AR-RRG: Anatomy-Guided Retrieval-Driven Radiology Report Generation
Radiology report generation (RRG) streamlines clinical workflows and alleviates the burden of radiologists' documentation. Standard vision-language models capture global visual cues and lack fine-grained alignment between anatomical regions and diagnostic text. Most retrieval-augmented methods retrieve complete historical reports, introducing redundant noise and severe vision-text mismatches that trigger clinically risky hallucinations and missed lesions. In this paper, we introduce AR-RRG, an anatomy-guided retrieval-driven method for the generation of radiology reports. AR-RRG consists of two core modules: the anatomy-aware self-training lesion detection network (ASLDNet) and the retrieval-driven radiology report generation (RRRG). ASLDNet leverages anatomy-aware spatial verification (ASV) and class-adaptive dynamic thresholding (CDT) via self-training, delivering accurate lesion localization to support subsequent generation. As the generative branch of AR-RRG, RRRG eliminates clinical hallucinations through dual-granularity retrieval (DR) and complements missing lesions with a neighborhood consensus (NC) mechanism. A parallel continuous visual perception (PCVP) stream converts radiographs into visual tokens through fixed medical encoding and resampling. Multi-scale text and visual features are fused, followed by LoRA-efficient large language model tuning to generate clinically consistent, visually grounded radiology reports. Extensive evaluations on MS-CXR, MIMIC-CXR, and IU X-Ray demonstrate that AR-RRG consistently outperforms state-of-the-art methods across mainstream metrics. Our code will be made publicly available.