Seth A. Berkowitz

Peiqi Wang, William M. Wells, Seth Berkowitz et al.

Image-text multimodal representation learning aligns data across modalities and enables important medical applications, e.g., image classification, visual grounding, and cross-modal retrieval. In this work, we establish a connection between multimodal representation learning and multiple instance learning. Based on this connection, we propose a generic framework for constructing permutation-invariant score functions with many existing multimodal representation learning approaches as special cases. Furthermore, we use the framework to derive a novel contrastive learning approach and demonstrate that our method achieves state-of-the-art results in several downstream tasks.

Keegan Quigley, Miriam Cha, Ruizhi Liao et al.

Automated analysis of chest radiography using deep learning has tremendous potential to enhance the clinical diagnosis of diseases in patients. However, deep learning models typically require large amounts of annotated data to achieve high performance -- often an obstacle to medical domain adaptation. In this paper, we build a data-efficient learning framework that utilizes radiology reports to improve medical image classification performance with limited labeled data (fewer than 1000 examples). Specifically, we examine image-captioning pretraining to learn high-quality medical image representations that train on fewer examples. Following joint pretraining of a convolutional encoder and transformer decoder, we transfer the learned encoder to various classification tasks. Averaged over 9 pathologies, we find that our model achieves higher classification performance than ImageNet-supervised and in-domain supervised pretraining when labeled training data is limited.

Peiqi Wang, Yingcheng Liu, Ching-Yun Ko et al.

Self-supervised representation learning on image-text data facilitates crucial medical applications, such as image classification, visual grounding, and cross-modal retrieval. One common approach involves contrasting semantically similar (positive) and dissimilar (negative) pairs of data points. Drawing negative samples uniformly from the training data set introduces false negatives, i.e., samples that are treated as dissimilar but belong to the same class. In healthcare data, the underlying class distribution is nonuniform, implying that false negatives occur at a highly variable rate. To improve the quality of learned representations, we develop a novel approach that corrects for false negatives. Our method can be viewed as a variant of debiased contrastive learning that uses estimated sample-specific class probabilities. We provide theoretical analysis of the objective function and demonstrate the proposed approach on both image and paired image-text data sets. Our experiments illustrate empirical advantages of sample-specific debiasing.

Keegan Quigley, Miriam Cha, Josh Barua et al.

Vision-language pretraining has been shown to produce high-quality visual encoders which transfer efficiently to downstream computer vision tasks. Contrastive learning approaches have increasingly been adopted for medical vision language pretraining (MVLP), yet recent developments in generative AI offer new modeling alternatives. This paper introduces RadTex, a CNN-encoder transformer-decoder architecture optimized for radiology. We explore bidirectional captioning as an alternative MVLP strategy and demonstrate that RadTex's captioning pretraining is competitive with established contrastive methods, achieving a CheXpert macro-AUC of 89.4%. Additionally, RadTex's lightweight text decoder not only generates clinically relevant radiology reports (macro-F1 score of 0.349), but also provides targeted, interactive responses, highlighting the utility of bidirectional captioning in advancing medical image analysis.

Geeticka Chauhan, Ruizhi Liao, William Wells et al.

We propose and demonstrate a novel machine learning algorithm that assesses pulmonary edema severity from chest radiographs. While large publicly available datasets of chest radiographs and free-text radiology reports exist, only limited numerical edema severity labels can be extracted from radiology reports. This is a significant challenge in learning such models for image classification. To take advantage of the rich information present in the radiology reports, we develop a neural network model that is trained on both images and free-text to assess pulmonary edema severity from chest radiographs at inference time. Our experimental results suggest that the joint image-text representation learning improves the performance of pulmonary edema assessment compared to a supervised model trained on images only. We also show the use of the text for explaining the image classification by the joint model. To the best of our knowledge, our approach is the first to leverage free-text radiology reports for improving the image model performance in this application. Our code is available at https://github.com/RayRuizhiLiao/joint_chestxray.