Can Medical Vision-Language Pre-training Succeed with Purely Synthetic Data?

Medical Vision-Language Pre-training (MedVLP) has made significant progress in enabling zero-shot tasks for medical image understanding. However, training MedVLP models typically requires large-scale datasets with paired, high-quality image-text data, which are scarce in the medical domain. Recent advancements in Large Language Models (LLMs) and diffusion models have made it possible to generate large-scale synthetic image-text pairs. This raises the question: *Can MedVLP succeed using purely synthetic data?* To address this, we use off-the-shelf generative models to create synthetic radiology reports and paired Chest X-ray (CXR) images, and propose an automated pipeline to build a diverse, high-quality synthetic dataset, enabling a rigorous study that isolates model and training settings, focusing entirely from the data perspective. Our results show that MedVLP models trained *exclusively on synthetic data* outperform those trained on real data by **3.8%** in averaged AUC on zero-shot classification. Moreover, using a combination of synthetic and real data leads to a further improvement of **9.07%**. Additionally, MedVLP models trained on synthetic or mixed data consistently outperform those trained on real data in zero-shot grounding, as well as in fine-tuned classification and segmentation tasks. Our analysis suggests MedVLP trained on well-designed synthetic data can outperform models trained on real datasets, which may be limited by low-quality samples and long-tailed distributions.

UniCompress: Enhancing Multi-Data Medical Image Compression with Knowledge Distillation

In the field of medical image compression, Implicit Neural Representation (INR) networks have shown remarkable versatility due to their flexible compression ratios, yet they are constrained by a one-to-one fitting approach that results in lengthy encoding times. Our novel method, ``\textbf{UniCompress}'', innovatively extends the compression capabilities of INR by being the first to compress multiple medical data blocks using a single INR network. By employing wavelet transforms and quantization, we introduce a codebook containing frequency domain information as a prior input to the INR network. This enhances the representational power of INR and provides distinctive conditioning for different image blocks. Furthermore, our research introduces a new technique for the knowledge distillation of implicit representations, simplifying complex model knowledge into more manageable formats to improve compression ratios. Extensive testing on CT and electron microscopy (EM) datasets has demonstrated that UniCompress outperforms traditional INR methods and commercial compression solutions like HEVC, especially in complex and high compression scenarios. Notably, compared to existing INR techniques, UniCompress achieves a 4$\sim$5 times increase in compression speed, marking a significant advancement in the field of medical image compression. Codes will be publicly available.

TokenUnify: Scalable Autoregressive Visual Pre-training with Mixture Token Prediction

Autoregressive next-token prediction is a standard pretraining method for large-scale language models, but its application to vision tasks is hindered by the non-sequential nature of image data, leading to cumulative errors. Most vision models employ masked autoencoder (MAE) based pretraining, which faces scalability issues. To address these challenges, we introduce \textbf{TokenUnify}, a novel pretraining method that integrates random token prediction, next-token prediction, and next-all token prediction. We provide theoretical evidence demonstrating that TokenUnify mitigates cumulative errors in visual autoregression. Cooperated with TokenUnify, we have assembled a large-scale electron microscopy (EM) image dataset with ultra-high resolution, ideal for creating spatially correlated long sequences. This dataset includes over 120 million annotated voxels, making it the largest neuron segmentation dataset to date and providing a unified benchmark for experimental validation. Leveraging the Mamba network inherently suited for long-sequence modeling on this dataset, TokenUnify not only reduces the computational complexity but also leads to a significant 45\% improvement in segmentation performance on downstream EM neuron segmentation tasks compared to existing methods. Furthermore, TokenUnify demonstrates superior scalability over MAE and traditional autoregressive methods, effectively bridging the gap between pretraining strategies for language and vision models. Code is available at \url{https://github.com/ydchen0806/TokenUnify}.

BIMCV-R: A Landmark Dataset for 3D CT Text-Image Retrieval

The burgeoning integration of 3D medical imaging into healthcare has led to a substantial increase in the workload of medical professionals. To assist clinicians in their diagnostic processes and alleviate their workload, the development of a robust system for retrieving similar case studies presents a viable solution. While the concept holds great promise, the field of 3D medical text-image retrieval is currently limited by the absence of robust evaluation benchmarks and curated datasets. To remedy this, our study presents a groundbreaking dataset, BIMCV-R (This dataset will be released upon acceptance.), which includes an extensive collection of 8,069 3D CT volumes, encompassing over 2 million slices, paired with their respective radiological reports. Expanding upon the foundational work of our dataset, we craft a retrieval strategy, MedFinder. This approach employs a dual-stream network architecture, harnessing the potential of large language models to advance the field of medical image retrieval beyond existing text-image retrieval solutions. It marks our preliminary step towards developing a system capable of facilitating text-to-image, image-to-text, and keyword-based retrieval tasks.

T3D: Towards 3D Medical Image Understanding through Vision-Language Pre-training

Expert annotation of 3D medical image for downstream analysis is resource-intensive, posing challenges in clinical applications. Visual self-supervised learning (vSSL), though effective for learning visual invariance, neglects the incorporation of domain knowledge from medicine. To incorporate medical knowledge into visual representation learning, vision-language pre-training (VLP) has shown promising results in 2D image. However, existing VLP approaches become generally impractical when applied to high-resolution 3D medical images due to GPU hardware constraints and the potential loss of critical details caused by downsampling, which is the intuitive solution to hardware constraints. To address the above limitations, we introduce T3D, the first VLP framework designed for high-resolution 3D medical images. T3D incorporates two text-informed pretext tasks: (\lowerromannumeral{1}) text-informed contrastive learning; (\lowerromannumeral{2}) text-informed image restoration. These tasks focus on learning 3D visual representations from high-resolution 3D medical images and integrating clinical knowledge from radiology reports, without distorting information through forced alignment of downsampled volumes with detailed anatomical text. Trained on a newly curated large-scale dataset of 3D medical images and radiology reports, T3D significantly outperforms current vSSL methods in tasks like organ and tumor segmentation, as well as disease classification. This underlines T3D's potential in representation learning for 3D medical image analysis. All data and code will be available upon acceptance.

Self-Supervised Neuron Segmentation with Multi-Agent Reinforcement Learning

The performance of existing supervised neuron segmentation methods is highly dependent on the number of accurate annotations, especially when applied to large scale electron microscopy (EM) data. By extracting semantic information from unlabeled data, self-supervised methods can improve the performance of downstream tasks, among which the mask image model (MIM) has been widely used due to its simplicity and effectiveness in recovering original information from masked images. However, due to the high degree of structural locality in EM images, as well as the existence of considerable noise, many voxels contain little discriminative information, making MIM pretraining inefficient on the neuron segmentation task. To overcome this challenge, we propose a decision-based MIM that utilizes reinforcement learning (RL) to automatically search for optimal image masking ratio and masking strategy. Due to the vast exploration space, using single-agent RL for voxel prediction is impractical. Therefore, we treat each input patch as an agent with a shared behavior policy, allowing for multi-agent collaboration. Furthermore, this multi-agent model can capture dependencies between voxels, which is beneficial for the downstream segmentation task. Experiments conducted on representative EM datasets demonstrate that our approach has a significant advantage over alternative self-supervised methods on the task of neuron segmentation. Code is available at \url{https://github.com/ydchen0806/dbMiM}.

Learning Multiscale Consistency for Self-supervised Electron Microscopy Instance Segmentation

Instance segmentation in electron microscopy (EM) volumes is tough due to complex shapes and sparse annotations. Self-supervised learning helps but still struggles with intricate visual patterns in EM. To address this, we propose a pretraining framework that enhances multiscale consistency in EM volumes. Our approach leverages a Siamese network architecture, integrating both strong and weak data augmentations to effectively extract multiscale features. We uphold voxel-level coherence by reconstructing the original input data from these augmented instances. Furthermore, we incorporate cross-attention mechanisms to facilitate fine-grained feature alignment between these augmentations. Finally, we apply contrastive learning techniques across a feature pyramid, allowing us to distill distinctive representations spanning various scales. After pretraining on four large-scale EM datasets, our framework significantly improves downstream tasks like neuron and mitochondria segmentation, especially with limited finetuning data. It effectively captures voxel and feature consistency, showing promise for learning transferable representations for EM analysis.

Generative Text-Guided 3D Vision-Language Pretraining for Unified Medical Image Segmentation

Vision-Language Pretraining (VLP) has demonstrated remarkable capabilities in learning visual representations from textual descriptions of images without annotations. Yet, effective VLP demands large-scale image-text pairs, a resource that suffers scarcity in the medical domain. Moreover, conventional VLP is limited to 2D images while medical images encompass diverse modalities, often in 3D, making the learning process more challenging. To address these challenges, we present Generative Text-Guided 3D Vision-Language Pretraining for Unified Medical Image Segmentation (GTGM), a framework that extends of VLP to 3D medical images without relying on paired textual descriptions. Specifically, GTGM utilizes large language models (LLM) to generate medical-style text from 3D medical images. This synthetic text is then used to supervise 3D visual representation learning. Furthermore, a negative-free contrastive learning objective strategy is introduced to cultivate consistent visual representations between augmented 3D medical image patches, which effectively mitigates the biases associated with strict positive-negative sample pairings. We evaluate GTGM on three imaging modalities - Computed Tomography (CT), Magnetic Resonance Imaging (MRI), and electron microscopy (EM) over 13 datasets. GTGM's superior performance across various medical image segmentation tasks underscores its effectiveness and versatility, by enabling VLP extension into 3D medical imagery while bypassing the need for paired text.