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Hallucination filtering in radiology vision-language models using discrete semantic entropy.

Patrick Wienholt1,2, Sophie Caselitz3,4, Robert Siepmann3,4

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Discrete semantic entropy (DSE) effectively detects hallucination-prone questions for vision-language models (VLMs). This method significantly improves accuracy in radiologic image analysis, enhancing VLM reliability for clinical applications.

Keywords:
Data accuracyDiagnostic imagingEntropyGenerative artificial intelligenceImage interpretation (Computer-assisted)

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Area of Science:

  • Artificial Intelligence
  • Medical Imaging
  • Natural Language Processing

Background:

  • Black-box vision-language models (VLMs) are increasingly used for radiologic image analysis.
  • Hallucinations, or inaccurate information generation, pose a significant challenge to VLM reliability in clinical settings.
  • Current methods for detecting VLM hallucinations are limited, especially in black-box scenarios.

Purpose of the Study:

  • To evaluate the efficacy of discrete semantic entropy (DSE) in identifying questions that may lead to hallucinations in VLMs.
  • To determine if DSE-based filtering can improve the accuracy of VLMs in radiologic image-based visual question answering (VQA).

Main Methods:

  • A retrospective study utilized two public datasets (VQA-Med 2019 and a diagnostic radiology dataset).
  • GPT-4o and GPT-4.1 models answered questions, with DSE computed from semantic response clusters.
  • Accuracy was assessed before and after filtering questions with DSE > 0.3.

Main Results:

  • Baseline accuracy for GPT-4o was 51.7% and for GPT-4.1 was 54.8%.
  • After DSE filtering (DSE > 0.3), accuracy increased to 76.3% for GPT-4o and 63.8% for GPT-4.1.
  • Accuracy gains were statistically significant across datasets, even after Bonferroni correction.

Conclusions:

  • DSE reliably detects hallucinations in black-box VLMs by quantifying semantic inconsistency.
  • This method significantly enhances diagnostic answer accuracy in radiologic VQA.
  • DSE provides a practical filtering strategy to improve the safety and trustworthiness of clinical VLM applications.