Knowledge Matters: Radiology Report Generation with General and Specific Knowledge

Automatic radiology report generation is critical in clinics which can relieve experienced radiologists from the heavy workload and remind inexperienced radiologists of misdiagnosis or missed diagnose. Existing approaches mainly formulate radiology report generation as an image captioning task and adopt the encoder-decoder framework. However, in the medical domain, such pure data-driven approaches suffer from the following problems: 1) visual and textual bias problem; 2) lack of expert knowledge. In this paper, we propose a knowledge-enhanced radiology report generation approach introduces two types of medical knowledge: 1) General knowledge, which is input independent and provides the broad knowledge for report generation; 2) Specific knowledge, which is input dependent and provides the fine-grained knowledge for report generation. To fully utilize both the general and specific knowledge, we also propose a knowledge-enhanced multi-head attention mechanism. By merging the visual features of the radiology image with general knowledge and specific knowledge, the proposed model can improve the quality of generated reports. Experimental results on two publicly available datasets IU-Xray and MIMIC-CXR show that the proposed knowledge enhanced approach outperforms state-of-the-art image captioning based methods. Ablation studies also demonstrate that both general and specific knowledge can help to improve the performance of radiology report generation.Comment: Medical Image Analysi

Customizing General-Purpose Foundation Models for Medical Report Generation

Medical caption prediction which can be regarded as a task of medical report generation (MRG), requires the automatic generation of coherent and accurate captions for the given medical images. However, the scarcity of labelled medical image-report pairs presents great challenges in the development of deep and large-scale neural networks capable of harnessing the potential artificial general intelligence power like large language models (LLMs). In this work, we propose customizing off-the-shelf general-purpose large-scale pre-trained models, i.e., foundation models (FMs), in computer vision and natural language processing with a specific focus on medical report generation. Specifically, following BLIP-2, a state-of-the-art vision-language pre-training approach, we introduce our encoder-decoder-based MRG model. This model utilizes a lightweight query Transformer to connect two FMs: the giant vision Transformer EVA-ViT-g and a bilingual LLM trained to align with human intentions (referred to as ChatGLM-6B). Furthermore, we conduct ablative experiments on the trainable components of the model to identify the crucial factors for effective transfer learning. Our findings demonstrate that unfreezing EVA-ViT-g to learn medical image representations, followed by parameter-efficient training of ChatGLM-6B to capture the writing styles of medical reports, is essential for achieving optimal results. Our best attempt (PCLmed Team) achieved the 4th and the 2nd, respectively, out of 13 participating teams, based on the BERTScore and ROUGE-1 metrics, in the ImageCLEFmedical Caption 2023 Caption Prediction Task competition.Comment: 14 pages, 3 figure

Knowledge Graph Embeddings for Multi-Lingual Structured Representations of Radiology Reports

The way we analyse clinical texts has undergone major changes over the last years. The introduction of language models such as BERT led to adaptations for the (bio)medical domain like PubMedBERT and ClinicalBERT. These models rely on large databases of archived medical documents. While performing well in terms of accuracy, both the lack of interpretability and limitations to transfer across languages limit their use in clinical setting. We introduce a novel light-weight graph-based embedding method specifically catering radiology reports. It takes into account the structure and composition of the report, while also connecting medical terms in the report through the multi-lingual SNOMED Clinical Terms knowledge base. The resulting graph embedding uncovers the underlying relationships among clinical terms, achieving a representation that is better understandable for clinicians and clinically more accurate, without reliance on large pre-training datasets. We show the use of this embedding on two tasks namely disease classification of X-ray reports and image classification. For disease classification our model is competitive with its BERT-based counterparts, while being magnitudes smaller in size and training data requirements. For image classification, we show the effectiveness of the graph embedding leveraging cross-modal knowledge transfer and show how this method is usable across different languages

Rethinking Medical Report Generation: Disease Revealing Enhancement with Knowledge Graph

Knowledge Graph (KG) plays a crucial role in Medical Report Generation (MRG) because it reveals the relations among diseases and thus can be utilized to guide the generation process. However, constructing a comprehensive KG is labor-intensive and its applications on the MRG process are under-explored. In this study, we establish a complete KG on chest X-ray imaging that includes 137 types of diseases and abnormalities. Based on this KG, we find that the current MRG data sets exhibit a long-tailed problem in disease distribution. To mitigate this problem, we introduce a novel augmentation strategy that enhances the representation of disease types in the tail-end of the distribution. We further design a two-stage MRG approach, where a classifier is first trained to detect whether the input images exhibit any abnormalities. The classified images are then independently fed into two transformer-based generators, namely, ``disease-specific generator" and ``disease-free generator" to generate the corresponding reports. To enhance the clinical evaluation of whether the generated reports correctly describe the diseases appearing in the input image, we propose diverse sensitivity (DS), a new metric that checks whether generated diseases match ground truth and measures the diversity of all generated diseases. Results show that the proposed two-stage generation framework and augmentation strategies improve DS by a considerable margin, indicating a notable reduction in the long-tailed problem associated with under-represented diseases

KU-DMIS-MSRA at RadSum23: Pre-trained Vision-Language Model for Radiology Report Summarization

In this paper, we introduce CheXOFA, a new pre-trained vision-language model (VLM) for the chest X-ray domain. Our model is initially pre-trained on various multimodal datasets within the general domain before being transferred to the chest X-ray domain. Following a prominent VLM, we unify various domain-specific tasks into a simple sequence-to-sequence schema. It enables the model to effectively learn the required knowledge and skills from limited resources in the domain. Demonstrating superior performance on the benchmark datasets provided by the BioNLP shared task, our model benefits from its training across multiple tasks and domains. With subtle techniques including ensemble and factual calibration, our system achieves first place on the RadSum23 leaderboard for the hidden test set.Comment: Published at BioNLP workshop @ ACL 202

Style-Aware Radiology Report Generation with RadGraph and Few-Shot Prompting

Automatically generated reports from medical images promise to improve the workflow of radiologists. Existing methods consider an image-to-report modeling task by directly generating a fully-fledged report from an image. However, this conflates the content of the report (e.g., findings and their attributes) with its style (e.g., format and choice of words), which can lead to clinically inaccurate reports. To address this, we propose a two-step approach for radiology report generation. First, we extract the content from an image; then, we verbalize the extracted content into a report that matches the style of a specific radiologist. For this, we leverage RadGraph -- a graph representation of reports -- together with large language models (LLMs). In our quantitative evaluations, we find that our approach leads to beneficial performance. Our human evaluation with clinical raters highlights that the AI-generated reports are indistinguishably tailored to the style of individual radiologist despite leveraging only a few examples as context.Comment: Accepted to Findings of EMNLP 202

Expert Knowledge-Aware Image Difference Graph Representation Learning for Difference-Aware Medical Visual Question Answering

To contribute to automating the medical vision-language model, we propose a novel Chest-Xray Difference Visual Question Answering (VQA) task. Given a pair of main and reference images, this task attempts to answer several questions on both diseases and, more importantly, the differences between them. This is consistent with the radiologist's diagnosis practice that compares the current image with the reference before concluding the report. We collect a new dataset, namely MIMIC-Diff-VQA, including 700,703 QA pairs from 164,324 pairs of main and reference images. Compared to existing medical VQA datasets, our questions are tailored to the Assessment-Diagnosis-Intervention-Evaluation treatment procedure used by clinical professionals. Meanwhile, we also propose a novel expert knowledge-aware graph representation learning model to address this task. The proposed baseline model leverages expert knowledge such as anatomical structure prior, semantic, and spatial knowledge to construct a multi-relationship graph, representing the image differences between two images for the image difference VQA task. The dataset and code can be found at https://github.com/Holipori/MIMIC-Diff-VQA. We believe this work would further push forward the medical vision language model