Radiology report generation (RRG) has shown great potential in assisting radiologists by automating the labor-intensive task of report writing. While recent advancements have improved the quality and coherence of generated reports, ensuring their factual correctness remains a critical challenge. Although generative medical Vision Large Language Models (VLLMs) have been proposed to address this issue, these models are prone to hallucinations and can produce inaccurate diagnostic information. To address these concerns, we introduce a novel Semantic Consistency-Based Uncertainty Quantification framework that provides both report-level and sentence-level uncertainties. Unlike existing approaches, our method does not require modifications to the underlying model or access to its inner state, such as output token logits, thus serving as a plug-and-play module that can be seamlessly integrated with state-of-the-art models. Extensive experiments demonstrate the efficacy of our method in detecting hallucinations and enhancing the factual accuracy of automatically generated radiology reports. By abstaining from high-uncertainty reports, our approach improves factuality scores by 10%, achieved by rejecting 20% of reports on the MIMIC-CXR dataset. Furthermore, sentence-level uncertainty flags the lowest-precision sentence in each report with an 82.9% success rate. Our implementation is open-source and available at https://github.com/BU-DEPEND-Lab/SCUQ-RRG.

In retrieval-augmented systems, context ranking techniques are commonly employed to reorder the retrieved contexts based on their relevance to a user query. A standard approach is to measure this relevance through the similarity between contexts and queries in the embedding space. However, such similarity often fails to capture the relevance. Alternatively, large language models (LLMs) have been used for ranking contexts. However, they can encounter scalability issues when the number of candidate contexts grows and the context window sizes of the LLMs remain constrained. Additionally, these approaches require fine-tuning LLMs with domain-specific data. In this work, we introduce a scalable ranking framework that combines embedding similarity and LLM capabilities without requiring LLM fine-tuning. Our framework uses a pre-trained LLM to hypothesize the user query based on the retrieved contexts and ranks the context based on the similarity between the hypothesized queries and the user query. Our framework is efficient at inference time and is compatible with many other retrieval and ranking techniques. Experimental results show that our method improves the ranking performance across multiple benchmarks.