MedSAM-based lung masking for multi-label chest X-ray classification

Chest X-ray (CXR) imaging is widely used for screening and diagnosing pulmonary abnormalities, yet automated interpretation remains challenging due to weak disease signals, dataset bias, and limited spatial supervision. Foundation models for medical image segmentation (MedSAM) provide an opportunity to introduce anatomically grounded priors that may improve robustness and interpretability in CXR analysis. We propose a segmentation-guided CXR classification pipeline that integrates MedSAM as a lung region extraction module prior to multi-label abnormality classification. MedSAM is fine-tuned using a public image-mask dataset from Airlangga University Hospital. We then apply it to a curated subset of the public NIH CXR dataset to train and evaluate deep convolutional neural networks for multi-label prediction of five abnormalities (Mass, Nodule, Pneumonia, Edema, and Fibrosis), with the normal case (No Finding) evaluated via a derived score. Experiments show that MedSAM produces anatomically plausible lung masks across diverse imaging conditions. We find that masking effects are both task-dependent and architecture-dependent. ResNet50 trained on original images achieves the strongest overall abnormality discrimination, while loose lung masking yields comparable macro AUROC but significantly improves No Finding discrimination, indicating a trade-off between abnormality-specific classification and normal case screening. Tight masking consistently reduces abnormality level performance but improves training efficiency. Loose masking partially mitigates this degradation by preserving perihilar and peripheral context. These results suggest that lung masking should be treated as a controllable spatial prior selected to match the backbone and clinical objective, rather than applied uniformly.

LongT2IBench: A Benchmark for Evaluating Long Text-to-Image Generation with Graph-structured Annotations

The increasing popularity of long Text-to-Image (T2I) generation has created an urgent need for automatic and interpretable models that can evaluate the image-text alignment in long prompt scenarios. However, the existing T2I alignment benchmarks predominantly focus on short prompt scenarios and only provide MOS or Likert scale annotations. This inherent limitation hinders the development of long T2I evaluators, particularly in terms of the interpretability of alignment. In this study, we contribute LongT2IBench, which comprises 14K long text-image pairs accompanied by graph-structured human annotations. Given the detail-intensive nature of long prompts, we first design a Generate-Refine-Qualify annotation protocol to convert them into textual graph structures that encompass entities, attributes, and relations. Through this transformation, fine-grained alignment annotations are achieved based on these granular elements. Finally, the graph-structed annotations are converted into alignment scores and interpretations to facilitate the design of T2I evaluation models. Based on LongT2IBench, we further propose LongT2IExpert, a LongT2I evaluator that enables multi-modal large language models (MLLMs) to provide both quantitative scores and structured interpretations through an instruction-tuning process with Hierarchical Alignment Chain-of-Thought (CoT). Extensive experiments and comparisons demonstrate the superiority of the proposed LongT2IExpert in alignment evaluation and interpretation. Data and code have been released in https://welldky.github.io/LongT2IBench-Homepage/.