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--> [Submitted on 5 Aug 2026] Title:Positive-Unlabeled Preference Optimization For Chest X-ray Report Generation View a PDF of the paper titled Positive-Unlabeled Preference Optimization For Chest X-ray Report Generation, by Yuta Kobayashi and 7 other authors View PDF HTML (experimental) Abstract:Vision-Language Models (VLMs) for radiology report generation are typically trained on retrospective clinical reports, which suffer from omission noise: clinically present findings are left unreported due to the omission of subtle findings. For example, prior studies show that cardiomegaly may be omitted from ICU chest X-ray reports when the imaging request is focused on monitoring support device placement. As a result, models trained with standard approaches inherit these omissions, learning to under-report findings themselves. We propose PU-DPO, a preference optimization framework to prevent omission noise from corrupting the preference signal. We reformulate the objective under a positive-unlabeled (PU) learning framework, treating absent mentions as unlabeled rather than truly negative. Our framework provides preference supervision using constructed contrastive pairs, generated using edits to model responses, producing variants that explicitly mention or omit a specific finding. Generated responses that mention the finding are naturally preferred in the context of visual evidence. Across semi-synthetic experiments and analyses on real-world chest radiograph benchmarks where adjudicated labels are available, PU-DPO yields consistent gains in detection rates and recovery of hidden positives across multiple pathologies, and is more robust to omission noise than prior approaches. Subjects: Computer Vision and Pattern Recognition (cs.CV); Machine Learning (cs.LG) Cite as: arXiv:2608.05341 [cs.CV] (or arXiv:2608.05341v1 [cs.CV] for this version) https://doi.org/10.48550/arXiv.2608.05341 arXiv-issued DOI via DataCite (pending registration) Submission history From: Yuta Kobayashi [view email] [v1] Wed, 5 Aug 2026 18:59:23 UTC (3,065 KB) Full-text links: Access Paper: View a PDF of the paper titled Positive-Unlabeled Preference Optimization For Chest X-ray Report Generation, by Yuta Kobayashi and 7 other authors View PDF HTML (experimental) TeX Source view license Current browse context: cs.CV new | recent | 2026-08 Change to browse by: cs cs.LG References & Citations NASA ADS Google Scholar Semantic Scholar Loading... Data provided by: 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 Code, Data and Media Associated with this Article alphaXiv Toggle alphaXiv (What is alphaXiv?) Links to Code Toggle CatalyzeX Code Finder for Papers (What is CatalyzeX?) DagsHub Toggle DagsHub (What is DagsHub?) GotitPub Toggle Gotit.pub (What is GotitPub?) Huggingface Toggle Hugging Face (What is Huggingface?) ScienceCast Toggle ScienceCast (What is ScienceCast?) Demos Demos Replicate Toggle Replicate (What is Replicate?) Spaces Toggle Hugging Face Spaces (What is Spaces?) Spaces Toggle TXYZ.AI (What is TXYZ.AI?) Related Papers Recommenders and Search Tools Link to Influence Flower Influence Flower (What are Influence Flowers?) Core recommender toggle CORE Recommender (What is CORE?) Author Venue Institution Topic About arXivLabs arXivLabs: experimental projects with community collaborators arXivLabs is a framework that allows collaborators to develop and share new arXiv features directly on our website. Both individuals and organizations that work with arXivLabs have embraced and accepted our values of openness, community, excellence, and user data privacy. arXiv is committed to these values and only works with partners that adhere to them. Have an idea for a project that will add value for arXiv's community? Learn more about arXivLabs. Which authors of this paper are endorsers? | Disable MathJax (What is MathJax?)