Unpaired Translation of Chest X-ray Images for Lung Opacity Diagnosis via Adaptive Activation Masks and Cross-Domain Alignment

Chest X-ray radiographs (CXRs) play a pivotal role in diagnosing and monitoring cardiopulmonary diseases. However, lung opac- ities in CXRs frequently obscure anatomical structures, impeding clear identification of lung borders and complicating the localization of pathology. This challenge significantly hampers segmentation accuracy and precise lesion identification, which are crucial for diagnosis. To tackle these issues, our study proposes an unpaired CXR translation framework that converts CXRs with lung opacities into counterparts without lung opacities while preserving semantic features. Central to our approach is the use of adaptive activation masks to selectively modify opacity regions in lung CXRs. Cross-domain alignment ensures translated CXRs without opacity issues align with feature maps and prediction labels from a pre-trained CXR lesion classifier, facilitating the interpretability of the translation process. We validate our method using RSNA, MIMIC-CXR-JPG and JSRT datasets, demonstrating superior translation quality through lower Frechet Inception Distance (FID) and Kernel Inception Distance (KID) scores compared to existing meth- ods (FID: 67.18 vs. 210.4, KID: 0.01604 vs. 0.225). Evaluation on RSNA opacity, MIMIC acute respiratory distress syndrome (ARDS) patient CXRs and JSRT CXRs show our method enhances segmentation accuracy of lung borders and improves lesion classification, further underscoring its potential in clinical settings (RSNA: mIoU: 76.58% vs. 62.58%, Sensitivity: 85.58% vs. 77.03%; MIMIC ARDS: mIoU: 86.20% vs. 72.07%, Sensitivity: 92.68% vs. 86.85%; JSRT: mIoU: 91.08% vs. 85.6%, Sensitivity: 97.62% vs. 95.04%). Our approach advances CXR imaging analysis, especially in investigating segmentation impacts through image translation techniques.

Anatomy-Guided Radiology Report Generation with Pathology-Aware Regional Prompts

Radiology reporting generative AI holds significant potential to alleviate clinical workloads and streamline medical care. However, achieving high clinical accuracy is challenging, as radiological images often feature subtle lesions and intricate structures. Existing systems often fall short, largely due to their reliance on fixed size, patch-level image features and insufficient incorporation of pathological information. This can result in the neglect of such subtle patterns and inconsistent descriptions of crucial pathologies. To address these challenges, we propose an innovative approach that leverages pathology-aware regional prompts to explicitly integrate anatomical and pathological information of various scales, significantly enhancing the precision and clinical relevance of generated reports. We develop an anatomical region detector that extracts features from distinct anatomical areas, coupled with a novel multi-label lesion detector that identifies global pathologies. Our approach emulates the diagnostic process of radiologists, producing clinically accurate reports with comprehensive diagnostic capabilities. Experimental results show that our model outperforms previous state-of-the-art methods on most natural language generation and clinical efficacy metrics, with formal expert evaluations affirming its potential to enhance radiology practice.

Decoding Report Generators: A Cyclic Vision-Language Adapter for Counterfactual Explanations

Despite significant advancements in report generation methods, a critical limitation remains: the lack of interpretability in the generated text. This paper introduces an innovative approach to enhance the explainability of text generated by report generation models. Our method employs cyclic text manipulation and visual comparison to identify and elucidate the features in the original content that influence the generated text. By manipulating the generated reports and producing corresponding images, we create a comparative framework that highlights key attributes and their impact on the text generation process. This approach not only identifies the image features aligned to the generated text but also improves transparency but also provides deeper insights into the decision-making mechanisms of the report generation models. Our findings demonstrate the potential of this method to significantly enhance the interpretability and transparency of AI-generated reports.

Deep Generative Models Unveil Patterns in Medical Images Through Vision-Language Conditioning

Deep generative models have significantly advanced medical imaging analysis by enhancing dataset size and quality. Beyond mere data augmentation, our research in this paper highlights an additional, significant capacity of deep generative models: their ability to reveal and demonstrate patterns in medical images. We employ a generative structure with hybrid conditions, combining clinical data and segmentation masks to guide the image synthesis process. Furthermore, we innovatively transformed the tabular clinical data into textual descriptions. This approach simplifies the handling of missing values and also enables us to leverage large pre-trained vision-language models that investigate the relations between independent clinical entries and comprehend general terms, such as gender and smoking status. Our approach differs from and presents a more challenging task than traditional medical report-guided synthesis due to the less visual correlation of our clinical information with the images. To overcome this, we introduce a text-visual embedding mechanism that strengthens the conditions, ensuring the network effectively utilizes the provided information. Our pipeline is generalizable to both GAN-based and diffusion models. Experiments on chest CT, particularly focusing on the smoking status, demonstrated a consistent intensity shift in the lungs which is in agreement with clinical observations, indicating the effectiveness of our method in capturing and visualizing the impact of specific attributes on medical image patterns. Our methods offer a new avenue for the early detection and precise visualization of complex clinical conditions with deep generative models. All codes are https://github.com/junzhin/DGM-VLC.