Enhancing Reinforcement Learning for Radiology Report Generation with Evidence-aware Rewards and Self-correcting Preference Learning
Qin Zhou East China University of Science and Technology, Guoyan Liang, Qianyi Yang, Jingyuan Chen Zhejiang University, Sai Wu Zhejiang University, Chang Yao Zhejiang University, Zhe Wang
Recent reinforcement learning (RL) approaches have advanced radiology report generation (RRG), yet two core limitations persist: (1) report-level rewards offer limited evidence-grounded guidance for clinical faithfulness; and (2) current methods lack an explicit self-improving mechanism to align with clinical preference. We introduce clinically aligned Evidence-aware Self-Correcting Reinforcement Learning (ESC-RL), comprising two key components. First, a Group-wise Evidence-aware Alignment Reward (GEAR) delivers group-wise, evidence-aware feedback. GEAR reinforces consistent grounding for true positives, recovers missed findings for false negatives, and suppresses unsupported content for false positives. Second, a Self-correcting Preference Learning (SPL) strategy automatically constructs a reliable, disease-aware preference dataset from multiple noisy observations and leverages an LLM to synthesize refined reports without human supervision. ESC-RL promotes clinically faithful, disease-aligned reward and supports continual self-improvement during training. Extensive experiments on two public chest X-ray datasets demonstrate consistent gains and state-of-the-art performance.
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Proceedings of the 64th Annual Meeting of the Association for Computational Linguistics (Volume 1: Long Papers) · 2026 · 正式发表