Towards Evaluating and Building Versatile Large Language Models for Medicine

In this study, we present MedS-Bench, a comprehensive benchmark designed to evaluate the performance of large language models (LLMs) in clinical contexts. Unlike existing benchmarks that focus on multiple-choice question answering, MedS-Bench spans 11 high-level clinical tasks, including clinical report summarization, treatment recommendations, diagnosis, named entity recognition, and medical concept explanation, among others. We evaluated six leading LLMs, e.g., MEDITRON, Mistral, InternLM 2, Llama 3, GPT-4, and Claude-3.5 using few-shot prompting, and found that even the most sophisticated models struggle with these complex tasks. To address these limitations, we developed MedS-Ins, a large-scale instruction tuning dataset for medicine. MedS-Ins comprises 58 medically oriented language corpora, totaling 13.5 million samples across 122 tasks. To demonstrate the dataset's utility, we conducted a proof-of-concept experiment by performing instruction tuning on a lightweight, open-source medical language model. The resulting model, MMedIns-Llama 3, significantly outperformed existing models across nearly all clinical tasks. To promote further advancements in the application of LLMs to clinical challenges, we have made the MedS-Ins dataset fully accessible and invite the research community to contribute to its expansion.Additionally, we have launched a dynamic leaderboard for MedS-Bench, which we plan to regularly update the test set to track progress and enhance the adaptation of general LLMs to the medical domain. Leaderboard: https://henrychur.github.io/MedS-Bench/. Github: https://github.com/MAGIC-AI4Med/MedS-Ins.

AutoRG-Brain: Grounded Report Generation for Brain MRI

Radiologists are tasked with interpreting a large number of images in a daily base, with the responsibility of generating corresponding reports. This demanding workload elevates the risk of human error, potentially leading to treatment delays, increased healthcare costs, revenue loss, and operational inefficiencies. To address these challenges, we initiate a series of work on grounded Automatic Report Generation (AutoRG), starting from the brain MRI interpretation system, which supports the delineation of brain structures, the localization of anomalies, and the generation of well-organized findings. We make contributions from the following aspects, first, on dataset construction, we release a comprehensive dataset encompassing segmentation masks of anomaly regions and manually authored reports, termed as RadGenome-Brain MRI. This data resource is intended to catalyze ongoing research and development in the field of AI-assisted report generation systems. Second, on system design, we propose AutoRG-Brain, the first brain MRI report generation system with pixel-level grounded visual clues. Third, for evaluation, we conduct quantitative assessments and human evaluations of brain structure segmentation, anomaly localization, and report generation tasks to provide evidence of its reliability and accuracy. This system has been integrated into real clinical scenarios, where radiologists were instructed to write reports based on our generated findings and anomaly segmentation masks. The results demonstrate that our system enhances the report-writing skills of junior doctors, aligning their performance more closely with senior doctors, thereby boosting overall productivity.

RaTEScore: A Metric for Radiology Report Generation

This paper introduces a novel, entity-aware metric, termed as Radiological Report (Text) Evaluation (RaTEScore), to assess the quality of medical reports generated by AI models. RaTEScore emphasizes crucial medical entities such as diagnostic outcomes and anatomical details, and is robust against complex medical synonyms and sensitive to negation expressions. Technically, we developed a comprehensive medical NER dataset, RaTE-NER, and trained an NER model specifically for this purpose. This model enables the decomposition of complex radiological reports into constituent medical entities. The metric itself is derived by comparing the similarity of entity embeddings, obtained from a language model, based on their types and relevance to clinical significance. Our evaluations demonstrate that RaTEScore aligns more closely with human preference than existing metrics, validated both on established public benchmarks and our newly proposed RaTE-Eval benchmark.

RadGenome-Chest CT: A Grounded Vision-Language Dataset for Chest CT Analysis

Developing generalist foundation model has recently attracted tremendous attention among researchers in the field of AI for Medicine (AI4Medicine). A pivotal insight in developing these models is their reliance on dataset scaling, which emphasizes the requirements on developing open-source medical image datasets that incorporate diverse supervision signals across various imaging modalities. In this paper, we introduce RadGenome-Chest CT, a comprehensive, large-scale, region-guided 3D chest CT interpretation dataset based on CT-RATE. Specifically, we leverage the latest powerful universal segmentation and large language models, to extend the original datasets (over 25,692 non-contrast 3D chest CT volume and reports from 20,000 patients) from the following aspects: (i) organ-level segmentation masks covering 197 categories, which provide intermediate reasoning visual clues for interpretation; (ii) 665 K multi-granularity grounded reports, where each sentence of the report is linked to the corresponding anatomical region of CT volume in the form of a segmentation mask; (iii) 1.3 M grounded VQA pairs, where questions and answers are all linked with reference segmentation masks, enabling models to associate visual evidence with textual explanations. All grounded reports and VQA pairs in the validation set have gone through manual verification to ensure dataset quality. We believe that RadGenome-Chest CT can significantly advance the development of multimodal medical foundation models, by training to generate texts based on given segmentation regions, which is unattainable with previous relevant datasets. We will release all segmentation masks, grounded reports, and VQA pairs to facilitate further research and development in this field.

Knowledge-enhanced Visual-Language Pretraining for Computational Pathology

In this paper, we consider the problem of visual representation learning for computational pathology, by exploiting large-scale image-text pairs gathered from public resources, along with the domain specific knowledge in pathology. Specifically, we make the following contributions: (i) We curate a pathology knowledge tree that consists of 50,470 informative attributes for 4,718 diseases requiring pathology diagnosis from 32 human tissues. To our knowledge, this is the first comprehensive structured pathology knowledge base; (ii) We develop a knowledge-enhanced visual-language pretraining approach, where we first project pathology-specific knowledge into latent embedding space via language model, and use it to guide the visual representation learning; (iii) We conduct thorough experiments to validate the effectiveness of our proposed components, demonstrating significant performance improvement on various downstream tasks, including cross-modal retrieval, zero-shot classification on pathology patches, and zero-shot tumor subtyping on whole slide images (WSIs). All codes, models and the pathology knowledge tree will be released to the research community

Towards Building Multilingual Language Model for Medicine

In this paper, we aim to develop an open-source, multilingual language model for medicine, that the benefits a wider, linguistically diverse audience from different regions. In general, we present the contribution from the following aspects: first, for multilingual medical-specific adaptation, we construct a new multilingual medical corpus, that contains approximately 25.5B tokens encompassing 6 main languages, termed as MMedC, that enables auto-regressive training for existing general LLMs. second, to monitor the development of multilingual LLMs in medicine, we propose a new multilingual medical multi-choice question-answering benchmark with rationale, termed as MMedBench; third, we have assessed a number of popular, opensource large language models (LLMs) on our benchmark, along with those further auto-regressive trained on MMedC, as a result, our final model, termed as MMedLM 2, with only 7B parameters, achieves superior performance compared to all other open-source models, even rivaling GPT-4 on MMedBench. We will make the resources publicly available, including code, model weights, and datasets.

Large-scale Long-tailed Disease Diagnosis on Radiology Images

In this study, we aim to investigate the problem of large-scale, large-vocabulary disease classification for radiologic images, which can be formulated as a multi-modal, multi-anatomy, multi-label, long-tailed classification. Our main contributions are three folds: (i), on dataset construction, we build up an academically accessible, large-scale diagnostic dataset that encompasses 5568 disorders linked with 930 unique ICD-10-CM codes, containing 39,026 cases (192,675 scans). (ii), on model design, we present a novel architecture that enables to process arbitrary number of input scans, from various imaging modalities, which is trained with knowledge enhancement to leverage the rich domain knowledge; (iii), on evaluation, we initialize a new benchmark for multi-modal multi-anatomy long-tailed diagnosis. Our method shows superior results on it. Additionally, our final model serves as a pre-trained model, and can be finetuned to benefit diagnosis on various external datasets.

One Model to Rule them All: Towards Universal Segmentation for Medical Images with Text Prompts

In this study, we focus on building up a model that can Segment Anything in medical scenarios, driven by Text prompts, termed as SAT. Our main contributions are three folds: (i) on data construction, we combine multiple knowledge sources to construct a multi-modal medical knowledge tree; Then we build up a large-scale segmentation dataset for training, by collecting over 11K 3D medical image scans from 31 segmentation datasets with careful standardization on both visual scans and label space; (ii) on model training, we formulate a universal segmentation model, that can be prompted by inputting medical terminologies in text form. We present a knowledge-enhanced representation learning framework, and a series of strategies for effectively training on the combination of a large number of datasets; (iii) on model evaluation, we train a SAT-Nano with only 107M parameters, to segment 31 different segmentation datasets with text prompt, resulting in 362 categories. We thoroughly evaluate the model from three aspects: averaged by body regions, averaged by classes, and average by datasets, demonstrating comparable performance to 36 specialist nnUNets, i.e., we train nnUNet models on each dataset/subset, resulting in 36 nnUNets with around 1000M parameters for the 31 datasets. We will release all the codes, and models used in this report, i.e., SAT-Nano. Moreover, we will offer SAT-Ultra in the near future, which is trained with model of larger size, on more diverse datasets. Webpage URL: https://zhaoziheng.github.io/MedUniSeg.

Can GPT-4V Serve Medical Applications? Case Studies on GPT-4V for Multimodal Medical Diagnosis

Driven by the large foundation models, the development of artificial intelligence has witnessed tremendous progress lately, leading to a surge of general interest from the public. In this study, we aim to assess the performance of OpenAI's newest model, GPT-4V(ision), specifically in the realm of multimodal medical diagnosis. Our evaluation encompasses 17 human body systems, including Central Nervous System, Head and Neck, Cardiac, Chest, Hematology, Hepatobiliary, Gastrointestinal, Urogenital, Gynecology, Obstetrics, Breast, Musculoskeletal, Spine, Vascular, Oncology, Trauma, Pediatrics, with images taken from 8 modalities used in daily clinic routine, e.g., X-ray, Computed Tomography (CT), Magnetic Resonance Imaging (MRI), Positron Emission Tomography (PET), Digital Subtraction Angiography (DSA), Mammography, Ultrasound, and Pathology. We probe the GPT-4V's ability on multiple clinical tasks with or without patent history provided, including imaging modality and anatomy recognition, disease diagnosis, report generation, disease localisation. Our observation shows that, while GPT-4V demonstrates proficiency in distinguishing between medical image modalities and anatomy, it faces significant challenges in disease diagnosis and generating comprehensive reports. These findings underscore that while large multimodal models have made significant advancements in computer vision and natural language processing, it remains far from being used to effectively support real-world medical applications and clinical decision-making. All images used in this report can be found in https://github.com/chaoyi-wu/GPT-4V_Medical_Evaluation.

UniBrain: Universal Brain MRI Diagnosis with Hierarchical Knowledge-enhanced Pre-training

Magnetic resonance imaging~(MRI) have played a crucial role in brain disease diagnosis, with which a range of computer-aided artificial intelligence methods have been proposed. However, the early explorations usually focus on the limited types of brain diseases in one study and train the model on the data in a small scale, yielding the bottleneck of generalization. Towards a more effective and scalable paradigm, we propose a hierarchical knowledge-enhanced pre-training framework for the universal brain MRI diagnosis, termed as UniBrain. Specifically, UniBrain leverages a large-scale dataset of 24,770 imaging-report pairs from routine diagnostics. Different from previous pre-training techniques for the unitary vision or textual feature, or with the brute-force alignment between vision and language information, we leverage the unique characteristic of report information in different granularity to build a hierarchical alignment mechanism, which strengthens the efficiency in feature learning. Our UniBrain is validated on three real world datasets with severe class imbalance and the public BraTS2019 dataset. It not only consistently outperforms all state-of-the-art diagnostic methods by a large margin and provides a superior grounding performance but also shows comparable performance compared to expert radiologists on certain disease types.