Abstract:Current vision-language pre-training (VLP) methodologies predominantly depend on paired image-text datasets, a resource that is challenging to acquire in radiology due to privacy considerations and labelling complexities. Data augmentation provides a practical solution to overcome the issue of data scarcity, however, most augmentation methods exhibit a limited focus, prioritising either image or text augmentation exclusively. Acknowledging this limitation, our objective is to devise a framework capable of concurrently augmenting medical image and text data. We design a Pairwise Augmentation (PairAug) approach that contains an Inter-patient Augmentation (InterAug) branch and an Intra-patient Augmentation (IntraAug) branch. Specifically, the InterAug branch of our approach generates radiology images using synthesised yet plausible reports derived from a Large Language Model (LLM). The generated pairs can be considered a collection of new patient cases since they are artificially created and may not exist in the original dataset. In contrast, the IntraAug branch uses newly generated reports to manipulate images. This process allows us to create new paired data for each individual with diverse medical conditions. Our extensive experiments on various downstream tasks covering medical image classification zero-shot and fine-tuning analysis demonstrate that our PairAug, concurrently expanding both image and text data, substantially outperforms image-/text-only expansion baselines and advanced medical VLP baselines. Our code is released at \url{https://github.com/YtongXie/PairAug}.