TIM: Temporal Decoupling with Iterative Mutual-Refinement Model for Longitudinal Radiology Report Generation

Overview & Synopsis

Automatic radiology report generation (RRG) aims to translate medical images into diagnostic text, reducing radiologists' workload and standardizing clinical documentation. Nonetheless, existing approaches mainly focus on single-timepoint analysis and fail to capture temporal disease evolution across longitudinal examinations. While recent longitudinal RRG (LRRG) approaches incorporate historical data, they often combine images from different time points within a single representation space, leading to blurred semantics and inconsistent temporal reasoning. In this work, we propose a Temporal Decoupling with Iterative Mutual-Refinement Model (TIM), a two-stage framework that explicitly decouples spatial pathology from temporal progression and iteratively refines reports through mutual feedback. Stage I performs temporal-decoupled representation learning, separating temporal evolution patterns from disease-specific features and generating radiology reports for both prior and current studies. Stage II introduces a mutual report refinement mechanism that identifies diagnostic inconsistencies within prior reports and iteratively rectifies both prior and current reports through error-sensitive feedback. Experiments on the Longitudinal-MIMIC dataset demonstrate that TIM surpasses existing single-image and longitudinal baselines, achieving new state-of-the-art performance across both language and clinical metrics. Code is available at https://github.com/yihengd/TIM.