Dataset and Benchmark for Enhancing Critical Retained Foreign Object Detection

Critical retained foreign objects (RFOs), including surgical instruments like sponges and needles, pose serious patient safety risks and carry significant financial and legal implications for healthcare institutions. Detecting critical RFOs using artificial intelligence remains challenging due to their rarity and the limited availability of chest X-ray datasets that specifically feature critical RFOs cases. Existing datasets only contain non-critical RFOs, like necklace or zipper, further limiting their utility for developing clinically impactful detection algorithms. To address these limitations, we introduce "Hopkins RFOs Bench", the first and largest dataset of its kind, containing 144 chest X-ray images of critical RFO cases collected over 18 years from the Johns Hopkins Health System. Using this dataset, we benchmark several state-of-the-art object detection models, highlighting the need for enhanced detection methodologies for critical RFO cases. Recognizing data scarcity challenges, we further explore image synthetic methods to bridge this gap. We evaluate two advanced synthetic image methods, DeepDRR-RFO, a physics-based method, and RoentGen-RFO, a diffusion-based method, for creating realistic radiographs featuring critical RFOs. Our comprehensive analysis identifies the strengths and limitations of each synthetic method, providing insights into effectively utilizing synthetic data to enhance model training. The Hopkins RFOs Bench and our findings significantly advance the development of reliable, generalizable AI-driven solutions for detecting critical RFOs in clinical chest X-rays.

Abn-BLIP: Abnormality-aligned Bootstrapping Language-Image Pre-training for Pulmonary Embolism Diagnosis and Report Generation from CTPA

Medical imaging plays a pivotal role in modern healthcare, with computed tomography pulmonary angiography (CTPA) being a critical tool for diagnosing pulmonary embolism and other thoracic conditions. However, the complexity of interpreting CTPA scans and generating accurate radiology reports remains a significant challenge. This paper introduces Abn-BLIP (Abnormality-aligned Bootstrapping Language-Image Pretraining), an advanced diagnosis model designed to align abnormal findings to generate the accuracy and comprehensiveness of radiology reports. By leveraging learnable queries and cross-modal attention mechanisms, our model demonstrates superior performance in detecting abnormalities, reducing missed findings, and generating structured reports compared to existing methods. Our experiments show that Abn-BLIP outperforms state-of-the-art medical vision-language models and 3D report generation methods in both accuracy and clinical relevance. These results highlight the potential of integrating multimodal learning strategies for improving radiology reporting. The source code is available at https://github.com/zzs95/abn-blip.

SMC-UDA: Structure-Modal Constraint for Unsupervised Cross-Domain Renal Segmentation

Medical image segmentation based on deep learning often fails when deployed on images from a different domain. The domain adaptation methods aim to solve domain-shift challenges, but still face some problems. The transfer learning methods require annotation on the target domain, and the generative unsupervised domain adaptation (UDA) models ignore domain-specific representations, whose generated quality highly restricts segmentation performance. In this study, we propose a novel Structure-Modal Constrained (SMC) UDA framework based on a discriminative paradigm and introduce edge structure as a bridge between domains. The proposed multi-modal learning backbone distills structure information from image texture to distinguish domain-invariant edge structure. With the structure-constrained self-learning and progressive ROI, our methods segment the kidney by locating the 3D spatial structure of the edge. We evaluated SMC-UDA on public renal segmentation datasets, adapting from the labeled source domain (CT) to the unlabeled target domain (CT/MRI). The experiments show that our proposed SMC-UDA has a strong generalization and outperforms generative UDA methods.