Multi-Modal Multi-Agent Reinforcement Learning for Radiology Report Generation: Radiologist-Like Workflow with Clinically Verifiable Rewards

Abstract

We propose MARL-Rad, a novel multi-modal multi-agent reinforcement learning framework for radiology report generation that coordinates region-specific agents and a global integrating agent, optimized via clinically verifiable rewards. Unlike prior single-model reinforcement learning or post-hoc agentization of independently trained models, our method jointly trains multiple agents and optimizes the entire agent system through reinforcement learning. Experiments on the MIMIC-CXR and IU X-ray datasets show that MARL-Rad consistently improves clinically efficacy (CE) metrics such as RadGraph, CheXbert, and GREEN scores, achieving state-of-the-art CE performance. Further analyses confirm that MARL-Rad enhances laterality consistency and produces more accurate, detail-informed reports.