new

Get trending papers in your email inbox!

Subscribe

byAK and the research community

Mar 21

Unsupervised Anomaly Detection in Medical Images with a Memory-augmented Multi-level Cross-attentional Masked Autoencoder

Unsupervised anomaly detection (UAD) aims to find anomalous images by optimising a detector using a training set that contains only normal images. UAD approaches can be based on reconstruction methods, self-supervised approaches, and Imagenet pre-trained models. Reconstruction methods, which detect anomalies from image reconstruction errors, are advantageous because they do not rely on the design of problem-specific pretext tasks needed by self-supervised approaches, and on the unreliable translation of models pre-trained from non-medical datasets. However, reconstruction methods may fail because they can have low reconstruction errors even for anomalous images. In this paper, we introduce a new reconstruction-based UAD approach that addresses this low-reconstruction error issue for anomalous images. Our UAD approach, the memory-augmented multi-level cross-attentional masked autoencoder (MemMC-MAE), is a transformer-based approach, consisting of a novel memory-augmented self-attention operator for the encoder and a new multi-level cross-attention operator for the decoder. MemMCMAE masks large parts of the input image during its reconstruction, reducing the risk that it will produce low reconstruction errors because anomalies are likely to be masked and cannot be reconstructed. However, when the anomaly is not masked, then the normal patterns stored in the encoder's memory combined with the decoder's multi-level cross attention will constrain the accurate reconstruction of the anomaly. We show that our method achieves SOTA anomaly detection and localisation on colonoscopy, pneumonia, and covid-19 chest x-ray datasets.

Towards Zero-Shot Anomaly Detection and Reasoning with Multimodal Large Language Models

Zero-Shot Anomaly Detection (ZSAD) is an emerging AD paradigm. Unlike the traditional unsupervised AD setting that requires a large number of normal samples to train a model, ZSAD is more practical for handling data-restricted real-world scenarios. Recently, Multimodal Large Language Models (MLLMs) have shown revolutionary reasoning capabilities in various vision tasks. However, the reasoning of image abnormalities remains underexplored due to the lack of corresponding datasets and benchmarks. To facilitate research in AD & reasoning, we establish the first visual instruction tuning dataset, Anomaly-Instruct-125k, and the evaluation benchmark, VisA-D&R. Through investigation with our benchmark, we reveal that current MLLMs like GPT-4o cannot accurately detect and describe fine-grained anomalous details in images. To address this, we propose Anomaly-OneVision (Anomaly-OV), the first specialist visual assistant for ZSAD and reasoning. Inspired by human behavior in visual inspection, Anomaly-OV leverages a Look-Twice Feature Matching (LTFM) mechanism to adaptively select and emphasize abnormal visual tokens. Extensive experiments demonstrate that Anomaly-OV achieves significant improvements over advanced generalist models in both detection and reasoning. Extensions to medical and 3D AD are provided for future study. The link to our project page: https://xujiacong.github.io/Anomaly-OV/

AnomalyCLIP: Object-agnostic Prompt Learning for Zero-shot Anomaly Detection

Zero-shot anomaly detection (ZSAD) requires detection models trained using auxiliary data to detect anomalies without any training sample in a target dataset. It is a crucial task when training data is not accessible due to various concerns, eg, data privacy, yet it is challenging since the models need to generalize to anomalies across different domains where the appearance of foreground objects, abnormal regions, and background features, such as defects/tumors on different products/organs, can vary significantly. Recently large pre-trained vision-language models (VLMs), such as CLIP, have demonstrated strong zero-shot recognition ability in various vision tasks, including anomaly detection. However, their ZSAD performance is weak since the VLMs focus more on modeling the class semantics of the foreground objects rather than the abnormality/normality in the images. In this paper we introduce a novel approach, namely AnomalyCLIP, to adapt CLIP for accurate ZSAD across different domains. The key insight of AnomalyCLIP is to learn object-agnostic text prompts that capture generic normality and abnormality in an image regardless of its foreground objects. This allows our model to focus on the abnormal image regions rather than the object semantics, enabling generalized normality and abnormality recognition on diverse types of objects. Large-scale experiments on 17 real-world anomaly detection datasets show that AnomalyCLIP achieves superior zero-shot performance of detecting and segmenting anomalies in datasets of highly diverse class semantics from various defect inspection and medical imaging domains. Code will be made available at https://github.com/zqhang/AnomalyCLIP.

Generative AI for Medical Imaging: extending the MONAI Framework

Recent advances in generative AI have brought incredible breakthroughs in several areas, including medical imaging. These generative models have tremendous potential not only to help safely share medical data via synthetic datasets but also to perform an array of diverse applications, such as anomaly detection, image-to-image translation, denoising, and MRI reconstruction. However, due to the complexity of these models, their implementation and reproducibility can be difficult. This complexity can hinder progress, act as a use barrier, and dissuade the comparison of new methods with existing works. In this study, we present MONAI Generative Models, a freely available open-source platform that allows researchers and developers to easily train, evaluate, and deploy generative models and related applications. Our platform reproduces state-of-art studies in a standardised way involving different architectures (such as diffusion models, autoregressive transformers, and GANs), and provides pre-trained models for the community. We have implemented these models in a generalisable fashion, illustrating that their results can be extended to 2D or 3D scenarios, including medical images with different modalities (like CT, MRI, and X-Ray data) and from different anatomical areas. Finally, we adopt a modular and extensible approach, ensuring long-term maintainability and the extension of current applications for future features.

How Well Does GPT-4V(ision) Adapt to Distribution Shifts? A Preliminary Investigation

In machine learning, generalization against distribution shifts -- where deployment conditions diverge from the training scenarios -- is crucial, particularly in fields like climate modeling, biomedicine, and autonomous driving. The emergence of foundation models, distinguished by their extensive pretraining and task versatility, has led to an increased interest in their adaptability to distribution shifts. GPT-4V(ision) acts as the most advanced publicly accessible multimodal foundation model, with extensive applications across various domains, including anomaly detection, video understanding, image generation, and medical diagnosis. However, its robustness against data distributions remains largely underexplored. Addressing this gap, this study rigorously evaluates GPT-4V's adaptability and generalization capabilities in dynamic environments, benchmarking against prominent models like CLIP and LLaVA. We delve into GPT-4V's zero-shot generalization across 13 diverse datasets spanning natural, medical, and molecular domains. We further investigate its adaptability to controlled data perturbations and examine the efficacy of in-context learning as a tool to enhance its adaptation. Our findings delineate GPT-4V's capability boundaries in distribution shifts, shedding light on its strengths and limitations across various scenarios. Importantly, this investigation contributes to our understanding of how AI foundation models generalize to distribution shifts, offering pivotal insights into their adaptability and robustness. Code is publicly available at https://github.com/jameszhou-gl/gpt-4v-distribution-shift.

Are we certain it's anomalous?

The progress in modelling time series and, more generally, sequences of structured data has recently revamped research in anomaly detection. The task stands for identifying abnormal behaviors in financial series, IT systems, aerospace measurements, and the medical domain, where anomaly detection may aid in isolating cases of depression and attend the elderly. Anomaly detection in time series is a complex task since anomalies are rare due to highly non-linear temporal correlations and since the definition of anomalous is sometimes subjective. Here we propose the novel use of Hyperbolic uncertainty for Anomaly Detection (HypAD). HypAD learns self-supervisedly to reconstruct the input signal. We adopt best practices from the state-of-the-art to encode the sequence by an LSTM, jointly learned with a decoder to reconstruct the signal, with the aid of GAN critics. Uncertainty is estimated end-to-end by means of a hyperbolic neural network. By using uncertainty, HypAD may assess whether it is certain about the input signal but it fails to reconstruct it because this is anomalous; or whether the reconstruction error does not necessarily imply anomaly, as the model is uncertain, e.g. a complex but regular input signal. The novel key idea is that a detectable anomaly is one where the model is certain but it predicts wrongly. HypAD outperforms the current state-of-the-art for univariate anomaly detection on established benchmarks based on data from NASA, Yahoo, Numenta, Amazon, and Twitter. It also yields state-of-the-art performance on a multivariate dataset of anomaly activities in elderly home residences, and it outperforms the baseline on SWaT. Overall, HypAD yields the lowest false alarms at the best performance rate, thanks to successfully identifying detectable anomalies.

Realism in Action: Anomaly-Aware Diagnosis of Brain Tumors from Medical Images Using YOLOv8 and DeiT

In the field of medical sciences, reliable detection and classification of brain tumors from images remains a formidable challenge due to the rarity of tumors within the population of patients. Therefore, the ability to detect tumors in anomaly scenarios is paramount for ensuring timely interventions and improved patient outcomes. This study addresses the issue by leveraging deep learning (DL) techniques to detect and classify brain tumors in challenging situations. The curated data set from the National Brain Mapping Lab (NBML) comprises 81 patients, including 30 Tumor cases and 51 Normal cases. The detection and classification pipelines are separated into two consecutive tasks. The detection phase involved comprehensive data analysis and pre-processing to modify the number of image samples and the number of patients of each class to anomaly distribution (9 Normal per 1 Tumor) to comply with real world scenarios. Next, in addition to common evaluation metrics for the testing, we employed a novel performance evaluation method called Patient to Patient (PTP), focusing on the realistic evaluation of the model. In the detection phase, we fine-tuned a YOLOv8n detection model to detect the tumor region. Subsequent testing and evaluation yielded competitive performance both in Common Evaluation Metrics and PTP metrics. Furthermore, using the Data Efficient Image Transformer (DeiT) module, we distilled a Vision Transformer (ViT) model from a fine-tuned ResNet152 as a teacher in the classification phase. This approach demonstrates promising strides in reliable tumor detection and classification, offering potential advancements in tumor diagnosis for real-world medical imaging scenarios.

Enhancing Abnormality Grounding for Vision Language Models with Knowledge Descriptions

Visual Language Models (VLMs) have demonstrated impressive capabilities in visual grounding tasks. However, their effectiveness in the medical domain, particularly for abnormality detection and localization within medical images, remains underexplored. A major challenge is the complex and abstract nature of medical terminology, which makes it difficult to directly associate pathological anomaly terms with their corresponding visual features. In this work, we introduce a novel approach to enhance VLM performance in medical abnormality detection and localization by leveraging decomposed medical knowledge. Instead of directly prompting models to recognize specific abnormalities, we focus on breaking down medical concepts into fundamental attributes and common visual patterns. This strategy promotes a stronger alignment between textual descriptions and visual features, improving both the recognition and localization of abnormalities in medical images.We evaluate our method on the 0.23B Florence-2 base model and demonstrate that it achieves comparable performance in abnormality grounding to significantly larger 7B LLaVA-based medical VLMs, despite being trained on only 1.5% of the data used for such models. Experimental results also demonstrate the effectiveness of our approach in both known and previously unseen abnormalities, suggesting its strong generalization capabilities.

AutoPaint: A Self-Inpainting Method for Unsupervised Anomaly Detection

Robust and accurate detection and segmentation of heterogenous tumors appearing in different anatomical organs with supervised methods require large-scale labeled datasets covering all possible types of diseases. Due to the unavailability of such rich datasets and the high cost of annotations, unsupervised anomaly detection (UAD) methods have been developed aiming to detect the pathologies as deviation from the normality by utilizing the unlabeled healthy image data. However, developed UAD models are often trained with an incomplete distribution of healthy anatomies and have difficulties in preserving anatomical constraints. This work intends to, first, propose a robust inpainting model to learn the details of healthy anatomies and reconstruct high-resolution images by preserving anatomical constraints. Second, we propose an autoinpainting pipeline to automatically detect tumors, replace their appearance with the learned healthy anatomies, and based on that segment the tumoral volumes in a purely unsupervised fashion. Three imaging datasets, including PET, CT, and PET-CT scans of lung tumors and head and neck tumors, are studied as benchmarks for evaluation. Experimental results demonstrate the significant superiority of the proposed method over a wide range of state-of-the-art UAD methods. Moreover, the unsupervised method we propose produces comparable results to a robust supervised segmentation method when applied to multimodal images.

Entity Embedding-based Anomaly Detection for Heterogeneous Categorical Events

Anomaly detection plays an important role in modern data-driven security applications, such as detecting suspicious access to a socket from a process. In many cases, such events can be described as a collection of categorical values that are considered as entities of different types, which we call heterogeneous categorical events. Due to the lack of intrinsic distance measures among entities, and the exponentially large event space, most existing work relies heavily on heuristics to calculate abnormal scores for events. Different from previous work, we propose a principled and unified probabilistic model APE (Anomaly detection via Probabilistic pairwise interaction and Entity embedding) that directly models the likelihood of events. In this model, we embed entities into a common latent space using their observed co-occurrence in different events. More specifically, we first model the compatibility of each pair of entities according to their embeddings. Then we utilize the weighted pairwise interactions of different entity types to define the event probability. Using Noise-Contrastive Estimation with "context-dependent" noise distribution, our model can be learned efficiently regardless of the large event space. Experimental results on real enterprise surveillance data show that our methods can accurately detect abnormal events compared to other state-of-the-art abnormal detection techniques.

Modeling the Distribution of Normal Data in Pre-Trained Deep Features for Anomaly Detection

Anomaly Detection (AD) in images is a fundamental computer vision problem and refers to identifying images and image substructures that deviate significantly from the norm. Popular AD algorithms commonly try to learn a model of normality from scratch using task specific datasets, but are limited to semi-supervised approaches employing mostly normal data due to the inaccessibility of anomalies on a large scale combined with the ambiguous nature of anomaly appearance. We follow an alternative approach and demonstrate that deep feature representations learned by discriminative models on large natural image datasets are well suited to describe normality and detect even subtle anomalies in a transfer learning setting. Our model of normality is established by fitting a multivariate Gaussian (MVG) to deep feature representations of classification networks trained on ImageNet using normal data only. By subsequently applying the Mahalanobis distance as the anomaly score we outperform the current state of the art on the public MVTec AD dataset, achieving an AUROC value of 95.8 pm 1.2 (mean pm SEM) over all 15 classes. We further investigate why the learned representations are discriminative to the AD task using Principal Component Analysis. We find that the principal components containing little variance in normal data are the ones crucial for discriminating between normal and anomalous instances. This gives a possible explanation to the often sub-par performance of AD approaches trained from scratch using normal data only. By selectively fitting a MVG to these most relevant components only, we are able to further reduce model complexity while retaining AD performance. We also investigate setting the working point by selecting acceptable False Positive Rate thresholds based on the MVG assumption. Code available at https://github.com/ORippler/gaussian-ad-mvtec

FiLo: Zero-Shot Anomaly Detection by Fine-Grained Description and High-Quality Localization

Zero-shot anomaly detection (ZSAD) methods entail detecting anomalies directly without access to any known normal or abnormal samples within the target item categories. Existing approaches typically rely on the robust generalization capabilities of multimodal pretrained models, computing similarities between manually crafted textual features representing "normal" or "abnormal" semantics and image features to detect anomalies and localize anomalous patches. However, the generic descriptions of "abnormal" often fail to precisely match diverse types of anomalies across different object categories. Additionally, computing feature similarities for single patches struggles to pinpoint specific locations of anomalies with various sizes and scales. To address these issues, we propose a novel ZSAD method called FiLo, comprising two components: adaptively learned Fine-Grained Description (FG-Des) and position-enhanced High-Quality Localization (HQ-Loc). FG-Des introduces fine-grained anomaly descriptions for each category using Large Language Models (LLMs) and employs adaptively learned textual templates to enhance the accuracy and interpretability of anomaly detection. HQ-Loc, utilizing Grounding DINO for preliminary localization, position-enhanced text prompts, and Multi-scale Multi-shape Cross-modal Interaction (MMCI) module, facilitates more accurate localization of anomalies of different sizes and shapes. Experimental results on datasets like MVTec and VisA demonstrate that FiLo significantly improves the performance of ZSAD in both detection and localization, achieving state-of-the-art performance with an image-level AUC of 83.9% and a pixel-level AUC of 95.9% on the VisA dataset. Code is available at https://github.com/CASIA-IVA-Lab/FiLo.

Anomaly Detection using Autoencoders in High Performance Computing Systems

Anomaly detection in supercomputers is a very difficult problem due to the big scale of the systems and the high number of components. The current state of the art for automated anomaly detection employs Machine Learning methods or statistical regression models in a supervised fashion, meaning that the detection tool is trained to distinguish among a fixed set of behaviour classes (healthy and unhealthy states). We propose a novel approach for anomaly detection in High Performance Computing systems based on a Machine (Deep) Learning technique, namely a type of neural network called autoencoder. The key idea is to train a set of autoencoders to learn the normal (healthy) behaviour of the supercomputer nodes and, after training, use them to identify abnormal conditions. This is different from previous approaches which where based on learning the abnormal condition, for which there are much smaller datasets (since it is very hard to identify them to begin with). We test our approach on a real supercomputer equipped with a fine-grained, scalable monitoring infrastructure that can provide large amount of data to characterize the system behaviour. The results are extremely promising: after the training phase to learn the normal system behaviour, our method is capable of detecting anomalies that have never been seen before with a very good accuracy (values ranging between 88% and 96%).

StRegA: Unsupervised Anomaly Detection in Brain MRIs using a Compact Context-encoding Variational Autoencoder

Expert interpretation of anatomical images of the human brain is the central part of neuro-radiology. Several machine learning-based techniques have been proposed to assist in the analysis process. However, the ML models typically need to be trained to perform a specific task, e.g., brain tumour segmentation or classification. Not only do the corresponding training data require laborious manual annotations, but a wide variety of abnormalities can be present in a human brain MRI - even more than one simultaneously, which renders representation of all possible anomalies very challenging. Hence, a possible solution is an unsupervised anomaly detection (UAD) system that can learn a data distribution from an unlabelled dataset of healthy subjects and then be applied to detect out of distribution samples. Such a technique can then be used to detect anomalies - lesions or abnormalities, for example, brain tumours, without explicitly training the model for that specific pathology. Several Variational Autoencoder (VAE) based techniques have been proposed in the past for this task. Even though they perform very well on controlled artificially simulated anomalies, many of them perform poorly while detecting anomalies in clinical data. This research proposes a compact version of the "context-encoding" VAE (ceVAE) model, combined with pre and post-processing steps, creating a UAD pipeline (StRegA), which is more robust on clinical data, and shows its applicability in detecting anomalies such as tumours in brain MRIs. The proposed pipeline achieved a Dice score of 0.642pm0.101 while detecting tumours in T2w images of the BraTS dataset and 0.859pm0.112 while detecting artificially induced anomalies, while the best performing baseline achieved 0.522pm0.135 and 0.783pm0.111, respectively.

Automated Chest X-Ray Report Generator Using Multi-Model Deep Learning Approach

Reading and interpreting chest X-ray images is one of the most radiologist's routines. However, it still can be challenging, even for the most experienced ones. Therefore, we proposed a multi-model deep learning-based automated chest X-ray report generator system designed to assist radiologists in their work. The basic idea of the proposed system is by utilizing multi binary-classification models for detecting multi abnormalities, with each model responsible for detecting one abnormality, in a single image. In this study, we limited the radiology abnormalities detection to only cardiomegaly, lung effusion, and consolidation. The system generates a radiology report by performing the following three steps: image pre-processing, utilizing deep learning models to detect abnormalities, and producing a report. The aim of the image pre-processing step is to standardize the input by scaling it to 128x128 pixels and slicing it into three segments, which covers the upper, lower, and middle parts of the lung. After pre-processing, each corresponding model classifies the image, resulting in a 0 (zero) for no abnormality detected and a 1 (one) for the presence of an abnormality. The prediction outputs of each model are then concatenated to form a 'result code'. The 'result code' is used to construct a report by selecting the appropriate pre-determined sentence for each detected abnormality in the report generation step. The proposed system is expected to reduce the workload of radiologists and increase the accuracy of chest X-ray diagnosis.

Exploring Intrinsic Normal Prototypes within a Single Image for Universal Anomaly Detection

Anomaly detection (AD) is essential for industrial inspection, yet existing methods typically rely on ``comparing'' test images to normal references from a training set. However, variations in appearance and positioning often complicate the alignment of these references with the test image, limiting detection accuracy. We observe that most anomalies manifest as local variations, meaning that even within anomalous images, valuable normal information remains. We argue that this information is useful and may be more aligned with the anomalies since both the anomalies and the normal information originate from the same image. Therefore, rather than relying on external normality from the training set, we propose INP-Former, a novel method that extracts Intrinsic Normal Prototypes (INPs) directly from the test image. Specifically, we introduce the INP Extractor, which linearly combines normal tokens to represent INPs. We further propose an INP Coherence Loss to ensure INPs can faithfully represent normality for the testing image. These INPs then guide the INP-Guided Decoder to reconstruct only normal tokens, with reconstruction errors serving as anomaly scores. Additionally, we propose a Soft Mining Loss to prioritize hard-to-optimize samples during training. INP-Former achieves state-of-the-art performance in single-class, multi-class, and few-shot AD tasks across MVTec-AD, VisA, and Real-IAD, positioning it as a versatile and universal solution for AD. Remarkably, INP-Former also demonstrates some zero-shot AD capability. Code is available at:https://github.com/luow23/INP-Former.

EfficientAD: Accurate Visual Anomaly Detection at Millisecond-Level Latencies

Detecting anomalies in images is an important task, especially in real-time computer vision applications. In this work, we focus on computational efficiency and propose a lightweight feature extractor that processes an image in less than a millisecond on a modern GPU. We then use a student-teacher approach to detect anomalous features. We train a student network to predict the extracted features of normal, i.e., anomaly-free training images. The detection of anomalies at test time is enabled by the student failing to predict their features. We propose a training loss that hinders the student from imitating the teacher feature extractor beyond the normal images. It allows us to drastically reduce the computational cost of the student-teacher model, while improving the detection of anomalous features. We furthermore address the detection of challenging logical anomalies that involve invalid combinations of normal local features, for example, a wrong ordering of objects. We detect these anomalies by efficiently incorporating an autoencoder that analyzes images globally. We evaluate our method, called EfficientAD, on 32 datasets from three industrial anomaly detection dataset collections. EfficientAD sets new standards for both the detection and the localization of anomalies. At a latency of two milliseconds and a throughput of six hundred images per second, it enables a fast handling of anomalies. Together with its low error rate, this makes it an economical solution for real-world applications and a fruitful basis for future research.

Devil is in the Queries: Advancing Mask Transformers for Real-world Medical Image Segmentation and Out-of-Distribution Localization

Real-world medical image segmentation has tremendous long-tailed complexity of objects, among which tail conditions correlate with relatively rare diseases and are clinically significant. A trustworthy medical AI algorithm should demonstrate its effectiveness on tail conditions to avoid clinically dangerous damage in these out-of-distribution (OOD) cases. In this paper, we adopt the concept of object queries in Mask Transformers to formulate semantic segmentation as a soft cluster assignment. The queries fit the feature-level cluster centers of inliers during training. Therefore, when performing inference on a medical image in real-world scenarios, the similarity between pixels and the queries detects and localizes OOD regions. We term this OOD localization as MaxQuery. Furthermore, the foregrounds of real-world medical images, whether OOD objects or inliers, are lesions. The difference between them is less than that between the foreground and background, possibly misleading the object queries to focus redundantly on the background. Thus, we propose a query-distribution (QD) loss to enforce clear boundaries between segmentation targets and other regions at the query level, improving the inlier segmentation and OOD indication. Our proposed framework is tested on two real-world segmentation tasks, i.e., segmentation of pancreatic and liver tumors, outperforming previous state-of-the-art algorithms by an average of 7.39% on AUROC, 14.69% on AUPR, and 13.79% on FPR95 for OOD localization. On the other hand, our framework improves the performance of inlier segmentation by an average of 5.27% DSC when compared with the leading baseline nnUNet.

MedDet: Generative Adversarial Distillation for Efficient Cervical Disc Herniation Detection

Cervical disc herniation (CDH) is a prevalent musculoskeletal disorder that significantly impacts health and requires labor-intensive analysis from experts. Despite advancements in automated detection of medical imaging, two significant challenges hinder the real-world application of these methods. First, the computational complexity and resource demands present a significant gap for real-time application. Second, noise in MRI reduces the effectiveness of existing methods by distorting feature extraction. To address these challenges, we propose three key contributions: Firstly, we introduced MedDet, which leverages the multi-teacher single-student knowledge distillation for model compression and efficiency, meanwhile integrating generative adversarial training to enhance performance. Additionally, we customize the second-order nmODE to improve the model's resistance to noise in MRI. Lastly, we conducted comprehensive experiments on the CDH-1848 dataset, achieving up to a 5% improvement in mAP compared to previous methods. Our approach also delivers over 5 times faster inference speed, with approximately 67.8% reduction in parameters and 36.9% reduction in FLOPs compared to the teacher model. These advancements significantly enhance the performance and efficiency of automated CDH detection, demonstrating promising potential for future application in clinical practice. See project website https://steve-zeyu-zhang.github.io/MedDet

Unilaterally Aggregated Contrastive Learning with Hierarchical Augmentation for Anomaly Detection

Anomaly detection (AD), aiming to find samples that deviate from the training distribution, is essential in safety-critical applications. Though recent self-supervised learning based attempts achieve promising results by creating virtual outliers, their training objectives are less faithful to AD which requires a concentrated inlier distribution as well as a dispersive outlier distribution. In this paper, we propose Unilaterally Aggregated Contrastive Learning with Hierarchical Augmentation (UniCon-HA), taking into account both the requirements above. Specifically, we explicitly encourage the concentration of inliers and the dispersion of virtual outliers via supervised and unsupervised contrastive losses, respectively. Considering that standard contrastive data augmentation for generating positive views may induce outliers, we additionally introduce a soft mechanism to re-weight each augmented inlier according to its deviation from the inlier distribution, to ensure a purified concentration. Moreover, to prompt a higher concentration, inspired by curriculum learning, we adopt an easy-to-hard hierarchical augmentation strategy and perform contrastive aggregation at different depths of the network based on the strengths of data augmentation. Our method is evaluated under three AD settings including unlabeled one-class, unlabeled multi-class, and labeled multi-class, demonstrating its consistent superiority over other competitors.

Medical Concept Representation Learning from Electronic Health Records and its Application on Heart Failure Prediction

Objective: To transform heterogeneous clinical data from electronic health records into clinically meaningful constructed features using data driven method that rely, in part, on temporal relations among data. Materials and Methods: The clinically meaningful representations of medical concepts and patients are the key for health analytic applications. Most of existing approaches directly construct features mapped to raw data (e.g., ICD or CPT codes), or utilize some ontology mapping such as SNOMED codes. However, none of the existing approaches leverage EHR data directly for learning such concept representation. We propose a new way to represent heterogeneous medical concepts (e.g., diagnoses, medications and procedures) based on co-occurrence patterns in longitudinal electronic health records. The intuition behind the method is to map medical concepts that are co-occuring closely in time to similar concept vectors so that their distance will be small. We also derive a simple method to construct patient vectors from the related medical concept vectors. Results: For qualitative evaluation, we study similar medical concepts across diagnosis, medication and procedure. In quantitative evaluation, our proposed representation significantly improves the predictive modeling performance for onset of heart failure (HF), where classification methods (e.g. logistic regression, neural network, support vector machine and K-nearest neighbors) achieve up to 23% improvement in area under the ROC curve (AUC) using this proposed representation. Conclusion: We proposed an effective method for patient and medical concept representation learning. The resulting representation can map relevant concepts together and also improves predictive modeling performance.

Cross-Modality Jailbreak and Mismatched Attacks on Medical Multimodal Large Language Models

Security concerns related to Large Language Models (LLMs) have been extensively explored, yet the safety implications for Multimodal Large Language Models (MLLMs), particularly in medical contexts (MedMLLMs), remain insufficiently studied. This paper delves into the underexplored security vulnerabilities of MedMLLMs, especially when deployed in clinical environments where the accuracy and relevance of question-and-answer interactions are critically tested against complex medical challenges. By combining existing clinical medical data with atypical natural phenomena, we redefine two types of attacks: mismatched malicious attack (2M-attack) and optimized mismatched malicious attack (O2M-attack). Using our own constructed voluminous 3MAD dataset, which covers a wide range of medical image modalities and harmful medical scenarios, we conduct a comprehensive analysis and propose the MCM optimization method, which significantly enhances the attack success rate on MedMLLMs. Evaluations with this dataset and novel attack methods, including white-box attacks on LLaVA-Med and transfer attacks on four other state-of-the-art models, indicate that even MedMLLMs designed with enhanced security features are vulnerable to security breaches. Our work underscores the urgent need for a concerted effort to implement robust security measures and enhance the safety and efficacy of open-source MedMLLMs, particularly given the potential severity of jailbreak attacks and other malicious or clinically significant exploits in medical settings. For further research and replication, anonymous access to our code is available at https://github.com/dirtycomputer/O2M_attack. Warning: Medical large model jailbreaking may generate content that includes unverified diagnoses and treatment recommendations. Always consult professional medical advice.

MedRAG: Enhancing Retrieval-augmented Generation with Knowledge Graph-Elicited Reasoning for Healthcare Copilot

Retrieval-augmented generation (RAG) is a well-suited technique for retrieving privacy-sensitive Electronic Health Records (EHR). It can serve as a key module of the healthcare copilot, helping reduce misdiagnosis for healthcare practitioners and patients. However, the diagnostic accuracy and specificity of existing heuristic-based RAG models used in the medical domain are inadequate, particularly for diseases with similar manifestations. This paper proposes MedRAG, a RAG model enhanced by knowledge graph (KG)-elicited reasoning for the medical domain that retrieves diagnosis and treatment recommendations based on manifestations. MedRAG systematically constructs a comprehensive four-tier hierarchical diagnostic KG encompassing critical diagnostic differences of various diseases. These differences are dynamically integrated with similar EHRs retrieved from an EHR database, and reasoned within a large language model. This process enables more accurate and specific decision support, while also proactively providing follow-up questions to enhance personalized medical decision-making. MedRAG is evaluated on both a public dataset DDXPlus and a private chronic pain diagnostic dataset (CPDD) collected from Tan Tock Seng Hospital, and its performance is compared against various existing RAG methods. Experimental results show that, leveraging the information integration and relational abilities of the KG, our MedRAG provides more specific diagnostic insights and outperforms state-of-the-art models in reducing misdiagnosis rates. Our code will be available at https://github.com/SNOWTEAM2023/MedRAG

Improving Medical Predictions by Irregular Multimodal Electronic Health Records Modeling

Health conditions among patients in intensive care units (ICUs) are monitored via electronic health records (EHRs), composed of numerical time series and lengthy clinical note sequences, both taken at irregular time intervals. Dealing with such irregularity in every modality, and integrating irregularity into multimodal representations to improve medical predictions, is a challenging problem. Our method first addresses irregularity in each single modality by (1) modeling irregular time series by dynamically incorporating hand-crafted imputation embeddings into learned interpolation embeddings via a gating mechanism, and (2) casting a series of clinical note representations as multivariate irregular time series and tackling irregularity via a time attention mechanism. We further integrate irregularity in multimodal fusion with an interleaved attention mechanism across temporal steps. To the best of our knowledge, this is the first work to thoroughly model irregularity in multimodalities for improving medical predictions. Our proposed methods for two medical prediction tasks consistently outperforms state-of-the-art (SOTA) baselines in each single modality and multimodal fusion scenarios. Specifically, we observe relative improvements of 6.5\%, 3.6\%, and 4.3\% in F1 for time series, clinical notes, and multimodal fusion, respectively. These results demonstrate the effectiveness of our methods and the importance of considering irregularity in multimodal EHRs.

SimpleNet: A Simple Network for Image Anomaly Detection and Localization

We propose a simple and application-friendly network (called SimpleNet) for detecting and localizing anomalies. SimpleNet consists of four components: (1) a pre-trained Feature Extractor that generates local features, (2) a shallow Feature Adapter that transfers local features towards target domain, (3) a simple Anomaly Feature Generator that counterfeits anomaly features by adding Gaussian noise to normal features, and (4) a binary Anomaly Discriminator that distinguishes anomaly features from normal features. During inference, the Anomaly Feature Generator would be discarded. Our approach is based on three intuitions. First, transforming pre-trained features to target-oriented features helps avoid domain bias. Second, generating synthetic anomalies in feature space is more effective, as defects may not have much commonality in the image space. Third, a simple discriminator is much efficient and practical. In spite of simplicity, SimpleNet outperforms previous methods quantitatively and qualitatively. On the MVTec AD benchmark, SimpleNet achieves an anomaly detection AUROC of 99.6%, reducing the error by 55.5% compared to the next best performing model. Furthermore, SimpleNet is faster than existing methods, with a high frame rate of 77 FPS on a 3080ti GPU. Additionally, SimpleNet demonstrates significant improvements in performance on the One-Class Novelty Detection task. Code: https://github.com/DonaldRR/SimpleNet.

DDXPlus: A New Dataset For Automatic Medical Diagnosis

There has been a rapidly growing interest in Automatic Symptom Detection (ASD) and Automatic Diagnosis (AD) systems in the machine learning research literature, aiming to assist doctors in telemedicine services. These systems are designed to interact with patients, collect evidence about their symptoms and relevant antecedents, and possibly make predictions about the underlying diseases. Doctors would review the interactions, including the evidence and the predictions, collect if necessary additional information from patients, before deciding on next steps. Despite recent progress in this area, an important piece of doctors' interactions with patients is missing in the design of these systems, namely the differential diagnosis. Its absence is largely due to the lack of datasets that include such information for models to train on. In this work, we present a large-scale synthetic dataset of roughly 1.3 million patients that includes a differential diagnosis, along with the ground truth pathology, symptoms and antecedents for each patient. Unlike existing datasets which only contain binary symptoms and antecedents, this dataset also contains categorical and multi-choice symptoms and antecedents useful for efficient data collection. Moreover, some symptoms are organized in a hierarchy, making it possible to design systems able to interact with patients in a logical way. As a proof-of-concept, we extend two existing AD and ASD systems to incorporate the differential diagnosis, and provide empirical evidence that using differentials as training signals is essential for the efficiency of such systems or for helping doctors better understand the reasoning of those systems.

DRAEM -- A discriminatively trained reconstruction embedding for surface anomaly detection

Visual surface anomaly detection aims to detect local image regions that significantly deviate from normal appearance. Recent surface anomaly detection methods rely on generative models to accurately reconstruct the normal areas and to fail on anomalies. These methods are trained only on anomaly-free images, and often require hand-crafted post-processing steps to localize the anomalies, which prohibits optimizing the feature extraction for maximal detection capability. In addition to reconstructive approach, we cast surface anomaly detection primarily as a discriminative problem and propose a discriminatively trained reconstruction anomaly embedding model (DRAEM). The proposed method learns a joint representation of an anomalous image and its anomaly-free reconstruction, while simultaneously learning a decision boundary between normal and anomalous examples. The method enables direct anomaly localization without the need for additional complicated post-processing of the network output and can be trained using simple and general anomaly simulations. On the challenging MVTec anomaly detection dataset, DRAEM outperforms the current state-of-the-art unsupervised methods by a large margin and even delivers detection performance close to the fully-supervised methods on the widely used DAGM surface-defect detection dataset, while substantially outperforming them in localization accuracy.

Large Language Models Illuminate a Progressive Pathway to Artificial Healthcare Assistant: A Review

With the rapid development of artificial intelligence, large language models (LLMs) have shown promising capabilities in mimicking human-level language comprehension and reasoning. This has sparked significant interest in applying LLMs to enhance various aspects of healthcare, ranging from medical education to clinical decision support. However, medicine involves multifaceted data modalities and nuanced reasoning skills, presenting challenges for integrating LLMs. This paper provides a comprehensive review on the applications and implications of LLMs in medicine. It begins by examining the fundamental applications of general-purpose and specialized LLMs, demonstrating their utilities in knowledge retrieval, research support, clinical workflow automation, and diagnostic assistance. Recognizing the inherent multimodality of medicine, the review then focuses on multimodal LLMs, investigating their ability to process diverse data types like medical imaging and EHRs to augment diagnostic accuracy. To address LLMs' limitations regarding personalization and complex clinical reasoning, the paper explores the emerging development of LLM-powered autonomous agents for healthcare. Furthermore, it summarizes the evaluation methodologies for assessing LLMs' reliability and safety in medical contexts. Overall, this review offers an extensive analysis on the transformative potential of LLMs in modern medicine. It also highlights the pivotal need for continuous optimizations and ethical oversight before these models can be effectively integrated into clinical practice. Visit https://github.com/mingze-yuan/Awesome-LLM-Healthcare for an accompanying GitHub repository containing latest papers.

Follow the Rules: Reasoning for Video Anomaly Detection with Large Language Models

Video Anomaly Detection (VAD) is crucial for applications such as security surveillance and autonomous driving. However, existing VAD methods provide little rationale behind detection, hindering public trust in real-world deployments. In this paper, we approach VAD with a reasoning framework. Although Large Language Models (LLMs) have shown revolutionary reasoning ability, we find that their direct use falls short of VAD. Specifically, the implicit knowledge pre-trained in LLMs focuses on general context and thus may not apply to every specific real-world VAD scenario, leading to inflexibility and inaccuracy. To address this, we propose AnomalyRuler, a novel rule-based reasoning framework for VAD with LLMs. AnomalyRuler comprises two main stages: induction and deduction. In the induction stage, the LLM is fed with few-shot normal reference samples and then summarizes these normal patterns to induce a set of rules for detecting anomalies. The deduction stage follows the induced rules to spot anomalous frames in test videos. Additionally, we design rule aggregation, perception smoothing, and robust reasoning strategies to further enhance AnomalyRuler's robustness. AnomalyRuler is the first reasoning approach for the one-class VAD task, which requires only few-normal-shot prompting without the need for full-shot training, thereby enabling fast adaption to various VAD scenarios. Comprehensive experiments across four VAD benchmarks demonstrate AnomalyRuler's state-of-the-art detection performance and reasoning ability. AnomalyRuler is open-source and available at: https://github.com/Yuchen413/AnomalyRuler

PromptMRG: Diagnosis-Driven Prompts for Medical Report Generation

Automatic medical report generation (MRG) is of great research value as it has the potential to relieve radiologists from the heavy burden of report writing. Despite recent advancements, accurate MRG remains challenging due to the need for precise clinical understanding and the identification of clinical findings. Moreover, the imbalanced distribution of diseases makes the challenge even more pronounced, as rare diseases are underrepresented in training data, making their diagnostic performance unreliable. To address these challenges, we propose diagnosis-driven prompts for medical report generation (PromptMRG), a novel framework that aims to improve the diagnostic accuracy of MRG with the guidance of diagnosis-aware prompts. Specifically, PromptMRG is based on encoder-decoder architecture with an extra disease classification branch. When generating reports, the diagnostic results from the classification branch are converted into token prompts to explicitly guide the generation process. To further improve the diagnostic accuracy, we design cross-modal feature enhancement, which retrieves similar reports from the database to assist the diagnosis of a query image by leveraging the knowledge from a pre-trained CLIP. Moreover, the disease imbalanced issue is addressed by applying an adaptive logit-adjusted loss to the classification branch based on the individual learning status of each disease, which overcomes the barrier of text decoder's inability to manipulate disease distributions. Experiments on two MRG benchmarks show the effectiveness of the proposed method, where it obtains state-of-the-art clinical efficacy performance on both datasets.

MuSc: Zero-Shot Industrial Anomaly Classification and Segmentation with Mutual Scoring of the Unlabeled Images

This paper studies zero-shot anomaly classification (AC) and segmentation (AS) in industrial vision. We reveal that the abundant normal and abnormal cues implicit in unlabeled test images can be exploited for anomaly determination, which is ignored by prior methods. Our key observation is that for the industrial product images, the normal image patches could find a relatively large number of similar patches in other unlabeled images, while the abnormal ones only have a few similar patches. We leverage such a discriminative characteristic to design a novel zero-shot AC/AS method by Mutual Scoring (MuSc) of the unlabeled images, which does not need any training or prompts. Specifically, we perform Local Neighborhood Aggregation with Multiple Degrees (LNAMD) to obtain the patch features that are capable of representing anomalies in varying sizes. Then we propose the Mutual Scoring Mechanism (MSM) to leverage the unlabeled test images to assign the anomaly score to each other. Furthermore, we present an optimization approach named Re-scoring with Constrained Image-level Neighborhood (RsCIN) for image-level anomaly classification to suppress the false positives caused by noises in normal images. The superior performance on the challenging MVTec AD and VisA datasets demonstrates the effectiveness of our approach. Compared with the state-of-the-art zero-shot approaches, MuSc achieves a 21.1% PRO absolute gain (from 72.7% to 93.8%) on MVTec AD, a 19.4% pixel-AP gain and a 14.7% pixel-AUROC gain on VisA. In addition, our zero-shot approach outperforms most of the few-shot approaches and is comparable to some one-class methods. Code is available at https://github.com/xrli-U/MuSc.

MedTrinity-25M: A Large-scale Multimodal Dataset with Multigranular Annotations for Medicine

This paper introduces MedTrinity-25M, a comprehensive, large-scale multimodal dataset for medicine, covering over 25 million images across 10 modalities, with multigranular annotations for more than 65 diseases. These enriched annotations encompass both global textual information, such as disease/lesion type, modality, region-specific descriptions, and inter-regional relationships, as well as detailed local annotations for regions of interest (ROIs), including bounding boxes, segmentation masks. Unlike existing approach which is limited by the availability of image-text pairs, we have developed the first automated pipeline that scales up multimodal data by generating multigranular visual and texual annotations (in the form of image-ROI-description triplets) without the need for any paired text descriptions. Specifically, data from over 90 different sources have been collected, preprocessed, and grounded using domain-specific expert models to identify ROIs related to abnormal regions. We then build a comprehensive knowledge base and prompt multimodal large language models to perform retrieval-augmented generation with the identified ROIs as guidance, resulting in multigranular texual descriptions. Compared to existing datasets, MedTrinity-25M provides the most enriched annotations, supporting a comprehensive range of multimodal tasks such as captioning and report generation, as well as vision-centric tasks like classification and segmentation. Pretraining on MedTrinity-25M, our model achieves state-of-the-art performance on VQA-RAD and PathVQA, surpassing both multimodal large language models and other representative SoTA approaches. This dataset can also be utilized to support large-scale pre-training of multimodal medical AI models, contributing to the development of future foundation models in the medical domain.

Potential of Multimodal Large Language Models for Data Mining of Medical Images and Free-text Reports

Medical images and radiology reports are crucial for diagnosing medical conditions, highlighting the importance of quantitative analysis for clinical decision-making. However, the diversity and cross-source heterogeneity of these data challenge the generalizability of current data-mining methods. Multimodal large language models (MLLMs) have recently transformed many domains, significantly affecting the medical field. Notably, Gemini-Vision-series (Gemini) and GPT-4-series (GPT-4) models have epitomized a paradigm shift in Artificial General Intelligence (AGI) for computer vision, showcasing their potential in the biomedical domain. In this study, we evaluated the performance of the Gemini, GPT-4, and 4 popular large models for an exhaustive evaluation across 14 medical imaging datasets, including 5 medical imaging categories (dermatology, radiology, dentistry, ophthalmology, and endoscopy), and 3 radiology report datasets. The investigated tasks encompass disease classification, lesion segmentation, anatomical localization, disease diagnosis, report generation, and lesion detection. Our experimental results demonstrated that Gemini-series models excelled in report generation and lesion detection but faces challenges in disease classification and anatomical localization. Conversely, GPT-series models exhibited proficiency in lesion segmentation and anatomical localization but encountered difficulties in disease diagnosis and lesion detection. Additionally, both the Gemini series and GPT series contain models that have demonstrated commendable generation efficiency. While both models hold promise in reducing physician workload, alleviating pressure on limited healthcare resources, and fostering collaboration between clinical practitioners and artificial intelligence technologies, substantial enhancements and comprehensive validations remain imperative before clinical deployment.

AnomalyGPT: Detecting Industrial Anomalies using Large Vision-Language Models

Large Vision-Language Models (LVLMs) such as MiniGPT-4 and LLaVA have demonstrated the capability of understanding images and achieved remarkable performance in various visual tasks. Despite their strong abilities in recognizing common objects due to extensive training datasets, they lack specific domain knowledge and have a weaker understanding of localized details within objects, which hinders their effectiveness in the Industrial Anomaly Detection (IAD) task. On the other hand, most existing IAD methods only provide anomaly scores and necessitate the manual setting of thresholds to distinguish between normal and abnormal samples, which restricts their practical implementation. In this paper, we explore the utilization of LVLM to address the IAD problem and propose AnomalyGPT, a novel IAD approach based on LVLM. We generate training data by simulating anomalous images and producing corresponding textual descriptions for each image. We also employ an image decoder to provide fine-grained semantic and design a prompt learner to fine-tune the LVLM using prompt embeddings. Our AnomalyGPT eliminates the need for manual threshold adjustments, thus directly assesses the presence and locations of anomalies. Additionally, AnomalyGPT supports multi-turn dialogues and exhibits impressive few-shot in-context learning capabilities. With only one normal shot, AnomalyGPT achieves the state-of-the-art performance with an accuracy of 86.1%, an image-level AUC of 94.1%, and a pixel-level AUC of 95.3% on the MVTec-AD dataset. Code is available at https://github.com/CASIA-IVA-Lab/AnomalyGPT.

UMAD: University of Macau Anomaly Detection Benchmark Dataset

Anomaly detection is critical in surveillance systems and patrol robots by identifying anomalous regions in images for early warning. Depending on whether reference data are utilized, anomaly detection can be categorized into anomaly detection with reference and anomaly detection without reference. Currently, anomaly detection without reference, which is closely related to out-of-distribution (OoD) object detection, struggles with learning anomalous patterns due to the difficulty of collecting sufficiently large and diverse anomaly datasets with the inherent rarity and novelty of anomalies. Alternatively, anomaly detection with reference employs the scheme of change detection to identify anomalies by comparing semantic changes between a reference image and a query one. However, there are very few ADr works due to the scarcity of public datasets in this domain. In this paper, we aim to address this gap by introducing the UMAD Benchmark Dataset. To our best knowledge, this is the first benchmark dataset designed specifically for anomaly detection with reference in robotic patrolling scenarios, e.g., where an autonomous robot is employed to detect anomalous objects by comparing a reference and a query video sequences. The reference sequences can be taken by the robot along a specified route when there are no anomalous objects in the scene. The query sequences are captured online by the robot when it is patrolling in the same scene following the same route. Our benchmark dataset is elaborated such that each query image can find a corresponding reference based on accurate robot localization along the same route in the prebuilt 3D map, with which the reference and query images can be geometrically aligned using adaptive warping. Besides the proposed benchmark dataset, we evaluate the baseline models of ADr on this dataset.

VILA-M3: Enhancing Vision-Language Models with Medical Expert Knowledge

Generalist vision language models (VLMs) have made significant strides in computer vision, but they fall short in specialized fields like healthcare, where expert knowledge is essential. In traditional computer vision tasks, creative or approximate answers may be acceptable, but in healthcare, precision is paramount.Current large multimodal models like Gemini and GPT-4o are insufficient for medical tasks due to their reliance on memorized internet knowledge rather than the nuanced expertise required in healthcare. VLMs are usually trained in three stages: vision pre-training, vision-language pre-training, and instruction fine-tuning (IFT). IFT has been typically applied using a mixture of generic and healthcare data. In contrast, we propose that for medical VLMs, a fourth stage of specialized IFT is necessary, which focuses on medical data and includes information from domain expert models. Domain expert models developed for medical use are crucial because they are specifically trained for certain clinical tasks, e.g. to detect tumors and classify abnormalities through segmentation and classification, which learn fine-grained features of medical data-features that are often too intricate for a VLM to capture effectively especially in radiology. This paper introduces a new framework, VILA-M3, for medical VLMs that utilizes domain knowledge via expert models. Through our experiments, we show an improved state-of-the-art (SOTA) performance with an average improvement of ~9% over the prior SOTA model Med-Gemini and ~6% over models trained on the specific tasks. Our approach emphasizes the importance of domain expertise in creating precise, reliable VLMs for medical applications.

3CAD: A Large-Scale Real-World 3C Product Dataset for Unsupervised Anomaly

Industrial anomaly detection achieves progress thanks to datasets such as MVTec-AD and VisA. However, they suf- fer from limitations in terms of the number of defect sam- ples, types of defects, and availability of real-world scenes. These constraints inhibit researchers from further exploring the performance of industrial detection with higher accuracy. To this end, we propose a new large-scale anomaly detection dataset called 3CAD, which is derived from real 3C produc- tion lines. Specifically, the proposed 3CAD includes eight different types of manufactured parts, totaling 27,039 high- resolution images labeled with pixel-level anomalies. The key features of 3CAD are that it covers anomalous regions of different sizes, multiple anomaly types, and the possibility of multiple anomalous regions and multiple anomaly types per anomaly image. This is the largest and first anomaly de- tection dataset dedicated to 3C product quality control for community exploration and development. Meanwhile, we in- troduce a simple yet effective framework for unsupervised anomaly detection: a Coarse-to-Fine detection paradigm with Recovery Guidance (CFRG). To detect small defect anoma- lies, the proposed CFRG utilizes a coarse-to-fine detection paradigm. Specifically, we utilize a heterogeneous distilla- tion model for coarse localization and then fine localiza- tion through a segmentation model. In addition, to better capture normal patterns, we introduce recovery features as guidance. Finally, we report the results of our CFRG frame- work and popular anomaly detection methods on the 3CAD dataset, demonstrating strong competitiveness and providing a highly challenging benchmark to promote the development of the anomaly detection field. Data and code are available: https://github.com/EnquanYang2022/3CAD.

Heart Disease Detection using Vision-Based Transformer Models from ECG Images

Heart disease, also known as cardiovascular disease, is a prevalent and critical medical condition characterized by the impairment of the heart and blood vessels, leading to various complications such as coronary artery disease, heart failure, and myocardial infarction. The timely and accurate detection of heart disease is of paramount importance in clinical practice. Early identification of individuals at risk enables proactive interventions, preventive measures, and personalized treatment strategies to mitigate the progression of the disease and reduce adverse outcomes. In recent years, the field of heart disease detection has witnessed notable advancements due to the integration of sophisticated technologies and computational approaches. These include machine learning algorithms, data mining techniques, and predictive modeling frameworks that leverage vast amounts of clinical and physiological data to improve diagnostic accuracy and risk stratification. In this work, we propose to detect heart disease from ECG images using cutting-edge technologies, namely vision transformer models. These models are Google-Vit, Microsoft-Beit, and Swin-Tiny. To the best of our knowledge, this is the initial endeavor concentrating on the detection of heart diseases through image-based ECG data by employing cuttingedge technologies namely, transformer models. To demonstrate the contribution of the proposed framework, the performance of vision transformer models are compared with state-of-the-art studies. Experiment results show that the proposed framework exhibits remarkable classification results.

Medical Image Classification with KAN-Integrated Transformers and Dilated Neighborhood Attention

Convolutional networks, transformers, hybrid models, and Mamba-based architectures have demonstrated strong performance across various medical image classification tasks. However, these methods were primarily designed to classify clean images using labeled data. In contrast, real-world clinical data often involve image corruptions that are unique to multi-center studies and stem from variations in imaging equipment across manufacturers. In this paper, we introduce the Medical Vision Transformer (MedViTV2), a novel architecture incorporating Kolmogorov-Arnold Network (KAN) layers into the transformer architecture for the first time, aiming for generalized medical image classification. We have developed an efficient KAN block to reduce computational load while enhancing the accuracy of the original MedViT. Additionally, to counteract the fragility of our MedViT when scaled up, we propose an enhanced Dilated Neighborhood Attention (DiNA), an adaptation of the efficient fused dot-product attention kernel capable of capturing global context and expanding receptive fields to scale the model effectively and addressing feature collapse issues. Moreover, a hierarchical hybrid strategy is introduced to stack our Local Feature Perception and Global Feature Perception blocks in an efficient manner, which balances local and global feature perceptions to boost performance. Extensive experiments on 17 medical image classification datasets and 12 corrupted medical image datasets demonstrate that MedViTV2 achieved state-of-the-art results in 27 out of 29 experiments with reduced computational complexity. MedViTV2 is 44\% more computationally efficient than the previous version and significantly enhances accuracy, achieving improvements of 4.6\% on MedMNIST, 5.8\% on NonMNIST, and 13.4\% on the MedMNIST-C benchmark.

Towards Generalist Biomedical AI

Medicine is inherently multimodal, with rich data modalities spanning text, imaging, genomics, and more. Generalist biomedical artificial intelligence (AI) systems that flexibly encode, integrate, and interpret this data at scale can potentially enable impactful applications ranging from scientific discovery to care delivery. To enable the development of these models, we first curate MultiMedBench, a new multimodal biomedical benchmark. MultiMedBench encompasses 14 diverse tasks such as medical question answering, mammography and dermatology image interpretation, radiology report generation and summarization, and genomic variant calling. We then introduce Med-PaLM Multimodal (Med-PaLM M), our proof of concept for a generalist biomedical AI system. Med-PaLM M is a large multimodal generative model that flexibly encodes and interprets biomedical data including clinical language, imaging, and genomics with the same set of model weights. Med-PaLM M reaches performance competitive with or exceeding the state of the art on all MultiMedBench tasks, often surpassing specialist models by a wide margin. We also report examples of zero-shot generalization to novel medical concepts and tasks, positive transfer learning across tasks, and emergent zero-shot medical reasoning. To further probe the capabilities and limitations of Med-PaLM M, we conduct a radiologist evaluation of model-generated (and human) chest X-ray reports and observe encouraging performance across model scales. In a side-by-side ranking on 246 retrospective chest X-rays, clinicians express a pairwise preference for Med-PaLM M reports over those produced by radiologists in up to 40.50% of cases, suggesting potential clinical utility. While considerable work is needed to validate these models in real-world use cases, our results represent a milestone towards the development of generalist biomedical AI systems.

Current Pathology Foundation Models are unrobust to Medical Center Differences

Pathology Foundation Models (FMs) hold great promise for healthcare. Before they can be used in clinical practice, it is essential to ensure they are robust to variations between medical centers. We measure whether pathology FMs focus on biological features like tissue and cancer type, or on the well known confounding medical center signatures introduced by staining procedure and other differences. We introduce the Robustness Index. This novel robustness metric reflects to what degree biological features dominate confounding features. Ten current publicly available pathology FMs are evaluated. We find that all current pathology foundation models evaluated represent the medical center to a strong degree. Significant differences in the robustness index are observed. Only one model so far has a robustness index greater than one, meaning biological features dominate confounding features, but only slightly. A quantitative approach to measure the influence of medical center differences on FM-based prediction performance is described. We analyze the impact of unrobustness on classification performance of downstream models, and find that cancer-type classification errors are not random, but specifically attributable to same-center confounders: images of other classes from the same medical center. We visualize FM embedding spaces, and find these are more strongly organized by medical centers than by biological factors. As a consequence, the medical center of origin is predicted more accurately than the tissue source and cancer type. The robustness index introduced here is provided with the aim of advancing progress towards clinical adoption of robust and reliable pathology FMs.

HRDE: Retrieval-Augmented Large Language Models for Chinese Health Rumor Detection and Explainability

As people increasingly prioritize their health, the speed and breadth of health information dissemination on the internet have also grown. At the same time, the presence of false health information (health rumors) intermingled with genuine content poses a significant potential threat to public health. However, current research on Chinese health rumors still lacks a large-scale, public, and open-source dataset of health rumor information, as well as effective and reliable rumor detection methods. This paper addresses this gap by constructing a dataset containing 1.12 million health-related rumors (HealthRCN) through web scraping of common health-related questions and a series of data processing steps. HealthRCN is the largest known dataset of Chinese health information rumors to date. Based on this dataset, we propose retrieval-augmented large language models for Chinese health rumor detection and explainability (HRDE). This model leverages retrieved relevant information to accurately determine whether the input health information is a rumor and provides explanatory responses, effectively aiding users in verifying the authenticity of health information. In evaluation experiments, we compared multiple models and found that HRDE outperformed them all, including GPT-4-1106-Preview, in rumor detection accuracy and answer quality. HRDE achieved an average accuracy of 91.04% and an F1 score of 91.58%.

Temporal-spatial Correlation Attention Network for Clinical Data Analysis in Intensive Care Unit

In recent years, medical information technology has made it possible for electronic health record (EHR) to store fairly complete clinical data. This has brought health care into the era of "big data". However, medical data are often sparse and strongly correlated, which means that medical problems cannot be solved effectively. With the rapid development of deep learning in recent years, it has provided opportunities for the use of big data in healthcare. In this paper, we propose a temporal-saptial correlation attention network (TSCAN) to handle some clinical characteristic prediction problems, such as predicting death, predicting length of stay, detecting physiologic decline, and classifying phenotypes. Based on the design of the attention mechanism model, our approach can effectively remove irrelevant items in clinical data and irrelevant nodes in time according to different tasks, so as to obtain more accurate prediction results. Our method can also find key clinical indicators of important outcomes that can be used to improve treatment options. Our experiments use information from the Medical Information Mart for Intensive Care (MIMIC-IV) database, which is open to the public. Finally, we have achieved significant performance benefits of 2.0\% (metric) compared to other SOTA prediction methods. We achieved a staggering 90.7\% on mortality rate, 45.1\% on length of stay. The source code can be find: https://github.com/yuyuheintju/TSCAN.

DR.BENCH: Diagnostic Reasoning Benchmark for Clinical Natural Language Processing

The meaningful use of electronic health records (EHR) continues to progress in the digital era with clinical decision support systems augmented by artificial intelligence. A priority in improving provider experience is to overcome information overload and reduce the cognitive burden so fewer medical errors and cognitive biases are introduced during patient care. One major type of medical error is diagnostic error due to systematic or predictable errors in judgment that rely on heuristics. The potential for clinical natural language processing (cNLP) to model diagnostic reasoning in humans with forward reasoning from data to diagnosis and potentially reduce the cognitive burden and medical error has not been investigated. Existing tasks to advance the science in cNLP have largely focused on information extraction and named entity recognition through classification tasks. We introduce a novel suite of tasks coined as Diagnostic Reasoning Benchmarks, DR.BENCH, as a new benchmark for developing and evaluating cNLP models with clinical diagnostic reasoning ability. The suite includes six tasks from ten publicly available datasets addressing clinical text understanding, medical knowledge reasoning, and diagnosis generation. DR.BENCH is the first clinical suite of tasks designed to be a natural language generation framework to evaluate pre-trained language models. Experiments with state-of-the-art pre-trained generative language models using large general domain models and models that were continually trained on a medical corpus demonstrate opportunities for improvement when evaluated in DR. BENCH. We share DR. BENCH as a publicly available GitLab repository with a systematic approach to load and evaluate models for the cNLP community.

Advancing Anomaly Detection: An Adaptation Model and a New Dataset

Industry surveillance is widely applicable in sectors like retail, manufacturing, education, and smart cities, each presenting unique anomalies requiring specialized detection. However, adapting anomaly detection models to novel viewpoints within the same scenario poses challenges. Extending these models to entirely new scenarios necessitates retraining or fine-tuning, a process that can be time consuming. To address these challenges, we propose the Scenario-Adaptive Anomaly Detection (SA2D) method, leveraging the few-shot learning framework for faster adaptation of pre-trained models to new concepts. Despite this approach, a significant challenge emerges from the absence of a comprehensive dataset with diverse scenarios and camera views. In response, we introduce the Multi-Scenario Anomaly Detection (MSAD) dataset, encompassing 14 distinct scenarios captured from various camera views. This real-world dataset is the first high-resolution anomaly detection dataset, offering a solid foundation for training superior models. MSAD includes diverse normal motion patterns, incorporating challenging variations like different lighting and weather conditions. Through experimentation, we validate the efficacy of SA2D, particularly when trained on the MSAD dataset. Our results show that SA2D not only excels under novel viewpoints within the same scenario but also demonstrates competitive performance when faced with entirely new scenarios. This highlights our method's potential in addressing challenges in detecting anomalies across diverse and evolving surveillance scenarios.

Self-supervised Feature Adaptation for 3D Industrial Anomaly Detection

Industrial anomaly detection is generally addressed as an unsupervised task that aims at locating defects with only normal training samples. Recently, numerous 2D anomaly detection methods have been proposed and have achieved promising results, however, using only the 2D RGB data as input is not sufficient to identify imperceptible geometric surface anomalies. Hence, in this work, we focus on multi-modal anomaly detection. Specifically, we investigate early multi-modal approaches that attempted to utilize models pre-trained on large-scale visual datasets, i.e., ImageNet, to construct feature databases. And we empirically find that directly using these pre-trained models is not optimal, it can either fail to detect subtle defects or mistake abnormal features as normal ones. This may be attributed to the domain gap between target industrial data and source data.Towards this problem, we propose a Local-to-global Self-supervised Feature Adaptation (LSFA) method to finetune the adaptors and learn task-oriented representation toward anomaly detection.Both intra-modal adaptation and cross-modal alignment are optimized from a local-to-global perspective in LSFA to ensure the representation quality and consistency in the inference stage.Extensive experiments demonstrate that our method not only brings a significant performance boost to feature embedding based approaches, but also outperforms previous State-of-The-Art (SoTA) methods prominently on both MVTec-3D AD and Eyecandies datasets, e.g., LSFA achieves 97.1% I-AUROC on MVTec-3D, surpass previous SoTA by +3.4%.

Question-Answering Model for Schizophrenia Symptoms and Their Impact on Daily Life using Mental Health Forums Data

In recent years, there is strong emphasis on mining medical data using machine learning techniques. A common problem is to obtain a noiseless set of textual documents, with a relevant content for the research question, and developing a Question Answering (QA) model for a specific medical field. The purpose of this paper is to present a new methodology for building a medical dataset and obtain a QA model for analysis of symptoms and impact on daily life for a specific disease domain. The ``Mental Health'' forum was used, a forum dedicated to people suffering from schizophrenia and different mental disorders. Relevant posts of active users, who regularly participate, were extrapolated providing a new method of obtaining low-bias content and without privacy issues. Furthermore, it is shown how to pre-process the dataset to convert it into a QA dataset. The Bidirectional Encoder Representations from Transformers (BERT), DistilBERT, RoBERTa, and BioBERT models were fine-tuned and evaluated via F1-Score, Exact Match, Precision and Recall. Accurate empirical experiments demonstrated the effectiveness of the proposed method for obtaining an accurate dataset for QA model implementation. By fine-tuning the BioBERT QA model, we achieved an F1 score of 0.885, showing a considerable improvement and outperforming the state-of-the-art model for mental disorders domain.

Interactive Medical Image Analysis with Concept-based Similarity Reasoning

The ability to interpret and intervene model decisions is important for the adoption of computer-aided diagnosis methods in clinical workflows. Recent concept-based methods link the model predictions with interpretable concepts and modify their activation scores to interact with the model. However, these concepts are at the image level, which hinders the model from pinpointing the exact patches the concepts are activated. Alternatively, prototype-based methods learn representations from training image patches and compare these with test image patches, using the similarity scores for final class prediction. However, interpreting the underlying concepts of these patches can be challenging and often necessitates post-hoc guesswork. To address this issue, this paper introduces the novel Concept-based Similarity Reasoning network (CSR), which offers (i) patch-level prototype with intrinsic concept interpretation, and (ii) spatial interactivity. First, the proposed CSR provides localized explanation by grounding prototypes of each concept on image regions. Second, our model introduces novel spatial-level interaction, allowing doctors to engage directly with specific image areas, making it an intuitive and transparent tool for medical imaging. CSR improves upon prior state-of-the-art interpretable methods by up to 4.5\% across three biomedical datasets. Our code is released at https://github.com/tadeephuy/InteractCSR.

Enhancing Adverse Drug Event Detection with Multimodal Dataset: Corpus Creation and Model Development

The mining of adverse drug events (ADEs) is pivotal in pharmacovigilance, enhancing patient safety by identifying potential risks associated with medications, facilitating early detection of adverse events, and guiding regulatory decision-making. Traditional ADE detection methods are reliable but slow, not easily adaptable to large-scale operations, and offer limited information. With the exponential increase in data sources like social media content, biomedical literature, and Electronic Medical Records (EMR), extracting relevant ADE-related information from these unstructured texts is imperative. Previous ADE mining studies have focused on text-based methodologies, overlooking visual cues, limiting contextual comprehension, and hindering accurate interpretation. To address this gap, we present a MultiModal Adverse Drug Event (MMADE) detection dataset, merging ADE-related textual information with visual aids. Additionally, we introduce a framework that leverages the capabilities of LLMs and VLMs for ADE detection by generating detailed descriptions of medical images depicting ADEs, aiding healthcare professionals in visually identifying adverse events. Using our MMADE dataset, we showcase the significance of integrating visual cues from images to enhance overall performance. This approach holds promise for patient safety, ADE awareness, and healthcare accessibility, paving the way for further exploration in personalized healthcare.

ConceptCLIP: Towards Trustworthy Medical AI via Concept-Enhanced Contrastive Langauge-Image Pre-training

Trustworthiness is essential for the precise and interpretable application of artificial intelligence (AI) in medical imaging. Traditionally, precision and interpretability have been addressed as separate tasks, namely medical image analysis and explainable AI, each developing its own models independently. In this study, for the first time, we investigate the development of a unified medical vision-language pre-training model that can achieve both accurate analysis and interpretable understanding of medical images across various modalities. To build the model, we construct MedConcept-23M, a large-scale dataset comprising 23 million medical image-text pairs extracted from 6.2 million scientific articles, enriched with concepts from the Unified Medical Language System (UMLS). Based on MedConcept-23M, we introduce ConceptCLIP, a medical AI model utilizing concept-enhanced contrastive language-image pre-training. The pre-training of ConceptCLIP involves two primary components: image-text alignment learning (IT-Align) and patch-concept alignment learning (PC-Align). This dual alignment strategy enhances the model's capability to associate specific image regions with relevant concepts, thereby improving both the precision of analysis and the interpretability of the AI system. We conducted extensive experiments on 5 diverse types of medical image analysis tasks, spanning 51 subtasks across 10 image modalities, with the broadest range of downstream tasks. The results demonstrate the effectiveness of the proposed vision-language pre-training model. Further explainability analysis across 6 modalities reveals that ConceptCLIP achieves superior performance, underscoring its robust ability to advance explainable AI in medical imaging. These findings highlight ConceptCLIP's capability in promoting trustworthy AI in the field of medicine.

MedImageInsight: An Open-Source Embedding Model for General Domain Medical Imaging

In this work, we present MedImageInsight, an open-source medical imaging embedding model. MedImageInsight is trained on medical images with associated text and labels across a diverse collection of domains, including X-Ray, CT, MRI, dermoscopy, OCT, fundus photography, ultrasound, histopathology, and mammography. Rigorous evaluations demonstrate MedImageInsight's ability to achieve state-of-the-art (SOTA) or human expert level performance across classification, image-image search, and fine-tuning tasks. Specifically, on public datasets, MedImageInsight achieves SOTA in CT 3D medical image retrieval, as well as SOTA in disease classification and search for chest X-ray, dermatology, and OCT imaging. Furthermore, MedImageInsight achieves human expert performance in bone age estimation (on both public and partner data), as well as AUC above 0.9 in most other domains. When paired with a text decoder, MedImageInsight achieves near SOTA level single image report findings generation with less than 10\% the parameters of other models. Compared to fine-tuning GPT-4o with only MIMIC-CXR data for the same task, MedImageInsight outperforms in clinical metrics, but underperforms on lexical metrics where GPT-4o sets a new SOTA. Importantly for regulatory purposes, MedImageInsight can generate ROC curves, adjust sensitivity and specificity based on clinical need, and provide evidence-based decision support through image-image search (which can also enable retrieval augmented generation). In an independent clinical evaluation of image-image search in chest X-ray, MedImageInsight outperformed every other publicly available foundation model evaluated by large margins (over 6 points AUC), and significantly outperformed other models in terms of AI fairness (across age and gender). We hope releasing MedImageInsight will help enhance collective progress in medical imaging AI research and development.

MEDEC: A Benchmark for Medical Error Detection and Correction in Clinical Notes

Several studies showed that Large Language Models (LLMs) can answer medical questions correctly, even outperforming the average human score in some medical exams. However, to our knowledge, no study has been conducted to assess the ability of language models to validate existing or generated medical text for correctness and consistency. In this paper, we introduce MEDEC (https://github.com/abachaa/MEDEC), the first publicly available benchmark for medical error detection and correction in clinical notes, covering five types of errors (Diagnosis, Management, Treatment, Pharmacotherapy, and Causal Organism). MEDEC consists of 3,848 clinical texts, including 488 clinical notes from three US hospital systems that were not previously seen by any LLM. The dataset has been used for the MEDIQA-CORR shared task to evaluate seventeen participating systems [Ben Abacha et al., 2024]. In this paper, we describe the data creation methods and we evaluate recent LLMs (e.g., o1-preview, GPT-4, Claude 3.5 Sonnet, and Gemini 2.0 Flash) for the tasks of detecting and correcting medical errors requiring both medical knowledge and reasoning capabilities. We also conducted a comparative study where two medical doctors performed the same task on the MEDEC test set. The results showed that MEDEC is a sufficiently challenging benchmark to assess the ability of models to validate existing or generated notes and to correct medical errors. We also found that although recent LLMs have a good performance in error detection and correction, they are still outperformed by medical doctors in these tasks. We discuss the potential factors behind this gap, the insights from our experiments, the limitations of current evaluation metrics, and share potential pointers for future research.

CARE to Compare: A real-world dataset for anomaly detection in wind turbine data

Anomaly detection plays a crucial role in the field of predictive maintenance for wind turbines, yet the comparison of different algorithms poses a difficult task because domain specific public datasets are scarce. Many comparisons of different approaches either use benchmarks composed of data from many different domains, inaccessible data or one of the few publicly available datasets which lack detailed information about the faults. Moreover, many publications highlight a couple of case studies where fault detection was successful. With this paper we publish a high quality dataset that contains data from 36 wind turbines across 3 different wind farms as well as the most detailed fault information of any public wind turbine dataset as far as we know. The new dataset contains 89 years worth of real-world operating data of wind turbines, distributed across 44 labeled time frames for anomalies that led up to faults, as well as 51 time series representing normal behavior. Additionally, the quality of training data is ensured by turbine-status-based labels for each data point. Furthermore, we propose a new scoring method, called CARE (Coverage, Accuracy, Reliability and Earliness), which takes advantage of the information depth that is present in the dataset to identify a good all-around anomaly detection model. This score considers the anomaly detection performance, the ability to recognize normal behavior properly and the capability to raise as few false alarms as possible while simultaneously detecting anomalies early.

Class-dependent Compression of Deep Neural Networks

Today's deep neural networks require substantial computation resources for their training, storage, and inference, which limits their effective use on resource-constrained devices. Many recent research activities explore different options for compressing and optimizing deep models. On the one hand, in many real-world applications, we face the data imbalance challenge, i.e. when the number of labeled instances of one class considerably outweighs the number of labeled instances of the other class. On the other hand, applications may pose a class imbalance problem, i.e. higher number of false positives produced when training a model and optimizing its performance may be tolerable, yet the number of false negatives must stay low. The problem originates from the fact that some classes are more important for the application than others, e.g. detection problems in medical and surveillance domains. Motivated by the success of the lottery ticket hypothesis, in this paper we propose an iterative deep model compression technique, which keeps the number of false negatives of the compressed model close to the one of the original model at the price of increasing the number of false positives if necessary. Our experimental evaluation using two benchmark data sets shows that the resulting compressed sub-networks 1) achieve up to 35% lower number of false negatives than the compressed model without class optimization, 2) provide an overall higher AUC_ROC measure, and 3) use up to 99% fewer parameters compared to the original network.

MultiMed: Massively Multimodal and Multitask Medical Understanding

Biomedical data is inherently multimodal, consisting of electronic health records, medical imaging, digital pathology, genome sequencing, wearable sensors, and more. The application of artificial intelligence tools to these multifaceted sensing technologies has the potential to revolutionize the prognosis, diagnosis, and management of human health and disease. However, current approaches to biomedical AI typically only train and evaluate with one or a small set of medical modalities and tasks. This limitation hampers the development of comprehensive tools that can leverage the rich interconnected information across many heterogeneous biomedical sensors. To address this challenge, we present MultiMed, a benchmark designed to evaluate and enable large-scale learning across a wide spectrum of medical modalities and tasks. MultiMed consists of 2.56 million samples across ten medical modalities such as medical reports, pathology, genomics, and protein data, and is structured into eleven challenging tasks, including disease prognosis, protein structure prediction, and medical question answering. Using MultiMed, we conduct comprehensive experiments benchmarking state-of-the-art unimodal, multimodal, and multitask models. Our analysis highlights the advantages of training large-scale medical models across many related modalities and tasks. Moreover, MultiMed enables studies of generalization across related medical concepts, robustness to real-world noisy data and distribution shifts, and novel modality combinations to improve prediction performance. MultiMed will be publicly available and regularly updated and welcomes inputs from the community.

Medical Unlearnable Examples: Securing Medical Data from Unauthorized Traning via Sparsity-Aware Local Masking

With the rapid growth of artificial intelligence (AI) in healthcare, there has been a significant increase in the generation and storage of sensitive medical data. This abundance of data, in turn, has propelled the advancement of medical AI technologies. However, concerns about unauthorized data exploitation, such as training commercial AI models, often deter researchers from making their invaluable datasets publicly available. In response to the need to protect this hard-to-collect data while still encouraging medical institutions to share it, one promising solution is to introduce imperceptible noise into the data. This method aims to safeguard the data against unauthorized training by inducing degradation in model generalization. Although existing methods have shown commendable data protection capabilities in general domains, they tend to fall short when applied to biomedical data, mainly due to their failure to account for the sparse nature of medical images. To address this problem, we propose the Sparsity-Aware Local Masking (SALM) method, a novel approach that selectively perturbs significant pixel regions rather than the entire image as previous strategies have done. This simple-yet-effective approach significantly reduces the perturbation search space by concentrating on local regions, thereby improving both the efficiency and effectiveness of data protection for biomedical datasets characterized by sparse features. Besides, we have demonstrated that SALM maintains the essential characteristics of the data, ensuring its clinical utility remains uncompromised. Our extensive experiments across various datasets and model architectures demonstrate that SALM effectively prevents unauthorized training of deep-learning models and outperforms previous state-of-the-art data protection methods.

Xplainer: From X-Ray Observations to Explainable Zero-Shot Diagnosis

Automated diagnosis prediction from medical images is a valuable resource to support clinical decision-making. However, such systems usually need to be trained on large amounts of annotated data, which often is scarce in the medical domain. Zero-shot methods address this challenge by allowing a flexible adaption to new settings with different clinical findings without relying on labeled data. Further, to integrate automated diagnosis in the clinical workflow, methods should be transparent and explainable, increasing medical professionals' trust and facilitating correctness verification. In this work, we introduce Xplainer, a novel framework for explainable zero-shot diagnosis in the clinical setting. Xplainer adapts the classification-by-description approach of contrastive vision-language models to the multi-label medical diagnosis task. Specifically, instead of directly predicting a diagnosis, we prompt the model to classify the existence of descriptive observations, which a radiologist would look for on an X-Ray scan, and use the descriptor probabilities to estimate the likelihood of a diagnosis. Our model is explainable by design, as the final diagnosis prediction is directly based on the prediction of the underlying descriptors. We evaluate Xplainer on two chest X-ray datasets, CheXpert and ChestX-ray14, and demonstrate its effectiveness in improving the performance and explainability of zero-shot diagnosis. Our results suggest that Xplainer provides a more detailed understanding of the decision-making process and can be a valuable tool for clinical diagnosis.

Vision Language Models in Medicine

With the advent of Vision-Language Models (VLMs), medical artificial intelligence (AI) has experienced significant technological progress and paradigm shifts. This survey provides an extensive review of recent advancements in Medical Vision-Language Models (Med-VLMs), which integrate visual and textual data to enhance healthcare outcomes. We discuss the foundational technology behind Med-VLMs, illustrating how general models are adapted for complex medical tasks, and examine their applications in healthcare. The transformative impact of Med-VLMs on clinical practice, education, and patient care is highlighted, alongside challenges such as data scarcity, narrow task generalization, interpretability issues, and ethical concerns like fairness, accountability, and privacy. These limitations are exacerbated by uneven dataset distribution, computational demands, and regulatory hurdles. Rigorous evaluation methods and robust regulatory frameworks are essential for safe integration into healthcare workflows. Future directions include leveraging large-scale, diverse datasets, improving cross-modal generalization, and enhancing interpretability. Innovations like federated learning, lightweight architectures, and Electronic Health Record (EHR) integration are explored as pathways to democratize access and improve clinical relevance. This review aims to provide a comprehensive understanding of Med-VLMs' strengths and limitations, fostering their ethical and balanced adoption in healthcare.

A Survey of Medical Vision-and-Language Applications and Their Techniques

Medical vision-and-language models (MVLMs) have attracted substantial interest due to their capability to offer a natural language interface for interpreting complex medical data. Their applications are versatile and have the potential to improve diagnostic accuracy and decision-making for individual patients while also contributing to enhanced public health monitoring, disease surveillance, and policy-making through more efficient analysis of large data sets. MVLMS integrate natural language processing with medical images to enable a more comprehensive and contextual understanding of medical images alongside their corresponding textual information. Unlike general vision-and-language models trained on diverse, non-specialized datasets, MVLMs are purpose-built for the medical domain, automatically extracting and interpreting critical information from medical images and textual reports to support clinical decision-making. Popular clinical applications of MVLMs include automated medical report generation, medical visual question answering, medical multimodal segmentation, diagnosis and prognosis and medical image-text retrieval. Here, we provide a comprehensive overview of MVLMs and the various medical tasks to which they have been applied. We conduct a detailed analysis of various vision-and-language model architectures, focusing on their distinct strategies for cross-modal integration/exploitation of medical visual and textual features. We also examine the datasets used for these tasks and compare the performance of different models based on standardized evaluation metrics. Furthermore, we highlight potential challenges and summarize future research trends and directions. The full collection of papers and codes is available at: https://github.com/YtongXie/Medical-Vision-and-Language-Tasks-and-Methodologies-A-Survey.

Bt-GAN: Generating Fair Synthetic Healthdata via Bias-transforming Generative Adversarial Networks

Synthetic data generation offers a promising solution to enhance the usefulness of Electronic Healthcare Records (EHR) by generating realistic de-identified data. However, the existing literature primarily focuses on the quality of synthetic health data, neglecting the crucial aspect of fairness in downstream predictions. Consequently, models trained on synthetic EHR have faced criticism for producing biased outcomes in target tasks. These biases can arise from either spurious correlations between features or the failure of models to accurately represent sub-groups. To address these concerns, we present Bias-transforming Generative Adversarial Networks (Bt-GAN), a GAN-based synthetic data generator specifically designed for the healthcare domain. In order to tackle spurious correlations (i), we propose an information-constrained Data Generation Process that enables the generator to learn a fair deterministic transformation based on a well-defined notion of algorithmic fairness. To overcome the challenge of capturing exact sub-group representations (ii), we incentivize the generator to preserve sub-group densities through score-based weighted sampling. This approach compels the generator to learn from underrepresented regions of the data manifold. We conduct extensive experiments using the MIMIC-III database. Our results demonstrate that Bt-GAN achieves SOTA accuracy while significantly improving fairness and minimizing bias amplification. We also perform an in-depth explainability analysis to provide additional evidence supporting the validity of our study. In conclusion, our research introduces a novel and professional approach to addressing the limitations of synthetic data generation in the healthcare domain. By incorporating fairness considerations and leveraging advanced techniques such as GANs, we pave the way for more reliable and unbiased predictions in healthcare applications.

Detailed Annotations of Chest X-Rays via CT Projection for Report Understanding

In clinical radiology reports, doctors capture important information about the patient's health status. They convey their observations from raw medical imaging data about the inner structures of a patient. As such, formulating reports requires medical experts to possess wide-ranging knowledge about anatomical regions with their normal, healthy appearance as well as the ability to recognize abnormalities. This explicit grasp on both the patient's anatomy and their appearance is missing in current medical image-processing systems as annotations are especially difficult to gather. This renders the models to be narrow experts e.g. for identifying specific diseases. In this work, we recover this missing link by adding human anatomy into the mix and enable the association of content in medical reports to their occurrence in associated imagery (medical phrase grounding). To exploit anatomical structures in this scenario, we present a sophisticated automatic pipeline to gather and integrate human bodily structures from computed tomography datasets, which we incorporate in our PAXRay: A Projected dataset for the segmentation of Anatomical structures in X-Ray data. Our evaluation shows that methods that take advantage of anatomical information benefit heavily in visually grounding radiologists' findings, as our anatomical segmentations allow for up to absolute 50% better grounding results on the OpenI dataset as compared to commonly used region proposals. The PAXRay dataset is available at https://constantinseibold.github.io/paxray/.

De-identification of Patient Notes with Recurrent Neural Networks

Objective: Patient notes in electronic health records (EHRs) may contain critical information for medical investigations. However, the vast majority of medical investigators can only access de-identified notes, in order to protect the confidentiality of patients. In the United States, the Health Insurance Portability and Accountability Act (HIPAA) defines 18 types of protected health information (PHI) that needs to be removed to de-identify patient notes. Manual de-identification is impractical given the size of EHR databases, the limited number of researchers with access to the non-de-identified notes, and the frequent mistakes of human annotators. A reliable automated de-identification system would consequently be of high value. Materials and Methods: We introduce the first de-identification system based on artificial neural networks (ANNs), which requires no handcrafted features or rules, unlike existing systems. We compare the performance of the system with state-of-the-art systems on two datasets: the i2b2 2014 de-identification challenge dataset, which is the largest publicly available de-identification dataset, and the MIMIC de-identification dataset, which we assembled and is twice as large as the i2b2 2014 dataset. Results: Our ANN model outperforms the state-of-the-art systems. It yields an F1-score of 97.85 on the i2b2 2014 dataset, with a recall 97.38 and a precision of 97.32, and an F1-score of 99.23 on the MIMIC de-identification dataset, with a recall 99.25 and a precision of 99.06. Conclusion: Our findings support the use of ANNs for de-identification of patient notes, as they show better performance than previously published systems while requiring no feature engineering.

GID: Graph-based Intrusion Detection on Massive Process Traces for Enterprise Security Systems

Intrusion detection system (IDS) is an important part of enterprise security system architecture. In particular, anomaly-based IDS has been widely applied to detect abnormal process behaviors that deviate from the majority. However, such abnormal behavior usually consists of a series of low-level heterogeneous events. The gap between the low-level events and the high-level abnormal behaviors makes it hard to infer which single events are related to the real abnormal activities, especially considering that there are massive "noisy" low-level events happening in between. Hence, the existing work that focus on detecting single entities/events can hardly achieve high detection accuracy. Different from previous work, we design and implement GID, an efficient graph-based intrusion detection technique that can identify abnormal event sequences from a massive heterogeneous process traces with high accuracy. GID first builds a compact graph structure to capture the interactions between different system entities. The suspiciousness or anomaly score of process paths is then measured by leveraging random walk technique to the constructed acyclic directed graph. To eliminate the score bias from the path length, the Box-Cox power transformation based approach is introduced to normalize the anomaly scores so that the scores of paths of different lengths have the same distribution. The efficiency of suspicious path discovery is further improved by the proposed optimization scheme. We fully implement our GID algorithm and deploy it into a real enterprise security system, and it greatly helps detect the advanced threats, and optimize the incident response. Executing GID on system monitoring datasets showing that GID is efficient (about 2 million records per minute) and accurate (higher than 80% in terms of detection rate).

MMed-RAG: Versatile Multimodal RAG System for Medical Vision Language Models

Artificial Intelligence (AI) has demonstrated significant potential in healthcare, particularly in disease diagnosis and treatment planning. Recent progress in Medical Large Vision-Language Models (Med-LVLMs) has opened up new possibilities for interactive diagnostic tools. However, these models often suffer from factual hallucination, which can lead to incorrect diagnoses. Fine-tuning and retrieval-augmented generation (RAG) have emerged as methods to address these issues. However, the amount of high-quality data and distribution shifts between training data and deployment data limit the application of fine-tuning methods. Although RAG is lightweight and effective, existing RAG-based approaches are not sufficiently general to different medical domains and can potentially cause misalignment issues, both between modalities and between the model and the ground truth. In this paper, we propose a versatile multimodal RAG system, MMed-RAG, designed to enhance the factuality of Med-LVLMs. Our approach introduces a domain-aware retrieval mechanism, an adaptive retrieved contexts selection method, and a provable RAG-based preference fine-tuning strategy. These innovations make the RAG process sufficiently general and reliable, significantly improving alignment when introducing retrieved contexts. Experimental results across five medical datasets (involving radiology, ophthalmology, pathology) on medical VQA and report generation demonstrate that MMed-RAG can achieve an average improvement of 43.8% in the factual accuracy of Med-LVLMs. Our data and code are available in https://github.com/richard-peng-xia/MMed-RAG.

Interpretable Bilingual Multimodal Large Language Model for Diverse Biomedical Tasks

Several medical Multimodal Large Languange Models (MLLMs) have been developed to address tasks involving visual images with textual instructions across various medical modalities, achieving impressive results. Most current medical generalist models are region-agnostic, treating the entire image as a holistic representation. However, they struggle to identify which specific regions they are focusing on when generating a sentence. To mimic the behavior of doctors, who typically begin by reviewing the entire image before concentrating on specific regions for a thorough evaluation, we aim to enhance the capability of medical MLLMs in understanding anatomical regions within entire medical scans. To achieve it, we first formulate Region-Centric tasks and construct a large-scale dataset, MedRegInstruct, to incorporate regional information into training. Combining our collected dataset with other medical multimodal corpora for training, we propose a Region-Aware medical MLLM, MedRegA, which is the first bilingual generalist medical AI system to simultaneously handle image-level and region-level medical vision-language tasks across a broad range of modalities. Our MedRegA not only enables three region-centric tasks, but also achieves the best performance for visual question answering, report generation and medical image classification over 8 modalities, showcasing significant versatility. Experiments demonstrate that our model can not only accomplish powerful performance across various medical vision-language tasks in bilingual settings, but also recognize and detect structures in multimodal medical scans, boosting the interpretability and user interactivity of medical MLLMs. Our project page is https://medrega.github.io.

Towards a Single Unified Model for Effective Detection, Segmentation, and Diagnosis of Eight Major Cancers Using a Large Collection of CT Scans

Human readers or radiologists routinely perform full-body multi-organ multi-disease detection and diagnosis in clinical practice, while most medical AI systems are built to focus on single organs with a narrow list of a few diseases. This might severely limit AI's clinical adoption. A certain number of AI models need to be assembled non-trivially to match the diagnostic process of a human reading a CT scan. In this paper, we construct a Unified Tumor Transformer (UniT) model to detect (tumor existence and location) and diagnose (tumor characteristics) eight major cancer-prevalent organs in CT scans. UniT is a query-based Mask Transformer model with the output of multi-organ and multi-tumor semantic segmentation. We decouple the object queries into organ queries, detection queries and diagnosis queries, and further establish hierarchical relationships among the three groups. This clinically-inspired architecture effectively assists inter- and intra-organ representation learning of tumors and facilitates the resolution of these complex, anatomically related multi-organ cancer image reading tasks. UniT is trained end-to-end using a curated large-scale CT images of 10,042 patients including eight major types of cancers and occurring non-cancer tumors (all are pathology-confirmed with 3D tumor masks annotated by radiologists). On the test set of 631 patients, UniT has demonstrated strong performance under a set of clinically relevant evaluation metrics, substantially outperforming both multi-organ segmentation methods and an assembly of eight single-organ expert models in tumor detection, segmentation, and diagnosis. Such a unified multi-cancer image reading model (UniT) can significantly reduce the number of false positives produced by combined multi-system models. This moves one step closer towards a universal high-performance cancer screening tool.

Label Dependent Attention Model for Disease Risk Prediction Using Multimodal Electronic Health Records

Disease risk prediction has attracted increasing attention in the field of modern healthcare, especially with the latest advances in artificial intelligence (AI). Electronic health records (EHRs), which contain heterogeneous patient information, are widely used in disease risk prediction tasks. One challenge of applying AI models for risk prediction lies in generating interpretable evidence to support the prediction results while retaining the prediction ability. In order to address this problem, we propose the method of jointly embedding words and labels whereby attention modules learn the weights of words from medical notes according to their relevance to the names of risk prediction labels. This approach boosts interpretability by employing an attention mechanism and including the names of prediction tasks in the model. However, its application is only limited to the handling of textual inputs such as medical notes. In this paper, we propose a label dependent attention model LDAM to 1) improve the interpretability by exploiting Clinical-BERT (a biomedical language model pre-trained on a large clinical corpus) to encode biomedically meaningful features and labels jointly; 2) extend the idea of joint embedding to the processing of time-series data, and develop a multi-modal learning framework for integrating heterogeneous information from medical notes and time-series health status indicators. To demonstrate our method, we apply LDAM to the MIMIC-III dataset to predict different disease risks. We evaluate our method both quantitatively and qualitatively. Specifically, the predictive power of LDAM will be shown, and case studies will be carried out to illustrate its interpretability.

ChestX-ray8: Hospital-scale Chest X-ray Database and Benchmarks on Weakly-Supervised Classification and Localization of Common Thorax Diseases

The chest X-ray is one of the most commonly accessible radiological examinations for screening and diagnosis of many lung diseases. A tremendous number of X-ray imaging studies accompanied by radiological reports are accumulated and stored in many modern hospitals' Picture Archiving and Communication Systems (PACS). On the other side, it is still an open question how this type of hospital-size knowledge database containing invaluable imaging informatics (i.e., loosely labeled) can be used to facilitate the data-hungry deep learning paradigms in building truly large-scale high precision computer-aided diagnosis (CAD) systems. In this paper, we present a new chest X-ray database, namely "ChestX-ray8", which comprises 108,948 frontal-view X-ray images of 32,717 unique patients with the text-mined eight disease image labels (where each image can have multi-labels), from the associated radiological reports using natural language processing. Importantly, we demonstrate that these commonly occurring thoracic diseases can be detected and even spatially-located via a unified weakly-supervised multi-label image classification and disease localization framework, which is validated using our proposed dataset. Although the initial quantitative results are promising as reported, deep convolutional neural network based "reading chest X-rays" (i.e., recognizing and locating the common disease patterns trained with only image-level labels) remains a strenuous task for fully-automated high precision CAD systems. Data download link: https://nihcc.app.box.com/v/ChestXray-NIHCC

RoentGen: Vision-Language Foundation Model for Chest X-ray Generation

Multimodal models trained on large natural image-text pair datasets have exhibited astounding abilities in generating high-quality images. Medical imaging data is fundamentally different to natural images, and the language used to succinctly capture relevant details in medical data uses a different, narrow but semantically rich, domain-specific vocabulary. Not surprisingly, multi-modal models trained on natural image-text pairs do not tend to generalize well to the medical domain. Developing generative imaging models faithfully representing medical concepts while providing compositional diversity could mitigate the existing paucity of high-quality, annotated medical imaging datasets. In this work, we develop a strategy to overcome the large natural-medical distributional shift by adapting a pre-trained latent diffusion model on a corpus of publicly available chest x-rays (CXR) and their corresponding radiology (text) reports. We investigate the model's ability to generate high-fidelity, diverse synthetic CXR conditioned on text prompts. We assess the model outputs quantitatively using image quality metrics, and evaluate image quality and text-image alignment by human domain experts. We present evidence that the resulting model (RoentGen) is able to create visually convincing, diverse synthetic CXR images, and that the output can be controlled to a new extent by using free-form text prompts including radiology-specific language. Fine-tuning this model on a fixed training set and using it as a data augmentation method, we measure a 5% improvement of a classifier trained jointly on synthetic and real images, and a 3% improvement when trained on a larger but purely synthetic training set. Finally, we observe that this fine-tuning distills in-domain knowledge in the text-encoder and can improve its representation capabilities of certain diseases like pneumothorax by 25%.

RAD-DINO: Exploring Scalable Medical Image Encoders Beyond Text Supervision

Language-supervised pre-training has proven to be a valuable method for extracting semantically meaningful features from images, serving as a foundational element in multimodal systems within the computer vision and medical imaging domains. However, resulting features are limited by the information contained within the text. This is particularly problematic in medical imaging, where radiologists' written findings focus on specific observations; a challenge compounded by the scarcity of paired imaging-text data due to concerns over leakage of personal health information. In this work, we fundamentally challenge the prevailing reliance on language supervision for learning general purpose biomedical imaging encoders. We introduce RAD-DINO, a biomedical image encoder pre-trained solely on unimodal biomedical imaging data that obtains similar or greater performance than state-of-the-art biomedical language supervised models on a diverse range of benchmarks. Specifically, the quality of learned representations is evaluated on standard imaging tasks (classification and semantic segmentation), and a vision-language alignment task (text report generation from images). To further demonstrate the drawback of language supervision, we show that features from RAD-DINO correlate with other medical records (e.g., sex or age) better than language-supervised models, which are generally not mentioned in radiology reports. Finally, we conduct a series of ablations determining the factors in RAD-DINO's performance; notably, we observe that RAD-DINO's downstream performance scales well with the quantity and diversity of training data, demonstrating that image-only supervision is a scalable approach for training a foundational biomedical image encoder.

Automatic Differential Diagnosis using Transformer-Based Multi-Label Sequence Classification

As the field of artificial intelligence progresses, assistive technologies are becoming more widely used across all industries. The healthcare industry is no different, with numerous studies being done to develop assistive tools for healthcare professionals. Automatic diagnostic systems are one such beneficial tool that can assist with a variety of tasks, including collecting patient information, analyzing test results, and diagnosing patients. However, the idea of developing systems that can provide a differential diagnosis has been largely overlooked in most of these research studies. In this study, we propose a transformer-based approach for providing differential diagnoses based on a patient's age, sex, medical history, and symptoms. We use the DDXPlus dataset, which provides differential diagnosis information for patients based on 49 disease types. Firstly, we propose a method to process the tabular patient data from the dataset and engineer them into patient reports to make them suitable for our research. In addition, we introduce two data modification modules to diversify the training data and consequently improve the robustness of the models. We approach the task as a multi-label classification problem and conduct extensive experiments using four transformer models. All the models displayed promising results by achieving over 97% F1 score on the held-out test set. Moreover, we design additional behavioral tests to get a broader understanding of the models. In particular, for one of our test cases, we prepared a custom test set of 100 samples with the assistance of a doctor. The results on the custom set showed that our proposed data modification modules improved the model's generalization capabilities. We hope our findings will provide future researchers with valuable insights and inspire them to develop reliable systems for automatic differential diagnosis.