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While multi-modal foundation models pre-trained on large-scale data have been successful in natural language understanding and vision recognition, their use in medical domains is still limited due to the fine-grained nature of medical tasks and the high demand for domain knowledge. To address this challenge, we propose a novel approach called Knowledge-enhanced Auto Diagnosis (KAD) which leverages existing medical domain knowledge to guide vision-language pre-training using paired chest X-rays and radiology reports. We evaluate KAD on {four} external X-ray datasets and demonstrate that its zero-shot performance is not only comparable to that of fully-supervised models, but also superior to the average of three expert radiologists for three (out of five) pathologies with statistical significance. Moreover, when few-shot annotation is available, KAD outperforms all existing approaches in fine-tuning settings, demonstrating its potential for application in different clinical scenarios.

Foundation models trained on large-scale dataset gain a recent surge in CV and NLP. In contrast, development in biomedical domain lags far behind due to data scarcity. To address this issue, we build and release PMC-OA, a biomedical dataset with 1.6M image-caption pairs collected from PubMedCentral's OpenAccess subset, which is 8 times larger than before. PMC-OA covers diverse modalities or diseases, with majority of the image-caption samples aligned at finer-grained level, i.e., subfigure and subcaption. While pretraining a CLIP-style model on PMC-OA, our model named PMC-CLIP achieves state-of-the-art results on various downstream tasks, including image-text retrieval on ROCO, MedMNIST image classification, Medical VQA, i.e. +8.1% R@10 on image-text retrieval, +3.9% accuracy on image classification., Comment: 10 pages, 3 figures

Large Language Models (LLMs) have showcased remarkable capabilities in natural language understanding in various domains. These models can usually behave well on daily dialog, or question answering scenarios, however, in areas that value precision, for example, in medical applications, they often exhibit unsatisfactory performance due to a lack of domain-specific knowledge. In this report, we introduce PMC-LLaMA, an open-source language model that is acquired by fine-tuning an open-source language model on a total of 4.8 million biomedical academic papers for further injecting medical knowledge, enhancing its capability in medical domain. Our preliminary evaluations are conducted on three biomedical QA datasets, including PubMedQA, MedMCQA, and USMLE, showing that the our model after finetuning, i.e., PMC-LLaMA, demonstrates better understanding of biomedical domain-specific concepts, thus achieving high performance on QA benchmarks. The model and codes, along with an online demo, are publicly available.

In this paper, we target self-supervised representation learning for zero-shot tumor segmentation. We make the following contributions: First, we advocate a zero-shot setting, where models from pre-training should be directly applicable for the downstream task, without using any manual annotations. Second, we take inspiration from "layer-decomposition", and innovate on the training regime with simulated tumor data. Third, we conduct extensive ablation studies to analyse the critical components in data simulation, and validate the necessity of different proxy tasks. We demonstrate that, with sufficient texture randomization in simulation, model trained on synthetic data can effortlessly generalise to segment real tumor data. Forth, our approach achieves superior results for zero-shot tumor segmentation on different downstream datasets, BraTS2018 for brain tumor segmentation and LiTS2017 for liver tumor segmentation. While evaluating the model transferability for tumor segmentation under a low-annotation regime, the proposed approach also outperforms all existing self-supervised approaches, opening up the usage of self-supervised learning in practical scenarios., Comment: Project webpage: https://xiaoman-zhang.github.io/Layer-Decomposition/

Automatic and accurate tumor segmentation on medical images is in high demand to assist physicians with diagnosis and treatment. However, it is difficult to obtain massive amounts of annotated training data required by the deep-learning models as the manual delineation process is often tedious and expertise required. Although self-supervised learning (SSL) scheme has been widely adopted to address this problem, most SSL methods focus only on global structure information, ignoring the key distinguishing features of tumor regions: local intensity variation and large size distribution. In this paper, we propose Scale-Aware Restoration (SAR), a SSL method for 3D tumor segmentation. Specifically, a novel proxy task, i.e. scale discrimination, is formulated to pre-train the 3D neural network combined with the self-restoration task. Thus, the pre-trained model learns multi-level local representations through multi-scale inputs. Moreover, an adversarial learning module is further introduced to learn modality invariant representations from multiple unlabeled source datasets. We demonstrate the effectiveness of our methods on two downstream tasks: i) Brain tumor segmentation, ii) Pancreas tumor segmentation. Compared with the state-of-the-art 3D SSL methods, our proposed approach can significantly improve the segmentation accuracy. Besides, we analyze its advantages from multiple perspectives such as data efficiency, performance, and convergence speed., Comment: Accepted by MICCAI 2021

Bone age assessment is an important clinical trial to measure skeletal child maturity and diagnose of growth disorders. Conventional approaches such as the Tanner-Whitehouse (TW) and Greulich and Pyle (GP) may not perform well due to their large inter-observer and intra-observer variations. In this paper, we propose a finger joint localization strategy to filter out most non-informative parts of images. When combining with the conventional full image-based deep network, we observe a much-improved performance. % Our approach utilizes full hand and specific joints images for skeletal maturity prediction. In this study, we applied powerful deep neural network and explored a process in the forecast of skeletal bone age with the specifically combine joints images to increase the performance accuracy compared with the whole hand images., Comment: Some changes will be made