# TRACE: Temporal Radiology with Anatomical Change Explanation for Grounded X-ray Report Generation

arXiv: https://arxiv.org/abs/2602.02963 · HTML: https://mlsanity.com/paper/2602.02963/

## Key facts

- Cited by 2 papers in the map (data through 14 Oct 2026).
- Builds on 22 of its 30 references that are in the map.
- First posted on arXiv 3 Feb 2026.

## Builds on (most cited first, 22 of 22)

- [LoRA: Low-Rank Adaptation of Large Language Models](https://mlsanity.com/paper/2106.09685/) (2021)
- [Visual Instruction Tuning](https://mlsanity.com/paper/2304.08485/) (2023)
- [LLaVA-Med: Training a Large Language-and-Vision Assistant for Biomedicine in One Day](https://mlsanity.com/paper/2306.00890/) (2023)
- [Generating Radiology Reports via Memory-driven Transformer](https://mlsanity.com/paper/2010.16056/) (2020)
- [Making the Most of Text Semantics to Improve Biomedical Vision--Language Processing](https://mlsanity.com/paper/2204.09817/) (2022)
- [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)
- [On the Automatic Generation of Medical Imaging Reports](https://mlsanity.com/paper/1711.08195/) (2017)
- [Learning to Exploit Temporal Structure for Biomedical Vision-Language Processing](https://mlsanity.com/paper/2301.04558/) (2023)
- [Cross-modal Memory Networks for Radiology Report Generation](https://mlsanity.com/paper/2204.13258/) (2022)
- [When Radiology Report Generation Meets Knowledge Graph](https://mlsanity.com/paper/2002.08277/) (2020)
- [MAIRA-2: Grounded Radiology Report Generation](https://mlsanity.com/paper/2406.04449/) (2024)
- [Improving Factual Completeness and Consistency of Image-to-Text Radiology Report Generation](https://mlsanity.com/paper/2010.10042/) (2020)
- [Knowledge-driven Encode, Retrieve, Paraphrase for Medical Image Report Generation](https://mlsanity.com/paper/1903.10122/) (2019)
- [METransformer: Radiology Report Generation by Transformer with Multiple Learnable Expert Tokens](https://mlsanity.com/paper/2304.02211/) (2023)
- [MAIRA-1: A specialised large multimodal model for radiology report generation](https://mlsanity.com/paper/2311.13668/) (2023)
- [Enhanced Contrastive Learning with Multi-view Longitudinal Data for Chest X-ray Report Generation](https://mlsanity.com/paper/2502.20056/) (2025)
- [A Survey on Deep Learning and Explainability for Automatic Report Generation from Medical Images](https://mlsanity.com/paper/2010.10563/) (2020)
- [Utilizing Longitudinal Chest X-Rays and Reports to Pre-Fill Radiology Reports](https://mlsanity.com/paper/2306.08749/) (2023)
- [Medical Phrase Grounding with Region-Phrase Context Contrastive Alignment](https://mlsanity.com/paper/2303.07618/) (2023)
- [CheXRelNet: An Anatomy-Aware Model for Tracking Longitudinal Relationships between Chest X-Rays](https://mlsanity.com/paper/2208.03873/) (2022)
- [ChEX: Interactive Localization and Region Description in Chest X-rays](https://mlsanity.com/paper/2404.15770/) (2024)

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

- [ProtoMedAgent: Multimodal Clinical Interpretability via Privacy-Aware Agentic Workflows](https://mlsanity.com/paper/2605.14113/) (2026)
- [GRCD: Grounded Region Change Detection for Multi-Finding Chest X-Ray Pairs](https://mlsanity.com/paper/2607.02719/) (2026)

## Abstract (arXiv)

Temporal comparison of chest X-rays is fundamental to clinical radiology, enabling detection of disease progression, treatment response, and new findings. While vision-language models have advanced single-image report generation and visual grounding, no existing method combines these capabilities for temporal change detection. We introduce Temporal Radiology with Anatomical Change Explanation (TRACE), the first model that jointly performs temporal comparison, change classification, and spatial localization. Given a prior and current chest X-ray, TRACE generates natural language descriptions of interval changes (worsened, improved, stable) while grounding each finding with bounding box coordinates. TRACE demonstrates effective spatial localization with over 90% grounding accuracy, establishing a foundation for this challenging new task. Our ablation study uncovers an emergent capability: change detection arises only when temporal comparison and spatial grounding are jointly learned, as neither alone enables meaningful change detection. This finding suggests that grounding provides a spatial attention mechanism essential for temporal reasoning.