Qingcong Kong

Jiayi Zhu, Fuxiang Huang, Yu Xie et al.

Breast cancer is a major global health concern, and mammography screening plays a central role in early detection. The large volume of screening examinations creates a substantial workload for radiologists, making accurate and consistent report generation a critical clinical challenge. Existing automated mammography report generation methods primarily focus on direct visual-to-text mapping, while overlooking the structured clinical reasoning process followed by radiologists in real-world practice. To address this limitation, we propose MammoRG, a mammography report generation framework that explicitly simulates the clinical reporting workflow by following the BI-RADS guideline and incorporating prior clinical knowledge to produce diagnostic reports. Specifically, MammoRG adopts a two-stage training framework. In the first stage, the model learns to integrate clinically relevant prior knowledge from a patient's four-view mammograms through classification-based supervision. In the second stage, a terminology-aware supervised fine-tuning strategy is introduced to model mammography-specific clinical terms as atomic semantic units, enabling the generation of high-quality reports with improved clinical consistency. To facilitate clinical efficacy evaluation of generated reports, we further develop MammoRGTool, a dedicated mammography report parsing tool that extracts structured clinical information from free-text reports. Extensive experiments demonstrate that MammoRG consistently outperforms existing methods across multiple clinical efficacy metrics, particularly in diagnosis-related BI-RADS F1, where it surpasses the second-best model by 2.73%, 2.04%, 1.90%, and 3.27% on the internal, external 1, external 2, and VinDr-Mammo datasets, respectively.

Fuxiang Huang, Jiayi Zhu, Yunfang Yu et al.

Breast cancer is the most commonly diagnosed cancer and the leading cause of cancer-related mortality in women globally. Mammography is essential for the early detection and diagnosis of breast lesions. Despite recent progress in foundation models (FMs) for mammogram analysis, their clinical translation remains constrained by several fundamental limitations, including insufficient diversity in training data, limited model generalizability, and a lack of comprehensive evaluation across clinically relevant tasks. Here, we introduce VersaMammo, a versatile foundation model for mammograms, designed to overcome these limitations. We curated the largest multi-institutional mammogram dataset to date, comprising 706,239 images from 21 sources. To improve generalization, we propose a two-stage pre-training strategy to develop VersaMammo, a mammogram foundation model. First, a teacher model is trained via self-supervised learning to extract transferable features from unlabeled mammograms. Then, supervised learning combined with knowledge distillation transfers both features and clinical knowledge into VersaMammo. To ensure a comprehensive evaluation, we established a benchmark comprising 92 specific tasks, including 68 internal tasks and 24 external validation tasks, spanning 5 major clinical task categories: lesion detection, segmentation, classification, image retrieval, and visual question answering. VersaMammo achieves state-of-the-art performance, ranking first in 50 out of 68 specific internal tasks and 20 out of 24 external validation tasks, with average ranks of 1.5 and 1.2, respectively. These results demonstrate its superior generalization and clinical utility, offering a substantial advancement toward reliable and scalable breast cancer screening and diagnosis.