Mechanisms are provided to implement an automated medical imaging report generator which receives an input medical image and inputs the input medical image into a machine learning (ML) computer model trained to predict finding labels based on patterns of image features extracted from the medical image. The ML computer model generates a prediction of a finding label applicable to the input medical image in terms of a finding label prediction output vector. Based on the finding label prediction output vector, a lookup operation is performed, in a medical report database of previously processed medical imaging report data structures, to find a matching medical imaging report data structure corresponding to the finding label. An output medical imaging report is generated for the input medical image based on natural language content of the matching medical imaging report data structure.