ChatRadio-Valuer: A Chat Large Language Model for Generalizable Radiology Report Generation Based on Multi-institution and Multi-system Data

Radiology report generation, as a key step in medical image analysis, is critical to the quantitative analysis of clinically informed decision-making levels. However, complex and diverse radiology reports with cross-source heterogeneity pose a huge generalizability challenge to the current methods under massive data volume, mainly because the style and normativity of radiology reports are obviously distinctive among institutions, body regions inspected and radiologists. Recently, the advent of large language models (LLM) offers great potential for recognizing signs of health conditions. To resolve the above problem, we collaborate with the Second Xiangya Hospital in China and propose ChatRadio-Valuer based on the LLM, a tailored model for automatic radiology report generation that learns generalizable representations and provides a basis pattern for model adaptation in sophisticated analysts' cases. Specifically, ChatRadio-Valuer is trained based on the radiology reports from a single institution by means of supervised fine-tuning, and then adapted to disease diagnosis tasks for human multi-system evaluation (i.e., chest, abdomen, muscle-skeleton, head, and maxillofacial $\&$ neck) from six different institutions in clinical-level events. The clinical dataset utilized in this study encompasses a remarkable total of \textbf{332,673} observations. From the comprehensive results on engineering indicators, clinical efficacy and deployment cost metrics, it can be shown that ChatRadio-Valuer consistently outperforms state-of-the-art models, especially ChatGPT (GPT-3.5-Turbo) and GPT-4 et al., in terms of the diseases diagnosis from radiology reports. ChatRadio-Valuer provides an effective avenue to boost model generalization performance and alleviate the annotation workload of experts to enable the promotion of clinical AI applications in radiology reports.

Radiology-Llama2: Best-in-Class Large Language Model for Radiology

This paper introduces Radiology-Llama2, a large language model specialized for radiology through a process known as instruction tuning. Radiology-Llama2 is based on the Llama2 architecture and further trained on a large dataset of radiology reports to generate coherent and clinically useful impressions from radiological findings. Quantitative evaluations using ROUGE metrics on the MIMIC-CXR and OpenI datasets demonstrate that Radiology-Llama2 achieves state-of-the-art performance compared to other generative language models, with a Rouge-1 score of 0.4834 on MIMIC-CXR and 0.4185 on OpenI. Additional assessments by radiology experts highlight the model's strengths in understandability, coherence, relevance, conciseness, and clinical utility. The work illustrates the potential of localized language models designed and tuned for specialized domains like radiology. When properly evaluated and deployed, such models can transform fields like radiology by automating rote tasks and enhancing human expertise.

Contrastive Diffusion Model with Auxiliary Guidance for Coarse-to-Fine PET Reconstruction

To obtain high-quality positron emission tomography (PET) scans while reducing radiation exposure to the human body, various approaches have been proposed to reconstruct standard-dose PET (SPET) images from low-dose PET (LPET) images. One widely adopted technique is the generative adversarial networks (GANs), yet recently, diffusion probabilistic models (DPMs) have emerged as a compelling alternative due to their improved sample quality and higher log-likelihood scores compared to GANs. Despite this, DPMs suffer from two major drawbacks in real clinical settings, i.e., the computationally expensive sampling process and the insufficient preservation of correspondence between the conditioning LPET image and the reconstructed PET (RPET) image. To address the above limitations, this paper presents a coarse-to-fine PET reconstruction framework that consists of a coarse prediction module (CPM) and an iterative refinement module (IRM). The CPM generates a coarse PET image via a deterministic process, and the IRM samples the residual iteratively. By delegating most of the computational overhead to the CPM, the overall sampling speed of our method can be significantly improved. Furthermore, two additional strategies, i.e., an auxiliary guidance strategy and a contrastive diffusion strategy, are proposed and integrated into the reconstruction process, which can enhance the correspondence between the LPET image and the RPET image, further improving clinical reliability. Extensive experiments on two human brain PET datasets demonstrate that our method outperforms the state-of-the-art PET reconstruction methods. The source code is available at \url{https://github.com/Show-han/PET-Reconstruction}.

Tissue Segmentation of Thick-Slice Fetal Brain MR Scans with Guidance from High-Quality Isotropic Volumes

Accurate tissue segmentation of thick-slice fetal brain magnetic resonance (MR) scans is crucial for both reconstruction of isotropic brain MR volumes and the quantification of fetal brain development. However, this task is challenging due to the use of thick-slice scans in clinically-acquired fetal brain data. To address this issue, we propose to leverage high-quality isotropic fetal brain MR volumes (and also their corresponding annotations) as guidance for segmentation of thick-slice scans. Due to existence of significant domain gap between high-quality isotropic volume (i.e., source data) and thick-slice scans (i.e., target data), we employ a domain adaptation technique to achieve the associated knowledge transfer (from high-quality <source> volumes to thick-slice <target> scans). Specifically, we first register the available high-quality isotropic fetal brain MR volumes across different gestational weeks to construct longitudinally-complete source data. To capture domain-invariant information, we then perform Fourier decomposition to extract image content and style codes. Finally, we propose a novel Cycle-Consistent Domain Adaptation Network (C2DA-Net) to efficiently transfer the knowledge learned from high-quality isotropic volumes for accurate tissue segmentation of thick-slice scans. Our C2DA-Net can fully utilize a small set of annotated isotropic volumes to guide tissue segmentation on unannotated thick-slice scans. Extensive experiments on a large-scale dataset of 372 clinically acquired thick-slice MR scans demonstrate that our C2DA-Net achieves much better performance than cutting-edge methods quantitatively and qualitatively.

TriDo-Former: A Triple-Domain Transformer for Direct PET Reconstruction from Low-Dose Sinograms

To obtain high-quality positron emission tomography (PET) images while minimizing radiation exposure, various methods have been proposed for reconstructing standard-dose PET (SPET) images from low-dose PET (LPET) sinograms directly. However, current methods often neglect boundaries during sinogram-to-image reconstruction, resulting in high-frequency distortion in the frequency domain and diminished or fuzzy edges in the reconstructed images. Furthermore, the convolutional architectures, which are commonly used, lack the ability to model long-range non-local interactions, potentially leading to inaccurate representations of global structures. To alleviate these problems, we propose a transformer-based model that unites triple domains of sinogram, image, and frequency for direct PET reconstruction, namely TriDo-Former. Specifically, the TriDo-Former consists of two cascaded networks, i.e., a sinogram enhancement transformer (SE-Former) for denoising the input LPET sinograms and a spatial-spectral reconstruction transformer (SSR-Former) for reconstructing SPET images from the denoised sinograms. Different from the vanilla transformer that splits an image into 2D patches, based specifically on the PET imaging mechanism, our SE-Former divides the sinogram into 1D projection view angles to maintain its inner-structure while denoising, preventing the noise in the sinogram from prorogating into the image domain. Moreover, to mitigate high-frequency distortion and improve reconstruction details, we integrate global frequency parsers (GFPs) into SSR-Former. The GFP serves as a learnable frequency filter that globally adjusts the frequency components in the frequency domain, enforcing the network to restore high-frequency details resembling real SPET images. Validations on a clinical dataset demonstrate that our TriDo-Former outperforms the state-of-the-art methods qualitatively and quantitatively.

Evaluating Large Language Models for Radiology Natural Language Processing

The rise of large language models (LLMs) has marked a pivotal shift in the field of natural language processing (NLP). LLMs have revolutionized a multitude of domains, and they have made a significant impact in the medical field. Large language models are now more abundant than ever, and many of these models exhibit bilingual capabilities, proficient in both English and Chinese. However, a comprehensive evaluation of these models remains to be conducted. This lack of assessment is especially apparent within the context of radiology NLP. This study seeks to bridge this gap by critically evaluating thirty two LLMs in interpreting radiology reports, a crucial component of radiology NLP. Specifically, the ability to derive impressions from radiologic findings is assessed. The outcomes of this evaluation provide key insights into the performance, strengths, and weaknesses of these LLMs, informing their practical applications within the medical domain.

Multi-View Vertebra Localization and Identification from CT Images

Accurately localizing and identifying vertebrae from CT images is crucial for various clinical applications. However, most existing efforts are performed on 3D with cropping patch operation, suffering from the large computation costs and limited global information. In this paper, we propose a multi-view vertebra localization and identification from CT images, converting the 3D problem into a 2D localization and identification task on different views. Without the limitation of the 3D cropped patch, our method can learn the multi-view global information naturally. Moreover, to better capture the anatomical structure information from different view perspectives, a multi-view contrastive learning strategy is developed to pre-train the backbone. Additionally, we further propose a Sequence Loss to maintain the sequential structure embedded along the vertebrae. Evaluation results demonstrate that, with only two 2D networks, our method can localize and identify vertebrae in CT images accurately, and outperforms the state-of-the-art methods consistently. Our code is available at https://github.com/ShanghaiTech-IMPACT/Multi-View-Vertebra-Localization-and-Identification-from-CT-Images.

Accurate 3D Prediction of Missing Teeth in Diverse Patterns for Precise Dental Implant Planning

In recent years, the demand for dental implants has surged, driven by their high success rates and esthetic advantages. However, accurate prediction of missing teeth for precise digital implant planning remains a challenge due to the intricate nature of dental structures and the variability in tooth loss patterns. This study presents a novel framework for accurate prediction of missing teeth in different patterns, facilitating digital implant planning. The proposed framework begins by estimating point-to-point correspondence among a dataset of dental mesh models reconstructed from CBCT images of healthy subjects. Subsequently, tooth dictionaries are constructed for each tooth type, encoding their position and shape information based on the established point-to-point correspondence. To predict missing teeth in a given dental mesh model, sparse coefficients are learned by sparsely representing adjacent teeth of the missing teeth using the corresponding tooth dictionaries. These coefficients are then applied to the dictionaries of the missing teeth to generate accurate predictions of their positions and shapes. The evaluation results on real subjects shows that our proposed framework achieves an average prediction error of 1.04mm for predictions of single missing tooth and an average prediction error of 1.33mm for the prediction of 14 missing teeth, which demonstrates its capability of accurately predicting missing teeth in various patterns. By accurately predicting missing teeth, dental professionals can improve the planning and placement of dental implants, leading to better esthetic and functional outcomes for patients undergoing dental implant procedures.

Review of Large Vision Models and Visual Prompt Engineering

Visual prompt engineering is a fundamental technology in the field of visual and image Artificial General Intelligence, serving as a key component for achieving zero-shot capabilities. As the development of large vision models progresses, the importance of prompt engineering becomes increasingly evident. Designing suitable prompts for specific visual tasks has emerged as a meaningful research direction. This review aims to summarize the methods employed in the computer vision domain for large vision models and visual prompt engineering, exploring the latest advancements in visual prompt engineering. We present influential large models in the visual domain and a range of prompt engineering methods employed on these models. It is our hope that this review provides a comprehensive and systematic description of prompt engineering methods based on large visual models, offering valuable insights for future researchers in their exploration of this field.

Artificial General Intelligence for Medical Imaging

In this review, we explore the potential applications of Artificial General Intelligence (AGI) models in healthcare, focusing on foundational Large Language Models (LLMs), Large Vision Models, and Large Multimodal Models. We emphasize the importance of integrating clinical expertise, domain knowledge, and multimodal capabilities into AGI models. In addition, we lay out key roadmaps that guide the development and deployment of healthcare AGI models. Throughout the review, we provide critical perspectives on the potential challenges and pitfalls associated with deploying large-scale AGI models in the medical field. This comprehensive review aims to offer insights into the future implications of AGI in medical imaging, healthcare and beyond.