Daniele Molino

Daniele Molino, Camillo Maria Caruso, Paolo Soda et al.

Text-conditioned generative models for volumetric medical imaging provide semantic control but lack explicit anatomical guidance, often resulting in outputs that are spatially ambiguous or anatomically inconsistent. In contrast, structure-driven methods ensure strong anatomical consistency but typically assume access to ground-truth annotations, which are unavailable when the target image is to be synthesized. We propose a retrieval-augmented approach for Text-to-CT generation that integrates semantic and anatomical information under a realistic inference setting. Given a radiology report, our method retrieves a semantically related clinical case using a 3D vision-language encoder and leverages its associated anatomical annotation as a structural proxy. This proxy is injected into a text-conditioned latent diffusion model via a ControlNet branch, providing coarse anatomical guidance while maintaining semantic flexibility. Experiments on the CT-RATE dataset show that retrieval-augmented generation improves image fidelity and clinical consistency compared to text-only baselines, while additionally enabling explicit spatial controllability, a capability inherently absent in such approaches. Further analysis highlights the importance of retrieval quality, with semantically aligned proxies yielding consistent gains across all evaluation axes. This work introduces a principled and scalable mechanism to bridge semantic conditioning and anatomical plausibility in volumetric medical image synthesis. Code is available at https://github.com/arco-group/RAGText2CT.

Daniele Molino, Camillo Maria Caruso, Filippo Ruffini et al.

Objective: While recent advances in text-conditioned generative models have enabled the synthesis of realistic medical images, progress has been largely confined to 2D modalities such as chest X-rays. Extending text-to-image generation to volumetric CT remains a significant challenge, due to its high dimensionality, anatomical complexity, and the absence of robust frameworks that align vision-language data in 3D medical imaging. Methods: We introduce a novel architecture for Text-to-CT generation that combines a latent diffusion model with a 3D contrastive vision-language pretraining scheme. Our approach leverages a dual-encoder CLIP-style model trained on paired CT volumes and radiology reports to establish a shared embedding space, which serves as the conditioning input for generation. CT volumes are compressed into a low-dimensional latent space via a pretrained volumetric VAE, enabling efficient 3D denoising diffusion without requiring external super-resolution stages. Results: We evaluate our method on the CT-RATE dataset and conduct a comprehensive assessment of image fidelity, clinical relevance, and semantic alignment. Our model achieves competitive performance across all tasks, significantly outperforming prior baselines for text-to-CT generation. Moreover, we demonstrate that CT scans synthesized by our framework can effectively augment real data, improving downstream diagnostic performance. Conclusion: Our results show that modality-specific vision-language alignment is a key component for high-quality 3D medical image generation. By integrating contrastive pretraining and volumetric diffusion, our method offers a scalable and controllable solution for synthesizing clinically meaningful CT volumes from text, paving the way for new applications in data augmentation, medical education, and automated clinical simulation. Code at https://github.com/cosbidev/Text2CT.

Daniele Molino, Francesco di Feola, Linlin Shen et al.

Generative models have revolutionized Artificial Intelligence (AI), particularly in multimodal applications. However, adapting these models to the medical domain poses unique challenges due to the complexity of medical data and the stringent need for clinical accuracy. In this work, we introduce a framework specifically designed for multimodal medical data generation. By enabling the generation of multi-view chest X-rays and their associated clinical report, it bridges the gap between general-purpose vision-language models and the specialized requirements of healthcare. Leveraging the MIMIC-CXR dataset, the proposed framework shows superior performance in generating high-fidelity images and semantically coherent reports. Our quantitative evaluation reveals significant results in terms of FID and BLEU scores, showcasing the quality of the generated data. Notably, our framework achieves comparable or even superior performance compared to real data on downstream disease classification tasks, underlining its potential as a tool for medical research and diagnostics. This study highlights the importance of domain-specific adaptations in enhancing the relevance and utility of generative models for clinical applications, paving the way for future advancements in synthetic multimodal medical data generation.

Daniele Molino, Francesco Di Feola, Eliodoro Faiella et al.

The adoption of Artificial Intelligence in medical imaging holds great promise, yet it remains hindered by challenges such as data scarcity, privacy concerns, and the need for robust multimodal integration. While recent advances in generative modeling have enabled high-quality synthetic data generation, existing approaches are often limited to unimodal, unidirectional synthesis and therefore lack the ability to jointly synthesize multiple modalities while preserving clinical consistency. To address this challenge, we introduce XGeM, a 6.77-billion-parameter multimodal generative model designed to support flexible, any-to-any synthesis between medical data modalities. XGeM constructs a shared latent space via contrastive learning and introduces a novel Multi-Prompt Training strategy, enabling conditioning on arbitrary subsets of input modalities. This design allows the model to adapt to heterogeneous clinical inputs and generate multiple outputs jointly, preserving both semantic and structural coherence. We extensively validate XGeM: first we benchmark it against five competitors on the MIMIC-CXR dataset, a state-of-the-art dataset for multi-view Chest X-ray and radiological report generation. Secondly, we perform a Visual Turing Test with expert radiologists to assess the realism and clinical relevance of the generated data, ensuring alignment with real-world scenarios. Finally, we show how XGeM can support key medical data challenges such as anonymization, class imbalance, and data scarcity, underscoring its utility as a foundation model for medical data synthesis. Project page is at https://cosbidev.github.io/XGeM/.