Abstract:Multimodal foundation models hold significant potential for automating radiology report generation, thereby assisting clinicians in diagnosing cardiac diseases. However, generated reports often suffer from serious factual inaccuracy. In this paper, we introduce a fact-aware multimodal retrieval-augmented pipeline in generating accurate radiology reports (FactMM-RAG). We first leverage RadGraph to mine factual report pairs, then integrate factual knowledge to train a universal multimodal retriever. Given a radiology image, our retriever can identify high-quality reference reports to augment multimodal foundation models, thus enhancing the factual completeness and correctness of report generation. Experiments on two benchmark datasets show that our multimodal retriever outperforms state-of-the-art retrievers on both language generation and radiology-specific metrics, up to 6.5% and 2% score in F1CheXbert and F1RadGraph. Further analysis indicates that employing our factually-informed training strategy imposes an effective supervision signal, without relying on explicit diagnostic label guidance, and successfully propagates fact-aware capabilities from the multimodal retriever to the multimodal foundation model in radiology report generation.