Zhihong Chen

Jinpeng Hu, Zhuo Li, Zhihong Chen et al.

The impression section of a radiology report summarizes the most prominent observation from the findings section and is the most important section for radiologists to communicate to physicians. Summarizing findings is time-consuming and can be prone to error for inexperienced radiologists, and thus automatic impression generation has attracted substantial attention. With the encoder-decoder framework, most previous studies explore incorporating extra knowledge (e.g., static pre-defined clinical ontologies or extra background information). Yet, they encode such knowledge by a separate encoder to treat it as an extra input to their models, which is limited in leveraging their relations with the original findings. To address the limitation, we propose a unified framework for exploiting both extra knowledge and the original findings in an integrated way so that the critical information (i.e., key words and their relations) can be extracted in an appropriate way to facilitate impression generation. In detail, for each input findings, it is encoded by a text encoder, and a graph is constructed through its entities and dependency tree. Then, a graph encoder (e.g., graph neural networks (GNNs)) is adopted to model relation information in the constructed graph. Finally, to emphasize the key words in the findings, contrastive learning is introduced to map positive samples (constructed by masking non-key words) closer and push apart negative ones (constructed by masking key words). The experimental results on OpenI and MIMIC-CXR confirm the effectiveness of our proposed method.

Jinpeng Hu, Zhihong Chen, Yang Liu et al.

The impression is crucial for the referring physicians to grasp key information since it is concluded from the findings and reasoning of radiologists. To alleviate the workload of radiologists and reduce repetitive human labor in impression writing, many researchers have focused on automatic impression generation. However, recent works on this task mainly summarize the corresponding findings and pay less attention to the radiology images. In clinical, radiographs can provide more detailed valuable observations to enhance radiologists' impression writing, especially for complicated cases. Besides, each sentence in findings usually focuses on single anatomy, so they only need to be matched to corresponding anatomical regions instead of the whole image, which is beneficial for textual and visual features alignment. Therefore, we propose a novel anatomy-enhanced multimodal model to promote impression generation. In detail, we first construct a set of rules to extract anatomies and put these prompts into each sentence to highlight anatomy characteristics. Then, two separate encoders are applied to extract features from the radiograph and findings. Afterward, we utilize a contrastive learning module to align these two representations at the overall level and use a co-attention to fuse them at the sentence level with the help of anatomy-enhanced sentence representation. Finally, the decoder takes the fused information as the input to generate impressions. The experimental results on two benchmark datasets confirm the effectiveness of the proposed method, which achieves state-of-the-art results.

Zhihong Chen, Maya Varma, Xiang Wan et al.

Radiology report summarization (RRS) is a growing area of research. Given the Findings section of a radiology report, the goal is to generate a summary (called an Impression section) that highlights the key observations and conclusions of the radiology study. However, RRS currently faces essential limitations.First, many prior studies conduct experiments on private datasets, preventing reproduction of results and fair comparisons across different systems and solutions. Second, most prior approaches are evaluated solely on chest X-rays. To address these limitations, we propose a dataset (MIMIC-RRS) involving three new modalities and seven new anatomies based on the MIMIC-III and MIMIC-CXR datasets. We then conduct extensive experiments to evaluate the performance of models both within and across modality-anatomy pairs in MIMIC-RRS. In addition, we evaluate their clinical efficacy via RadGraph, a factual correctness metric.

Magdalini Paschali, Zhihong Chen, Louis Blankemeier et al. · stanford

Recent advances in artificial intelligence have witnessed the emergence of large-scale deep learning models capable of interpreting and generating both textual and imaging data. Such models, typically referred to as foundation models, are trained on extensive corpora of unlabeled data and demonstrate high performance across various tasks. Foundation models have recently received extensive attention from academic, industry, and regulatory bodies. Given the potentially transformative impact that foundation models can have on the field of radiology, this review aims to establish a standardized terminology concerning foundation models, with a specific focus on the requirements of training data, model training paradigms, model capabilities, and evaluation strategies. We further outline potential pathways to facilitate the training of radiology-specific foundation models, with a critical emphasis on elucidating both the benefits and challenges associated with such models. Overall, we envision that this review can unify technical advances and clinical needs in the training of foundation models for radiology in a safe and responsible manner, for ultimately benefiting patients, providers, and radiologists.

Eva Prakash, Jeya Maria Jose Valanarasu, Zhihong Chen et al.

Purpose: To explore best-practice approaches for generating synthetic chest X-ray images and augmenting medical imaging datasets to optimize the performance of deep learning models in downstream tasks like classification and segmentation. Materials and Methods: We utilized a latent diffusion model to condition the generation of synthetic chest X-rays on text prompts and/or segmentation masks. We explored methods like using a proxy model and using radiologist feedback to improve the quality of synthetic data. These synthetic images were then generated from relevant disease information or geometrically transformed segmentation masks and added to ground truth training set images from the CheXpert, CANDID-PTX, SIIM, and RSNA Pneumonia datasets to measure improvements in classification and segmentation model performance on the test sets. F1 and Dice scores were used to evaluate classification and segmentation respectively. One-tailed t-tests with Bonferroni correction assessed the statistical significance of performance improvements with synthetic data. Results: Across all experiments, the synthetic data we generated resulted in a maximum mean classification F1 score improvement of 0.150453 (CI: 0.099108-0.201798; P=0.0031) compared to using only real data. For segmentation, the maximum Dice score improvement was 0.14575 (CI: 0.108267-0.183233; P=0.0064). Conclusion: Best practices for generating synthetic chest X-ray images for downstream tasks include conditioning on single-disease labels or geometrically transformed segmentation masks, as well as potentially using proxy modeling for fine-tuning such generations.

Jinpeng Hu, Jianling Li, Zhihong Chen et al.

Radiology reports play a critical role in communicating medical findings to physicians. In each report, the impression section summarizes essential radiology findings. In clinical practice, writing impression is highly demanded yet time-consuming and prone to errors for radiologists. Therefore, automatic impression generation has emerged as an attractive research direction to facilitate such clinical practice. Existing studies mainly focused on introducing salient word information to the general text summarization framework to guide the selection of the key content in radiology findings. However, for this task, a model needs not only capture the important words in findings but also accurately describe their relations so as to generate high-quality impressions. In this paper, we propose a novel method for automatic impression generation, where a word graph is constructed from the findings to record the critical words and their relations, then a Word Graph guided Summarization model (WGSum) is designed to generate impressions with the help of the word graph. Experimental results on two datasets, OpenI and MIMIC-CXR, confirm the validity and effectiveness of our proposed approach, where the state-of-the-art results are achieved on both datasets. Further experiments are also conducted to analyze the impact of different graph designs to the performance of our method.

Zhihong Chen, Yan Song, Tsung-Hui Chang et al.

Medical imaging is frequently used in clinical practice and trials for diagnosis and treatment. Writing imaging reports is time-consuming and can be error-prone for inexperienced radiologists. Therefore, automatically generating radiology reports is highly desired to lighten the workload of radiologists and accordingly promote clinical automation, which is an essential task to apply artificial intelligence to the medical domain. In this paper, we propose to generate radiology reports with memory-driven Transformer, where a relational memory is designed to record key information of the generation process and a memory-driven conditional layer normalization is applied to incorporating the memory into the decoder of Transformer. Experimental results on two prevailing radiology report datasets, IU X-Ray and MIMIC-CXR, show that our proposed approach outperforms previous models with respect to both language generation metrics and clinical evaluations. Particularly, this is the first work reporting the generation results on MIMIC-CXR to the best of our knowledge. Further analyses also demonstrate that our approach is able to generate long reports with necessary medical terms as well as meaningful image-text attention mappings.