重新思考放射报告生成：从叙事流到主题引导 findings

ICLR 2026 Poster accepted paper at ICLR 2026. Vision-Language Models (VLMs) for radiology report generation are typically trained to mimic the narrative flow of human experts. However, we identify a potential limitation in this conventional paradigm. We hypothesize that optimizing for narrative coherence encourages models to rely on linguistic priors and inter-sentence correlations, which can weaken their grounding in direct visual evidence and lead to factual inaccuracies. To investigate this, we design a controlled experiment demonstrating that as textual context increases, a model's reliance on the input image systematically decays. We propose LLaVA-TA (Topic-guided and Anatomy-aware), a new fine-tuning framework that directly addresses this challenge by re-engineering the generation process.