Bowen Guo

Qin Wang, Zhiqing He, Yu Liu et al.

Reliable interpretation of echocardiography (Echo) is crucial for assessing cardiac function, which demands clinicians to synchronously orchestrate multiple capabilities, including visual observation (eyes), manual measurement (hands), and expert knowledge learning and reasoning (minds). While current task-specific deep-learning approaches and multimodal large language models have demonstrated promise in assisting Echo analysis through automated segmentation or reasoning, they remain focused on restricted skills, i.e., eyes-hands or eyes-minds, thereby limiting clinical reliability and utility. To address these issues, we propose EchoAgent, an agentic system tailored for end-to-end Echo interpretation, which achieves a fully coordinated eyes-hands-minds workflow that learns, observes, operates, and reasons like a cardiac sonographer. First, we introduce an expertise-driven cognition engine where our agent can automatically assimilate credible Echo guidelines into a structured knowledge base, thus constructing an Echo-customized mind. Second, we devise a hierarchical collaboration toolkit to endow EchoAgent with eyes-hands, which can automatically parse Echo video streams, identify cardiac views, perform anatomical segmentation, and quantitative measurement. Third, we integrate the perceived multimodal evidence with the exclusive knowledge base into an orchestrated reasoning hub to conduct explainable inferences. We evaluate EchoAgent on CAMUS and MIMIC-EchoQA datasets, which cover 48 distinct echocardiographic views spanning 14 cardiac anatomical regions. Experimental results show that EchoAgent achieves optimal performance across diverse structure analyses, yielding overall accuracy of up to 80.00%. Importantly, EchoAgent empowers a single system with abilities to learn, observe, operate and reason like an echocardiologist, which holds great promise for reliable Echo interpretation.

Peng Huang, Bowen Guo, Shuyu Liang et al.

Text-To-Image (TTI) generation is significant for controlled and diverse image generation with broad potential applications. Although current medical TTI methods have made some progress in report-to-Chest-Xray (CXR) generation, their generation performance may be limited due to the intrinsic characteristics of medical data. In this paper, we propose a novel disease-knowledge enhanced Diffusion-based TTI learning framework, named Diff-CXR, for medical report-to-CXR generation. First, to minimize the negative impacts of noisy data on generation, we devise a Latent Noise Filtering Strategy that gradually learns the general patterns of anomalies and removes them in the latent space. Then, an Adaptive Vision-Aware Textual Learning Strategy is designed to learn concise and important report embeddings in a domain-specific Vision-Language Model, providing textual guidance for Chest-Xray generation. Finally, by incorporating the general disease knowledge into the pretrained TTI model via a delicate control adapter, a disease-knowledge enhanced diffusion model is introduced to achieve realistic and precise report-to-CXR generation. Experimentally, our Diff-CXR outperforms previous SOTA medical TTI methods by 33.4\% / 8.0\% and 23.8\% / 56.4\% in the FID and mAUC score on MIMIC-CXR and IU-Xray, with the lowest computational complexity at 29.641 GFLOPs. Downstream experiments on three thorax disease classification benchmarks and one CXR-report generation benchmark demonstrate that Diff-CXR is effective in improving classical CXR analysis methods. Notably, models trained on the combination of 1\% real data and synthetic data can achieve a competitive mAUC score compared to models trained on all data, presenting promising clinical applications.

Peng Huang, Junhu Fu, Bowen Guo et al.

As the appearance of medical images is influenced by multiple underlying factors, generative models require rich attribute information beyond labels to produce realistic and diverse images. For instance, generating an image of skin lesion with specific patterns demands descriptions that go beyond diagnosis, such as shape, size, texture, and color. However, such detailed descriptions are not always accessible. To address this, we explore a framework, termed Visual Attribute Prompts (VAP)-Diffusion, to leverage external knowledge from pre-trained Multi-modal Large Language Models (MLLMs) to improve the quality and diversity of medical image generation. First, to derive descriptions from MLLMs without hallucination, we design a series of prompts following Chain-of-Thoughts for common medical imaging tasks, including dermatologic, colorectal, and chest X-ray images. Generated descriptions are utilized during training and stored across different categories. During testing, descriptions are randomly retrieved from the corresponding category for inference. Moreover, to make the generator robust to unseen combination of descriptions at the test time, we propose a Prototype Condition Mechanism that restricts test embeddings to be similar to those from training. Experiments on three common types of medical imaging across four datasets verify the effectiveness of VAP-Diffusion.