Knowledge-driven AI-generated data for accurate and interpretable breast ultrasound diagnoses

Data-driven deep learning models have shown great capabilities to assist radiologists in breast ultrasound (US) diagnoses. However, their effectiveness is limited by the long-tail distribution of training data, which leads to inaccuracies in rare cases. In this study, we address a long-standing challenge of improving the diagnostic model performance on rare cases using long-tailed data. Specifically, we introduce a pipeline, TAILOR, that builds a knowledge-driven generative model to produce tailored synthetic data. The generative model, using 3,749 lesions as source data, can generate millions of breast-US images, especially for error-prone rare cases. The generated data can be further used to build a diagnostic model for accurate and interpretable diagnoses. In the prospective external evaluation, our diagnostic model outperforms the average performance of nine radiologists by 33.5% in specificity with the same sensitivity, improving their performance by providing predictions with an interpretable decision-making process. Moreover, on ductal carcinoma in situ (DCIS), our diagnostic model outperforms all radiologists by a large margin, with only 34 DCIS lesions in the source data. We believe that TAILOR can potentially be extended to various diseases and imaging modalities.

Retrieve-Plan-Generation: An Iterative Planning and Answering Framework for Knowledge-Intensive LLM Generation

Despite the significant progress of large language models (LLMs) in various tasks, they often produce factual errors due to their limited internal knowledge. Retrieval-Augmented Generation (RAG), which enhances LLMs with external knowledge sources, offers a promising solution. However, these methods can be misled by irrelevant paragraphs in retrieved documents. Due to the inherent uncertainty in LLM generation, inputting the entire document may introduce off-topic information, causing the model to deviate from the central topic and affecting the relevance of the generated content. To address these issues, we propose the Retrieve-Plan-Generation (RPG) framework. RPG generates plan tokens to guide subsequent generation in the plan stage. In the answer stage, the model selects relevant fine-grained paragraphs based on the plan and uses them for further answer generation. This plan-answer process is repeated iteratively until completion, enhancing generation relevance by focusing on specific topics. To implement this framework efficiently, we utilize a simple but effective multi-task prompt-tuning method, enabling the existing LLMs to handle both planning and answering. We comprehensively compare RPG with baselines across 5 knowledge-intensive generation tasks, demonstrating the effectiveness of our approach.