SDR: Set-Distance Rewards for Radiology Report Generation

Computer Science > Artificial Intelligence [Submitted on 30 May 2026] SDR: Set-Distance Rewards for Radiology Report Generation Halil Ibrahim Gulluk, Max Van Puyvelde, Wim Van Criekinge, Olivier Gevaert Reinforcement learning with verifiable rewards has rapidly advanced reasoning in vision--language models. However, for chest X-ray report generation, the standard rewards (i.e. exact-match accuracy and step-level processes) are incompatible because the reports consist of unordered and orthogonal findings, rather than a causal reasoning chain. We address this gap with a set-based view: each report is split into sentences and embedded by a frozen sentence transformer, yielding unordered embedding sets. We propose the use of set-to-set distances between generated and reference embeddings as continuous, permutation-invariant rewards. Across two datasets and three vision--language models (Qwen3-VL-2B/4B, Gemma3-4B), post-training with set-to-set distance based rewards via GRPO consistently outperforms supervised fine-tuning and exact-match GRPO on all headline metrics (BERTScore, RadGraph F1 and CheXbert F1 by average \%6.80, \%7.82 and \%4.45 relative improvements respectively). The same set distances also enable test-time best-of-N selection: scoring candidates by their distance to training-report embeddings outperforms random selection on our trained models as well as three closed-source LLMs (Mistral-Small, Gemini-2.5 Flash-Lite, GPT-4o-mini) with on average \%16.4 relative improvement on BERTScore. Used as a streaming signal, they support a more efficient form of test-time scaling: pruning low-scoring candidates mid-generation reduces generated tokens by over 50\% while preserving the Findings quality of full best-of-N selection. Together these results establish set-distance rewards as a unified signal for both post-training and test-time scaling in chest X-ray report generation. Our code is publicly \href{this https URL}{available}. Subjects: Artificial Intelligence (cs.AI) Cite as: arXiv:2606.00440 [cs.AI]   (or arXiv:2606.00440v1 [cs.AI] for this version)   https://doi.org/10.48550/arXiv.2606.00440 Focus to learn more Submission history From: Halil Ibrahim Gulluk [view email] [v1] Sat, 30 May 2026 00:10:51 UTC (1,951 KB) Access Paper: HTML (experimental) view license Current browse context: cs.AI < prev   |   next > new | recent | 2026-06 Change to browse by: cs 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?)