CLIP-IT: CLIP-based Pairing for Histology Images Classification

Multimodal learning has shown significant promise for improving medical image analysis by integrating information from complementary data sources. This is widely employed for training vision-language models (VLMs) for cancer detection based on histology images and text reports. However, one of the main limitations in training these VLMs is the requirement for large paired datasets, raising concerns over privacy, and data collection, annotation, and maintenance costs. To address this challenge, we introduce CLIP-IT method to train a vision backbone model to classify histology images by pairing them with privileged textual information from an external source. At first, the modality pairing step relies on a CLIP-based model to match histology images with semantically relevant textual report data from external sources, creating an augmented multimodal dataset without the need for manually paired samples. Then, we propose a multimodal training procedure that distills the knowledge from the paired text modality to the unimodal image classifier for enhanced performance without the need for the textual data during inference. A parameter-efficient fine-tuning method is used to efficiently address the misalignment between the main (image) and paired (text) modalities. During inference, the improved unimodal histology classifier is used, with only minimal additional computational complexity. Our experiments on challenging PCAM, CRC, and BACH histology image datasets show that CLIP-IT can provide a cost-effective approach to leverage privileged textual information and outperform unimodal classifiers for histology.

Meta-Entity Driven Triplet Mining for Aligning Medical Vision-Language Models

Diagnostic imaging relies on interpreting both images and radiology reports, but the growing data volumes place significant pressure on medical experts, yielding increased errors and workflow backlogs. Medical vision-language models (med-VLMs) have emerged as a powerful framework to efficiently process multimodal imaging data, particularly in chest X-ray (CXR) evaluations, albeit their performance hinges on how well image and text representations are aligned. Existing alignment methods, predominantly based on contrastive learning, prioritize separation between disease classes over segregation of fine-grained pathology attributes like location, size or severity, leading to suboptimal representations. Here, we propose MedTrim (Meta-entity-driven Triplet mining), a novel method that enhances image-text alignment through multimodal triplet learning synergistically guided by disease class as well as adjectival and directional pathology descriptors. Unlike common alignment methods that separate broad disease classes, MedTrim leverages structured meta-entity information to preserve subtle but clinically significant intra-class variations. For this purpose, we first introduce an ontology-based entity recognition module that extracts pathology-specific meta-entities from CXR reports, as annotations on pathology attributes are rare in public datasets. For refined sample selection in triplet mining, we then introduce a novel score function that captures an aggregate measure of inter-sample similarity based on disease classes and adjectival/directional descriptors. Lastly, we introduce a multimodal triplet alignment objective for explicit within- and cross-modal alignment between samples sharing detailed pathology characteristics. Our demonstrations indicate that MedTrim improves performance in downstream retrieval and classification tasks compared to state-of-the-art alignment methods.

Embedding Radiomics into Vision Transformers for Multimodal Medical Image Classification

Background: Deep learning has significantly advanced medical image analysis, with Vision Transformers (ViTs) offering a powerful alternative to convolutional models by modeling long-range dependencies through self-attention. However, ViTs are inherently data-intensive and lack domain-specific inductive biases, limiting their applicability in medical imaging. In contrast, radiomics provides interpretable, handcrafted descriptors of tissue heterogeneity but suffers from limited scalability and integration into end-to-end learning frameworks. In this work, we propose the Radiomics-Embedded Vision Transformer (RE-ViT) that combines radiomic features with data-driven visual embeddings within a ViT backbone. Purpose: To develop a hybrid RE-ViT framework that integrates radiomics and patch-wise ViT embeddings through early fusion, enhancing robustness and performance in medical image classification. Methods: Following the standard ViT pipeline, images were divided into patches. For each patch, handcrafted radiomic features were extracted and fused with linearly projected pixel embeddings. The fused representations were normalized, positionally encoded, and passed to the ViT encoder. A learnable [CLS] token aggregated patch-level information for classification. We evaluated RE-ViT on three public datasets (including BUSI, ChestXray2017, and Retinal OCT) using accuracy, macro AUC, sensitivity, and specificity. RE-ViT was benchmarked against CNN-based (VGG-16, ResNet) and hybrid (TransMed) models. Results: RE-ViT achieved state-of-the-art results: on BUSI, AUC=0.950+/-0.011; on ChestXray2017, AUC=0.989+/-0.004; on Retinal OCT, AUC=0.986+/-0.001, which outperforms other comparison models. Conclusions: The RE-ViT framework effectively integrates radiomics with ViT architectures, demonstrating improved performance and generalizability across multimodal medical image classification tasks.

Integrating Vision and Location with Transformers: A Multimodal Deep Learning Framework for Medical Wound Analysis

Effective recognition of acute and difficult-to-heal wounds is a necessary step in wound diagnosis. An efficient classification model can help wound specialists classify wound types with less financial and time costs and also help in deciding on the optimal treatment method. Traditional machine learning models suffer from feature selection and are usually cumbersome models for accurate recognition. Recently, deep learning (DL) has emerged as a powerful tool in wound diagnosis. Although DL seems promising for wound type recognition, there is still a large scope for improving the efficiency and accuracy of the model. In this study, a DL-based multimodal classifier was developed using wound images and their corresponding locations to classify them into multiple classes, including diabetic, pressure, surgical, and venous ulcers. A body map was also created to provide location data, which can help wound specialists label wound locations more effectively. The model uses a Vision Transformer to extract hierarchical features from input images, a Discrete Wavelet Transform (DWT) layer to capture low and high frequency components, and a Transformer to extract spatial features. The number of neurons and weight vector optimization were performed using three swarm-based optimization techniques (Monster Gorilla Toner (MGTO), Improved Gray Wolf Optimization (IGWO), and Fox Optimization Algorithm). The evaluation results show that weight vector optimization using optimization algorithms can increase diagnostic accuracy and make it a very effective approach for wound detection. In the classification using the original body map, the proposed model was able to achieve an accuracy of 0.8123 using image data and an accuracy of 0.8007 using a combination of image data and wound location. Also, the accuracy of the model in combination with the optimization models varied from 0.7801 to 0.8342.

MedM-VL: What Makes a Good Medical LVLM?

Medical image analysis is a fundamental component. As deep learning progresses, the focus has shifted from single-task applications, such as classification and segmentation, to more complex multimodal tasks, including medical visual question answering and report generation. Traditional shallow and task-specific models are increasingly limited in addressing the complexity and scalability required in clinical practice. The emergence of large language models (LLMs) has driven the development of medical Large Vision-Language Models (LVLMs), offering a unified solution for diverse vision-language tasks. In this study, we investigate various architectural designs for medical LVLMs based on the widely adopted LLaVA framework, which follows an encoder-connector-LLM paradigm. We construct two distinct models targeting 2D and 3D modalities, respectively. These models are designed to support both general-purpose medical tasks and domain-specific fine-tuning, thereby serving as effective foundation models. To facilitate reproducibility and further research, we develop a modular and extensible codebase, MedM-VL, and release two LVLM variants: MedM-VL-2D for 2D medical image analysis and MedM-VL-CT-Chest for 3D CT-based applications. The code and models are available at: https://github.com/MSIIP/MedM-VL

3D Convolutional Neural Networks for Improved Detection of Intracranial bleeding in CT Imaging

Background: Intracranial bleeding (IB) is a life-threatening condition caused by traumatic brain injuries, including epidural, subdural, subarachnoid, and intraparenchymal hemorrhages. Rapid and accurate detection is crucial to prevent severe complications. Traditional imaging can be slow and prone to variability, especially in high-pressure scenarios. Artificial Intelligence (AI) provides a solution by quickly analyzing medical images, identifying subtle hemorrhages, and flagging urgent cases. By enhancing diagnostic speed and accuracy, AI improves workflows and patient care. This article explores AI's role in transforming IB detection in emergency settings. Methods: A U-shaped 3D Convolutional Neural Network (CNN) automates IB detection and classification in volumetric CT scans. Advanced preprocessing, including CLAHE and intensity normalization, enhances image quality. The architecture preserves spatial and contextual details for precise segmentation. A dataset of 2,912 annotated CT scans was used for training and evaluation. Results: The model achieved high performance across major bleed types, with precision, recall, and accuracy exceeding 90 percent in most cases 96 percent precision for epidural hemorrhages and 94 percent accuracy for subarachnoid hemorrhages. Its ability to classify and localize hemorrhages highlights its clinical reliability. Conclusion: This U-shaped 3D CNN offers a scalable solution for automating IB detection, reducing diagnostic delays, and improving emergency care outcomes. Future work will expand dataset diversity, optimize real-time processing, and integrate multimodal data for enhanced clinical applicability.

PSO-UNet: Particle Swarm-Optimized U-Net Framework for Precise Multimodal Brain Tumor Segmentation

Medical image segmentation, particularly for brain tumor analysis, demands precise and computationally efficient models due to the complexity of multimodal MRI datasets and diverse tumor morphologies. This study introduces PSO-UNet, which integrates Particle Swarm Optimization (PSO) with the U-Net architecture for dynamic hyperparameter optimization. Unlike traditional manual tuning or alternative optimization approaches, PSO effectively navigates complex hyperparameter search spaces, explicitly optimizing the number of filters, kernel size, and learning rate. PSO-UNet substantially enhances segmentation performance, achieving Dice Similarity Coefficients (DSC) of 0.9578 and 0.9523 and Intersection over Union (IoU) scores of 0.9194 and 0.9097 on the BraTS 2021 and Figshare datasets, respectively. Moreover, the method reduces computational complexity significantly, utilizing only 7.8 million parameters and executing in approximately 906 seconds, markedly faster than comparable U-Net-based frameworks. These outcomes underscore PSO-UNet's robust generalization capabilities across diverse MRI modalities and tumor classifications, emphasizing its clinical potential and clear advantages over conventional hyperparameter tuning methods. Future research will explore hybrid optimization strategies and validate the framework against other bio-inspired algorithms to enhance its robustness and scalability.

Advancing Medical Representation Learning Through High-Quality Data

Despite the growing scale of medical Vision-Language datasets, the impact of dataset quality on model performance remains under-explored. We introduce Open-PMC, a high-quality medical dataset from PubMed Central, containing 2.2 million image-text pairs, enriched with image modality annotations, subfigures, and summarized in-text references. Notably, the in-text references provide richer medical context, extending beyond the abstract information typically found in captions. Through extensive experiments, we benchmark Open-PMC against larger datasets across retrieval and zero-shot classification tasks. Our results show that dataset quality-not just size-drives significant performance gains. We complement our benchmark with an in-depth analysis of feature representation. Our findings highlight the crucial role of data curation quality in advancing multimodal medical AI. We release Open-PMC, along with the trained models and our codebase.

A Novel Ophthalmic Benchmark for Evaluating Multimodal Large Language Models with Fundus Photographs and OCT Images

In recent years, large language models (LLMs) have demonstrated remarkable potential across various medical applications. Building on this foundation, multimodal large language models (MLLMs) integrate LLMs with visual models to process diverse inputs, including clinical data and medical images. In ophthalmology, LLMs have been explored for analyzing optical coherence tomography (OCT) reports, assisting in disease classification, and even predicting treatment outcomes. However, existing MLLM benchmarks often fail to capture the complexities of real-world clinical practice, particularly in the analysis of OCT images. Many suffer from limitations such as small sample sizes, a lack of diverse OCT datasets, and insufficient expert validation. These shortcomings hinder the accurate assessment of MLLMs' ability to interpret OCT scans and their broader applicability in ophthalmology. Our dataset, curated through rigorous quality control and expert annotation, consists of 439 fundus images and 75 OCT images. Using a standardized API-based framework, we assessed seven mainstream MLLMs and observed significant variability in diagnostic accuracy across different diseases. While some models performed well in diagnosing conditions such as diabetic retinopathy and age-related macular degeneration, they struggled with others, including choroidal neovascularization and myopia, highlighting inconsistencies in performance and the need for further refinement. Our findings emphasize the importance of developing clinically relevant benchmarks to provide a more accurate assessment of MLLMs' capabilities. By refining these models and expanding their scope, we can enhance their potential to transform ophthalmic diagnosis and treatment.

Semantic Alignment of Unimodal Medical Text and Vision Representations

General-purpose AI models, particularly those designed for text and vision, demonstrate impressive versatility across a wide range of deep-learning tasks. However, they often underperform in specialised domains like medical imaging, where domain-specific solutions or alternative knowledge transfer approaches are typically required. Recent studies have noted that general-purpose models can exhibit similar latent spaces when processing semantically related data, although this alignment does not occur naturally. Building on this insight, it has been shown that applying a simple transformation - at most affine - estimated from a subset of semantically corresponding samples, known as anchors, enables model stitching across diverse training paradigms, architectures, and modalities. In this paper, we explore how semantic alignment - estimating transformations between anchors - can bridge general-purpose AI with specialised medical knowledge. Using multiple public chest X-ray datasets, we demonstrate that model stitching across model architectures allows general models to integrate domain-specific knowledge without additional training, leading to improved performance on medical tasks. Furthermore, we introduce a novel zero-shot classification approach for unimodal vision encoders that leverages semantic alignment across modalities. Our results show that our method not only outperforms general multimodal models but also approaches the performance levels of fully trained, medical-specific multimodal solutions