VERT: Reliable LLM Judges for Radiology Report Evaluation

Computer Science > Artificial Intelligence [Submitted on 3 Apr 2026] VERT: Reliable LLM Judges for Radiology Report Evaluation Federica Bologna, Jean-Philippe Corbeil, Matthew Wilkens, Asma Ben Abacha Current literature on radiology report evaluation has focused primarily on designing LLM-based metrics and fine-tuning small models for chest X-rays. However, it remains unclear whether these approaches are robust when applied to reports from other modalities and anatomies. Which model and prompt configurations are best suited to serve as LLM judges for radiology evaluation? We conduct a thorough correlation analysis between expert and LLM-based ratings. We compare three existing LLM-as-a-judge metrics (RadFact, GREEN, and FineRadScore) alongside VERT, our proposed LLM-based metric, using open- and closed-source models (reasoning and non-reasoning) of different sizes across two expert-annotated datasets, RadEval and RaTE-Eval, spanning multiple modalities and anatomies. We further evaluate few-shot approaches, ensembling, and parameter-efficient fine-tuning using RaTE-Eval. To better understand metric behavior, we perform a systematic error detection and categorization study to assess alignment of these metrics against expert judgments and identify areas of lower and higher agreement. Our results show that VERT improves correlation with radiologist judgments by up to 11.7% relative to GREEN. Furthermore, fine-tuning Qwen3 30B yield gains of up to 25% using only 1,300 training samples. The fine-tuned model also reduces inference time up to 37.2 times. These findings highlight the effectiveness of LLM-based judges and demonstrate that reliable evaluation can be achieved with lightweight adaptation. Subjects: Artificial Intelligence (cs.AI); Computation and Language (cs.CL) Cite as: arXiv:2604.03376 [cs.AI]   (or arXiv:2604.03376v1 [cs.AI] for this version)   https://doi.org/10.48550/arXiv.2604.03376 Focus to learn more Submission history From: Federica Bologna [view email] [v1] Fri, 3 Apr 2026 18:10:21 UTC (1,287 KB) Access Paper: HTML (experimental) view license Current browse context: cs.AI < prev   |   next > new | recent | 2026-04 Change to browse by: cs cs.CL References & Citations NASA ADS Google Scholar Semantic Scholar Export BibTeX Citation Bookmark Bibliographic Tools Bibliographic and Citation Tools Bibliographic Explorer Toggle Bibliographic Explorer (What is the Explorer?) Connected Papers Toggle Connected Papers (What is Connected Papers?) Litmaps Toggle Litmaps (What is Litmaps?) scite.ai Toggle scite Smart Citations (What are Smart Citations?) Code, Data, Media Demos Related Papers About arXivLabs Which authors of this paper are endorsers? | Disable MathJax (What is MathJax?)