# GTA-Net: Cooperative Game Theory for Vision-Language Alignment in Chest X-Ray Report Generation

arXiv: https://arxiv.org/abs/2606.21915 · HTML: https://mlsanity.com/paper/2606.21915/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 12 of its 24 references that are in the map.
- First posted on arXiv 20 Jun 2026.

## Builds on (most cited first, 12 of 12)

- [LoRA: Low-Rank Adaptation of Large Language Models](https://mlsanity.com/paper/2106.09685/) (2021)
- [LLaMA: Open and Efficient Foundation Language Models](https://mlsanity.com/paper/2302.13971/) (2023)
- [Swin Transformer: Hierarchical Vision Transformer using Shifted Windows](https://mlsanity.com/paper/2103.14030/) (2021)
- [CIDEr: Consensus-based Image Description Evaluation](https://mlsanity.com/paper/1411.5726/) (2014)
- [Generating Radiology Reports via Memory-driven Transformer](https://mlsanity.com/paper/2010.16056/) (2020)
- [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)
- [Auto-Encoding Knowledge Graph for Unsupervised Medical Report Generation](https://mlsanity.com/paper/2111.04318/) (2021)
- [Activating Associative Disease-Aware Vision Token Memory for LLM-Based X-ray Report Generation](https://mlsanity.com/paper/2501.03458/) (2025)
- [A Survey of Deep Learning-based Radiology Report Generation Using Multimodal Data](https://mlsanity.com/paper/2405.12833/) (2024)
- [R2GenKG: Hierarchical Multi-modal Knowledge Graph for LLM-based Radiology Report Generation](https://mlsanity.com/paper/2508.03426/) (2025)
- [EMRRG: Efficient Fine-Tuning Pre-trained X-ray Mamba Networks for Radiology Report Generation](https://mlsanity.com/paper/2510.16776/) (2025)

## Abstract (arXiv)

Automated chest X-ray report generation requires precise cross-modal grounding to ensure clinically reliable descriptions. However, existing vision-language models rely on implicit attention mechanisms that fail to enforce explicit region-word correspondence and disease-level consistency. We propose Game-Theoretic Alignment Network (GTA-Net), a vision-language framework that formulates report generation as a cooperative game-theoretic alignment problem. The model introduces a BinaryGameAligner that models interactions between image regions and text tokens using similarity-based payoff matrices with Shapley-inspired importance weighting. To enforce clinical semantics, we further develop a Disease-Aware Ternary Aligner, which captures joint interactions among images, reports, and structured disease concepts. GTA-Net combines a Swin-based visual encoder with a LoRA-adapted large language model and is trained with a unified objective for generation and alignment. Experiments on CheXpertPlus and IU-XRay demonstrate state-of-the-art performance across standard generation metrics and improved clinical consistency, highlighting the effectiveness of explicit game-theoretic alignment for medical vision-language generation.