Sandra Costa Sousa

Chihcheng Hsieh, Isabel Blanco Nobre, Sandra Costa Sousa et al.

This study investigates the effects of including patients' clinical information on the performance of deep learning (DL) classifiers for disease location in chest X-ray images. Although current classifiers achieve high performance using chest X-ray images alone, our interviews with radiologists indicate that clinical data is highly informative and essential for interpreting images and making proper diagnoses. In this work, we propose a novel architecture consisting of two fusion methods that enable the model to simultaneously process patients' clinical data (structured data) and chest X-rays (image data). Since these data modalities are in different dimensional spaces, we propose a spatial arrangement strategy, spatialization, to facilitate the multimodal learning process in a Mask R-CNN model. We performed an extensive experimental evaluation using MIMIC-Eye, a dataset comprising modalities: MIMIC-CXR (chest X-ray images), MIMIC IV-ED (patients' clinical data), and REFLACX (annotations of disease locations in chest X-rays). Results show that incorporating patients' clinical data in a DL model together with the proposed fusion methods improves the disease localization in chest X-rays by 12\% in terms of Average Precision compared to a standard Mask R-CNN using only chest X-rays. Further ablation studies also emphasize the importance of multimodal DL architectures and the incorporation of patients' clinical data in disease localization. The architecture proposed in this work is publicly available to promote the scientific reproducibility of our study (https://github.com/ChihchengHsieh/multimodal-abnormalities-detection)

Catarina Moreira, Isabel Blanco Nobre, Sandra Costa Sousa et al.

There is a growing need to assist radiologists in performing X-ray readings and diagnoses fast, comfortably, and effectively. As radiologists strive to maximize productivity, it is essential to consider the impact of reading rooms in interpreting complex examinations and ensure that higher volume and reporting speeds do not compromise patient outcomes. Virtual Reality (VR) is a disruptive technology for clinical practice in assessing X-ray images. We argue that conjugating eye-tracking with VR devices and Machine Learning may overcome obstacles posed by inadequate ergonomic postures and poor room conditions that often cause erroneous diagnostics when professionals examine digital images.

André Luís, Chihcheng Hsieh, Isabel Blanco Nobre et al.

This paper proposes a novel multimodal DL architecture incorporating medical images and eye-tracking data for abnormality detection in chest x-rays. Our results show that applying eye gaze data directly into DL architectures does not show superior predictive performance in abnormality detection chest X-rays. These results support other works in the literature and suggest that human-generated data, such as eye gaze, needs a more thorough investigation before being applied to DL architectures.

Chihcheng Hsieh, Catarina Moreira, Isabel Blanco Nobre et al.

X-ray images are vital in medical diagnostics, but their effectiveness is limited without clinical context. Radiologists often find chest X-rays insufficient for diagnosing underlying diseases, necessitating the integration of structured clinical features with radiology reports. To address this, we introduce DALL-M, a novel framework that enhances clinical datasets by generating contextual synthetic data. DALL-M augments structured patient data, including vital signs (e.g., heart rate, oxygen saturation), radiology findings (e.g., lesion presence), and demographic factors. It integrates this tabular data with contextual knowledge extracted from radiology reports and domain-specific resources (e.g., Radiopaedia, Wikipedia), ensuring clinical consistency and reliability. DALL-M follows a three-phase process: (i) clinical context storage, (ii) expert query generation, and (iii) context-aware feature augmentation. Using large language models (LLMs), it generates both contextual synthetic values for existing clinical features and entirely new, clinically relevant features. Applied to 799 cases from the MIMIC-IV dataset, DALL-M expanded the original 9 clinical features to 91. Empirical validation with machine learning models (including Decision Trees, Random Forests, XGBoost, and TabNET) demonstrated a 16.5% improvement in F1 score and a 25% increase in Precision and Recall. DALL-M bridges an important gap in clinical data augmentation by preserving data integrity while enhancing predictive modeling in healthcare. Our results show that integrating LLM-generated synthetic features significantly improves model performance, making DALL-M a scalable and practical approach for AI-driven medical diagnostics.