# Precision Recall Controllable Radiology Report Generation via Hybrid Natural Language and Clinical Reward Learning

arXiv: https://arxiv.org/abs/2606.21447 · HTML: https://mlsanity.com/paper/2606.21447/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 17 of its 31 references that are in the map.
- First posted on arXiv 19 Jun 2026.

## Builds on (most cited first, 17 of 17)

- [DeepSeekMath: Pushing the Limits of Mathematical Reasoning in Open Language Models](https://mlsanity.com/paper/2402.03300/) (2024)
- [FiLM: Visual Reasoning with a General Conditioning Layer](https://mlsanity.com/paper/1709.07871/) (2017)
- [MIMIC-CXR-JPG, a large publicly available database of labeled chest radiographs](https://mlsanity.com/paper/1901.07042/) (2019)
- [MedGemma Technical Report](https://mlsanity.com/paper/2507.05201/) (2025)
- [Generating Radiology Reports via Memory-driven Transformer](https://mlsanity.com/paper/2010.16056/) (2020)
- [A Deep Reinforced Model for Abstractive Summarization](https://mlsanity.com/paper/1705.04304/) (2017)
- [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)
- [GDPO: Group reward-Decoupled Normalization Policy Optimization for Multi-reward RL Optimization](https://mlsanity.com/paper/2601.05242/) (2026)
- [Hybrid Retrieval-Generation Reinforced Agent for Medical Image Report Generation](https://mlsanity.com/paper/1805.08298/) (2018)
- [R2GenGPT: Radiology Report Generation with Frozen LLMs](https://mlsanity.com/paper/2309.09812/) (2023)
- [METransformer: Radiology Report Generation by Transformer with Multiple Learnable Expert Tokens](https://mlsanity.com/paper/2304.02211/) (2023)
- [Optimizing the Factual Correctness of a Summary: A Study of Summarizing Radiology Reports](https://mlsanity.com/paper/1911.02541/) (2019)
- [Deep Communicating Agents for Abstractive Summarization](https://mlsanity.com/paper/1803.10357/) (2018)
- [Automated Radiology Report Generation: A Review of Recent Advances](https://mlsanity.com/paper/2405.10842/) (2024)
- [Enhanced Contrastive Learning with Multi-view Longitudinal Data for Chest X-ray Report Generation](https://mlsanity.com/paper/2502.20056/) (2025)
- [CURE: Curriculum-guided Multi-task Training for Reliable Anatomy Grounded Report Generation](https://mlsanity.com/paper/2601.15408/) (2026)

## Abstract (arXiv)

Automated radiology report generation (RRG) has gained increasing attention because it can reduce the heavy workload of clinical report writing. However, most existing methods mainly optimize for natural language generation (NLG) metrics that focus on language fluency, while providing little control over clinically important factors such as precision and recall. As consequence, generated reports may be fluent but not well aligned with different clinical needs. To address this challenge, we propose a reinforcement learning framework for precision recall controllable RRG, where a control parameter explicitly adjusts the trade-off between clinical precision and recall during inference. This design allows the model to flexibly generate reports according to different clinical requirements. To ensure clinical correctness, we introduce a clinical reward into the training objective, which helps improve clinical efficacy (CE) beyond standard language-based optimization. In addition, we apply a group-relative training strategy that normalizes rewards within each training group, reducing reward variance and improving training stability. Extensive experiments on the MIMIC-CXR dataset show that our method consistently outperforms state-of-the-art approaches in both NLG and CE evaluation metrics, while providing reliable control over the CE precision recall trade-off.