STRIVE: Multi-Agent Structured Temporal Reasoning with Integrated Verification for Longitudinal Radiology Report Generation

STRIVE is a new framework for longitudinal radiology report generation that separates clinical reasoning into distinct Diagnosis, Attribute, and Temporal Change agents, each producing explicit evidence. The Temporal Change agent is refined with a Progression-Aware GRPO reward that differentiates direction-preserving errors from reversals. Verification occurs twice: a Consistency Gate aligns agent outputs before report generation, and a Validation Agent ensures the final report is supported by the aggregated evidence. On the Longitudinal-MIMIC dataset, STRIVE achieves superior clinical efficacy and more than doubles Longitudinal Change Concordance compared to the strongest baseline.

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• agents