MedCoDi-M: A Multi-Prompt Foundation Model for Multimodal Medical Data Generation

Artificial Intelligence is revolutionizing medical practice, enhancing diagnostic accuracy and healthcare delivery. However, its adaptation in medical settings still faces significant challenges, related to data availability and privacy constraints. Synthetic data has emerged as a promising solution to mitigate these issues, addressing data scarcity while preserving privacy. Recently, Latent Diffusion Models have emerged as a powerful tool for generating high-quality synthetic data. Meanwhile, the integration of different modalities has gained interest, emphasizing the need of models capable of handle multimodal medical data.Existing approaches struggle to integrate complementary information and lack the ability to generate modalities simultaneously. To address this challenge, we present MedCoDi-M, a 6.77-billion-parameter model, designed for multimodal medical data generation, that, following Foundation Model paradigm, exploits contrastive learning and large quantity of data to build a shared latent space which capture the relationships between different data modalities. Further, we introduce the Multi-Prompt training technique, which significantly boosts MedCoDi-M's generation under different settings. We extensively validate MedCoDi-M: first we benchmark it against five competitors on the MIMIC-CXR dataset, a state-of-the-art dataset for Chest X-ray and radiological report generation. Secondly, we perform a Visual Turing Test with expert radiologists to assess the realism and clinical relevance of the generated data, ensuring alignment with real-world scenarios. Finally, we assess the utility of MedCoDi-M in addressing key challenges in the medical field, such as anonymization, data scarcity and imbalance learning. The results are promising, demonstrating the applicability of MedCoDi-M in medical contexts. Project page is at https://cosbidev.github.io/MedCoDi-M/.

A Systematic Review of Intermediate Fusion in Multimodal Deep Learning for Biomedical Applications

Deep learning has revolutionized biomedical research by providing sophisticated methods to handle complex, high-dimensional data. Multimodal deep learning (MDL) further enhances this capability by integrating diverse data types such as imaging, textual data, and genetic information, leading to more robust and accurate predictive models. In MDL, differently from early and late fusion methods, intermediate fusion stands out for its ability to effectively combine modality-specific features during the learning process. This systematic review aims to comprehensively analyze and formalize current intermediate fusion methods in biomedical applications. We investigate the techniques employed, the challenges faced, and potential future directions for advancing intermediate fusion methods. Additionally, we introduce a structured notation to enhance the understanding and application of these methods beyond the biomedical domain. Our findings are intended to support researchers, healthcare professionals, and the broader deep learning community in developing more sophisticated and insightful multimodal models. Through this review, we aim to provide a foundational framework for future research and practical applications in the dynamic field of MDL.

Multi-Scale Texture Loss for CT denoising with GANs

Generative Adversarial Networks (GANs) have proved as a powerful framework for denoising applications in medical imaging. However, GAN-based denoising algorithms still suffer from limitations in capturing complex relationships within the images. In this regard, the loss function plays a crucial role in guiding the image generation process, encompassing how much a synthetic image differs from a real image. To grasp highly complex and non-linear textural relationships in the training process, this work presents a loss function that leverages the intrinsic multi-scale nature of the Gray-Level-Co-occurrence Matrix (GLCM). Although the recent advances in deep learning have demonstrated superior performance in classification and detection tasks, we hypothesize that its information content can be valuable when integrated into GANs' training. To this end, we propose a differentiable implementation of the GLCM suited for gradient-based optimization. Our approach also introduces a self-attention layer that dynamically aggregates the multi-scale texture information extracted from the images. We validate our approach by carrying out extensive experiments in the context of low-dose CT denoising, a challenging application that aims to enhance the quality of noisy CT scans. We utilize three publicly available datasets, including one simulated and two real datasets. The results are promising as compared to other well-established loss functions, being also consistent across three different GAN architectures. The code is available at: https://github.com/FrancescoDiFeola/DenoTextureLoss

A comparative study between paired and unpaired Image Quality Assessment in Low-Dose CT Denoising

The current deep learning approaches for low-dose CT denoising can be divided into paired and unpaired methods. The former involves the use of well-paired datasets, whilst the latter relaxes this constraint. The large availability of unpaired datasets has raised the interest in deepening unpaired denoising strategies that, in turn, need for robust evaluation techniques going beyond the qualitative evaluation. To this end, we can use quantitative image quality assessment scores that we divided into two categories, i.e., paired and unpaired measures. However, the interpretation of unpaired metrics is not straightforward, also because the consistency with paired metrics has not been fully investigated. To cope with this limitation, in this work we consider 15 paired and unpaired scores, which we applied to assess the performance of low-dose CT denoising. We perform an in-depth statistical analysis that not only studies the correlation between paired and unpaired metrics but also within each category. This brings out useful guidelines that can help researchers and practitioners select the right measure for their applications.