ACL2026

Multimodal Dual-Path Decoding for Medical Report Generation

Jinghan Sun, Dong Wei, Zhihong Zhu, Yuyang Xue, Steven McDonagh, Xian Wu

Abstract

Radiology report generation requires precise alignment between medical imaging findings and clinically coherent textual descriptions. While current methods predominantly rely on either large vision-language models (LVLMs) for visual grounding or large language models (LLMs) for medical narrative generation, they often fail to effectively integrate multimodal clinical evidence with domain-specific knowledge. This paper proposes a novel multimodal dual-path framework that synergistically combines LVLMs and LLMs to address these limitations. Our approach establishes a dynamic fusion between LVLMs' visual-semantic grounding capabilities and LLMs' clinical knowledge reasoning. Specifically, we employ a structured prompting strategy that models the report generation task into three clinically meaningful sections and introduces fine-grained multilabel classification prompts to guide the models, enabling more accurate and comprehensive clinical report generation. Experiments on the public MIMIC-CXR and IU-Xray benchmarks demonstrate our framework's superiority over state-of-the-art methods.