cs.CLFeb 28, 2026

LLM-Bootstrapped Targeted Finding Guidance for Factual MLLM-based Medical Report Generation

Authors: Cunyuan Yang, Dejuan Song, Xiaotao Pang, Qianqian Shen, Wenjie Nie, Yifan Huang, Lei Wu, Wei Han, 

Organizations: Zhejiang University · The Second Affiliated Hospital Zhejiang University School of Medicine · Hangzhou Pu Jian Medical Technology Co., Ltd.

Abstract

The automatic generation of medical reports utilizing Multimodal Large Language Models (MLLMs) frequently encounters challenges related to factual instability, which may manifest as the omission of findings or the incorporation of inaccurate information, thereby constraining their applicability in clinical settings. Current methodologies typically produce reports based directly on image features, which inherently lack a definitive factual basis. In response to this limitation, we introduce Fact-Flow, an innovative framework that separates the process of visual fact identification from the generation of reports. This is achieved by initially predicting clinical findings from the image, which subsequently directs the MLLM to produce a report that is factually precise. A pivotal advancement of our approach is a pipeline that leverages a Large Language Model (LLM) to autonomously create a dataset of labeled medical findings, effectively eliminating the need for expensive manual annotation. Extensive experimental evaluations conducted on two disease-focused medical datasets validate the efficacy of our method, demonstrating a significant enhancement in factual accuracy compared to state-of-the-art models, while concurrently preserving high standards of text quality.

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