# Diagnosis-Conditioned Spatial Gating and Decoder-Level Supervised Contrastive Learning for Radiology Report Generation

arXiv: https://arxiv.org/abs/2610.04159 · HTML: https://mlsanity.com/paper/2610.04159/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 10 of its 18 references that are in the map.
- First posted on arXiv 3 Oct 2026.

## Builds on (most cited first, 10 of 10)

- [CheXpert: A Large Chest Radiograph Dataset with Uncertainty Labels and Expert Comparison](https://mlsanity.com/paper/1901.07031/) (2019)
- [Generating Radiology Reports via Memory-driven Transformer](https://mlsanity.com/paper/2010.16056/) (2020)
- [CheXbert: Combining Automatic Labelers and Expert Annotations for Accurate Radiology Report Labeling Using BERT](https://mlsanity.com/paper/2004.09167/) (2020)
- [Improving Factual Completeness and Consistency of Image-to-Text Radiology Report Generation](https://mlsanity.com/paper/2010.10042/) (2020)
- [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)
- [Improving Chest X-Ray Report Generation by Leveraging Warm Starting](https://mlsanity.com/paper/2201.09405/) (2022)
- [PromptMRG: Diagnosis-Driven Prompts for Medical Report Generation](https://mlsanity.com/paper/2308.12604/) (2023)
- [KiUT: Knowledge-injected U-Transformer for Radiology Report Generation](https://mlsanity.com/paper/2306.11345/) (2023)
- [A Disease-Aware Dual-Stage Framework for Chest X-ray Report Generation](https://mlsanity.com/paper/2511.12259/) (2025)

## Abstract (arXiv)

Radiology report generation models can produce fluent text while still containing finding-level inaccuracies. Diagnosis-driven methods improve generation by conditioning on predicted findings, but these predictions do not directly modify the visual patch features provided to the decoder, and global gating applies the same modulation across spatial locations. We introduce a Position-Aware Gate (PAG) that uses predicted finding representations to modulate visual patches spatially without region supervision. We also propose a Decoder-level Supervised Contrastive Loss (DSCL) that structures decoder representations using shared positive findings rather than instance identity. On MIMIC-CXR, PAG+DSCL improves clinical efficacy (CE) F1 from 0.484 to 0.502 over a matched global-gate reference, while PAG and DSCL individually reach 0.491 and 0.495. Without additional fine-tuning, the combined model achieves 0.226 CE F1 on IU X-Ray, compared with 0.211 reported by PromptMRG.