Yuanxu Gao

Hong-Yu Zhou, Yizhou Yu, Chengdi Wang et al.

During the diagnostic process, clinicians leverage multimodal information, such as chief complaints, medical images, and laboratory-test results. Deep-learning models for aiding diagnosis have yet to meet this requirement. Here we report a Transformer-based representation-learning model as a clinical diagnostic aid that processes multimodal input in a unified manner. Rather than learning modality-specific features, the model uses embedding layers to convert images and unstructured and structured text into visual tokens and text tokens, and bidirectional blocks with intramodal and intermodal attention to learn a holistic representation of radiographs, the unstructured chief complaint and clinical history, structured clinical information such as laboratory-test results and patient demographic information. The unified model outperformed an image-only model and non-unified multimodal diagnosis models in the identification of pulmonary diseases (by 12% and 9%, respectively) and in the prediction of adverse clinical outcomes in patients with COVID-19 (by 29% and 7%, respectively). Leveraging unified multimodal Transformer-based models may help streamline triage of patients and facilitate the clinical decision process.

Hao Yang, Hong-Yu Zhou, Jiarun Liu et al.

Existing deep learning models for defining pathology from clinical imaging data rely on expert annotations and lack generalization capabilities in open clinical environments. Here, we present a generalizable vision-language model for Annotation-Free pathology Localization (AFLoc). The core strength of AFLoc is extensive multi-level semantic structure-based contrastive learning, which comprehensively aligns multi-granularity medical concepts with abundant image features to adapt to the diverse expressions of pathologies without the reliance on expert image annotations. We conduct primary experiments on a dataset of 220K pairs of image-report chest X-ray images and perform validation across eight external datasets encompassing 34 types of chest pathologies. The results demonstrate that AFLoc outperforms state-of-the-art methods in both annotation-free localization and classification tasks. Additionally, we assess the generalizability of AFLoc on other modalities, including histopathology and retinal fundus images. We show that AFLoc exhibits robust generalization capabilities, even surpassing human benchmarks in localizing five different types of pathological images. These results highlight the potential of AFLoc in reducing annotation requirements and its applicability in complex clinical environments.