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.

CIT: Rethinking Class-incremental Semantic Segmentation with a Class Independent Transformation

Class-incremental semantic segmentation (CSS) requires that a model learn to segment new classes without forgetting how to segment previous ones: this is typically achieved by distilling the current knowledge and incorporating the latest data. However, bypassing iterative distillation by directly transferring outputs of initial classes to the current learning task is not supported in existing class-specific CSS methods. Via Softmax, they enforce dependency between classes and adjust the output distribution at each learning step, resulting in a large probability distribution gap between initial and current tasks. We introduce a simple, yet effective Class Independent Transformation (CIT) that converts the outputs of existing semantic segmentation models into class-independent forms with negligible cost or performance loss. By utilizing class-independent predictions facilitated by CIT, we establish an accumulative distillation framework, ensuring equitable incorporation of all class information. We conduct extensive experiments on various segmentation architectures, including DeepLabV3, Mask2Former, and SegViTv2. Results from these experiments show minimal task forgetting across different datasets, with less than 5% for ADE20K in the most challenging 11 task configurations and less than 1% across all configurations for the PASCAL VOC 2012 dataset.

Guardians of Discourse: Evaluating LLMs on Multilingual Offensive Language Detection

Identifying offensive language is essential for maintaining safety and sustainability in the social media era. Though large language models (LLMs) have demonstrated encouraging potential in social media analytics, they lack thorough evaluation when in offensive language detection, particularly in multilingual environments. We for the first time evaluate multilingual offensive language detection of LLMs in three languages: English, Spanish, and German with three LLMs, GPT-3.5, Flan-T5, and Mistral, in both monolingual and multilingual settings. We further examine the impact of different prompt languages and augmented translation data for the task in non-English contexts. Furthermore, we discuss the impact of the inherent bias in LLMs and the datasets in the mispredictions related to sensitive topics.

SPFresh: Incremental In-Place Update for Billion-Scale Vector Search

Approximate Nearest Neighbor Search (ANNS) is now widely used in various applications, ranging from information retrieval, question answering, and recommendation, to search for similar high-dimensional vectors. As the amount of vector data grows continuously, it becomes important to support updates to vector index, the enabling technique that allows for efficient and accurate ANNS on vectors. Because of the curse of high dimensionality, it is often costly to identify the right neighbors of a single new vector, a necessary process for index update. To amortize update costs, existing systems maintain a secondary index to accumulate updates, which are merged by the main index by global rebuilding the entire index periodically. However, this approach has high fluctuations of search latency and accuracy, not even to mention that it requires substantial resources and is extremely time-consuming for rebuilds. We introduce SPFresh, a system that supports in-place vector updates. At the heart of SPFresh is LIRE, a lightweight incremental rebalancing protocol to split vector partitions and reassign vectors in the nearby partitions to adapt to data distribution shift. LIRE achieves low-overhead vector updates by only reassigning vectors at the boundary between partitions, where in a high-quality vector index the amount of such vectors are deemed small. With LIRE, SPFresh provides superior query latency and accuracy to solutions based on global rebuild, with only 1% of DRAM and less than 10% cores needed at the peak compared to the state-of-the-art, in a billion scale vector index with 1% of daily vector update rate.

PAPL-SLAM: Principal Axis-Anchored Monocular Point-Line SLAM

In point-line SLAM systems, the utilization of line structural information and the optimization of lines are two significant problems. The former is usually addressed through structural regularities, while the latter typically involves using minimal parameter representations of lines in optimization. However, separating these two steps leads to the loss of constraint information to each other. We anchor lines with similar directions to a principal axis and optimize them with $n+2$ parameters for $n$ lines, solving both problems together. Our method considers scene structural information, which can be easily extended to different world hypotheses while significantly reducing the number of line parameters to be optimized, enabling rapid and accurate mapping and tracking. To further enhance the system's robustness and avoid mismatch, we have modeled the line-axis probabilistic data association and provided the algorithm for axis creation, updating, and optimization. Additionally, considering that most real-world scenes conform to the Atlanta World hypothesis, we provide a structural line detection strategy based on vertical priors and vanishing points. Experimental results and ablation studies on various indoor and outdoor datasets demonstrate the effectiveness of our system.

Weak-eval-Strong: Evaluating and Eliciting Lateral Thinking of LLMs with Situation Puzzles

While advancements in NLP have significantly improved the performance of Large Language Models (LLMs) on tasks requiring vertical thinking, their lateral thinking capabilities remain under-explored and challenging to measure due to the complexity of assessing creative thought processes and the scarcity of relevant data. To address these challenges, we introduce SPLAT, a benchmark leveraging Situation Puzzles to evaluate and elicit LAteral Thinking of LLMs. This benchmark, containing 975 graded situation puzzles across three difficulty levels, employs a new multi-turn player-judge framework instead of the traditional model-based evaluation, which often necessitates a stronger evaluation model. This framework simulates an interactive game where the model (player) asks the evaluation model (judge) questions about an incomplete story to infer the full scenario. The judge answers based on a detailed reference scenario or evaluates if the player's predictions align with the reference one. This approach lessens dependence on more robust evaluation models, enabling the assessment of state-of-the-art LLMs. The experiments demonstrate that a robust evaluation model, such as WizardLM-2, closely matches human judgements in both intermediate question-answering and final scenario accuracy, achieving over 80% agreement-similar to the agreement levels among humans. Furthermore, applying data and reasoning processes from our benchmark to other lateral thinking-related benchmarks, e.g., RiddleSense and BrainTeaser, leads to performance enhancements. This suggests that our benchmark effectively evaluates and elicits the lateral thinking abilities of LLMs. Code is available at: https://github.com/chenqi008/LateralThinking.

Integrative Decoding: Improve Factuality via Implicit Self-consistency

Self-consistency-based approaches, which involve repeatedly sampling multiple outputs and selecting the most consistent one as the final response, prove to be remarkably effective in improving the factual accuracy of large language models. Nonetheless, existing methods usually have strict constraints on the task format, largely limiting their applicability. In this paper, we present Integrative Decoding (ID), to unlock the potential of self-consistency in open-ended generation tasks. ID operates by constructing a set of inputs, each prepended with a previously sampled response, and then processes them concurrently, with the next token being selected by aggregating of all their corresponding predictions at each decoding step. In essence, this simple approach implicitly incorporates self-consistency in the decoding objective. Extensive evaluation shows that ID consistently enhances factuality over a wide range of language models, with substantial improvements on the TruthfulQA (+11.2%), Biographies (+15.4%) and LongFact (+8.5%) benchmarks. The performance gains amplify progressively as the number of sampled responses increases, indicating the potential of ID to scale up with repeated sampling.

Accelerated Multi-Contrast MRI Reconstruction via Frequency and Spatial Mutual Learning

To accelerate Magnetic Resonance (MR) imaging procedures, Multi-Contrast MR Reconstruction (MCMR) has become a prevalent trend that utilizes an easily obtainable modality as an auxiliary to support high-quality reconstruction of the target modality with under-sampled k-space measurements. The exploration of global dependency and complementary information across different modalities is essential for MCMR. However, existing methods either struggle to capture global dependency due to the limited receptive field or suffer from quadratic computational complexity. To tackle this dilemma, we propose a novel Frequency and Spatial Mutual Learning Network (FSMNet), which efficiently explores global dependencies across different modalities. Specifically, the features for each modality are extracted by the Frequency-Spatial Feature Extraction (FSFE) module, featuring a frequency branch and a spatial branch. Benefiting from the global property of the Fourier transform, the frequency branch can efficiently capture global dependency with an image-size receptive field, while the spatial branch can extract local features. To exploit complementary information from the auxiliary modality, we propose a Cross-Modal Selective fusion (CMS-fusion) module that selectively incorporate the frequency and spatial features from the auxiliary modality to enhance the corresponding branch of the target modality. To further integrate the enhanced global features from the frequency branch and the enhanced local features from the spatial branch, we develop a Frequency-Spatial fusion (FS-fusion) module, resulting in a comprehensive feature representation for the target modality. Extensive experiments on the BraTS and fastMRI datasets demonstrate that the proposed FSMNet achieves state-of-the-art performance for the MCMR task with different acceleration factors. The code is available at: https://github.com/qic999/FSMNet.

RetrievalAttention: Accelerating Long-Context LLM Inference via Vector Retrieval

Transformer-based large Language Models (LLMs) become increasingly important in various domains. However, the quadratic time complexity of attention operation poses a significant challenge for scaling to longer contexts due to the extremely high inference latency and GPU memory consumption for caching key-value (KV) vectors. This paper proposes RetrievalAttention, a training-free approach to accelerate attention computation. To leverage the dynamic sparse property of attention, RetrievalAttention builds approximate nearest neighbor search (ANNS) indexes upon KV vectors in CPU memory and retrieves the most relevant ones via vector search during generation. Due to the out-of-distribution (OOD) between query vectors and key vectors, off-the-shelf ANNS indexes still need to scan O(N) (usually 30% of all keys) data for accurate retrieval, which fails to exploit the high sparsity. RetrievalAttention first identifies the OOD challenge of ANNS-based attention, and addresses it via an attention-aware vector search algorithm that can adapt to queries and only access 1--3% of data, thus achieving a sub-linear time complexity. RetrievalAttention greatly reduces the inference cost of long-context LLM with much lower GPU memory requirements while maintaining the model accuracy. Especially, RetrievalAttention only needs 16GB GPU memory for serving 128K tokens in LLMs with 8B parameters, which is capable of generating one token in 0.188 seconds on a single NVIDIA RTX4090 (24GB).

Analyzing Tumors by Synthesis

Computer-aided tumor detection has shown great potential in enhancing the interpretation of over 80 million CT scans performed annually in the United States. However, challenges arise due to the rarity of CT scans with tumors, especially early-stage tumors. Developing AI with real tumor data faces issues of scarcity, annotation difficulty, and low prevalence. Tumor synthesis addresses these challenges by generating numerous tumor examples in medical images, aiding AI training for tumor detection and segmentation. Successful synthesis requires realistic and generalizable synthetic tumors across various organs. This chapter reviews AI development on real and synthetic data and summarizes two key trends in synthetic data for cancer imaging research: modeling-based and learning-based approaches. Modeling-based methods, like Pixel2Cancer, simulate tumor development over time using generic rules, while learning-based methods, like DiffTumor, learn from a few annotated examples in one organ to generate synthetic tumors in others. Reader studies with expert radiologists show that synthetic tumors can be convincingly realistic. We also present case studies in the liver, pancreas, and kidneys reveal that AI trained on synthetic tumors can achieve performance comparable to, or better than, AI only trained on real data. Tumor synthesis holds significant promise for expanding datasets, enhancing AI reliability, improving tumor detection performance, and preserving patient privacy.