CARZero: Cross-Attention Alignment for Radiology Zero-Shot Classification

The advancement of Zero-Shot Learning in the medical domain has been driven forward by using pre-trained models on large-scale image-text pairs, focusing on image-text alignment. However, existing methods primarily rely on cosine similarity for alignment, which may not fully capture the complex relationship between medical images and reports. To address this gap, we introduce a novel approach called Cross-Attention Alignment for Radiology Zero-Shot Classification (CARZero). Our approach innovatively leverages cross-attention mechanisms to process image and report features, creating a Similarity Representation that more accurately reflects the intricate relationships in medical semantics. This representation is then linearly projected to form an image-text similarity matrix for cross-modality alignment. Additionally, recognizing the pivotal role of prompt selection in zero-shot learning, CARZero incorporates a Large Language Model-based prompt alignment strategy. This strategy standardizes diverse diagnostic expressions into a unified format for both training and inference phases, overcoming the challenges of manual prompt design. Our approach is simple yet effective, demonstrating state-of-the-art performance in zero-shot classification on five official chest radiograph diagnostic test sets, including remarkable results on datasets with long-tail distributions of rare diseases. This achievement is attributed to our new image-text alignment strategy, which effectively addresses the complex relationship between medical images and reports.

ECAMP: Entity-centered Context-aware Medical Vision Language Pre-training

Despite significant advancements in medical vision-language pre-training, existing methods have largely overlooked the inherent entity-specific context within radiology reports and the complex cross-modality contextual relationships between text and images. To close this gap, we propose a novel Entity-centered Context-aware Medical Vision-language Pre-training (ECAMP) framework, which is designed to enable a more entity-centered and context-sensitive interpretation of medical data. Utilizing the recent powerful large language model, we distill entity-centered context from medical reports, which enables ECAMP to gain more effective supervision from the text modality. By further pre-training our model with carefully designed entity-aware, context-enhanced masked language modeling and context-guided super-resolution tasks, ECAMP significantly refines the interplay between text and image modalities, leading to an enhanced ability to extract entity-centered contextual features. Besides, our proposed multi-scale context fusion design also improves the semantic integration of both coarse and fine-level image representations, prompting better performance for multi-scale downstream applications. Combining these components leads to significant performance leaps over current state-of-the-art methods and establishes a new standard for cross-modality learning in medical imaging, whose effectiveness is demonstrated by our extensive experiments on various tasks including classification, segmentation, and detection across several public datasets. Code and models are available at https://github.com/ToniChopp/ECAMP.

Long-tailed multi-label classification with noisy label of thoracic diseases from chest X-ray

Chest X-rays (CXR) often reveal rare diseases, demanding precise diagnosis. However, current computer-aided diagnosis (CAD) methods focus on common diseases, leading to inadequate detection of rare conditions due to the absence of comprehensive datasets. To overcome this, we present a novel benchmark for long-tailed multi-label classification in CXRs, encapsulating both common and rare thoracic diseases. Our approach includes developing the "LTML-MIMIC-CXR" dataset, an augmentation of MIMIC-CXR with 26 additional rare diseases. We propose a baseline method for this classification challenge, integrating adaptive negative regularization to address negative logits' over-suppression in tail classes, and a large loss reconsideration strategy for correcting noisy labels from automated annotations. Our evaluation on LTML-MIMIC-CXR demonstrates significant advancements in rare disease detection. This work establishes a foundation for robust CAD methods, achieving a balance in identifying a spectrum of thoracic diseases in CXRs. Access to our code and dataset is provided at:https://github.com/laihaoran/LTML-MIMIC-CXR.