Spatio-Temporal and Retrieval-Augmented Modeling for Chest X-Ray Report Generation
Yan Qin Yang, Xiaoxing You, Ke Zhang, Zhenqi Fu, Xianyun Wang, Jiajun Ding, Jiamei Sun, Yu Zhou, Qingming Huang, Weidong Han, Jun Yu · IEEE Transactions on Medical Imaging · 2025
Chest X-ray report generation has attracted increasing research attention. However, most existing methods neglect the temporal information and typically generate reports conditioned on a fixed number of images. In this paper, we propose STREAM: Spatio-Temporal and REtrieval-Augmented Modelling for automatic chest X-ray report generation. It mimics clinical diagnosis by integrating current and historical studies to interpret the present condition (temporal), with each study containing images from multi-views (spatial). Concretely, our STREAM is built upon an encoder-decoder architecture, utilizing a large language model (LLM) as the decoder. Overall, spatio-temporal visual dynamics are packed as visual prompts and regional semantic entities are retrieved as textual prompts. First, a token packer is proposed to capture condensed spatio-temporal visual dynamics, enabling the flexible fusion of images from current and historical studies. Second, to augment the generation with existing knowledge and regional details, a progressive semantic retriever is proposed to retrieve semantic entities from a preconstructed knowledge bank as heuristic text prompts. The knowledge bank is constructed to encapsulate anatomical chest X-ray knowledge into structured entities, each linked to a specific chest region. Extensive experiments on public datasets have shown the state-of-the-art performance of our method. Related codes and the knowledge bank are available at https://github.com/yangyan22/STREAM.