Songyue Han

Songyue Han, Mingye Zou, Shuchang Ye et al.

Medical image segmentation is essential for modern computer-aided medicine. Recently, text-guided segmentation has shown promise by incorporating clinician-formulated textual reports as semantic guidance for image segmentation. These reports describe target appearance, location, and neighboring anatomy, providing explicit guidance for localization and delineation. Existing text-guided segmentation methods typically extract textual semantics implicitly through a pretrained text encoder and then integrate vision-language semantics via straightforward image-text feature fusion. However, these methods do not explicitly capture target-oriented information embedded in textual reports, particularly target location, and do not explore multi-level information fusion strategies beyond basic feature-level fusion, limiting the extraction and integration of critical textual semantics. In this study, we propose LoG, a localization-infused vision-language fusion framework for text-guided medical image segmentation. By jointly performing multi-scale target localization tasks, LoG explicitly captures target-oriented vision-language semantics and enables three-level localization-infused semantic fusion: (i) localization-guided feature fusion that directly infuses location-relevant semantics into visual features, (ii) localization-gated attention fusion that redirects multi-scale localization predictions to reinforce critical regions, and (iii) localization-constrained loss fusion that supervises segmentation based on spatial consistency with target localization. Extensive experiments on three benchmark datasets, involving three medical imaging modalities with paired textual reports, demonstrate that LoG achieves Dice scores of 91.59%, 80.71%, and 94.59% on QaTa-COV19, MosMedData+, and Kvasir-SEG, respectively, consistently outperforming state-of-the-art medical image segmentation methods.

Vincent M. D'Anniballe, Fakrul Islam Tushar, Khrystyna Faryna et al.

Purpose: To develop high throughput multi-label annotators for body (chest, abdomen, and pelvis) Computed Tomography (CT) reports that can be applied across a variety of abnormalities, organs, and disease states. Approach: We used a dictionary approach to develop rule-based algorithms (RBA) for extraction of disease labels from radiology text reports. We targeted three organ systems (lungs/pleura, liver/gallbladder, kidneys/ureters) with four diseases per system based on their prevalence in our dataset. To expand the algorithms beyond pre-defined keywords, attention-guided recurrent neural networks (RNN) were trained using the RBA-extracted labels to classify reports as being positive for one or more diseases or normal for each organ system. Confounding effects on model performance were evaluated using random initialization or pre-trained embedding as well as different sizes of training datasets. Performance was evaluated using the receiver operating characteristic (ROC) area under the curve (AUC) against 2,158 manually obtained labels. Results: Our models extracted disease labels from 261,229 radiology reports of 112,501 unique subjects. Pre-trained models outperformed random initialization across all diseases. As the training dataset size was reduced, performance was robust except for a few diseases with relatively small number of cases. Pre-trained classification AUCs achieved > 0.95 for all five disease outcomes across all three organ systems. Conclusions: Our label-extracting pipeline was able to encompass a variety of cases and diseases by generalizing beyond strict rules with exceptional accuracy. This method can be easily adapted to enable automated labeling of hospital-scale medical data sets for training image-based disease classifiers.