific pathology categories through cross-attention mechanisms and multi-label classification, while simultaneously aligning vision and language representations via contrastive learning. In Stage~2, we introduce a Disease-Visual Attention Fusion (DVAF) module to integrate disease-aware representations with visual features, along with a Dual-Modal Similarity Retrieval (DMSR) mechanism that combines visual and disease-specific similarities to retrieve relevant exemplars, providing contextual guidance during report generation. Extensive experiments on benchmark datasets (i.e., CheXpert Plus, IU X-ray, and MIMIC-CXR) demonstrate that our disease-aware framework achieves state-of-the-art performance in chest X-ray report generation, with significant improvements in clinical accuracy and linguistic quality.