Eye-gaze Guided Multi-modal Alignment Framework for Radiology

In multi-modal frameworks, the alignment of cross-modal features presents a significant challenge. The predominant approach in multi-modal pre-training emphasizes either global or local alignment between modalities, utilizing extensive datasets. This bottom-up driven method often suffers from a lack of interpretability, a critical concern in radiology. Previous studies have integrated high-level labels in medical images or text, but these still rely on manual annotation, a costly and labor-intensive process. Our work introduces a novel approach by using eye-gaze data, collected synchronously by radiologists during diagnostic evaluations. This data, indicating radiologists' focus areas, naturally links chest X-rays to diagnostic texts. We propose the Eye-gaze Guided Multi-modal Alignment (EGMA) framework to harness eye-gaze data for better alignment of image and text features, aiming to reduce reliance on manual annotations and thus cut training costs. Our model demonstrates robust performance, outperforming other state-of-the-art methods in zero-shot classification and retrieval tasks. The incorporation of easily-obtained eye-gaze data during routine radiological diagnoses signifies a step towards minimizing manual annotation dependency. Additionally, we explore the impact of varying amounts of eye-gaze data on model performance, highlighting the feasibility and utility of integrating this auxiliary data into multi-modal pre-training.

Medical Image Synthesis via Fine-Grained Image-Text Alignment and Anatomy-Pathology Prompting

Data scarcity and privacy concerns limit the availability of high-quality medical images for public use, which can be mitigated through medical image synthesis. However, current medical image synthesis methods often struggle to accurately capture the complexity of detailed anatomical structures and pathological conditions. To address these challenges, we propose a novel medical image synthesis model that leverages fine-grained image-text alignment and anatomy-pathology prompts to generate highly detailed and accurate synthetic medical images. Our method integrates advanced natural language processing techniques with image generative modeling, enabling precise alignment between descriptive text prompts and the synthesized images' anatomical and pathological details. The proposed approach consists of two key components: an anatomy-pathology prompting module and a fine-grained alignment-based synthesis module. The anatomy-pathology prompting module automatically generates descriptive prompts for high-quality medical images. To further synthesize high-quality medical images from the generated prompts, the fine-grained alignment-based synthesis module pre-defines a visual codebook for the radiology dataset and performs fine-grained alignment between the codebook and generated prompts to obtain key patches as visual clues, facilitating accurate image synthesis. We validate the superiority of our method through experiments on public chest X-ray datasets and demonstrate that our synthetic images preserve accurate semantic information, making them valuable for various medical applications.

Asclepius: A Spectrum Evaluation Benchmark for Medical Multi-Modal Large Language Models

The significant breakthroughs of Medical Multi-Modal Large Language Models (Med-MLLMs) renovate modern healthcare with robust information synthesis and medical decision support. However, these models are often evaluated on benchmarks that are unsuitable for the Med-MLLMs due to the intricate nature of the real-world diagnostic frameworks, which encompass diverse medical specialties and involve complex clinical decisions. Moreover, these benchmarks are susceptible to data leakage, since Med-MLLMs are trained on large assemblies of publicly available data. Thus, an isolated and clinically representative benchmark is highly desirable for credible Med-MLLMs evaluation. To this end, we introduce Asclepius, a novel Med-MLLM benchmark that rigorously and comprehensively assesses model capability in terms of: distinct medical specialties (cardiovascular, gastroenterology, etc.) and different diagnostic capacities (perception, disease analysis, etc.). Grounded in 3 proposed core principles, Asclepius ensures a comprehensive evaluation by encompassing 15 medical specialties, stratifying into 3 main categories and 8 sub-categories of clinical tasks, and exempting from train-validate contamination. We further provide an in-depth analysis of 6 Med-MLLMs and compare them with 5 human specialists, providing insights into their competencies and limitations in various medical contexts. Our work not only advances the understanding of Med-MLLMs' capabilities but also sets a precedent for future evaluations and the safe deployment of these models in clinical environments. We launch and maintain a leaderboard for community assessment of Med-MLLM capabilities (https://asclepius-med.github.io/).

Fine-Grained Image-Text Alignment in Medical Imaging Enables Cyclic Image-Report Generation

To address these issues, we propose a novel Adaptive patch-word Matching (AdaMatch) model to correlate chest X-ray (CXR) image regions with words in medical reports and apply it to CXR-report generation to provide explainability for the generation process. AdaMatch exploits the fine-grained relation between adaptive patches and words to provide explanations of specific image regions with corresponding words. To capture the abnormal regions of varying sizes and positions, we introduce the Adaptive Patch extraction (AdaPatch) module to acquire the adaptive patches for these regions adaptively. In order to provide explicit explainability for CXR-report generation task, we propose an AdaMatch-based bidirectional large language model for Cyclic CXR-report generation (AdaMatch-Cyclic). It employs the AdaMatch to obtain the keywords for CXR images and `keypatches' for medical reports as hints to guide CXR-report generation. Extensive experiments on two publicly available CXR datasets prove the effectiveness of our method and its superior performance to existing methods.

Two-Stream Regression Network for Dental Implant Position Prediction

In implant prosthesis treatment, the design of surgical guide requires lots of manual labors and is prone to subjective variations. When deep learning based methods has started to be applied to address this problem, the space between teeth are various and some of them might present similar texture characteristic with the actual implant region. Both problems make a big challenge for the implant position prediction. In this paper, we develop a two-stream implant position regression framework (TSIPR), which consists of an implant region detector (IRD) and a multi-scale patch embedding regression network (MSPENet), to address this issue. For the training of IRD, we extend the original annotation to provide additional supervisory information, which contains much more rich characteristic and do not introduce extra labeling costs. A multi-scale patch embedding module is designed for the MSPENet to adaptively extract features from the images with various tooth spacing. The global-local feature interaction block is designed to build the encoder of MSPENet, which combines the transformer and convolution for enriched feature representation. During inference, the RoI mask extracted from the IRD is used to refine the prediction results of the MSPENet. Extensive experiments on a dental implant dataset through five-fold cross-validation demonstrated that the proposed TSIPR achieves superior performance than existing methods.

Gated SwitchGAN for multi-domain facial image translation

Recent studies on multi-domain facial image translation have achieved impressive results. The existing methods generally provide a discriminator with an auxiliary classifier to impose domain translation. However, these methods neglect important information regarding domain distribution matching. To solve this problem, we propose a switch generative adversarial network (SwitchGAN) with a more adaptive discriminator structure and a matched generator to perform delicate image translation among multiple domains. A feature-switching operation is proposed to achieve feature selection and fusion in our conditional modules. We demonstrate the effectiveness of our model. Furthermore, we also introduce a new capability of our generator that represents attribute intensity control and extracts content information without tailored training. Experiments on the Morph, RaFD and CelebA databases visually and quantitatively show that our extended SwitchGAN (i.e., Gated SwitchGAN) can achieve better translation results than StarGAN, AttGAN and STGAN. The attribute classification accuracy achieved using the trained ResNet-18 model and the FID score obtained using the ImageNet pretrained Inception-v3 model also quantitatively demonstrate the superior performance of our models.

TR-GAN: Topology Ranking GAN with Triplet Loss for Retinal Artery/Vein Classification

Retinal artery/vein (A/V) classification lays the foundation for the quantitative analysis of retinal vessels, which is associated with potential risks of various cardiovascular and cerebral diseases. The topological connection relationship, which has been proved effective in improving the A/V classification performance for the conventional graph based method, has not been exploited by the deep learning based method. In this paper, we propose a Topology Ranking Generative Adversarial Network (TR-GAN) to improve the topology connectivity of the segmented arteries and veins, and further to boost the A/V classification performance. A topology ranking discriminator based on ordinal regression is proposed to rank the topological connectivity level of the ground-truth, the generated A/V mask and the intentionally shuffled mask. The ranking loss is further back-propagated to the generator to generate better connected A/V masks. In addition, a topology preserving module with triplet loss is also proposed to extract the high-level topological features and further to narrow the feature distance between the predicted A/V mask and the ground-truth. The proposed framework effectively increases the topological connectivity of the predicted A/V masks and achieves state-of-the-art A/V classification performance on the publicly available AV-DRIVE dataset.

Translate the Facial Regions You Like Using Region-Wise Normalization

Though GAN (Generative Adversarial Networks) based technique has greatly advanced the performance of image synthesis and face translation, only few works available in literature provide region based style encoding and translation. We propose in this paper a region-wise normalization framework, for region level face translation. While per-region style is encoded using available approach, we build a so called RIN (region-wise normalization) block to individually inject the styles into per-region feature maps and then fuse them for following convolution and upsampling. Both shape and texture of different regions can thus be translated to various target styles. A region matching loss has also been proposed to significantly reduce the inference between regions during the translation process. Extensive experiments on three publicly available datasets, i.e. Morph, RaFD and CelebAMask-HQ, suggest that our approach demonstrate a large improvement over state-of-the-art methods like StarGAN, SEAN and FUNIT. Our approach has further advantages in precise control of the regions to be translated. As a result, region level expression changes and step by step make up can be achieved. The video demo is available at https://youtu.be/ceRqsbzXAfk.

Leveraging Undiagnosed Data for Glaucoma Classification with Teacher-Student Learning

Recently, deep learning has been adopted to the glaucoma classification task with performance comparable to that of human experts. However, a well trained deep learning model demands a large quantity of properly labeled data, which is relatively expensive since the accurate labeling of glaucoma requires years of specialist training. In order to alleviate this problem, we propose a glaucoma classification framework which takes advantage of not only the properly labeled images, but also undiagnosed images without glaucoma labels. To be more specific, the proposed framework is adapted from the teacher-student-learning paradigm. The teacher model encodes the wrapped information of undiagnosed images to a latent feature space, meanwhile the student model learns from the teacher through knowledge transfer to improve the glaucoma classification. For the model training procedure, we propose a novel training strategy that simulates the real-world teaching practice named as 'Learning To Teach with Knowledge Transfer (L2T-KT)', and establish a 'Quiz Pool' as the teacher's optimization target. Experiments show that the proposed framework is able to utilize the undiagnosed data effectively to improve the glaucoma prediction performance.