PET2Rep: Towards Vision-Language Model-Drived Automated Radiology Report Generation for Positron Emission Tomography

Positron emission tomography (PET) is a cornerstone of modern oncologic and neurologic imaging, distinguished by its unique ability to illuminate dynamic metabolic processes that transcend the anatomical focus of traditional imaging technologies. Radiology reports are essential for clinical decision making, yet their manual creation is labor-intensive and time-consuming. Recent advancements of vision-language models (VLMs) have shown strong potential in medical applications, presenting a promising avenue for automating report generation. However, existing applications of VLMs in the medical domain have predominantly focused on structural imaging modalities, while the unique characteristics of molecular PET imaging have largely been overlooked. To bridge the gap, we introduce PET2Rep, a large-scale comprehensive benchmark for evaluation of general and medical VLMs for radiology report generation for PET images. PET2Rep stands out as the first dedicated dataset for PET report generation with metabolic information, uniquely capturing whole-body image-report pairs that cover dozens of organs to fill the critical gap in existing benchmarks and mirror real-world clinical comprehensiveness. In addition to widely recognized natural language generation metrics, we introduce a series of clinical efficiency metrics to evaluate the quality of radiotracer uptake pattern description in key organs in generated reports. We conduct a head-to-head comparison of 30 cutting-edge general-purpose and medical-specialized VLMs. The results show that the current state-of-the-art VLMs perform poorly on PET report generation task, falling considerably short of fulfilling practical needs. Moreover, we identify several key insufficiency that need to be addressed to advance the development in medical applications.

Fast on the Easy, Deep on the Hard: Efficient Reasoning via Powered Length Penalty

Large language models (LLMs) have demonstrated significant advancements in reasoning capabilities, performing well on various challenging benchmarks. Techniques like Chain-of-Thought prompting have been introduced to further improve reasoning. However, these approaches frequently generate longer outputs, which in turn increase computational latency. Although some methods use reinforcement learning to shorten reasoning, they often apply uniform penalties without considering the problem's complexity, leading to suboptimal outcomes. In this study, we seek to enhance the efficiency of LLM reasoning by promoting conciseness for simpler problems while preserving sufficient reasoning for more complex ones for accuracy, thus improving the model's overall performance. Specifically, we manage the model's reasoning efficiency by dividing the reward function and including a novel penalty for output length. Our approach has yielded impressive outcomes in benchmark evaluations across three datasets: GSM8K, MATH500, and AIME2024. For the comparatively simpler datasets GSM8K and MATH500, our method has effectively shortened output lengths while preserving or enhancing accuracy. On the more demanding AIME2024 dataset, our approach has resulted in improved accuracy.