{"id":"https://openalex.org/W7129438380","doi":"https://doi.org/10.1109/tmi.2026.3665561","title":"FiR-Rad: Fine-Grained Reinforcement With Structured Reasoning for Chest X-Ray Report Generation","display_name":"FiR-Rad: Fine-Grained Reinforcement With Structured Reasoning for Chest X-Ray Report Generation","publication_year":2026,"publication_date":"2026-02-17","ids":{"openalex":"https://openalex.org/W7129438380","doi":"https://doi.org/10.1109/tmi.2026.3665561","pmid":"https://pubmed.ncbi.nlm.nih.gov/41701595"},"language":"en","primary_location":{"id":"doi:10.1109/tmi.2026.3665561","is_oa":false,"landing_page_url":"https://doi.org/10.1109/tmi.2026.3665561","pdf_url":null,"source":{"id":"https://openalex.org/S58069681","display_name":"IEEE Transactions on Medical Imaging","issn_l":"0278-0062","issn":["0278-0062","1558-254X"],"is_oa":false,"is_in_doaj":false,"is_core":true,"host_organization":"https://openalex.org/P4310319808","host_organization_name":"Institute of Electrical and Electronics Engineers","host_organization_lineage":["https://openalex.org/P4310319808"],"host_organization_lineage_names":["Institute of Electrical and Electronics Engineers"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"IEEE Transactions on Medical Imaging","raw_type":"journal-article"},"type":"article","indexed_in":["crossref","pubmed"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5013016726","display_name":"Xin Mei","orcid":"https://orcid.org/0000-0002-2768-5252"},"institutions":[{"id":"https://openalex.org/I17145004","display_name":"Northwestern Polytechnical University","ror":"https://ror.org/01y0j0j86","country_code":"CN","type":"education","lineage":["https://openalex.org/I17145004"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Xin Mei","raw_affiliation_strings":["School of Automation, Northwestern Polytechnical University, Xi&#x2019;an, China"],"raw_orcid":"https://orcid.org/0000-0002-2768-5252","affiliations":[{"raw_affiliation_string":"School of Automation, Northwestern Polytechnical University, Xi&#x2019;an, China","institution_ids":["https://openalex.org/I17145004"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5110170948","display_name":"Libin Yang","orcid":null},"institutions":[{"id":"https://openalex.org/I17145004","display_name":"Northwestern Polytechnical University","ror":"https://ror.org/01y0j0j86","country_code":"CN","type":"education","lineage":["https://openalex.org/I17145004"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Libin Yang","raw_affiliation_strings":["School of Cybersecurity, Northwestern Polytechnical University, Xi&#x2019;an, China"],"raw_orcid":"https://orcid.org/0000-0001-5316-7689","affiliations":[{"raw_affiliation_string":"School of Cybersecurity, Northwestern Polytechnical University, Xi&#x2019;an, China","institution_ids":["https://openalex.org/I17145004"]}]},{"author_position":"middle","author":{"id":null,"display_name":"Dehong Gao","orcid":"https://orcid.org/0000-0002-6636-5702"},"institutions":[{"id":"https://openalex.org/I17145004","display_name":"Northwestern Polytechnical University","ror":"https://ror.org/01y0j0j86","country_code":"CN","type":"education","lineage":["https://openalex.org/I17145004"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Dehong Gao","raw_affiliation_strings":["School of Cybersecurity, Northwestern Polytechnical University, Xi&#x2019;an, China"],"raw_orcid":"https://orcid.org/0000-0002-6636-5702","affiliations":[{"raw_affiliation_string":"School of Cybersecurity, Northwestern Polytechnical University, Xi&#x2019;an, China","institution_ids":["https://openalex.org/I17145004"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5070472433","display_name":"Xiaoyan Cai","orcid":null},"institutions":[{"id":"https://openalex.org/I17145004","display_name":"Northwestern Polytechnical University","ror":"https://ror.org/01y0j0j86","country_code":"CN","type":"education","lineage":["https://openalex.org/I17145004"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Xiaoyan Cai","raw_affiliation_strings":["School of Automation, Northwestern Polytechnical University, Xi&#x2019;an, China"],"raw_orcid":"https://orcid.org/0000-0002-1406-107X","affiliations":[{"raw_affiliation_string":"School of Automation, Northwestern Polytechnical University, Xi&#x2019;an, China","institution_ids":["https://openalex.org/I17145004"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5126265701","display_name":"Junwei Han","orcid":null},"institutions":[{"id":"https://openalex.org/I10535382","display_name":"Chongqing University of Posts and Telecommunications","ror":"https://ror.org/03dgaqz26","country_code":"CN","type":"education","lineage":["https://openalex.org/I10535382"]}],"countries":["CN"],"is_corresponding":false,"raw_author_name":"Junwei Han","raw_affiliation_strings":["School of Artificial Intelligence, Chongqing University of Posts and Telecommunications, Chongqing, China"],"raw_orcid":"https://orcid.org/0000-0001-5545-7217","affiliations":[{"raw_affiliation_string":"School of Artificial Intelligence, Chongqing University of Posts and Telecommunications, Chongqing, China","institution_ids":["https://openalex.org/I10535382"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5126263077","display_name":"Tianming Liu","orcid":null},"institutions":[{"id":"https://openalex.org/I165733156","display_name":"University of Georgia","ror":"https://ror.org/00te3t702","country_code":"US","type":"education","lineage":["https://openalex.org/I165733156"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Tianming Liu","raw_affiliation_strings":["Department of Computer Science, University of Georgia, Georgia, Athens, GA, USA"],"raw_orcid":"https://orcid.org/0000-0002-8132-9048","affiliations":[{"raw_affiliation_string":"Department of Computer Science, University of Georgia, Georgia, Athens, GA, USA","institution_ids":["https://openalex.org/I165733156"]}]}],"institutions":[],"countries_distinct_count":2,"institutions_distinct_count":3,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":0.0,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":{"value":0.16019912,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"45","issue":"6","first_page":"2922","last_page":"2935"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11775","display_name":"COVID-19 diagnosis using AI","score":0.6312999725341797,"subfield":{"id":"https://openalex.org/subfields/2741","display_name":"Radiology, Nuclear Medicine and Imaging"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T11775","display_name":"COVID-19 diagnosis using AI","score":0.6312999725341797,"subfield":{"id":"https://openalex.org/subfields/2741","display_name":"Radiology, Nuclear Medicine and Imaging"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T13702","display_name":"Machine Learning in Healthcare","score":0.07509999722242355,"subfield":{"id":"https://openalex.org/subfields/1702","display_name":"Artificial Intelligence"},"field":{"id":"https://openalex.org/fields/17","display_name":"Computer Science"},"domain":{"id":"https://openalex.org/domains/3","display_name":"Physical Sciences"}},{"id":"https://openalex.org/T11714","display_name":"Multimodal Machine Learning Applications","score":0.07100000232458115,"subfield":{"id":"https://openalex.org/subfields/1707","display_name":"Computer Vision and Pattern Recognition"},"field":{"id":"https://openalex.org/fields/17","display_name":"Computer Science"},"domain":{"id":"https://openalex.org/domains/3","display_name":"Physical Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/interpretability","display_name":"Interpretability","score":0.9136999845504761},{"id":"https://openalex.org/keywords/generalization","display_name":"Generalization","score":0.6933000087738037},{"id":"https://openalex.org/keywords/consistency","display_name":"Consistency (knowledge bases)","score":0.6898000240325928},{"id":"https://openalex.org/keywords/reinforcement-learning","display_name":"Reinforcement learning","score":0.65420001745224},{"id":"https://openalex.org/keywords/key","display_name":"Key (lock)","score":0.4429999887943268},{"id":"https://openalex.org/keywords/structured-prediction","display_name":"Structured prediction","score":0.4133000075817108}],"concepts":[{"id":"https://openalex.org/C2781067378","wikidata":"https://www.wikidata.org/wiki/Q17027399","display_name":"Interpretability","level":2,"score":0.9136999845504761},{"id":"https://openalex.org/C41008148","wikidata":"https://www.wikidata.org/wiki/Q21198","display_name":"Computer science","level":0,"score":0.6966000199317932},{"id":"https://openalex.org/C177148314","wikidata":"https://www.wikidata.org/wiki/Q170084","display_name":"Generalization","level":2,"score":0.6933000087738037},{"id":"https://openalex.org/C2776436953","wikidata":"https://www.wikidata.org/wiki/Q5163215","display_name":"Consistency (knowledge bases)","level":2,"score":0.6898000240325928},{"id":"https://openalex.org/C97541855","wikidata":"https://www.wikidata.org/wiki/Q830687","display_name":"Reinforcement learning","level":2,"score":0.65420001745224},{"id":"https://openalex.org/C154945302","wikidata":"https://www.wikidata.org/wiki/Q11660","display_name":"Artificial intelligence","level":1,"score":0.641700029373169},{"id":"https://openalex.org/C119857082","wikidata":"https://www.wikidata.org/wiki/Q2539","display_name":"Machine learning","level":1,"score":0.5249999761581421},{"id":"https://openalex.org/C26517878","wikidata":"https://www.wikidata.org/wiki/Q228039","display_name":"Key (lock)","level":2,"score":0.4429999887943268},{"id":"https://openalex.org/C22367795","wikidata":"https://www.wikidata.org/wiki/Q7625208","display_name":"Structured prediction","level":2,"score":0.4133000075817108},{"id":"https://openalex.org/C31601959","wikidata":"https://www.wikidata.org/wiki/Q931309","display_name":"Medical imaging","level":2,"score":0.3772999942302704},{"id":"https://openalex.org/C204323151","wikidata":"https://www.wikidata.org/wiki/Q905424","display_name":"Range (aeronautics)","level":2,"score":0.3598000109195709},{"id":"https://openalex.org/C50965678","wikidata":"https://www.wikidata.org/wiki/Q2724302","display_name":"Abnormality","level":2,"score":0.3440999984741211},{"id":"https://openalex.org/C534262118","wikidata":"https://www.wikidata.org/wiki/Q177719","display_name":"Medical diagnosis","level":2,"score":0.32589998841285706},{"id":"https://openalex.org/C2779974597","wikidata":"https://www.wikidata.org/wiki/Q28448986","display_name":"Clinical Practice","level":2,"score":0.27869999408721924},{"id":"https://openalex.org/C204321447","wikidata":"https://www.wikidata.org/wiki/Q30642","display_name":"Natural language processing","level":1,"score":0.2759999930858612},{"id":"https://openalex.org/C20162079","wikidata":"https://www.wikidata.org/wiki/Q1151406","display_name":"Case-based reasoning","level":2,"score":0.2685999870300293}],"mesh":[{"descriptor_ui":"D000098408","descriptor_name":"Reinforcement Machine Learning","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D000098408","descriptor_name":"Reinforcement Machine Learning","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D000465","descriptor_name":"Algorithms","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D000465","descriptor_name":"Algorithms","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D011857","descriptor_name":"Radiographic Image Interpretation, Computer-Assisted","qualifier_ui":"Q000379","qualifier_name":"methods","is_major_topic":true},{"descriptor_ui":"D011857","descriptor_name":"Radiographic Image Interpretation, Computer-Assisted","qualifier_ui":"Q000379","qualifier_name":"methods","is_major_topic":true},{"descriptor_ui":"D011873","descriptor_name":"Radiology Information Systems","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D011873","descriptor_name":"Radiology Information Systems","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D013902","descriptor_name":"Radiography, Thoracic","qualifier_ui":"Q000379","qualifier_name":"methods","is_major_topic":true},{"descriptor_ui":"D013902","descriptor_name":"Radiography, Thoracic","qualifier_ui":"Q000379","qualifier_name":"methods","is_major_topic":true}],"locations_count":2,"locations":[{"id":"doi:10.1109/tmi.2026.3665561","is_oa":false,"landing_page_url":"https://doi.org/10.1109/tmi.2026.3665561","pdf_url":null,"source":{"id":"https://openalex.org/S58069681","display_name":"IEEE Transactions on Medical Imaging","issn_l":"0278-0062","issn":["0278-0062","1558-254X"],"is_oa":false,"is_in_doaj":false,"is_core":true,"host_organization":"https://openalex.org/P4310319808","host_organization_name":"Institute of Electrical and Electronics Engineers","host_organization_lineage":["https://openalex.org/P4310319808"],"host_organization_lineage_names":["Institute of Electrical and Electronics Engineers"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"IEEE Transactions on Medical Imaging","raw_type":"journal-article"},{"id":"pmid:41701595","is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/41701595","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"IEEE transactions on medical imaging","raw_type":null}],"best_oa_location":null,"sustainable_development_goals":[{"display_name":"Peace, Justice and strong institutions","id":"https://metadata.un.org/sdg/16","score":0.5803396105766296}],"awards":[{"id":"https://openalex.org/G1160214813","display_name":null,"funder_award_id":"62372380","funder_id":"https://openalex.org/F4320321001","funder_display_name":"National Natural Science Foundation of China"},{"id":"https://openalex.org/G192882225","display_name":null,"funder_award_id":"U22B2036","funder_id":"https://openalex.org/F4320321001","funder_display_name":"National Natural Science Foundation of China"},{"id":"https://openalex.org/G4135153692","display_name":null,"funder_award_id":"TC20250730001","funder_id":"https://openalex.org/F4320316335","funder_display_name":"Shanghai Key Basic Research Program"},{"id":"https://openalex.org/G8011902955","display_name":null,"funder_award_id":"2024JC-YBMS-513","funder_id":"https://openalex.org/F4320336567","funder_display_name":"Natural Science Basic Research Program of Shaanxi Province"},{"id":"https://openalex.org/G8701258770","display_name":null,"funder_award_id":"2022YFB3104005","funder_id":"https://openalex.org/F4320335777","funder_display_name":"National Key Research and Development Program of China"}],"funders":[{"id":"https://openalex.org/F4320316335","display_name":"Shanghai Key Basic Research Program","ror":null},{"id":"https://openalex.org/F4320321001","display_name":"National Natural Science Foundation of China","ror":"https://ror.org/01h0zpd94"},{"id":"https://openalex.org/F4320335777","display_name":"National Key Research and Development Program of China","ror":null},{"id":"https://openalex.org/F4320336567","display_name":"Natural Science Basic Research Program of Shaanxi Province","ror":null}],"has_content":{"grobid_xml":false,"pdf":false},"content_urls":null,"referenced_works_count":0,"referenced_works":[],"related_works":[],"abstract_inverted_index":{"Automated":[0],"chest":[1],"X-ray":[2],"report":[3,162],"generation":[4],"requires":[5],"not":[6],"only":[7],"clinical":[8,136,153],"accuracy":[9,93],"but":[10],"also":[11],"transparent":[12],"and":[13,49,109,116,125,137,152],"interpretable":[14],"diagnostic":[15,118],"reasoning.":[16],"In":[17,35,63],"this":[18],"work,":[19],"we":[20,67],"propose":[21],"FiR-Rad,":[22],"a":[23,39,51,69],"two-stage":[24],"framework":[25,131],"that":[26,129],"combines":[27],"explicit":[28],"structured":[29],"reasoning":[30,88,108],"with":[31,140],"targeted":[32],"fine-grained":[33],"optimization.":[34],"the":[36,44,64,92,98,123],"first":[37],"stage,":[38,66],"supervised":[40],"chain-of-thought":[41],"approach":[42],"guides":[43],"model":[45],"to":[46,85],"sequentially":[47],"analyze":[48],"describe":[50],"comprehensive":[52],"range":[53],"of":[54,94],"clinically":[55,60],"significant":[56],"thoracic":[57],"abnormalities,":[58],"ensuring":[59],"meaningful":[61],"coverage.":[62],"second":[65],"introduce":[68],"segment-level":[70],"reinforcement":[71],"learning":[72],"strategy":[73],"based":[74],"on":[75,122,144],"Group":[76],"Relative":[77],"Policy":[78],"Optimization":[79],"(GRPO),":[80],"which":[81],"assigns":[82],"precise":[83],"rewards":[84],"each":[86],"disease-specific":[87],"step":[89],"by":[90],"evaluating":[91],"corresponding":[95],"findings":[96],"in":[97,159],"synthesized":[99],"report.":[100],"This":[101],"design":[102],"provides":[103],"direct":[104],"feedback":[105],"for":[106],"intermediate":[107],"encourages":[110],"consistency":[111],"between":[112],"detailed":[113],"abnormality":[114],"analysis":[115],"final":[117],"conclusions.":[119],"Experimental":[120],"results":[121],"MIMIC-CXR":[124],"IU-Xray":[126],"datasets":[127],"demonstrate":[128],"our":[130],"achieves":[132],"state-of-the-art":[133],"performance":[134],"across":[135],"linguistic":[138],"metrics,":[139],"strong":[141],"zero-shot":[142],"generalization":[143],"IU-Xray.":[145],"The":[146],"proposed":[147],"method":[148],"significantly":[149],"enhances":[150],"interpretability":[151],"accuracy,":[154],"effectively":[155],"addressing":[156],"key":[157],"limitations":[158],"automated":[160],"radiology":[161],"generation.":[163]},"counts_by_year":[],"updated_date":"2026-06-05T06:17:00.636019","created_date":"2026-02-18T00:00:00"}
