Carving Radiology Reports at Their Evidential Joints: Anatomical Region Sets as Generation Units

Abstract

Organizing radiology reports into independently generated units offers a way to generate fine-grained clinical content and bind it to visual evidence. However, existing methods typically adopt generation-unit structures not directly specified in natural reports or their annotations, introducing additional modeling compromises. We propose RadCarve, which instead defines generation units directly from the anatomical region sets in existing statement-region correspondences, unifying unit formation with visual evidence selection. RadCarve's planner uses composition-specialized query banks to jointly predict unit existence and region composition from the image, iteratively refining both with regional evidence aggregated according to current membership predictions. The generator independently produces each unit's text conditioned on the joint visual evidence of its predicted region set. Compared with strong baselines, RadCarve improves CXRFEScore by 9.4% in unit generation given region sets and achieves 2.4 times the end-to-end binding F1. It also achieves leading report-generation results on Chest ImaGenome and PadChest-GR, using fewer than one-sixth as many parameters as large-scale baselines.