Daily Papers

We present a comprehensive evaluation of Parameter-Efficient Fine-Tuning (PEFT) techniques for diverse medical image analysis tasks. PEFT is increasingly exploited as a valuable approach for knowledge transfer from pre-trained models in natural language processing, vision, speech, and cross-modal tasks, such as vision-language and text-to-image generation. However, its application in medical image analysis remains relatively unexplored. As foundation models are increasingly exploited in the medical domain, it is crucial to investigate and comparatively assess various strategies for knowledge transfer that can bolster a range of downstream tasks. Our study, the first of its kind (to the best of our knowledge), evaluates 16 distinct PEFT methodologies proposed for convolutional and transformer-based networks, focusing on image classification and text-to-image generation tasks across six medical datasets ranging in size, modality, and complexity. Through a battery of more than 600 controlled experiments, we demonstrate performance gains of up to 22% under certain scenarios and demonstrate the efficacy of PEFT for medical text-to-image generation. Further, we reveal the instances where PEFT methods particularly dominate over conventional fine-tuning approaches by studying their relationship with downstream data volume.

We present Autoregressive Representation Alignment (ARRA), a new training framework that unlocks global-coherent text-to-image generation in autoregressive LLMs without architectural changes. Unlike prior work that requires complex architectural redesigns, ARRA aligns LLM hidden states with visual representations from external visual foundational models via a global visual alignment loss and a hybrid token, <HYBNEXT>. This token enforces dual constraints: local next-token prediction and global semantic distillation, enabling LLMs to implicitly learn spatial and contextual coherence while retaining their original autoregressive paradigm. Extensive experiments validate ARRA's plug-and-play versatility. When training from text-generation-only LLMs or random initialization, ARRA reduces FID by 25.5% (MIMIC-CXR), 8.8% (DeepEyeNet), and 7.5% (ImageNet) for advanced autoregressive LLMs like Chameleon and LlamaGen, all without framework modifications. For domain adaption, ARRA aligns general-purpose LLMs with specialized models (e.g., BioMedCLIP), achieving an 18.6% FID reduction over direct fine-tuning on medical imaging (MIMIC-CXR). By demonstrating that training objective redesign -- not just architectural innovation -- can resolve cross-modal global coherence challenges, ARRA offers a complementary paradigm for advancing autoregressive models. Code and models will be released to advance autoregressive image generation.

Existing text-to-image generation approaches have set high standards for photorealism and text-image correspondence, largely benefiting from web-scale text-image datasets, which can include up to 5~billion pairs. However, text-to-image generation models trained on domain-specific datasets, such as urban scenes, medical images, and faces, still suffer from low text-image correspondence due to the lack of text-image pairs. Additionally, collecting billions of text-image pairs for a specific domain can be time-consuming and costly. Thus, ensuring high text-image correspondence without relying on web-scale text-image datasets remains a challenging task. In this paper, we present a novel approach for enhancing text-image correspondence by leveraging available semantic layouts. Specifically, we propose a Gaussian-categorical diffusion process that simultaneously generates both images and corresponding layout pairs. Our experiments reveal that we can guide text-to-image generation models to be aware of the semantics of different image regions, by training the model to generate semantic labels for each pixel. We demonstrate that our approach achieves higher text-image correspondence compared to existing text-to-image generation approaches in the Multi-Modal CelebA-HQ and the Cityscapes dataset, where text-image pairs are scarce. Codes are available in this https://pmh9960.github.io/research/GCDP

Generative models, particularly text-to-image (T2I) diffusion models, play a crucial role in medical image analysis. However, these models are prone to training data memorization, posing significant risks to patient privacy. Synthetic chest X-ray generation is one of the most common applications in medical image analysis with the MIMIC-CXR dataset serving as the primary data repository for this task. This study adopts a data-driven approach and presents the first systematic attempt to identify prompts and text tokens in MIMIC-CXR that contribute the most to training data memorization. Our analysis reveals an unexpected finding: prompts containing traces of de-identification procedures are among the most memorized, with de-identification markers contributing the most. Furthermore, we also find existing inference-time memorization mitigation strategies are ineffective and fail to sufficiently reduce the model's reliance on memorized text tokens highlighting a broader issue in T2I synthesis with MIMIC-CXR. On this front, we propose actionable strategies to enhance privacy and improve the reliability of generative models in medical imaging. Finally, our results provide a foundation for future work on developing and benchmarking memorization mitigation techniques for synthetic chest X-ray generation using the MIMIC-CXR dataset.

Medical vision-and-language pre-training (Med-VLP) has shown promising improvements on many downstream medical tasks owing to its applicability to extracting generic representations from medical images and texts. Practically, there exist two typical types, i.e., the fusion-encoder type and the dual-encoder type, depending on whether a heavy fusion module is used. The former is superior at multi-modal tasks owing to the sufficient interaction between modalities; the latter is good at uni-modal and cross-modal tasks due to the single-modality encoding ability. To take advantage of these two types, we propose an effective yet straightforward scheme named PTUnifier to unify the two types. We first unify the input format by introducing visual and textual prompts, which serve as a feature bank that stores the most representative images/texts. By doing so, a single model could serve as a foundation model that processes various tasks adopting different input formats (i.e., image-only, text-only, and image-text-pair). Furthermore, we construct a prompt pool (instead of static ones) to improve diversity and scalability. Experimental results show that our approach achieves state-of-the-art results on a broad range of tasks, spanning uni-modal tasks (i.e., image/text classification and text summarization), cross-modal tasks (i.e., image-to-text generation and image-text/text-image retrieval), and multi-modal tasks (i.e., visual question answering), demonstrating the effectiveness of our approach. Note that the adoption of prompts is orthogonal to most existing Med-VLP approaches and could be a beneficial and complementary extension to these approaches.

Following the impressive development of LLMs, vision-language alignment in LLMs is actively being researched to enable multimodal reasoning and visual IO. This direction of research is particularly relevant to medical imaging because medical image analysis and generation consist of reasoning based on a combination of visual features and prior knowledge. Many recent works have focused on training adapter networks that serve as an information bridge between image processing networks and LLMs; but presumably, in order to achieve maximum reasoning potential of LLMs on visual information as well, visual and language features should be allowed to interact more freely. This is especially important in the medical domain because understanding and generating medical images such as chest X-rays (CXR) require not only accurate visual and language-based reasoning but also a more intimate mapping between the two modalities. Thus, taking inspiration from previous work on the transformer and VQ-GAN combination for bidirectional image and text generation, we build upon this approach and develop a method for instruction-tuning an LLM pre-trained only on text to gain vision-language capabilities for medical images. Specifically, we leverage a pretrained LLM's existing question-answering and instruction-following abilities to teach it to understand visual inputs by instructing it to answer questions about image inputs and, symmetrically, output both text and image responses appropriate to a given query by tuning the LLM with diverse tasks that encompass image-based text-generation and text-based image-generation. We show that our model, LLM-CXR, trained in this approach shows better image-text alignment in both CXR understanding and generation tasks while being smaller in size compared to previously developed models that perform a narrower range of tasks. The code is at https://github.com/hyn2028/llm-cxr.

Generative modeling has experienced substantial progress in recent years, particularly in text-to-image and text-to-video synthesis. However, the medical field has not yet fully exploited the potential of large-scale foundational models for synthetic data generation. In this paper, we introduce GenerateCT, the first method for text-conditional computed tomography (CT) generation, addressing the limitations in 3D medical imaging research and making our entire framework open-source. GenerateCT consists of a pre-trained large language model, a transformer-based text-conditional 3D chest CT generation architecture, and a text-conditional spatial super-resolution diffusion model. We also propose CT-ViT, which efficiently compresses CT volumes while preserving auto-regressiveness in-depth, enabling the generation of 3D CT volumes with variable numbers of axial slices. Our experiments demonstrate that GenerateCT can produce realistic, high-resolution, and high-fidelity 3D chest CT volumes consistent with medical language text prompts. We further investigate the potential of GenerateCT by training a model using generated CT volumes for multi-abnormality classification of chest CT volumes. Our contributions provide a valuable foundation for future research in text-conditional 3D medical image generation and have the potential to accelerate advancements in medical imaging research. Our code, pre-trained models, and generated data are available at https://github.com/ibrahimethemhamamci/GenerateCT.

Medical image segmentation has recently demonstrated impressive progress with deep neural networks, yet the heterogeneous modalities and scarcity of mask annotations limit the development of segmentation models on unannotated modalities. This paper investigates a new paradigm for leveraging generative models in medical applications: controllably synthesizing data for unannotated modalities, without requiring registered data pairs. Specifically, we make the following contributions in this paper: (i) we collect and curate a large-scale radiology image-text dataset, MedGen-1M, comprising modality labels, attributes, region, and organ information, along with a subset of organ mask annotations, to support research in controllable medical image generation; (ii) we propose a diffusion-based data engine, termed MRGen, which enables generation conditioned on text prompts and masks, synthesizing MR images for diverse modalities lacking mask annotations, to train segmentation models on unannotated modalities; (iii) we conduct extensive experiments across various modalities, illustrating that our data engine can effectively synthesize training samples and extend MRI segmentation towards unannotated modalities.

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.

Medical image analysis is essential to clinical diagnosis and treatment, which is increasingly supported by multi-modal large language models (MLLMs). However, previous research has primarily focused on 2D medical images, leaving 3D images under-explored, despite their richer spatial information. This paper aims to advance 3D medical image analysis with MLLMs. To this end, we present a large-scale 3D multi-modal medical dataset, M3D-Data, comprising 120K image-text pairs and 662K instruction-response pairs specifically tailored for various 3D medical tasks, such as image-text retrieval, report generation, visual question answering, positioning, and segmentation. Additionally, we propose M3D-LaMed, a versatile multi-modal large language model for 3D medical image analysis. Furthermore, we introduce a new 3D multi-modal medical benchmark, M3D-Bench, which facilitates automatic evaluation across eight tasks. Through comprehensive evaluation, our method proves to be a robust model for 3D medical image analysis, outperforming existing solutions. All code, data, and models are publicly available at: https://github.com/BAAI-DCAI/M3D.

Large language models (LLMs) have recently demonstrated their potential in clinical applications, providing valuable medical knowledge and advice. For example, a large dialog LLM like ChatGPT has successfully passed part of the US medical licensing exam. However, LLMs currently have difficulty processing images, making it challenging to interpret information from medical images, which are rich in information that supports clinical decisions. On the other hand, computer-aided diagnosis (CAD) networks for medical images have seen significant success in the medical field by using advanced deep-learning algorithms to support clinical decision-making. This paper presents a method for integrating LLMs into medical-image CAD networks. The proposed framework uses LLMs to enhance the output of multiple CAD networks, such as diagnosis networks, lesion segmentation networks, and report generation networks, by summarizing and reorganizing the information presented in natural language text format. The goal is to merge the strengths of LLMs' medical domain knowledge and logical reasoning with the vision understanding capability of existing medical-image CAD models to create a more user-friendly and understandable system for patients compared to conventional CAD systems. In the future, LLM's medical knowledge can be also used to improve the performance of vision-based medical-image CAD models.

Multimodal models trained on large natural image-text pair datasets have exhibited astounding abilities in generating high-quality images. Medical imaging data is fundamentally different to natural images, and the language used to succinctly capture relevant details in medical data uses a different, narrow but semantically rich, domain-specific vocabulary. Not surprisingly, multi-modal models trained on natural image-text pairs do not tend to generalize well to the medical domain. Developing generative imaging models faithfully representing medical concepts while providing compositional diversity could mitigate the existing paucity of high-quality, annotated medical imaging datasets. In this work, we develop a strategy to overcome the large natural-medical distributional shift by adapting a pre-trained latent diffusion model on a corpus of publicly available chest x-rays (CXR) and their corresponding radiology (text) reports. We investigate the model's ability to generate high-fidelity, diverse synthetic CXR conditioned on text prompts. We assess the model outputs quantitatively using image quality metrics, and evaluate image quality and text-image alignment by human domain experts. We present evidence that the resulting model (RoentGen) is able to create visually convincing, diverse synthetic CXR images, and that the output can be controlled to a new extent by using free-form text prompts including radiology-specific language. Fine-tuning this model on a fixed training set and using it as a data augmentation method, we measure a 5% improvement of a classifier trained jointly on synthetic and real images, and a 3% improvement when trained on a larger but purely synthetic training set. Finally, we observe that this fine-tuning distills in-domain knowledge in the text-encoder and can improve its representation capabilities of certain diseases like pneumothorax by 25%.

Medical visual question answering (VQA) is a challenging multimodal task, where Vision-Language Pre-training (VLP) models can effectively improve the generalization performance. However, most methods in the medical field treat VQA as an answer classification task which is difficult to transfer to practical application scenarios. Additionally, due to the privacy of medical images and the expensive annotation process, large-scale medical image-text pairs datasets for pretraining are severely lacking. In this paper, we propose a large-scale MultI-task Self-Supervised learning based framework (MISS) for medical VQA tasks. Unlike existing methods, we treat medical VQA as a generative task. We unify the text encoder and multimodal encoder and align image-text features through multi-task learning. Furthermore, we propose a Transfer-and-Caption method that extends the feature space of single-modal image datasets using large language models (LLMs), enabling those traditional medical vision field task data to be applied to VLP. Experiments show that our method achieves excellent results with fewer multimodal datasets and demonstrates the advantages of generative VQA models. The code and model weights will be released upon the paper's acceptance.

This paper introduces an innovative methodology for producing high-quality 3D lung CT images guided by textual information. While diffusion-based generative models are increasingly used in medical imaging, current state-of-the-art approaches are limited to low-resolution outputs and underutilize radiology reports' abundant information. The radiology reports can enhance the generation process by providing additional guidance and offering fine-grained control over the synthesis of images. Nevertheless, expanding text-guided generation to high-resolution 3D images poses significant memory and anatomical detail-preserving challenges. Addressing the memory issue, we introduce a hierarchical scheme that uses a modified UNet architecture. We start by synthesizing low-resolution images conditioned on the text, serving as a foundation for subsequent generators for complete volumetric data. To ensure the anatomical plausibility of the generated samples, we provide further guidance by generating vascular, airway, and lobular segmentation masks in conjunction with the CT images. The model demonstrates the capability to use textual input and segmentation tasks to generate synthesized images. The results of comparative assessments indicate that our approach exhibits superior performance compared to the most advanced models based on GAN and diffusion techniques, especially in accurately retaining crucial anatomical features such as fissure lines, airways, and vascular structures. This innovation introduces novel possibilities. This study focuses on two main objectives: (1) the development of a method for creating images based on textual prompts and anatomical components, and (2) the capability to generate new images conditioning on anatomical elements. The advancements in image generation can be applied to enhance numerous downstream tasks.

Generating synthetic text addresses the challenge of data availability in privacy-sensitive domains such as healthcare. This study explores the applicability of synthetic data in real-world medical settings. We introduce MedSyn, a novel medical text generation framework that integrates large language models with a Medical Knowledge Graph (MKG). We use MKG to sample prior medical information for the prompt and generate synthetic clinical notes with GPT-4 and fine-tuned LLaMA models. We assess the benefit of synthetic data through application in the ICD code prediction task. Our research indicates that synthetic data can increase the classification accuracy of vital and challenging codes by up to 17.8% compared to settings without synthetic data. Furthermore, to provide new data for further research in the healthcare domain, we present the largest open-source synthetic dataset of clinical notes for the Russian language, comprising over 41k samples covering 219 ICD-10 codes.

Learning visual representations of medical images (e.g., X-rays) is core to medical image understanding but its progress has been held back by the scarcity of human annotations. Existing work commonly relies on fine-tuning weights transferred from ImageNet pretraining, which is suboptimal due to drastically different image characteristics, or rule-based label extraction from the textual report data paired with medical images, which is inaccurate and hard to generalize. Meanwhile, several recent studies show exciting results from unsupervised contrastive learning from natural images, but we find these methods help little on medical images because of their high inter-class similarity. We propose ConVIRT, an alternative unsupervised strategy to learn medical visual representations by exploiting naturally occurring paired descriptive text. Our new method of pretraining medical image encoders with the paired text data via a bidirectional contrastive objective between the two modalities is domain-agnostic, and requires no additional expert input. We test ConVIRT by transferring our pretrained weights to 4 medical image classification tasks and 2 zero-shot retrieval tasks, and show that it leads to image representations that considerably outperform strong baselines in most settings. Notably, in all 4 classification tasks, our method requires only 10\% as much labeled training data as an ImageNet initialized counterpart to achieve better or comparable performance, demonstrating superior data efficiency.

This paper introduces MedTrinity-25M, a comprehensive, large-scale multimodal dataset for medicine, covering over 25 million images across 10 modalities, with multigranular annotations for more than 65 diseases. These enriched annotations encompass both global textual information, such as disease/lesion type, modality, region-specific descriptions, and inter-regional relationships, as well as detailed local annotations for regions of interest (ROIs), including bounding boxes, segmentation masks. Unlike existing approach which is limited by the availability of image-text pairs, we have developed the first automated pipeline that scales up multimodal data by generating multigranular visual and texual annotations (in the form of image-ROI-description triplets) without the need for any paired text descriptions. Specifically, data from over 90 different sources have been collected, preprocessed, and grounded using domain-specific expert models to identify ROIs related to abnormal regions. We then build a comprehensive knowledge base and prompt multimodal large language models to perform retrieval-augmented generation with the identified ROIs as guidance, resulting in multigranular texual descriptions. Compared to existing datasets, MedTrinity-25M provides the most enriched annotations, supporting a comprehensive range of multimodal tasks such as captioning and report generation, as well as vision-centric tasks like classification and segmentation. Pretraining on MedTrinity-25M, our model achieves state-of-the-art performance on VQA-RAD and PathVQA, surpassing both multimodal large language models and other representative SoTA approaches. This dataset can also be utilized to support large-scale pre-training of multimodal medical AI models, contributing to the development of future foundation models in the medical domain.

One of the major challenges in training text-to-image generation models is the need of a large number of high-quality image-text pairs. While image samples are often easily accessible, the associated text descriptions typically require careful human captioning, which is particularly time- and cost-consuming. In this paper, we propose the first work to train text-to-image generation models without any text data. Our method leverages the well-aligned multi-modal semantic space of the powerful pre-trained CLIP model: the requirement of text-conditioning is seamlessly alleviated via generating text features from image features. Extensive experiments are conducted to illustrate the effectiveness of the proposed method. We obtain state-of-the-art results in the standard text-to-image generation tasks. Importantly, the proposed language-free model outperforms most existing models trained with full image-text pairs. Furthermore, our method can be applied in fine-tuning pre-trained models, which saves both training time and cost in training text-to-image generation models. Our pre-trained model obtains competitive results in zero-shot text-to-image generation on the MS-COCO dataset, yet with around only 1% of the model size and training data size relative to the recently proposed large DALL-E model.

Recent text-to-image generation models have demonstrated impressive capability of generating text-aligned images with high fidelity. However, generating images of novel concept provided by the user input image is still a challenging task. To address this problem, researchers have been exploring various methods for customizing pre-trained text-to-image generation models. Currently, most existing methods for customizing pre-trained text-to-image generation models involve the use of regularization techniques to prevent over-fitting. While regularization will ease the challenge of customization and leads to successful content creation with respect to text guidance, it may restrict the model capability, resulting in the loss of detailed information and inferior performance. In this work, we propose a novel framework for customized text-to-image generation without the use of regularization. Specifically, our proposed framework consists of an encoder network and a novel sampling method which can tackle the over-fitting problem without the use of regularization. With the proposed framework, we are able to customize a large-scale text-to-image generation model within half a minute on single GPU, with only one image provided by the user. We demonstrate in experiments that our proposed framework outperforms existing methods, and preserves more fine-grained details.

The rapid development of multimodal large language models (MLLMs), such as GPT-4V, has led to significant advancements. However, these models still face challenges in medical multimodal capabilities due to limitations in the quantity and quality of medical vision-text data, stemming from data privacy concerns and high annotation costs. While pioneering approaches utilize PubMed's large-scale, de-identified medical image-text pairs to address these limitations, they still fall short due to inherent data noise. To tackle this, we refined medical image-text pairs from PubMed and employed MLLMs (GPT-4V) in an 'unblinded' capacity to denoise and reformat the data, resulting in the creation of the PubMedVision dataset with 1.3 million medical VQA samples. Our validation demonstrates that: (1) PubMedVision can significantly enhance the medical multimodal capabilities of current MLLMs, showing significant improvement in benchmarks including the MMMU Health & Medicine track; (2) manual checks by medical experts and empirical results validate the superior data quality of our dataset compared to other data construction methods. Using PubMedVision, we train a 34B medical MLLM HuatuoGPT-Vision, which shows superior performance in medical multimodal scenarios among open-source MLLMs.

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.

Medicine, by its nature, is a multifaceted domain that requires the synthesis of information across various modalities. Medical generative vision-language models (VLMs) make a first step in this direction and promise many exciting clinical applications. However, existing models typically have to be fine-tuned on sizeable down-stream datasets, which poses a significant limitation as in many medical applications data is scarce, necessitating models that are capable of learning from few examples in real-time. Here we propose Med-Flamingo, a multimodal few-shot learner adapted to the medical domain. Based on OpenFlamingo-9B, we continue pre-training on paired and interleaved medical image-text data from publications and textbooks. Med-Flamingo unlocks few-shot generative medical visual question answering (VQA) abilities, which we evaluate on several datasets including a novel challenging open-ended VQA dataset of visual USMLE-style problems. Furthermore, we conduct the first human evaluation for generative medical VQA where physicians review the problems and blinded generations in an interactive app. Med-Flamingo improves performance in generative medical VQA by up to 20\% in clinician's rating and firstly enables multimodal medical few-shot adaptations, such as rationale generation. We release our model, code, and evaluation app under https://github.com/snap-stanford/med-flamingo.

The rapid advancement of large-scale vision-language models has showcased remarkable capabilities across various tasks. However, the lack of extensive and high-quality image-text data in medicine has greatly hindered the development of large-scale medical vision-language models. In this work, we present a diagnosis-guided bootstrapping strategy that exploits both image and label information to construct vision-language datasets. Based on the constructed dataset, we developed MedDr, a generalist foundation model for healthcare capable of handling diverse medical data modalities, including radiology, pathology, dermatology, retinography, and endoscopy. Moreover, during inference, we propose a simple but effective retrieval-augmented medical diagnosis strategy, which enhances the model's generalization ability. Extensive experiments on visual question answering, medical report generation, and medical image diagnosis demonstrate the superiority of our method.

Text-to-image generative models often reflect the biases of the training data, leading to unequal representations of underrepresented groups. This study investigates inclusive text-to-image generative models that generate images based on human-written prompts and ensure the resulting images are uniformly distributed across attributes of interest. Unfortunately, directly expressing the desired attributes in the prompt often leads to sub-optimal results due to linguistic ambiguity or model misrepresentation. Hence, this paper proposes a drastically different approach that adheres to the maxim that "a picture is worth a thousand words". We show that, for some attributes, images can represent concepts more expressively than text. For instance, categories of skin tones are typically hard to specify by text but can be easily represented by example images. Building upon these insights, we propose a novel approach, ITI-GEN, that leverages readily available reference images for Inclusive Text-to-Image GENeration. The key idea is learning a set of prompt embeddings to generate images that can effectively represent all desired attribute categories. More importantly, ITI-GEN requires no model fine-tuning, making it computationally efficient to augment existing text-to-image models. Extensive experiments demonstrate that ITI-GEN largely improves over state-of-the-art models to generate inclusive images from a prompt. Project page: https://czhang0528.github.io/iti-gen.

In the era of modern healthcare, swiftly generating medical question summaries is crucial for informed and timely patient care. Despite the increasing complexity and volume of medical data, existing studies have focused solely on text-based summarization, neglecting the integration of visual information. Recognizing the untapped potential of combining textual queries with visual representations of medical conditions, we introduce the Multimodal Medical Question Summarization (MMQS) Dataset. This dataset, a major contribution to our work, pairs medical queries with visual aids, facilitating a richer and more nuanced understanding of patient needs. We also propose a framework, utilizing the power of Contrastive Language Image Pretraining(CLIP) and Large Language Models(LLMs), consisting of four modules that identify medical disorders, generate relevant context, filter medical concepts, and craft visually aware summaries. Our comprehensive framework harnesses the power of CLIP, a multimodal foundation model, and various general-purpose LLMs, comprising four main modules: the medical disorder identification module, the relevant context generation module, the context filtration module for distilling relevant medical concepts and knowledge, and finally, a general-purpose LLM to generate visually aware medical question summaries. Leveraging our MMQS dataset, we showcase how visual cues from images enhance the generation of medically nuanced summaries. This multimodal approach not only enhances the decision-making process in healthcare but also fosters a more nuanced understanding of patient queries, laying the groundwork for future research in personalized and responsive medical care

Medical report generation from X-ray images is a challenging task, particularly in an unpaired setting where paired image-report data is unavailable for training. To address this challenge, we propose a novel model that leverages the available information in two distinct datasets, one comprising reports and the other consisting of images. The core idea of our model revolves around the notion that combining auto-encoding report generation with multi-modal (report-image) alignment can offer a solution. However, the challenge persists regarding how to achieve this alignment when pair correspondence is absent. Our proposed solution involves the use of auxiliary tasks, particularly contrastive learning and classification, to position related images and reports in close proximity to each other. This approach differs from previous methods that rely on pre-processing steps, such as using external information stored in a knowledge graph. Our model, named MedRAT, surpasses previous state-of-the-art methods, demonstrating the feasibility of generating comprehensive medical reports without the need for paired data or external tools.

While deep networks have achieved broad success in analyzing natural images, when applied to medical scans, they often fail in unexcepted situations. We investigate this challenge and focus on model sensitivity to domain shifts, such as data sampled from different hospitals or data confounded by demographic variables such as sex, race, etc, in the context of chest X-rays and skin lesion images. A key finding we show empirically is that existing visual backbones lack an appropriate prior from the architecture for reliable generalization in these settings. Taking inspiration from medical training, we propose giving deep networks a prior grounded in explicit medical knowledge communicated in natural language. To this end, we introduce Knowledge-enhanced Bottlenecks (KnoBo), a class of concept bottleneck models that incorporates knowledge priors that constrain it to reason with clinically relevant factors found in medical textbooks or PubMed. KnoBo uses retrieval-augmented language models to design an appropriate concept space paired with an automatic training procedure for recognizing the concept. We evaluate different resources of knowledge and recognition architectures on a broad range of domain shifts across 20 datasets. In our comprehensive evaluation with two imaging modalities, KnoBo outperforms fine-tuned models on confounded datasets by 32.4% on average. Finally, evaluations reveal that PubMed is a promising resource for making medical models less sensitive to domain shift, outperforming other resources on both diversity of information and final prediction performance.

Text-to-image synthesis refers to computational methods which translate human written textual descriptions, in the form of keywords or sentences, into images with similar semantic meaning to the text. In earlier research, image synthesis relied mainly on word to image correlation analysis combined with supervised methods to find best alignment of the visual content matching to the text. Recent progress in deep learning (DL) has brought a new set of unsupervised deep learning methods, particularly deep generative models which are able to generate realistic visual images using suitably trained neural network models. In this paper, we review the most recent development in the text-to-image synthesis research domain. Our survey first introduces image synthesis and its challenges, and then reviews key concepts such as generative adversarial networks (GANs) and deep convolutional encoder-decoder neural networks (DCNN). After that, we propose a taxonomy to summarize GAN based text-to-image synthesis into four major categories: Semantic Enhancement GANs, Resolution Enhancement GANs, Diversity Enhancement GANS, and Motion Enhancement GANs. We elaborate the main objective of each group, and further review typical GAN architectures in each group. The taxonomy and the review outline the techniques and the evolution of different approaches, and eventually provide a clear roadmap to summarize the list of contemporaneous solutions that utilize GANs and DCNNs to generate enthralling results in categories such as human faces, birds, flowers, room interiors, object reconstruction from edge maps (games) etc. The survey will conclude with a comparison of the proposed solutions, challenges that remain unresolved, and future developments in the text-to-image synthesis domain.

We introduce a radiology-focused visual language model designed to generate radiology reports from chest X-rays. Building on previous findings that large language models (LLMs) can acquire multimodal capabilities when aligned with pretrained vision encoders, we demonstrate similar potential with chest X-ray images. This integration enhances the ability of model to understand and describe chest X-ray images. Our model combines an image encoder with a fine-tuned LLM based on the Vicuna-7B architecture, enabling it to generate different sections of a radiology report with notable accuracy. The training process involves a two-stage approach: (i) initial alignment of chest X-ray features with the LLM (ii) followed by fine-tuning for radiology report generation.

Recent advancements in artificial intelligence (AI) have precipitated significant breakthroughs in healthcare, particularly in refining diagnostic procedures. However, previous studies have often been constrained to limited functionalities. This study introduces MiniGPT-Med, a vision-language model derived from large-scale language models and tailored for medical applications. MiniGPT-Med demonstrates remarkable versatility across various imaging modalities, including X-rays, CT scans, and MRIs, enhancing its utility. The model is capable of performing tasks such as medical report generation, visual question answering (VQA), and disease identification within medical imagery. Its integrated processing of both image and textual clinical data markedly improves diagnostic accuracy. Our empirical assessments confirm MiniGPT-Med's superior performance in disease grounding, medical report generation, and VQA benchmarks, representing a significant step towards reducing the gap in assisting radiology practice. Furthermore, it achieves state-of-the-art performance on medical report generation, higher than the previous best model by 19\% accuracy. MiniGPT-Med promises to become a general interface for radiology diagnoses, enhancing diagnostic efficiency across a wide range of medical imaging applications.

Despite the success of Large Language Models (LLMs) in general image tasks, a gap persists in the medical field for a multimodal large model adept at handling the nuanced diversity of medical images. Addressing this, we propose MedXChat, a unified multimodal large model designed for seamless interactions between medical assistants and users. MedXChat encompasses three key functionalities: CXR(Chest X-ray)-to-Report generation, CXR-based visual question-answering (VQA), and Text-to-CXR synthesis. Our contributions are as follows. Firstly, our model showcases exceptional cross-task adaptability, displaying adeptness across all three defined tasks and outperforming the benchmark models on the MIMIC dataset in medical multimodal applications. Secondly, we introduce an innovative Text-to-CXR synthesis approach that utilizes instruction-following capabilities within the Stable Diffusion (SD) architecture. This technique integrates smoothly with the existing model framework, requiring no extra parameters, thereby maintaining the SD's generative strength while also bestowing upon it the capacity to render fine-grained medical images with high fidelity. Comprehensive experiments validate MedXChat's synergistic enhancement across all tasks. Our instruction data and model will be open-sourced.

Background: General-purpose large language models that utilize both text and images have not been evaluated on a diverse array of challenging medical cases. Methods: Using 934 cases from the NEJM Image Challenge published between 2005 and 2023, we evaluated the accuracy of the recently released Generative Pre-trained Transformer 4 with Vision model (GPT-4V) compared to human respondents overall and stratified by question difficulty, image type, and skin tone. We further conducted a physician evaluation of GPT-4V on 69 NEJM clinicopathological conferences (CPCs). Analyses were conducted for models utilizing text alone, images alone, and both text and images. Results: GPT-4V achieved an overall accuracy of 61% (95% CI, 58 to 64%) compared to 49% (95% CI, 49 to 50%) for humans. GPT-4V outperformed humans at all levels of difficulty and disagreement, skin tones, and image types; the exception was radiographic images, where performance was equivalent between GPT-4V and human respondents. Longer, more informative captions were associated with improved performance for GPT-4V but similar performance for human respondents. GPT-4V included the correct diagnosis in its differential for 80% (95% CI, 68 to 88%) of CPCs when using text alone, compared to 58% (95% CI, 45 to 70%) of CPCs when using both images and text. Conclusions: GPT-4V outperformed human respondents on challenging medical cases and was able to synthesize information from both images and text, but performance deteriorated when images were added to highly informative text. Overall, our results suggest that multimodal AI models may be useful in medical diagnostic reasoning but that their accuracy may depend heavily on context.

High-quality, large-scale data is essential for robust deep learning models in medical applications, particularly ultrasound image analysis. Diffusion models facilitate high-fidelity medical image generation, reducing the costs associated with acquiring and annotating new images. This paper utilizes recent vision-language models to produce diverse and realistic synthetic echocardiography image data, preserving key features of the original images guided by textual and semantic label maps. Specifically, we investigate three potential avenues: unconditional generation, generation guided by text, and a hybrid approach incorporating both textual and semantic supervision. We show that the rich contextual information present in the synthesized data potentially enhances the accuracy and interpretability of downstream tasks, such as echocardiography segmentation and classification with improved metrics and faster convergence. Our implementation with checkpoints, prompts, and the created synthetic dataset will be publicly available at https://github.com/Pooria90/DiffEcho{GitHub}.

Medical vision-and-language pre-training (Med-VLP) has received considerable attention owing to its applicability to extracting generic vision-and-language representations from medical images and texts. Most existing methods mainly contain three elements: uni-modal encoders (i.e., a vision encoder and a language encoder), a multi-modal fusion module, and pretext tasks, with few studies considering the importance of medical domain expert knowledge and explicitly exploiting such knowledge to facilitate Med-VLP. Although there exist knowledge-enhanced vision-and-language pre-training (VLP) methods in the general domain, most require off-the-shelf toolkits (e.g., object detectors and scene graph parsers), which are unavailable in the medical domain. In this paper, we propose a systematic and effective approach to enhance Med-VLP by structured medical knowledge from three perspectives. First, considering knowledge can be regarded as the intermediate medium between vision and language, we align the representations of the vision encoder and the language encoder through knowledge. Second, we inject knowledge into the multi-modal fusion model to enable the model to perform reasoning using knowledge as the supplementation of the input image and text. Third, we guide the model to put emphasis on the most critical information in images and texts by designing knowledge-induced pretext tasks. To perform a comprehensive evaluation and facilitate further research, we construct a medical vision-and-language benchmark including three tasks. Experimental results illustrate the effectiveness of our approach, where state-of-the-art performance is achieved on all downstream tasks. Further analyses explore the effects of different components of our approach and various settings of pre-training.

To synthesize high-fidelity samples, diffusion models typically require auxiliary data to guide the generation process. However, it is impractical to procure the painstaking patch-level annotation effort required in specialized domains like histopathology and satellite imagery; it is often performed by domain experts and involves hundreds of millions of patches. Modern-day self-supervised learning (SSL) representations encode rich semantic and visual information. In this paper, we posit that such representations are expressive enough to act as proxies to fine-grained human labels. We introduce a novel approach that trains diffusion models conditioned on embeddings from SSL. Our diffusion models successfully project these features back to high-quality histopathology and remote sensing images. In addition, we construct larger images by assembling spatially consistent patches inferred from SSL embeddings, preserving long-range dependencies. Augmenting real data by generating variations of real images improves downstream classifier accuracy for patch-level and larger, image-scale classification tasks. Our models are effective even on datasets not encountered during training, demonstrating their robustness and generalizability. Generating images from learned embeddings is agnostic to the source of the embeddings. The SSL embeddings used to generate a large image can either be extracted from a reference image, or sampled from an auxiliary model conditioned on any related modality (e.g. class labels, text, genomic data). As proof of concept, we introduce the text-to-large image synthesis paradigm where we successfully synthesize large pathology and satellite images out of text descriptions.

Medical imaging plays a crucial role in diagnosis, with radiology reports serving as vital documentation. Automating report generation has emerged as a critical need to alleviate the workload of radiologists. While machine learning has facilitated report generation for 2D medical imaging, extending this to 3D has been unexplored due to computational complexity and data scarcity. We introduce the first method to generate radiology reports for 3D medical imaging, specifically targeting chest CT volumes. Given the absence of comparable methods, we establish a baseline using an advanced 3D vision encoder in medical imaging to demonstrate our method's effectiveness, which leverages a novel auto-regressive causal transformer. Furthermore, recognizing the benefits of leveraging information from previous visits, we augment CT2Rep with a cross-attention-based multi-modal fusion module and hierarchical memory, enabling the incorporation of longitudinal multimodal data. Access our code at https://github.com/ibrahimethemhamamci/CT2Rep

Recent advances in text-to-image synthesis have been enabled by exploiting a combination of language and vision through foundation models. These models are pre-trained on tremendous amounts of text-image pairs sourced from the World Wide Web or other large-scale databases. As the demand for high-quality image generation shifts towards ensuring content alignment between text and image, novel evaluation metrics have been developed with the aim of mimicking human judgments. Thus, researchers have started to collect datasets with increasingly complex annotations to study the compositionality of vision-language models and their incorporation as a quality measure of compositional alignment between text and image contents. In this work, we provide a comprehensive overview of existing text-to-image evaluation metrics and propose a new taxonomy for categorizing these metrics. We also review frequently adopted text-image benchmark datasets before discussing techniques to optimize text-to-image synthesis models towards quality and human preferences. Ultimately, we derive guidelines for improving text-to-image evaluation and discuss the open challenges and current limitations.

Text-to-image synthesis has made encouraging progress and attracted lots of public attention recently. However, popular evaluation metrics in this area, like the Inception Score and Fr'echet Inception Distance, incur several issues. First of all, they cannot explicitly assess the perceptual quality of generated images and poorly reflect the semantic alignment of each text-image pair. Also, they are inefficient and need to sample thousands of images to stabilise their evaluation results. In this paper, we propose to evaluate text-to-image generation performance by directly estimating the likelihood of the generated images using a pre-trained likelihood-based text-to-image generative model, i.e., a higher likelihood indicates better perceptual quality and better text-image alignment. To prevent the likelihood of being dominated by the non-crucial part of the generated image, we propose several new designs to develop a credit assignment strategy based on the semantic and perceptual significance of the image patches. In the experiments, we evaluate the proposed metric on multiple popular text-to-image generation models and datasets in accessing both the perceptual quality and the text-image alignment. Moreover, it can successfully assess the generation ability of these models with as few as a hundred samples, making it very efficient in practice.

We propose a method to fuse frozen text-only large language models (LLMs) with pre-trained image encoder and decoder models, by mapping between their embedding spaces. Our model demonstrates a wide suite of multimodal capabilities: image retrieval, novel image generation, and multimodal dialogue. Ours is the first approach capable of conditioning on arbitrarily interleaved image and text inputs to generate coherent image (and text) outputs. To achieve strong performance on image generation, we propose an efficient mapping network to ground the LLM to an off-the-shelf text-to-image generation model. This mapping network translates hidden representations of text into the embedding space of the visual models, enabling us to leverage the strong text representations of the LLM for visual outputs. Our approach outperforms baseline generation models on tasks with longer and more complex language. In addition to novel image generation, our model is also capable of image retrieval from a prespecified dataset, and decides whether to retrieve or generate at inference time. This is done with a learnt decision module which conditions on the hidden representations of the LLM. Our model exhibits a wider range of capabilities compared to prior multimodal language models. It can process image-and-text inputs, and produce retrieved images, generated images, and generated text -- outperforming non-LLM based generation models across several text-to-image tasks that measure context dependence.

This paper explores the task of radiology report generation, which aims at generating free-text descriptions for a set of radiographs. One significant challenge of this task is how to correctly maintain the consistency between the images and the lengthy report. Previous research explored solving this issue through planning-based methods, which generate reports only based on high-level plans. However, these plans usually only contain the major observations from the radiographs (e.g., lung opacity), lacking much necessary information, such as the observation characteristics and preliminary clinical diagnoses. To address this problem, the system should also take the image information into account together with the textual plan and perform stronger reasoning during the generation process. In this paper, we propose an observation-guided radiology report generation framework (ORGAN). It first produces an observation plan and then feeds both the plan and radiographs for report generation, where an observation graph and a tree reasoning mechanism are adopted to precisely enrich the plan information by capturing the multi-formats of each observation. Experimental results demonstrate that our framework outperforms previous state-of-the-art methods regarding text quality and clinical efficacy

Over the past few years, Text-to-Image (T2I) generation approaches based on diffusion models have gained significant attention. However, vanilla diffusion models often suffer from spelling inaccuracies in the text displayed within the generated images. The capability to generate visual text is crucial, offering both academic interest and a wide range of practical applications. To produce accurate visual text images, state-of-the-art techniques adopt a glyph-controlled image generation approach, consisting of a text layout generator followed by an image generator that is conditioned on the generated text layout. Nevertheless, our study reveals that these models still face three primary challenges, prompting us to develop a testbed to facilitate future research. We introduce a benchmark, LenCom-Eval, specifically designed for testing models' capability in generating images with Lengthy and Complex visual text. Subsequently, we introduce a training-free framework to enhance the two-stage generation approaches. We examine the effectiveness of our approach on both LenCom-Eval and MARIO-Eval benchmarks and demonstrate notable improvements across a range of evaluation metrics, including CLIPScore, OCR precision, recall, F1 score, accuracy, and edit distance scores. For instance, our proposed framework improves the backbone model, TextDiffuser, by more than 23\% and 13.5\% in terms of OCR word F1 on LenCom-Eval and MARIO-Eval, respectively. Our work makes a unique contribution to the field by focusing on generating images with long and rare text sequences, a niche previously unexplored by existing literature

Personalized text-to-image generation has attracted unprecedented attention in the recent few years due to its unique capability of generating highly-personalized images via using the input concept dataset and novel textual prompt. However, previous methods solely focus on the performance of the reconstruction task, degrading its ability to combine with different textual prompt. Besides, optimizing in the high-dimensional embedding space usually leads to unnecessary time-consuming training process and slow convergence. To address these issues, we propose an efficient method to explore the target embedding in a textual subspace, drawing inspiration from the self-expressiveness property. Additionally, we propose an efficient selection strategy for determining the basis vectors of the textual subspace. The experimental evaluations demonstrate that the learned embedding can not only faithfully reconstruct input image, but also significantly improves its alignment with novel input textual prompt. Furthermore, we observe that optimizing in the textual subspace leads to an significant improvement of the robustness to the initial word, relaxing the constraint that requires users to input the most relevant initial word. Our method opens the door to more efficient representation learning for personalized text-to-image generation.

Automatic radiology report generation is booming due to its huge application potential for the healthcare industry. However, existing computer vision and natural language processing approaches to tackle this problem are limited in two aspects. First, when extracting image features, most of them neglect multi-view reasoning in vision and model single-view structure of medical images, such as space-view or channel-view. However, clinicians rely on multi-view imaging information for comprehensive judgment in daily clinical diagnosis. Second, when generating reports, they overlook context reasoning with multi-modal information and focus on pure textual optimization utilizing retrieval-based methods. We aim to address these two issues by proposing a model that better simulates clinicians' perspectives and generates more accurate reports. Given the above limitation in feature extraction, we propose a Globally-intensive Attention (GIA) module in the medical image encoder to simulate and integrate multi-view vision perception. GIA aims to learn three types of vision perception: depth view, space view, and pixel view. On the other hand, to address the above problem in report generation, we explore how to involve multi-modal signals to generate precisely matched reports, i.e., how to integrate previously predicted words with region-aware visual content in next word prediction. Specifically, we design a Visual Knowledge-guided Decoder (VKGD), which can adaptively consider how much the model needs to rely on visual information and previously predicted text to assist next word prediction. Hence, our final Intensive Vision-guided Network (IVGN) framework includes a GIA-guided Visual Encoder and the VKGD. Experiments on two commonly-used datasets IU X-Ray and MIMIC-CXR demonstrate the superior ability of our method compared with other state-of-the-art approaches.

Current vision-language generative models rely on expansive corpora of paired image-text data to attain optimal performance and generalization capabilities. However, automatically collecting such data (e.g. via large-scale web scraping) leads to low quality and poor image-text correlation, while human annotation is more accurate but requires significant manual effort and expense. We introduce ITIT (InTegrating Image Text): an innovative training paradigm grounded in the concept of cycle consistency which allows vision-language training on unpaired image and text data. ITIT is comprised of a joint image-text encoder with disjoint image and text decoders that enable bidirectional image-to-text and text-to-image generation in a single framework. During training, ITIT leverages a small set of paired image-text data to ensure its output matches the input reasonably well in both directions. Simultaneously, the model is also trained on much larger datasets containing only images or texts. This is achieved by enforcing cycle consistency between the original unpaired samples and the cycle-generated counterparts. For instance, it generates a caption for a given input image and then uses the caption to create an output image, and enforces similarity between the input and output images. Our experiments show that ITIT with unpaired datasets exhibits similar scaling behavior as using high-quality paired data. We demonstrate image generation and captioning performance on par with state-of-the-art text-to-image and image-to-text models with orders of magnitude fewer (only 3M) paired image-text data.

Vision-Language Models (VLMs) trained via contrastive learning have achieved notable success in natural image tasks. However, their application in the medical domain remains limited due to the scarcity of openly accessible, large-scale medical image-text datasets. Existing medical VLMs either train on closed-source proprietary or relatively small open-source datasets that do not generalize well. Similarly, most models remain specific to a single or limited number of medical imaging domains, again restricting their applicability to other modalities. To address this gap, we introduce UniMed, a large-scale, open-source multi-modal medical dataset comprising over 5.3 million image-text pairs across six diverse imaging modalities: X-ray, CT, MRI, Ultrasound, Pathology, and Fundus. UniMed is developed using a data-collection framework that leverages Large Language Models (LLMs) to transform modality-specific classification datasets into image-text formats while incorporating existing image-text data from the medical domain, facilitating scalable VLM pretraining. Using UniMed, we trained UniMed-CLIP, a unified VLM for six modalities that significantly outperforms existing generalist VLMs and matches modality-specific medical VLMs, achieving notable gains in zero-shot evaluations. For instance, UniMed-CLIP improves over BiomedCLIP (trained on proprietary data) by an absolute gain of +12.61, averaged over 21 datasets, while using 3x less training data. To facilitate future research, we release UniMed dataset, training codes, and models at https://github.com/mbzuai-oryx/UniMed-CLIP.

Recent breakthroughs in text-to-image generation has shown encouraging results via large generative models. Due to the scarcity of 3D assets, it is hardly to transfer the success of text-to-image generation to that of text-to-3D generation. Existing text-to-3D generation methods usually adopt the paradigm of DreamFusion, which conducts per-asset optimization by distilling a pretrained text-to-image diffusion model. The generation speed usually ranges from several minutes to tens of minutes per 3D asset, which degrades the user experience and also imposes a burden to the service providers due to the high computational budget. In this work, we present an efficient text-to-3D generation method, which requires only around 8 ms to generate a 3D asset given the text prompt on a consumer graphic card. The main insight is that we exploit the images generated by a large pre-trained text-to-image diffusion model, to supervise the training of a text conditioned 3D generative adversarial network. Once the network is trained, we are able to efficiently generate a 3D asset via a single forward pass. Our method requires no 3D training data and provides an alternative approach for efficient text-to-3D generation by distilling pre-trained image diffusion models.

Text-to-image generation has traditionally focused on finding better modeling assumptions for training on a fixed dataset. These assumptions might involve complex architectures, auxiliary losses, or side information such as object part labels or segmentation masks supplied during training. We describe a simple approach for this task based on a transformer that autoregressively models the text and image tokens as a single stream of data. With sufficient data and scale, our approach is competitive with previous domain-specific models when evaluated in a zero-shot fashion.

This short technical report demonstrates a simple technique that yields state of the art results in medical image-text matching tasks. We analyze the use of OpenAI's CLIP, a general image-text matching model, and observe that CLIP's limited textual input size has negative impact on downstream performance in the medical domain where encoding longer textual contexts is often required. We thus train and release ClipMD, which is trained with a simple sliding window technique to encode textual captions. ClipMD was tested on two medical image-text datasets and compared with other image-text matching models. The results show that ClipMD outperforms other models on both datasets by a large margin. We make our code and pretrained model publicly available.

Research on text-to-image generation has witnessed significant progress in generating diverse and photo-realistic images, driven by diffusion and auto-regressive models trained on large-scale image-text data. Though state-of-the-art models can generate high-quality images of common entities, they often have difficulty generating images of uncommon entities, such as `Chortai (dog)' or `Picarones (food)'. To tackle this issue, we present the Retrieval-Augmented Text-to-Image Generator (Re-Imagen), a generative model that uses retrieved information to produce high-fidelity and faithful images, even for rare or unseen entities. Given a text prompt, Re-Imagen accesses an external multi-modal knowledge base to retrieve relevant (image, text) pairs and uses them as references to generate the image. With this retrieval step, Re-Imagen is augmented with the knowledge of high-level semantics and low-level visual details of the mentioned entities, and thus improves its accuracy in generating the entities' visual appearances. We train Re-Imagen on a constructed dataset containing (image, text, retrieval) triples to teach the model to ground on both text prompt and retrieval. Furthermore, we develop a new sampling strategy to interleave the classifier-free guidance for text and retrieval conditions to balance the text and retrieval alignment. Re-Imagen achieves significant gain on FID score over COCO and WikiImage. To further evaluate the capabilities of the model, we introduce EntityDrawBench, a new benchmark that evaluates image generation for diverse entities, from frequent to rare, across multiple object categories including dogs, foods, landmarks, birds, and characters. Human evaluation on EntityDrawBench shows that Re-Imagen can significantly improve the fidelity of generated images, especially on less frequent entities.

Learning to represent free text is a core task in many clinical machine learning (ML) applications, as clinical text contains observations and plans not otherwise available for inference. State-of-the-art methods use large language models developed with immense computational resources and training data; however, applying these models is challenging because of the highly varying syntax and vocabulary in clinical free text. Structured information such as International Classification of Disease (ICD) codes often succinctly abstracts the most important facts of a clinical encounter and yields good performance, but is often not as available as clinical text in real-world scenarios. We propose a multi-view learning framework that jointly learns from codes and text to combine the availability and forward-looking nature of text and better performance of ICD codes. The learned text embeddings can be used as inputs to predictive algorithms independent of the ICD codes during inference. Our approach uses a Graph Neural Network (GNN) to process ICD codes, and Bi-LSTM to process text. We apply Deep Canonical Correlation Analysis (DCCA) to enforce the two views to learn a similar representation of each patient. In experiments using planned surgical procedure text, our model outperforms BERT models fine-tuned to clinical data, and in experiments using diverse text in MIMIC-III, our model is competitive to a fine-tuned BERT at a tiny fraction of its computational effort.

Medical vision-language models enable co-learning and integrating features from medical imaging and clinical text. However, these models are not easy to train and the latent representation space can be complex. Here we propose a novel way for pre-training and regularising medical vision-language models. The proposed method, named Medical vision-language pre-training with Frozen language models and Latent spAce Geometry optimization (M-FLAG), leverages a frozen language model for training stability and efficiency and introduces a novel orthogonality loss to harmonize the latent space geometry. We demonstrate the potential of the pre-trained model on three downstream tasks: medical image classification, segmentation, and object detection. Extensive experiments across five public datasets demonstrate that M-FLAG significantly outperforms existing medical vision-language pre-training approaches and reduces the number of parameters by 78\%. Notably, M-FLAG achieves outstanding performance on the segmentation task while using only 1\% of the RSNA dataset, even outperforming ImageNet pre-trained models that have been fine-tuned using 100\% of the data.

Benefiting from large-scale pre-trained text-to-image (T2I) generative models, impressive progress has been achieved in customized image generation, which aims to generate user-specified concepts. Existing approaches have extensively focused on single-concept customization and still encounter challenges when it comes to complex scenarios that involve combining multiple concepts. These approaches often require retraining/fine-tuning using a few images, leading to time-consuming training processes and impeding their swift implementation. Furthermore, the reliance on multiple images to represent a singular concept increases the difficulty of customization. To this end, we propose FreeCustom, a novel tuning-free method to generate customized images of multi-concept composition based on reference concepts, using only one image per concept as input. Specifically, we introduce a new multi-reference self-attention (MRSA) mechanism and a weighted mask strategy that enables the generated image to access and focus more on the reference concepts. In addition, MRSA leverages our key finding that input concepts are better preserved when providing images with context interactions. Experiments show that our method's produced images are consistent with the given concepts and better aligned with the input text. Our method outperforms or performs on par with other training-based methods in terms of multi-concept composition and single-concept customization, but is simpler. Codes can be found at https://github.com/aim-uofa/FreeCustom.

Recently, with the rapid advancements of generative models, the field of visual text generation has witnessed significant progress. However, it is still challenging to render high-quality text images in real-world scenarios, as three critical criteria should be satisfied: (1) Fidelity: the generated text images should be photo-realistic and the contents are expected to be the same as specified in the given conditions; (2) Reasonability: the regions and contents of the generated text should cohere with the scene; (3) Utility: the generated text images can facilitate related tasks (e.g., text detection and recognition). Upon investigation, we find that existing methods, either rendering-based or diffusion-based, can hardly meet all these aspects simultaneously, limiting their application range. Therefore, we propose in this paper a visual text generator (termed SceneVTG), which can produce high-quality text images in the wild. Following a two-stage paradigm, SceneVTG leverages a Multimodal Large Language Model to recommend reasonable text regions and contents across multiple scales and levels, which are used by a conditional diffusion model as conditions to generate text images. Extensive experiments demonstrate that the proposed SceneVTG significantly outperforms traditional rendering-based methods and recent diffusion-based methods in terms of fidelity and reasonability. Besides, the generated images provide superior utility for tasks involving text detection and text recognition. Code and datasets are available at AdvancedLiterateMachinery.

In this work, we present MedImageInsight, an open-source medical imaging embedding model. MedImageInsight is trained on medical images with associated text and labels across a diverse collection of domains, including X-Ray, CT, MRI, dermoscopy, OCT, fundus photography, ultrasound, histopathology, and mammography. Rigorous evaluations demonstrate MedImageInsight's ability to achieve state-of-the-art (SOTA) or human expert level performance across classification, image-image search, and fine-tuning tasks. Specifically, on public datasets, MedImageInsight achieves SOTA in CT 3D medical image retrieval, as well as SOTA in disease classification and search for chest X-ray, dermatology, and OCT imaging. Furthermore, MedImageInsight achieves human expert performance in bone age estimation (on both public and partner data), as well as AUC above 0.9 in most other domains. When paired with a text decoder, MedImageInsight achieves near SOTA level single image report findings generation with less than 10\% the parameters of other models. Compared to fine-tuning GPT-4o with only MIMIC-CXR data for the same task, MedImageInsight outperforms in clinical metrics, but underperforms on lexical metrics where GPT-4o sets a new SOTA. Importantly for regulatory purposes, MedImageInsight can generate ROC curves, adjust sensitivity and specificity based on clinical need, and provide evidence-based decision support through image-image search (which can also enable retrieval augmented generation). In an independent clinical evaluation of image-image search in chest X-ray, MedImageInsight outperformed every other publicly available foundation model evaluated by large margins (over 6 points AUC), and significantly outperformed other models in terms of AI fairness (across age and gender). We hope releasing MedImageInsight will help enhance collective progress in medical imaging AI research and development.

Text-to-image models are powerful tools for image creation. However, the generation process is akin to a dice roll and makes it difficult to achieve a single image that captures everything a user wants. In this paper, we propose a framework for creating the desired image by compositing it from various parts of generated images, in essence forming a Generative Photomontage. Given a stack of images generated by ControlNet using the same input condition and different seeds, we let users select desired parts from the generated results using a brush stroke interface. We introduce a novel technique that takes in the user's brush strokes, segments the generated images using a graph-based optimization in diffusion feature space, and then composites the segmented regions via a new feature-space blending method. Our method faithfully preserves the user-selected regions while compositing them harmoniously. We demonstrate that our flexible framework can be used for many applications, including generating new appearance combinations, fixing incorrect shapes and artifacts, and improving prompt alignment. We show compelling results for each application and demonstrate that our method outperforms existing image blending methods and various baselines.

Clinical natural language processing requires methods that can address domain-specific challenges, such as complex medical terminology and clinical contexts. Recently, large language models (LLMs) have shown promise in this domain. Yet, their direct deployment can lead to privacy issues and are constrained by resources. To address this challenge, we delve into synthetic clinical text generation using LLMs for clinical NLP tasks. We propose an innovative, resource-efficient approach, ClinGen, which infuses knowledge into the process. Our model involves clinical knowledge extraction and context-informed LLM prompting. Both clinical topics and writing styles are drawn from external domain-specific knowledge graphs and LLMs to guide data generation. Our extensive empirical study across 7 clinical NLP tasks and 16 datasets reveals that ClinGen consistently enhances performance across various tasks, effectively aligning the distribution of real datasets and significantly enriching the diversity of generated training instances. We will publish our code and all the generated data in https://github.com/ritaranx/ClinGen.

Recent text-to-image generation methods provide a simple yet exciting conversion capability between text and image domains. While these methods have incrementally improved the generated image fidelity and text relevancy, several pivotal gaps remain unanswered, limiting applicability and quality. We propose a novel text-to-image method that addresses these gaps by (i) enabling a simple control mechanism complementary to text in the form of a scene, (ii) introducing elements that substantially improve the tokenization process by employing domain-specific knowledge over key image regions (faces and salient objects), and (iii) adapting classifier-free guidance for the transformer use case. Our model achieves state-of-the-art FID and human evaluation results, unlocking the ability to generate high fidelity images in a resolution of 512x512 pixels, significantly improving visual quality. Through scene controllability, we introduce several new capabilities: (i) Scene editing, (ii) text editing with anchor scenes, (iii) overcoming out-of-distribution text prompts, and (iv) story illustration generation, as demonstrated in the story we wrote.

We present HealthGPT, a powerful Medical Large Vision-Language Model (Med-LVLM) that integrates medical visual comprehension and generation capabilities within a unified autoregressive paradigm. Our bootstrapping philosophy is to progressively adapt heterogeneous comprehension and generation knowledge to pre-trained large language models (LLMs). This is achieved through a novel heterogeneous low-rank adaptation (H-LoRA) technique, which is complemented by a tailored hierarchical visual perception approach and a three-stage learning strategy. To effectively learn the HealthGPT, we devise a comprehensive medical domain-specific comprehension and generation dataset called VL-Health. Experimental results demonstrate exceptional performance and scalability of HealthGPT in medical visual unified tasks. Our project can be accessed at https://github.com/DCDmllm/HealthGPT.

Large Language Models (LLMs) have introduced a new era of proficiency in comprehending complex healthcare and biomedical topics. However, there is a noticeable lack of models in languages other than English and models that can interpret multi-modal input, which is crucial for global healthcare accessibility. In response, this study introduces Qilin-Med-VL, the first Chinese large vision-language model designed to integrate the analysis of textual and visual data. Qilin-Med-VL combines a pre-trained Vision Transformer (ViT) with a foundational LLM. It undergoes a thorough two-stage curriculum training process that includes feature alignment and instruction tuning. This method enhances the model's ability to generate medical captions and answer complex medical queries. We also release ChiMed-VL, a dataset consisting of more than 1M image-text pairs. This dataset has been carefully curated to enable detailed and comprehensive interpretation of medical data using various types of images.

Automatic medical report generation (MRG), which possesses significant research value as it can aid radiologists in clinical diagnosis and report composition, has garnered increasing attention. Despite recent progress, generating accurate reports remains arduous due to the requirement for precise clinical comprehension and disease diagnosis inference. Furthermore, owing to the limited accessibility of medical data and the imbalanced distribution of diseases, the underrepresentation of rare diseases in training data makes large-scale medical visual language models (LVLMs) prone to hallucinations, such as omissions or fabrications, severely undermining diagnostic performance and further intensifying the challenges for MRG in practice. In this study, to effectively mitigate hallucinations in medical report generation, we propose a chain-of-medical-thought approach (CoMT), which intends to imitate the cognitive process of human doctors by decomposing diagnostic procedures. The radiological features with different importance are structured into fine-grained medical thought chains to enhance the inferential ability during diagnosis, thereby alleviating hallucination problems and enhancing the diagnostic accuracy of MRG. The code and dataset have been released at https://github.com/FRENKIE-CHIANG/CoMT.

Research on language technology for the development of medical applications is currently a hot topic in Natural Language Understanding and Generation. Thus, a number of large language models (LLMs) have recently been adapted to the medical domain, so that they can be used as a tool for mediating in human-AI interaction. While these LLMs display competitive performance on automated medical texts benchmarks, they have been pre-trained and evaluated with a focus on a single language (English mostly). This is particularly true of text-to-text models, which typically require large amounts of domain-specific pre-training data, often not easily accessible for many languages. In this paper, we address these shortcomings by compiling, to the best of our knowledge, the largest multilingual corpus for the medical domain in four languages, namely English, French, Italian and Spanish. This new corpus has been used to train Medical mT5, the first open-source text-to-text multilingual model for the medical domain. Additionally, we present two new evaluation benchmarks for all four languages with the aim of facilitating multilingual research in this domain. A comprehensive evaluation shows that Medical mT5 outperforms both encoders and similarly sized text-to-text models for the Spanish, French, and Italian benchmarks, while being competitive with current state-of-the-art LLMs in English.

Recently, text-to-image generation has exhibited remarkable advancements, with the ability to produce visually impressive results. In contrast, text-to-3D generation has not yet reached a comparable level of quality. Existing methods primarily rely on text-guided score distillation sampling (SDS), and they encounter difficulties in transferring 2D attributes of the generated images to 3D content. In this work, we aim to develop an effective 3D generative model capable of synthesizing high-resolution textured meshes by leveraging both textual and image information. To this end, we introduce Guide3D, a zero-shot text-and-image-guided generative model for 3D avatar generation based on diffusion models. Our model involves (1) generating sparse-view images of a text-consistent character using diffusion models, and (2) jointly optimizing multi-resolution differentiable marching tetrahedral grids with pixel-aligned image features. We further propose a similarity-aware feature fusion strategy for efficiently integrating features from different views. Moreover, we introduce two novel training objectives as an alternative to calculating SDS, significantly enhancing the optimization process. We thoroughly evaluate the performance and components of our framework, which outperforms the current state-of-the-art in producing topologically and structurally correct geometry and high-resolution textures. Guide3D enables the direct transfer of 2D-generated images to the 3D space. Our code will be made publicly available.

Recent text-to-image generation models have shown promising results in generating high-fidelity photo-realistic images. Though the results are astonishing to human eyes, how applicable these generated images are for recognition tasks remains under-explored. In this work, we extensively study whether and how synthetic images generated from state-of-the-art text-to-image generation models can be used for image recognition tasks, and focus on two perspectives: synthetic data for improving classification models in data-scarce settings (i.e. zero-shot and few-shot), and synthetic data for large-scale model pre-training for transfer learning. We showcase the powerfulness and shortcomings of synthetic data from existing generative models, and propose strategies for better applying synthetic data for recognition tasks. Code: https://github.com/CVMI-Lab/SyntheticData.

Knowledge of the medical decision process, which can be modeled as medical decision trees (MDTs), is critical to build clinical decision support systems. However, the current MDT construction methods rely heavily on time-consuming and laborious manual annotation. In this work, we propose a novel task, Text2MDT, to explore the automatic extraction of MDTs from medical texts such as medical guidelines and textbooks. We normalize the form of the MDT and create an annotated Text-to-MDT dataset in Chinese with the participation of medical experts. We investigate two different methods for the Text2MDT tasks: (a) an end-to-end framework which only relies on a GPT style large language models (LLM) instruction tuning to generate all the node information and tree structures. (b) The pipeline framework which decomposes the Text2MDT task to three subtasks. Experiments on our Text2MDT dataset demonstrate that: (a) the end-to-end method basd on LLMs (7B parameters or larger) show promising results, and successfully outperform the pipeline methods. (b) The chain-of-thought (COT) prompting method Wei2022ChainOT can improve the performance of the fine-tuned LLMs on the Text2MDT test set. (c) the lightweight pipelined method based on encoder-based pretrained models can perform comparably with LLMs with model complexity two magnititudes smaller. Our Text2MDT dataset is open-sourced at https://tianchi.aliyun.com/dataset/95414, and the source codes are open-sourced at https://github.com/michael-wzhu/text2dt.

Recent advances in text-to-image generation have primarily relied on extensive datasets and parameter-heavy architectures. These requirements severely limit accessibility for researchers and practitioners who lack substantial computational resources. In this paper, we introduce \model, an efficient training paradigm for image generation models that uses knowledge distillation (KD) and Direct Preference Optimization (DPO). Drawing inspiration from the success of data KD techniques widely adopted in Multi-Modal Large Language Models (MLLMs), LightGen distills knowledge from state-of-the-art (SOTA) text-to-image models into a compact Masked Autoregressive (MAR) architecture with only 0.7B parameters. Using a compact synthetic dataset of just 2M high-quality images generated from varied captions, we demonstrate that data diversity significantly outweighs data volume in determining model performance. This strategy dramatically reduces computational demands and reduces pre-training time from potentially thousands of GPU-days to merely 88 GPU-days. Furthermore, to address the inherent shortcomings of synthetic data, particularly poor high-frequency details and spatial inaccuracies, we integrate the DPO technique that refines image fidelity and positional accuracy. Comprehensive experiments confirm that LightGen achieves image generation quality comparable to SOTA models while significantly reducing computational resources and expanding accessibility for resource-constrained environments. Code is available at https://github.com/XianfengWu01/LightGen

Automatic medical text simplification can assist providers with patient-friendly communication and make medical texts more accessible, thereby improving health literacy. But curating a quality corpus for this task requires the supervision of medical experts. In this work, we present Med-EASi (textbf{Med}ical dataset for textbf{E}laborative and textbf{A}bstractive textbf{Si}mplification), a uniquely crowdsourced and finely annotated dataset for supervised simplification of short medical texts. Its expert-layman-AI collaborative annotations facilitate controllability over text simplification by marking four kinds of textual transformations: elaboration, replacement, deletion, and insertion. To learn medical text simplification, we fine-tune T5-large with four different styles of input-output combinations, leading to two control-free and two controllable versions of the model. We add two types of controllability into text simplification, by using a multi-angle training approach: position-aware, which uses in-place annotated inputs and outputs, and position-agnostic, where the model only knows the contents to be edited, but not their positions. Our results show that our fine-grained annotations improve learning compared to the unannotated baseline. Furthermore, position-aware control generates better simplification than the position-agnostic one. The data and code are available at https://github.com/Chandrayee/CTRL-SIMP.

Despite significant advancements in general artificial intelligence, such as GPT-4, their effectiveness in the medical domain (general medical AI, GMAI) remains constrained due to the absence of specialized medical knowledge. To address this challenge, we present GMAI-VL-5.5M, a comprehensive multimodal medical dataset created by converting hundreds of specialized medical datasets into meticulously constructed image-text pairs. This dataset features comprehensive task coverage, diverse modalities, and high-quality image-text data. Building upon this multimodal dataset, we propose GMAI-VL, a general medical vision-language model with a progressively three-stage training strategy. This approach significantly enhances the model's ability by integrating visual and textual information, thereby improving its ability to process multimodal data and support accurate diagnosis and clinical decision-making. Experimental evaluations demonstrate that GMAI-VL achieves state-of-the-art results across a wide range of multimodal medical tasks, such as visual question answering and medical image diagnosis. Our contributions include the development of the GMAI-VL-5.5M dataset, the introduction of the GMAI-VL model, and the establishment of new benchmarks in multiple medical domains. Code and dataset will be released at https://github.com/uni-medical/GMAI-VL.

Medical Dialogue Generation serves a critical role in telemedicine by facilitating the dissemination of medical expertise to patients. Existing studies focus on incorporating textual representations, which have limited their ability to represent the semantics of text, such as ignoring important medical entities. To enhance the model's understanding of the textual semantics and the medical knowledge including entities and relations, we introduce the use of Abstract Meaning Representations (AMR) to construct graphical representations that delineate the roles of language constituents and medical entities within the dialogues. In this paper, We propose a novel framework that models dialogues between patients and healthcare professionals using AMR graphs, where the neural networks incorporate textual and graphical knowledge with a dual attention mechanism. Experimental results show that our framework outperforms strong baseline models in medical dialogue generation, demonstrating the effectiveness of AMR graphs in enhancing the representations of medical knowledge and logical relationships. Furthermore, to support future research in this domain, we provide the corresponding source code at https://github.com/Bernard-Yang/MedDiaAMR.

The generative modeling landscape has experienced tremendous growth in recent years, particularly in generating natural images and art. Recent techniques have shown impressive potential in creating complex visual compositions while delivering impressive realism and quality. However, state-of-the-art methods have been focusing on the narrow domain of natural images, while other distributions remain unexplored. In this paper, we introduce the problem of text-to-figure generation, that is creating scientific figures of papers from text descriptions. We present FigGen, a diffusion-based approach for text-to-figure as well as the main challenges of the proposed task. Code and models are available at https://github.com/joanrod/figure-diffusion

In subject-driven text-to-image generation, recent works have achieved superior performance by training the model on synthetic datasets containing numerous image pairs. Trained on these datasets, generative models can produce text-aligned images for specific subject from arbitrary testing image in a zero-shot manner. They even outperform methods which require additional fine-tuning on testing images. However, the cost of creating such datasets is prohibitive for most researchers. To generate a single training pair, current methods fine-tune a pre-trained text-to-image model on the subject image to capture fine-grained details, then use the fine-tuned model to create images for the same subject based on creative text prompts. Consequently, constructing a large-scale dataset with millions of subjects can require hundreds of thousands of GPU hours. To tackle this problem, we propose Toffee, an efficient method to construct datasets for subject-driven editing and generation. Specifically, our dataset construction does not need any subject-level fine-tuning. After pre-training two generative models, we are able to generate infinite number of high-quality samples. We construct the first large-scale dataset for subject-driven image editing and generation, which contains 5 million image pairs, text prompts, and masks. Our dataset is 5 times the size of previous largest dataset, yet our cost is tens of thousands of GPU hours lower. To test the proposed dataset, we also propose a model which is capable of both subject-driven image editing and generation. By simply training the model on our proposed dataset, it obtains competitive results, illustrating the effectiveness of the proposed dataset construction framework.

Text-to-image generation models have grown in popularity due to their ability to produce high-quality images from a text prompt. One use for this technology is to enable the creation of more accessible art creation software. In this paper, we document the development of an alternative user interface that reduces the typing effort needed to enter image prompts by providing suggestions from a large language model, developed through iterative design and testing within the project team. The results of this testing demonstrate how generative text models can support the accessibility of text-to-image models, enabling users with a range of abilities to create visual art.

This paper presents medBERTde, a pre-trained German BERT model specifically designed for the German medical domain. The model has been trained on a large corpus of 4.7 Million German medical documents and has been shown to achieve new state-of-the-art performance on eight different medical benchmarks covering a wide range of disciplines and medical document types. In addition to evaluating the overall performance of the model, this paper also conducts a more in-depth analysis of its capabilities. We investigate the impact of data deduplication on the model's performance, as well as the potential benefits of using more efficient tokenization methods. Our results indicate that domain-specific models such as medBERTde are particularly useful for longer texts, and that deduplication of training data does not necessarily lead to improved performance. Furthermore, we found that efficient tokenization plays only a minor role in improving model performance, and attribute most of the improved performance to the large amount of training data. To encourage further research, the pre-trained model weights and new benchmarks based on radiological data are made publicly available for use by the scientific community.

Modern text-to-image generation models produce high-quality images that are both photorealistic and faithful to the text prompts. However, this quality comes at significant computational cost: nearly all of these models are iterative and require running inference multiple times with large models. This iterative process is needed to ensure that different regions of the image are not only aligned with the text prompt, but also compatible with each other. In this work, we propose a light-weight approach to achieving this compatibility between different regions of an image, using a Markov Random Field (MRF) model. This method is shown to work in conjunction with the recently proposed Muse model. The MRF encodes the compatibility among image tokens at different spatial locations and enables us to significantly reduce the required number of Muse prediction steps. Inference with the MRF is significantly cheaper, and its parameters can be quickly learned through back-propagation by modeling MRF inference as a differentiable neural-network layer. Our full model, SPEGTI, uses this proposed MRF model to speed up Muse by 1.5X with no loss in output image quality.

We present a radiology-specific multimodal model for the task for generating radiological reports from chest X-rays (CXRs). Our work builds on the idea that large language model(s) can be equipped with multimodal capabilities through alignment with pre-trained vision encoders. On natural images, this has been shown to allow multimodal models to gain image understanding and description capabilities. Our proposed model (MAIRA-1) leverages a CXR-specific image encoder in conjunction with a fine-tuned large language model based on Vicuna-7B, and text-based data augmentation, to produce reports with state-of-the-art quality. In particular, MAIRA-1 significantly improves on the radiologist-aligned RadCliQ metric and across all lexical metrics considered. Manual review of model outputs demonstrates promising fluency and accuracy of generated reports while uncovering failure modes not captured by existing evaluation practices. More information and resources can be found on the project website: https://aka.ms/maira.

The automated generation of imaging reports proves invaluable in alleviating the workload of radiologists. A clinically applicable reports generation algorithm should demonstrate its effectiveness in producing reports that accurately describe radiology findings and attend to patient-specific indications. In this paper, we introduce a novel method, Structural Entities extraction and patient indications Incorporation (SEI) for chest X-ray report generation. Specifically, we employ a structural entities extraction (SEE) approach to eliminate presentation-style vocabulary in reports and improve the quality of factual entity sequences. This reduces the noise in the following cross-modal alignment module by aligning X-ray images with factual entity sequences in reports, thereby enhancing the precision of cross-modal alignment and further aiding the model in gradient-free retrieval of similar historical cases. Subsequently, we propose a cross-modal fusion network to integrate information from X-ray images, similar historical cases, and patient-specific indications. This process allows the text decoder to attend to discriminative features of X-ray images, assimilate historical diagnostic information from similar cases, and understand the examination intention of patients. This, in turn, assists in triggering the text decoder to produce high-quality reports. Experiments conducted on MIMIC-CXR validate the superiority of SEI over state-of-the-art approaches on both natural language generation and clinical efficacy metrics.

In this paper, we consider enhancing medical visual-language pre-training (VLP) with domain-specific knowledge, by exploiting the paired image-text reports from the radiological daily practice. In particular, we make the following contributions: First, unlike existing works that directly process the raw reports, we adopt a novel triplet extraction module to extract the medical-related information, avoiding unnecessary complexity from language grammar and enhancing the supervision signals; Second, we propose a novel triplet encoding module with entity translation by querying a knowledge base, to exploit the rich domain knowledge in medical field, and implicitly build relationships between medical entities in the language embedding space; Third, we propose to use a Transformer-based fusion model for spatially aligning the entity description with visual signals at the image patch level, enabling the ability for medical diagnosis; Fourth, we conduct thorough experiments to validate the effectiveness of our architecture, and benchmark on numerous public benchmarks, e.g., ChestX-ray14, RSNA Pneumonia, SIIM-ACR Pneumothorax, COVIDx CXR-2, COVID Rural, and EdemaSeverity. In both zero-shot and fine-tuning settings, our model has demonstrated strong performance compared with the former methods on disease classification and grounding.

We introduce a novel graph-based Retrieval-Augmented Generation (RAG) framework specifically designed for the medical domain, called MedGraphRAG, aimed at enhancing Large Language Model (LLM) capabilities and generating evidence-based results, thereby improving safety and reliability when handling private medical data. Our comprehensive pipeline begins with a hybrid static-semantic approach to document chunking, significantly improving context capture over traditional methods. Extracted entities are used to create a three-tier hierarchical graph structure, linking entities to foundational medical knowledge sourced from medical papers and dictionaries. These entities are then interconnected to form meta-graphs, which are merged based on semantic similarities to develop a comprehensive global graph. This structure supports precise information retrieval and response generation. The retrieval process employs a U-retrieve method to balance global awareness and indexing efficiency of the LLM. Our approach is validated through a comprehensive ablation study comparing various methods for document chunking, graph construction, and information retrieval. The results not only demonstrate that our hierarchical graph construction method consistently outperforms state-of-the-art models on multiple medical Q\&A benchmarks, but also confirms that the responses generated include source documentation, significantly enhancing the reliability of medical LLMs in practical applications. Code will be at: https://github.com/MedicineToken/Medical-Graph-RAG/tree/main

Text-to-image generative models excel in creating images from text but struggle with ensuring alignment and consistency between outputs and prompts. This paper introduces TextMatch, a novel framework that leverages multimodal optimization to address image-text discrepancies in text-to-image (T2I) generation and editing. TextMatch employs a scoring strategy powered by large language models (LLMs) and visual question-answering (VQA) models to evaluate semantic consistency between prompts and generated images. By integrating multimodal in-context learning and chain of thought reasoning, our method dynamically refines prompts through iterative optimization. This process ensures that the generated images better capture user intent of, resulting in higher fidelity and relevance. Extensive experiments demonstrate that TextMatch significantly improves text-image consistency across multiple benchmarks, establishing a reliable framework for advancing the capabilities of text-to-image generative models. Our code is available at https://anonymous.4open.science/r/TextMatch-F55C/.

Recent text-to-image models have achieved impressive results. However, since they require large-scale datasets of text-image pairs, it is impractical to train them on new domains where data is scarce or not labeled. In this work, we propose using large-scale retrieval methods, in particular, efficient k-Nearest-Neighbors (kNN), which offers novel capabilities: (1) training a substantially small and efficient text-to-image diffusion model without any text, (2) generating out-of-distribution images by simply swapping the retrieval database at inference time, and (3) performing text-driven local semantic manipulations while preserving object identity. To demonstrate the robustness of our method, we apply our kNN approach on two state-of-the-art diffusion backbones, and show results on several different datasets. As evaluated by human studies and automatic metrics, our method achieves state-of-the-art results compared to existing approaches that train text-to-image generation models using images only (without paired text data)

Large diffusion-based Text-to-Image (T2I) models have shown impressive generative powers for text-to-image generation as well as spatially conditioned image generation. For most applications, we can train the model end-toend with paired data to obtain photorealistic generation quality. However, to add an additional task, one often needs to retrain the model from scratch using paired data across all modalities to retain good generation performance. In this paper, we tackle this issue and propose a novel strategy to scale a generative model across new tasks with minimal compute. During our experiments, we discovered that the variance maps of intermediate feature maps of diffusion models capture the intensity of conditioning. Utilizing this prior information, we propose MaxFusion, an efficient strategy to scale up text-to-image generation models to accommodate new modality conditions. Specifically, we combine aligned features of multiple models, hence bringing a compositional effect. Our fusion strategy can be integrated into off-the-shelf models to enhance their generative prowess.

Vision-language datasets are vital for both text-to-image (T2I) and image-to-text (I2T) research. However, current datasets lack descriptions with fine-grained detail that would allow for richer associations to be learned by models. To fill the gap, we introduce Descriptions of Connected and Contrasting Images (DOCCI), a dataset with long, human-annotated English descriptions for 15k images that were taken, curated and donated by a single researcher intent on capturing key challenges such as spatial relations, counting, text rendering, world knowledge, and more. We instruct human annotators to create comprehensive descriptions for each image; these average 136 words in length and are crafted to clearly distinguish each image from those that are related or similar. Each description is highly compositional and typically encompasses multiple challenges. Through both quantitative and qualitative analyses, we demonstrate that DOCCI serves as an effective training resource for image-to-text generation -- a PaLI 5B model finetuned on DOCCI shows equal or superior results compared to highly-performant larger models like LLaVA-1.5 7B and InstructBLIP 7B. Furthermore, we show that DOCCI is a useful testbed for text-to-image generation, highlighting the limitations of current text-to-image models in capturing long descriptions and fine details.

Conventional medical image segmentation methods have been found inadequate in facilitating physicians with the identification of specific lesions for diagnosis and treatment. Given the utility of text as an instructional format, we introduce a novel task termed Medical Image Referring Segmentation (MIRS), which requires segmenting specified lesions in images based on the given language expressions. Due to the varying object scales in medical images, MIRS demands robust vision-language modeling and comprehensive multi-scale interaction for precise localization and segmentation under linguistic guidance. However, existing medical image segmentation methods fall short in meeting these demands, resulting in insufficient segmentation accuracy. In response, we propose an approach named Language-guided Scale-aware MedSegmentor (LSMS), incorporating two appealing designs: (1)~a Scale-aware Vision-Language Attention module that leverages diverse convolutional kernels to acquire rich visual knowledge and interact closely with linguistic features, thereby enhancing lesion localization capability; (2)~a Full-Scale Decoder that globally models multi-modal features across various scales, capturing complementary information between scales to accurately outline lesion boundaries. Addressing the lack of suitable datasets for MIRS, we constructed a vision-language medical dataset called Reference Hepatic Lesion Segmentation (RefHL-Seg). This dataset comprises 2,283 abdominal CT slices from 231 cases, with corresponding textual annotations and segmentation masks for various liver lesions in images. We validated the performance of LSMS for MIRS and conventional medical image segmentation tasks across various datasets. Our LSMS consistently outperforms on all datasets with lower computational costs. The code and datasets will be released.

In this study, we aim to initiate the development of Radiology Foundation Model, termed as RadFM.We consider the construction of foundational models from the perspectives of data, model design, and evaluation thoroughly. Our contribution can be concluded as follows: (i), we construct a large-scale Medical Multi-modal Dataset, MedMD, consisting of 16M 2D and 3D medical scans. To the best of our knowledge, this is the first multi-modal dataset containing 3D medical scans. (ii), We propose an architecture that enables visually conditioned generative pre-training, allowing for the integration of text input interleaved with 2D or 3D medical scans to generate response for diverse radiologic tasks. The model was initially pre-trained on MedMD and subsequently domain-specific fine-tuned on RadMD, a radiologic cleaned version of MedMD, containing 3M radiologic visual-language pairs. (iii), we propose a new evaluation benchmark that comprises five tasks, aiming to comprehensively assess the capability of foundation models in handling practical clinical problems. Our experimental results confirm that RadFM significantly outperforms existing multi-modal foundation models. The codes, data, and model checkpoint will all be made publicly available to promote further research and development in the field.

Text-conditioned image generation has gained significant attention in recent years and are processing increasingly longer and comprehensive text prompt. In everyday life, dense and intricate text appears in contexts like advertisements, infographics, and signage, where the integration of both text and visuals is essential for conveying complex information. However, despite these advances, the generation of images containing long-form text remains a persistent challenge, largely due to the limitations of existing datasets, which often focus on shorter and simpler text. To address this gap, we introduce TextAtlas5M, a novel dataset specifically designed to evaluate long-text rendering in text-conditioned image generation. Our dataset consists of 5 million long-text generated and collected images across diverse data types, enabling comprehensive evaluation of large-scale generative models on long-text image generation. We further curate 3000 human-improved test set TextAtlasEval across 3 data domains, establishing one of the most extensive benchmarks for text-conditioned generation. Evaluations suggest that the TextAtlasEval benchmarks present significant challenges even for the most advanced proprietary models (e.g. GPT4o with DallE-3), while their open-source counterparts show an even larger performance gap. These evidences position TextAtlas5M as a valuable dataset for training and evaluating future-generation text-conditioned image generation models.

Accurate diagnostic coding of medical notes is crucial for enhancing patient care, medical research, and error-free billing in healthcare organizations. Manual coding is a time-consuming task for providers, and diagnostic codes often exhibit low sensitivity and specificity, whereas the free text in medical notes can be a more precise description of a patients status. Thus, accurate automated diagnostic coding of medical notes has become critical for a learning healthcare system. Recent developments in long-document transformer architectures have enabled attention-based deep-learning models to adjudicate medical notes. In addition, contrastive loss functions have been used to jointly pre-train large language and image models with noisy labels. To further improve the automated adjudication of medical notes, we developed an approach based on i) models for ICD-10 diagnostic code sequences using a large real-world data set, ii) large language models for medical notes, and iii) contrastive pre-training to build an integrated model of both ICD-10 diagnostic codes and corresponding medical text. We demonstrate that a contrastive approach for pre-training improves performance over prior state-of-the-art models for the MIMIC-III-50, MIMIC-III-rare50, and MIMIC-III-full diagnostic coding tasks.

The recent availability and adaptability of text-to-image models has sparked a new era in many related domains that benefit from the learned text priors as well as high-quality and fast generation capabilities, one of which is texture generation for 3D objects. Although recent texture generation methods achieve impressive results by using text-to-image networks, the combination of global consistency, quality, and speed, which is crucial for advancing texture generation to real-world applications, remains elusive. To that end, we introduce Meta 3D TextureGen: a new feedforward method comprised of two sequential networks aimed at generating high-quality and globally consistent textures for arbitrary geometries of any complexity degree in less than 20 seconds. Our method achieves state-of-the-art results in quality and speed by conditioning a text-to-image model on 3D semantics in 2D space and fusing them into a complete and high-resolution UV texture map, as demonstrated by extensive qualitative and quantitative evaluations. In addition, we introduce a texture enhancement network that is capable of up-scaling any texture by an arbitrary ratio, producing 4k pixel resolution textures.

Machine translation is indispensable in healthcare for enabling the global dissemination of medical knowledge across languages. However, complex medical terminology poses unique challenges to achieving adequate translation quality and accuracy. This study introduces a novel "LLMs-in-the-loop" approach to develop supervised neural machine translation models optimized specifically for medical texts. While large language models (LLMs) have demonstrated powerful capabilities, this research shows that small, specialized models trained on high-quality in-domain (mostly synthetic) data can outperform even vastly larger LLMs. Custom parallel corpora in six languages were compiled from scientific articles, synthetically generated clinical documents, and medical texts. Our LLMs-in-the-loop methodology employs synthetic data generation, rigorous evaluation, and agent orchestration to enhance performance. We developed small medical translation models using the MarianMT base model. We introduce a new medical translation test dataset to standardize evaluation in this domain. Assessed using BLEU, METEOR, ROUGE, and BERT scores on this test set, our MarianMT-based models outperform Google Translate, DeepL, and GPT-4-Turbo. Results demonstrate that our LLMs-in-the-loop approach, combined with fine-tuning high-quality, domain-specific data, enables specialized models to outperform general-purpose and some larger systems. This research, part of a broader series on expert small models, paves the way for future healthcare-related AI developments, including deidentification and bio-medical entity extraction models. Our study underscores the potential of tailored neural translation models and the LLMs-in-the-loop methodology to advance the field through improved data generation, evaluation, agent, and modeling techniques.

Blind and low vision (BLV) creators use images to communicate with sighted audiences. However, creating or retrieving images is challenging for BLV creators as it is difficult to use authoring tools or assess image search results. Thus, creators limit the types of images they create or recruit sighted collaborators. While text-to-image generation models let creators generate high-fidelity images based on a text description (i.e. prompt), it is difficult to assess the content and quality of generated images. We present GenAssist, a system to make text-to-image generation accessible. Using our interface, creators can verify whether generated image candidates followed the prompt, access additional details in the image not specified in the prompt, and skim a summary of similarities and differences between image candidates. To power the interface, GenAssist uses a large language model to generate visual questions, vision-language models to extract answers, and a large language model to summarize the results. Our study with 12 BLV creators demonstrated that GenAssist enables and simplifies the process of image selection and generation, making visual authoring more accessible to all.

Several medical Multimodal Large Languange Models (MLLMs) have been developed to address tasks involving visual images with textual instructions across various medical modalities, achieving impressive results. Most current medical generalist models are region-agnostic, treating the entire image as a holistic representation. However, they struggle to identify which specific regions they are focusing on when generating a sentence. To mimic the behavior of doctors, who typically begin by reviewing the entire image before concentrating on specific regions for a thorough evaluation, we aim to enhance the capability of medical MLLMs in understanding anatomical regions within entire medical scans. To achieve it, we first formulate Region-Centric tasks and construct a large-scale dataset, MedRegInstruct, to incorporate regional information into training. Combining our collected dataset with other medical multimodal corpora for training, we propose a Region-Aware medical MLLM, MedRegA, which is the first bilingual generalist medical AI system to simultaneously handle image-level and region-level medical vision-language tasks across a broad range of modalities. Our MedRegA not only enables three region-centric tasks, but also achieves the best performance for visual question answering, report generation and medical image classification over 8 modalities, showcasing significant versatility. Experiments demonstrate that our model can not only accomplish powerful performance across various medical vision-language tasks in bilingual settings, but also recognize and detect structures in multimodal medical scans, boosting the interpretability and user interactivity of medical MLLMs. Our project page is https://medrega.github.io.

Recent text-to-image (T2I) generative models allow for high-quality synthesis following either text instructions or visual examples. Despite their capabilities, these models face limitations in creating new, detailed creatures within specific categories (e.g., virtual dog or bird species), which are valuable in digital asset creation and biodiversity analysis. To bridge this gap, we introduce a novel task, Virtual Creatures Generation: Given a set of unlabeled images of the target concepts (e.g., 200 bird species), we aim to train a T2I model capable of creating new, hybrid concepts within diverse backgrounds and contexts. We propose a new method called DreamCreature, which identifies and extracts the underlying sub-concepts (e.g., body parts of a specific species) in an unsupervised manner. The T2I thus adapts to generate novel concepts (e.g., new bird species) with faithful structures and photorealistic appearance by seamlessly and flexibly composing learned sub-concepts. To enhance sub-concept fidelity and disentanglement, we extend the textual inversion technique by incorporating an additional projector and tailored attention loss regularization. Extensive experiments on two fine-grained image benchmarks demonstrate the superiority of DreamCreature over prior methods in both qualitative and quantitative evaluation. Ultimately, the learned sub-concepts facilitate diverse creative applications, including innovative consumer product designs and nuanced property modifications.

Recent advancements in medical imaging and artificial intelligence (AI) have greatly enhanced diagnostic capabilities, but the development of effective deep learning (DL) models is still constrained by the lack of high-quality annotated datasets. The traditional manual annotation process by medical experts is time- and resource-intensive, limiting the scalability of these datasets. In this work, we introduce a robust and versatile framework that combines AI and crowdsourcing to improve both the quality and quantity of medical image datasets across different modalities. Our approach utilises a user-friendly online platform that enables a diverse group of crowd annotators to label medical images efficiently. By integrating the MedSAM segmentation AI with this platform, we accelerate the annotation process while maintaining expert-level quality through an algorithm that merges crowd-labelled images. Additionally, we employ pix2pixGAN, a generative AI model, to expand the training dataset with synthetic images that capture realistic morphological features. These methods are combined into a cohesive framework designed to produce an enhanced dataset, which can serve as a universal pre-processing pipeline to boost the training of any medical deep learning segmentation model. Our results demonstrate that this framework significantly improves model performance, especially when training data is limited.

The generation of high-quality human images through text-to-image (T2I) methods is a significant yet challenging task. Distinct from general image generation, human image synthesis must satisfy stringent criteria related to human pose, anatomy, and alignment with textual prompts, making it particularly difficult to achieve realistic results. Recent advancements in T2I generation based on diffusion models have shown promise, yet challenges remain in meeting human-specific preferences. In this paper, we introduce a novel approach tailored specifically for human image generation utilizing Direct Preference Optimization (DPO). Specifically, we introduce an efficient method for constructing a specialized DPO dataset for training human image generation models without the need for costly human feedback. We also propose a modified loss function that enhances the DPO training process by minimizing artifacts and improving image fidelity. Our method demonstrates its versatility and effectiveness in generating human images, including personalized text-to-image generation. Through comprehensive evaluations, we show that our approach significantly advances the state of human image generation, achieving superior results in terms of natural anatomies, poses, and text-image alignment.

Recent text-to-image generative models have demonstrated an unparalleled ability to generate diverse and creative imagery guided by a target text prompt. While revolutionary, current state-of-the-art diffusion models may still fail in generating images that fully convey the semantics in the given text prompt. We analyze the publicly available Stable Diffusion model and assess the existence of catastrophic neglect, where the model fails to generate one or more of the subjects from the input prompt. Moreover, we find that in some cases the model also fails to correctly bind attributes (e.g., colors) to their corresponding subjects. To help mitigate these failure cases, we introduce the concept of Generative Semantic Nursing (GSN), where we seek to intervene in the generative process on the fly during inference time to improve the faithfulness of the generated images. Using an attention-based formulation of GSN, dubbed Attend-and-Excite, we guide the model to refine the cross-attention units to attend to all subject tokens in the text prompt and strengthen - or excite - their activations, encouraging the model to generate all subjects described in the text prompt. We compare our approach to alternative approaches and demonstrate that it conveys the desired concepts more faithfully across a range of text prompts.

Synthetic medical data generation has opened up new possibilities in the healthcare domain, offering a powerful tool for simulating clinical scenarios, enhancing diagnostic and treatment quality, gaining granular medical knowledge, and accelerating the development of unbiased algorithms. In this context, we present a novel approach called ViewXGen, designed to overcome the limitations of existing methods that rely on general domain pipelines using only radiology reports to generate frontal-view chest X-rays. Our approach takes into consideration the diverse view positions found in the dataset, enabling the generation of chest X-rays with specific views, which marks a significant advancement in the field. To achieve this, we introduce a set of specially designed tokens for each view position, tailoring the generation process to the user's preferences. Furthermore, we leverage multi-view chest X-rays as input, incorporating valuable information from different views within the same study. This integration rectifies potential errors and contributes to faithfully capturing abnormal findings in chest X-ray generation. To validate the effectiveness of our approach, we conducted statistical analyses, evaluating its performance in a clinical efficacy metric on the MIMIC-CXR dataset. Also, human evaluation demonstrates the remarkable capabilities of ViewXGen, particularly in producing realistic view-specific X-rays that closely resemble the original images.

Recent advances in text-to-image diffusion models have enabled the generation of diverse and high-quality images. However, generated images often fall short of depicting subtle details and are susceptible to errors due to ambiguity in the input text. One way of alleviating these issues is to train diffusion models on class-labeled datasets. This comes with a downside, doing so limits their expressive power: (i) supervised datasets are generally small compared to large-scale scraped text-image datasets on which text-to-image models are trained, and so the quality and diversity of generated images are severely affected, or (ii) the input is a hard-coded label, as opposed to free-form text, which limits the control over the generated images. In this work, we propose a non-invasive fine-tuning technique that capitalizes on the expressive potential of free-form text while achieving high accuracy through discriminative signals from a pretrained classifier, which guides the generation. This is done by iteratively modifying the embedding of a single input token of a text-to-image diffusion model, using the classifier, by steering generated images toward a given target class. Our method is fast compared to prior fine-tuning methods and does not require a collection of in-class images or retraining of a noise-tolerant classifier. We evaluate our method extensively, showing that the generated images are: (i) more accurate and of higher quality than standard diffusion models, (ii) can be used to augment training data in a low-resource setting, and (iii) reveal information about the data used to train the guiding classifier. The code is available at https://github.com/idansc/discriminative_class_tokens

Recent text-to-image matching models apply contrastive learning to large corpora of uncurated pairs of images and sentences. While such models can provide a powerful score for matching and subsequent zero-shot tasks, they are not capable of generating caption given an image. In this work, we repurpose such models to generate a descriptive text given an image at inference time, without any further training or tuning steps. This is done by combining the visual-semantic model with a large language model, benefiting from the knowledge in both web-scale models. The resulting captions are much less restrictive than those obtained by supervised captioning methods. Moreover, as a zero-shot learning method, it is extremely flexible and we demonstrate its ability to perform image arithmetic in which the inputs can be either images or text, and the output is a sentence. This enables novel high-level vision capabilities such as comparing two images or solving visual analogy tests. Our code is available at: https://github.com/YoadTew/zero-shot-image-to-text.

How humans can efficiently and effectively acquire images has always been a perennial question. A typical solution is text-to-image retrieval from an existing database given the text query; however, the limited database typically lacks creativity. By contrast, recent breakthroughs in text-to-image generation have made it possible to produce fancy and diverse visual content, but it faces challenges in synthesizing knowledge-intensive images. In this work, we rethink the relationship between text-to-image generation and retrieval and propose a unified framework in the context of Multimodal Large Language Models (MLLMs). Specifically, we first explore the intrinsic discriminative abilities of MLLMs and introduce a generative retrieval method to perform retrieval in a training-free manner. Subsequently, we unify generation and retrieval in an autoregressive generation way and propose an autonomous decision module to choose the best-matched one between generated and retrieved images as the response to the text query. Additionally, we construct a benchmark called TIGeR-Bench, including creative and knowledge-intensive domains, to standardize the evaluation of unified text-to-image generation and retrieval. Extensive experimental results on TIGeR-Bench and two retrieval benchmarks, i.e., Flickr30K and MS-COCO, demonstrate the superiority and effectiveness of our proposed method.

This work investigates a challenging task named open-domain interleaved image-text generation, which generates interleaved texts and images following an input query. We propose a new interleaved generation framework based on prompting large-language models (LLMs) and pre-trained text-to-image (T2I) models, namely OpenLEAF. In OpenLEAF, the LLM generates textual descriptions, coordinates T2I models, creates visual prompts for generating images, and incorporates global contexts into the T2I models. This global context improves the entity and style consistencies of images in the interleaved generation. For model assessment, we first propose to use large multi-modal models (LMMs) to evaluate the entity and style consistencies of open-domain interleaved image-text sequences. According to the LMM evaluation on our constructed evaluation set, the proposed interleaved generation framework can generate high-quality image-text content for various domains and applications, such as how-to question answering, storytelling, graphical story rewriting, and webpage/poster generation tasks. Moreover, we validate the effectiveness of the proposed LMM evaluation technique with human assessment. We hope our proposed framework, benchmark, and LMM evaluation could help establish the intriguing interleaved image-text generation task.

Diffusion models have revitalized the image generation domain, playing crucial roles in both academic research and artistic expression. With the emergence of new diffusion models, assessing the performance of text-to-image models has become increasingly important. Current metrics focus on directly matching the input text with the generated image, but due to cross-modal information asymmetry, this leads to unreliable or incomplete assessment results. Motivated by this, we introduce the Image Regeneration task in this study to assess text-to-image models by tasking the T2I model with generating an image according to the reference image. We use GPT4V to bridge the gap between the reference image and the text input for the T2I model, allowing T2I models to understand image content. This evaluation process is simplified as comparisons between the generated image and the reference image are straightforward. Two regeneration datasets spanning content-diverse and style-diverse evaluation dataset are introduced to evaluate the leading diffusion models currently available. Additionally, we present ImageRepainter framework to enhance the quality of generated images by improving content comprehension via MLLM guided iterative generation and revision. Our comprehensive experiments have showcased the effectiveness of this framework in assessing the generative capabilities of models. By leveraging MLLM, we have demonstrated that a robust T2M can produce images more closely resembling the reference image.

Generating Natural Language Explanations (NLEs) for model predictions on medical images, particularly those depicting thoracic pathologies, remains a critical and challenging task. Existing methodologies often struggle due to general models' insufficient domain-specific medical knowledge and privacy concerns associated with retrieval-based augmentation techniques. To address these issues, we propose a novel Vision-Language framework augmented with a Knowledge Graph (KG)-based datastore, which enhances the model's understanding by incorporating additional domain-specific medical knowledge essential for generating accurate and informative NLEs. Our framework employs a KG-based retrieval mechanism that not only improves the precision of the generated explanations but also preserves data privacy by avoiding direct data retrieval. The KG datastore is designed as a plug-and-play module, allowing for seamless integration with various model architectures. We introduce and evaluate three distinct frameworks within this paradigm: KG-LLaVA, which integrates the pre-trained LLaVA model with KG-RAG; Med-XPT, a custom framework combining MedCLIP, a transformer-based projector, and GPT-2; and Bio-LLaVA, which adapts LLaVA by incorporating the Bio-ViT-L vision model. These frameworks are validated on the MIMIC-NLE dataset, where they achieve state-of-the-art results, underscoring the effectiveness of KG augmentation in generating high-quality NLEs for thoracic pathologies.

Recent advancements in text-to-image generation have significantly enhanced the quality of synthesized images. Despite this progress, evaluations predominantly focus on aesthetic appeal or alignment with text prompts. Consequently, there is limited understanding of whether these models can accurately represent a wide variety of realistic visual entities - a task requiring real-world knowledge. To address this gap, we propose a benchmark focused on evaluating Knowledge-InTensive image generaTion on real-world ENtities (i.e., KITTEN). Using KITTEN, we conduct a systematic study on the fidelity of entities in text-to-image generation models, focusing on their ability to generate a wide range of real-world visual entities, such as landmark buildings, aircraft, plants, and animals. We evaluate the latest text-to-image models and retrieval-augmented customization models using both automatic metrics and carefully-designed human evaluations, with an emphasis on the fidelity of entities in the generated images. Our findings reveal that even the most advanced text-to-image models often fail to generate entities with accurate visual details. Although retrieval-augmented models can enhance the fidelity of entity by incorporating reference images during testing, they often over-rely on these references and struggle to produce novel configurations of the entity as requested in creative text prompts.

During their formative years, radiology trainees are required to interpret hundreds of mammograms per month, with the objective of becoming apt at discerning the subtle patterns differentiating benign from malignant lesions. Unfortunately, medico-legal and technical hurdles make it difficult to access and query medical images for training. In this paper we train a generative adversarial network (GAN) to synthesize 512 x 512 high-resolution mammograms. The resulting model leads to the unsupervised separation of high-level features (e.g. the standard mammography views and the nature of the breast lesions), with stochastic variation in the generated images (e.g. breast adipose tissue, calcification), enabling user-controlled global and local attribute-editing of the synthesized images. We demonstrate the model's ability to generate anatomically and medically relevant mammograms by achieving an average AUC of 0.54 in a double-blind study on four expert mammography radiologists to distinguish between generated and real images, ascribing to the high visual quality of the synthesized and edited mammograms, and to their potential use in advancing and facilitating medical education.

Recent advancements in mixed-modal generative models have enabled flexible integration of information across image-text content. These models have opened new avenues for developing unified biomedical assistants capable of analyzing biomedical images, answering complex questions about them, and predicting the impact of medical procedures on a patient's health. However, existing resources face challenges such as limited data availability, narrow domain coverage, and restricted sources (e.g., medical papers). To address these gaps, we present MedMax, the first large-scale multimodal biomedical instruction-tuning dataset for mixed-modal foundation models. With 1.47 million instances, MedMax encompasses a diverse range of tasks, including multimodal content generation (interleaved image-text data), biomedical image captioning and generation, visual chatting, and report understanding. These tasks span diverse medical domains such as radiology and histopathology. Subsequently, we fine-tune a mixed-modal foundation model on the MedMax dataset, achieving significant performance improvements: a 26% gain over the Chameleon model and an 18.3% improvement over GPT-4o across 12 downstream biomedical visual question-answering tasks. Additionally, we introduce a unified evaluation suite for biomedical tasks, providing a robust framework to guide the development of next-generation mixed-modal biomedical AI assistants.

Multi-modal data abounds in biomedicine, such as radiology images and reports. Interpreting this data at scale is essential for improving clinical care and accelerating clinical research. Biomedical text with its complex semantics poses additional challenges in vision--language modelling compared to the general domain, and previous work has used insufficiently adapted models that lack domain-specific language understanding. In this paper, we show that principled textual semantic modelling can substantially improve contrastive learning in self-supervised vision--language processing. We release a language model that achieves state-of-the-art results in radiology natural language inference through its improved vocabulary and novel language pretraining objective leveraging semantics and discourse characteristics in radiology reports. Further, we propose a self-supervised joint vision--language approach with a focus on better text modelling. It establishes new state of the art results on a wide range of publicly available benchmarks, in part by leveraging our new domain-specific language model. We release a new dataset with locally-aligned phrase grounding annotations by radiologists to facilitate the study of complex semantic modelling in biomedical vision--language processing. A broad evaluation, including on this new dataset, shows that our contrastive learning approach, aided by textual-semantic modelling, outperforms prior methods in segmentation tasks, despite only using a global-alignment objective.

Recent Text-to-Image (T2I) generation models such as Stable Diffusion and Imagen have made significant progress in generating high-resolution images based on text descriptions. However, many generated images still suffer from issues such as artifacts/implausibility, misalignment with text descriptions, and low aesthetic quality. Inspired by the success of Reinforcement Learning with Human Feedback (RLHF) for large language models, prior works collected human-provided scores as feedback on generated images and trained a reward model to improve the T2I generation. In this paper, we enrich the feedback signal by (i) marking image regions that are implausible or misaligned with the text, and (ii) annotating which words in the text prompt are misrepresented or missing on the image. We collect such rich human feedback on 18K generated images and train a multimodal transformer to predict the rich feedback automatically. We show that the predicted rich human feedback can be leveraged to improve image generation, for example, by selecting high-quality training data to finetune and improve the generative models, or by creating masks with predicted heatmaps to inpaint the problematic regions. Notably, the improvements generalize to models (Muse) beyond those used to generate the images on which human feedback data were collected (Stable Diffusion variants).

Multimodal large language models (LLMs) have demonstrated impressive capabilities in generating high-quality images from textual instructions. However, their performance in generating scientific images--a critical application for accelerating scientific progress--remains underexplored. In this work, we address this gap by introducing ScImage, a benchmark designed to evaluate the multimodal capabilities of LLMs in generating scientific images from textual descriptions. ScImage assesses three key dimensions of understanding: spatial, numeric, and attribute comprehension, as well as their combinations, focusing on the relationships between scientific objects (e.g., squares, circles). We evaluate five models, GPT-4o, Llama, AutomaTikZ, Dall-E, and StableDiffusion, using two modes of output generation: code-based outputs (Python, TikZ) and direct raster image generation. Additionally, we examine four different input languages: English, German, Farsi, and Chinese. Our evaluation, conducted with 11 scientists across three criteria (correctness, relevance, and scientific accuracy), reveals that while GPT-4o produces outputs of decent quality for simpler prompts involving individual dimensions such as spatial, numeric, or attribute understanding in isolation, all models face challenges in this task, especially for more complex prompts.

Recent breakthroughs in the field of language-guided image generation have yielded impressive achievements, enabling the creation of high-quality and diverse images based on user instructions.Although the synthesis performance is fascinating, one significant limitation of current image generation models is their insufficient ability to generate text coherently within images, particularly for complex glyph structures like Chinese characters. To address this problem, we introduce GlyphDraw, a general learning framework aiming to endow image generation models with the capacity to generate images coherently embedded with text for any specific language.We first sophisticatedly design the image-text dataset's construction strategy, then build our model specifically on a diffusion-based image generator and carefully modify the network structure to allow the model to learn drawing language characters with the help of glyph and position information.Furthermore, we maintain the model's open-domain image synthesis capability by preventing catastrophic forgetting by using parameter-efficient fine-tuning techniques.Extensive qualitative and quantitative experiments demonstrate that our method not only produces accurate language characters as in prompts, but also seamlessly blends the generated text into the background.Please refer to our https://1073521013.github.io/glyph-draw.github.io/{project page}. abstract

Generative models hold promise for revolutionizing medical education, robot-assisted surgery, and data augmentation for medical AI development. Diffusion models can now generate realistic images from text prompts, while recent advancements have demonstrated their ability to create diverse, high-quality videos. However, these models often struggle with generating accurate representations of medical procedures and detailed anatomical structures. This paper introduces Bora, the first spatio-temporal diffusion probabilistic model designed for text-guided biomedical video generation. Bora leverages Transformer architecture and is pre-trained on general-purpose video generation tasks. It is fine-tuned through model alignment and instruction tuning using a newly established medical video corpus, which includes paired text-video data from various biomedical fields. To the best of our knowledge, this is the first attempt to establish such a comprehensive annotated biomedical video dataset. Bora is capable of generating high-quality video data across four distinct biomedical domains, adhering to medical expert standards and demonstrating consistency and diversity. This generalist video generative model holds significant potential for enhancing medical consultation and decision-making, particularly in resource-limited settings. Additionally, Bora could pave the way for immersive medical training and procedure planning. Extensive experiments on distinct medical modalities such as endoscopy, ultrasound, MRI, and cell tracking validate the effectiveness of our model in understanding biomedical instructions and its superior performance across subjects compared to state-of-the-art generation models.

Text-to-image generative models have enabled high-resolution image synthesis across different domains, but require users to specify the content they wish to generate. In this paper, we consider the inverse problem -- given a collection of different images, can we discover the generative concepts that represent each image? We present an unsupervised approach to discover generative concepts from a collection of images, disentangling different art styles in paintings, objects, and lighting from kitchen scenes, and discovering image classes given ImageNet images. We show how such generative concepts can accurately represent the content of images, be recombined and composed to generate new artistic and hybrid images, and be further used as a representation for downstream classification tasks.

In this work, we present TextHarmony, a unified and versatile multimodal generative model proficient in comprehending and generating visual text. Simultaneously generating images and texts typically results in performance degradation due to the inherent inconsistency between vision and language modalities. To overcome this challenge, existing approaches resort to modality-specific data for supervised fine-tuning, necessitating distinct model instances. We propose Slide-LoRA, which dynamically aggregates modality-specific and modality-agnostic LoRA experts, partially decoupling the multimodal generation space. Slide-LoRA harmonizes the generation of vision and language within a singular model instance, thereby facilitating a more unified generative process. Additionally, we develop a high-quality image caption dataset, DetailedTextCaps-100K, synthesized with a sophisticated closed-source MLLM to enhance visual text generation capabilities further. Comprehensive experiments across various benchmarks demonstrate the effectiveness of the proposed approach. Empowered by Slide-LoRA, TextHarmony achieves comparable performance to modality-specific fine-tuning results with only a 2% increase in parameters and shows an average improvement of 2.5% in visual text comprehension tasks and 4.0% in visual text generation tasks. Our work delineates the viability of an integrated approach to multimodal generation within the visual text domain, setting a foundation for subsequent inquiries.

Understanding the relationship between figures and text is key to scientific document understanding. Medical figures in particular are quite complex, often consisting of several subfigures (75% of figures in our dataset), with detailed text describing their content. Previous work studying figures in scientific papers focused on classifying figure content rather than understanding how images relate to the text. To address challenges in figure retrieval and figure-to-text alignment, we introduce MedICaT, a dataset of medical images in context. MedICaT consists of 217K images from 131K open access biomedical papers, and includes captions, inline references for 74% of figures, and manually annotated subfigures and subcaptions for a subset of figures. Using MedICaT, we introduce the task of subfigure to subcaption alignment in compound figures and demonstrate the utility of inline references in image-text matching. Our data and code can be accessed at https://github.com/allenai/medicat.

Recent text-to-image generative models have enabled us to transform our words into vibrant, captivating imagery. The surge of personalization techniques that has followed has also allowed us to imagine unique concepts in new scenes. However, an intriguing question remains: How can we generate a new, imaginary concept that has never been seen before? In this paper, we present the task of creative text-to-image generation, where we seek to generate new members of a broad category (e.g., generating a pet that differs from all existing pets). We leverage the under-studied Diffusion Prior models and show that the creative generation problem can be formulated as an optimization process over the output space of the diffusion prior, resulting in a set of "prior constraints". To keep our generated concept from converging into existing members, we incorporate a question-answering model that adaptively adds new constraints to the optimization problem, encouraging the model to discover increasingly more unique creations. Finally, we show that our prior constraints can also serve as a strong mixing mechanism allowing us to create hybrids between generated concepts, introducing even more flexibility into the creative process.

Customizing pre-trained text-to-image generation model has attracted massive research interest recently, due to its huge potential in real-world applications. Although existing methods are able to generate creative content for a novel concept contained in single user-input image, their capability are still far from perfection. Specifically, most existing methods require fine-tuning the generative model on testing images. Some existing methods do not require fine-tuning, while their performance are unsatisfactory. Furthermore, the interaction between users and models are still limited to directive and descriptive prompts such as instructions and captions. In this work, we build a customization assistant based on pre-trained large language model and diffusion model, which can not only perform customized generation in a tuning-free manner, but also enable more user-friendly interactions: users can chat with the assistant and input either ambiguous text or clear instruction. Specifically, we propose a new framework consists of a new model design and a novel training strategy. The resulting assistant can perform customized generation in 2-5 seconds without any test time fine-tuning. Extensive experiments are conducted, competitive results have been obtained across different domains, illustrating the effectiveness of the proposed method.

The increasing interest in developing Artificial Intelligence applications in the medical domain, suffers from the lack of high-quality dataset, mainly due to privacy-related issues. Moreover, the recent rising of Multimodal Large Language Models (MLLM) leads to a need for multimodal medical datasets, where clinical reports and findings are attached to the corresponding CT or MR scans. This paper illustrates the entire workflow for building the data set MedPix 2.0. Starting from the well-known multimodal dataset MedPix\textregistered, mainly used by physicians, nurses and healthcare students for Continuing Medical Education purposes, a semi-automatic pipeline was developed to extract visual and textual data followed by a manual curing procedure where noisy samples were removed, thus creating a MongoDB database. Along with the dataset, we developed a GUI aimed at navigating efficiently the MongoDB instance, and obtaining the raw data that can be easily used for training and/or fine-tuning MLLMs. To enforce this point, we also propose a CLIP-based model trained on MedPix 2.0 for scan classification tasks.

Language-supervised pre-training has proven to be a valuable method for extracting semantically meaningful features from images, serving as a foundational element in multimodal systems within the computer vision and medical imaging domains. However, resulting features are limited by the information contained within the text. This is particularly problematic in medical imaging, where radiologists' written findings focus on specific observations; a challenge compounded by the scarcity of paired imaging-text data due to concerns over leakage of personal health information. In this work, we fundamentally challenge the prevailing reliance on language supervision for learning general purpose biomedical imaging encoders. We introduce RAD-DINO, a biomedical image encoder pre-trained solely on unimodal biomedical imaging data that obtains similar or greater performance than state-of-the-art biomedical language supervised models on a diverse range of benchmarks. Specifically, the quality of learned representations is evaluated on standard imaging tasks (classification and semantic segmentation), and a vision-language alignment task (text report generation from images). To further demonstrate the drawback of language supervision, we show that features from RAD-DINO correlate with other medical records (e.g., sex or age) better than language-supervised models, which are generally not mentioned in radiology reports. Finally, we conduct a series of ablations determining the factors in RAD-DINO's performance; notably, we observe that RAD-DINO's downstream performance scales well with the quantity and diversity of training data, demonstrating that image-only supervision is a scalable approach for training a foundational biomedical image encoder.

Radiology reporting generative AI holds significant potential to alleviate clinical workloads and streamline medical care. However, achieving high clinical accuracy is challenging, as radiological images often feature subtle lesions and intricate structures. Existing systems often fall short, largely due to their reliance on fixed size, patch-level image features and insufficient incorporation of pathological information. This can result in the neglect of such subtle patterns and inconsistent descriptions of crucial pathologies. To address these challenges, we propose an innovative approach that leverages pathology-aware regional prompts to explicitly integrate anatomical and pathological information of various scales, significantly enhancing the precision and clinical relevance of generated reports. We develop an anatomical region detector that extracts features from distinct anatomical areas, coupled with a novel multi-label lesion detector that identifies global pathologies. Our approach emulates the diagnostic process of radiologists, producing clinically accurate reports with comprehensive diagnostic capabilities. Experimental results show that our model outperforms previous state-of-the-art methods on most natural language generation and clinical efficacy metrics, with formal expert evaluations affirming its potential to enhance radiology practice.

Most text-to-3D generators build upon off-the-shelf text-to-image models trained on billions of images. They use variants of Score Distillation Sampling (SDS), which is slow, somewhat unstable, and prone to artifacts. A mitigation is to fine-tune the 2D generator to be multi-view aware, which can help distillation or can be combined with reconstruction networks to output 3D objects directly. In this paper, we further explore the design space of text-to-3D models. We significantly improve multi-view generation by considering video instead of image generators. Combined with a 3D reconstruction algorithm which, by using Gaussian splatting, can optimize a robust image-based loss, we directly produce high-quality 3D outputs from the generated views. Our new method, IM-3D, reduces the number of evaluations of the 2D generator network 10-100x, resulting in a much more efficient pipeline, better quality, fewer geometric inconsistencies, and higher yield of usable 3D assets.

Medical imaging is critical to the diagnosis and treatment of numerous medical problems, including many forms of cancer. Medical imaging reports distill the findings and observations of radiologists, creating an unstructured textual representation of unstructured medical images. Large-scale use of this text-encoded information requires converting the unstructured text to a structured, semantic representation. We explore the extraction and normalization of anatomical information in radiology reports that is associated with radiological findings. We investigate this extraction and normalization task using a span-based relation extraction model that jointly extracts entities and relations using BERT. This work examines the factors that influence extraction and normalization performance, including the body part/organ system, frequency of occurrence, span length, and span diversity. It discusses approaches for improving performance and creating high-quality semantic representations of radiological phenomena.

Recent advances in text-to-image models have enabled high-quality personalized image synthesis of user-provided concepts with flexible textual control. In this work, we analyze the limitations of two primary techniques in text-to-image personalization: Textual Inversion and DreamBooth. When integrating the learned concept into new prompts, Textual Inversion tends to overfit the concept, while DreamBooth often overlooks it. We attribute these issues to the incorrect learning of the embedding alignment for the concept. We introduce AttnDreamBooth, a novel approach that addresses these issues by separately learning the embedding alignment, the attention map, and the subject identity in different training stages. We also introduce a cross-attention map regularization term to enhance the learning of the attention map. Our method demonstrates significant improvements in identity preservation and text alignment compared to the baseline methods.

Recent strides in Text-to-3D techniques have been propelled by distilling knowledge from powerful large text-to-image diffusion models (LDMs). Nonetheless, existing Text-to-3D approaches often grapple with challenges such as over-saturation, inadequate detailing, and unrealistic outputs. This study presents a novel strategy that leverages explicitly synthesized multi-view images to address these issues. Our approach involves the utilization of image-to-image pipelines, empowered by LDMs, to generate posed high-quality images based on the renderings of coarse 3D models. Although the generated images mostly alleviate the aforementioned issues, challenges such as view inconsistency and significant content variance persist due to the inherent generative nature of large diffusion models, posing extensive difficulties in leveraging these images effectively. To overcome this hurdle, we advocate integrating a discriminator alongside a novel Diffusion-GAN dual training strategy to guide the training of 3D models. For the incorporated discriminator, the synthesized multi-view images are considered real data, while the renderings of the optimized 3D models function as fake data. We conduct a comprehensive set of experiments that demonstrate the effectiveness of our method over baseline approaches.

Plain text has become a prevalent interface for text-to-image synthesis. However, its limited customization options hinder users from accurately describing desired outputs. For example, plain text makes it hard to specify continuous quantities, such as the precise RGB color value or importance of each word. Furthermore, creating detailed text prompts for complex scenes is tedious for humans to write and challenging for text encoders to interpret. To address these challenges, we propose using a rich-text editor supporting formats such as font style, size, color, and footnote. We extract each word's attributes from rich text to enable local style control, explicit token reweighting, precise color rendering, and detailed region synthesis. We achieve these capabilities through a region-based diffusion process. We first obtain each word's region based on attention maps of a diffusion process using plain text. For each region, we enforce its text attributes by creating region-specific detailed prompts and applying region-specific guidance, and maintain its fidelity against plain-text generation through region-based injections. We present various examples of image generation from rich text and demonstrate that our method outperforms strong baselines with quantitative evaluations.

Diffusion models create data from noise by inverting the forward paths of data towards noise and have emerged as a powerful generative modeling technique for high-dimensional, perceptual data such as images and videos. Rectified flow is a recent generative model formulation that connects data and noise in a straight line. Despite its better theoretical properties and conceptual simplicity, it is not yet decisively established as standard practice. In this work, we improve existing noise sampling techniques for training rectified flow models by biasing them towards perceptually relevant scales. Through a large-scale study, we demonstrate the superior performance of this approach compared to established diffusion formulations for high-resolution text-to-image synthesis. Additionally, we present a novel transformer-based architecture for text-to-image generation that uses separate weights for the two modalities and enables a bidirectional flow of information between image and text tokens, improving text comprehension, typography, and human preference ratings. We demonstrate that this architecture follows predictable scaling trends and correlates lower validation loss to improved text-to-image synthesis as measured by various metrics and human evaluations. Our largest models outperform state-of-the-art models, and we will make our experimental data, code, and model weights publicly available.

Text-to-image models offer unprecedented freedom to guide creation through natural language. Yet, it is unclear how such freedom can be exercised to generate images of specific unique concepts, modify their appearance, or compose them in new roles and novel scenes. In other words, we ask: how can we use language-guided models to turn our cat into a painting, or imagine a new product based on our favorite toy? Here we present a simple approach that allows such creative freedom. Using only 3-5 images of a user-provided concept, like an object or a style, we learn to represent it through new "words" in the embedding space of a frozen text-to-image model. These "words" can be composed into natural language sentences, guiding personalized creation in an intuitive way. Notably, we find evidence that a single word embedding is sufficient for capturing unique and varied concepts. We compare our approach to a wide range of baselines, and demonstrate that it can more faithfully portray the concepts across a range of applications and tasks. Our code, data and new words will be available at: https://textual-inversion.github.io

Large-scale text-to-image diffusion models have significantly improved the state of the art in generative image modelling and allow for an intuitive and powerful user interface to drive the image generation process. Expressing spatial constraints, e.g. to position specific objects in particular locations, is cumbersome using text; and current text-based image generation models are not able to accurately follow such instructions. In this paper we consider image generation from text associated with segments on the image canvas, which combines an intuitive natural language interface with precise spatial control over the generated content. We propose ZestGuide, a zero-shot segmentation guidance approach that can be plugged into pre-trained text-to-image diffusion models, and does not require any additional training. It leverages implicit segmentation maps that can be extracted from cross-attention layers, and uses them to align the generation with input masks. Our experimental results combine high image quality with accurate alignment of generated content with input segmentations, and improve over prior work both quantitatively and qualitatively, including methods that require training on images with corresponding segmentations. Compared to Paint with Words, the previous state-of-the art in image generation with zero-shot segmentation conditioning, we improve by 5 to 10 mIoU points on the COCO dataset with similar FID scores.

Text-to-image (T2I) generation aims at producing realistic images corresponding to text descriptions. Generative Adversarial Network (GAN) has proven to be successful in this task. Typical T2I GANs are 2 phase methods that first pretrain an inter-modal representation from aligned image-text pairs and then use GAN to train image generator on that basis. However, such representation ignores the inner-modal semantic correspondence, e.g. the images with same label. The semantic label in priory describes the inherent distribution pattern with underlying cross-image relationships, which is supplement to the text description for understanding the full characteristics of image. In this paper, we propose a framework leveraging both inter- and inner-modal correspondence by label guided supervised contrastive learning. We extend the T2I GANs to two parameter-sharing contrast branches in both pretraining and generation phases. This integration effectively clusters the semantically similar image-text pair representations, thereby fostering the generation of higher-quality images. We demonstrate our framework on four novel T2I GANs by both single-object dataset CUB and multi-object dataset COCO, achieving significant improvements in the Inception Score (IS) and Frechet Inception Distance (FID) metrics of imagegeneration evaluation. Notably, on more complex multi-object COCO, our framework improves FID by 30.1%, 27.3%, 16.2% and 17.1% for AttnGAN, DM-GAN, SSA-GAN and GALIP, respectively. We also validate our superiority by comparing with other label guided T2I GANs. The results affirm the effectiveness and competitiveness of our approach in advancing the state-of-the-art GAN for T2I generation

This study investigates the integration of diverse patient data sources into multimodal language models for automated chest X-ray (CXR) report generation. Traditionally, CXR report generation relies solely on CXR images and limited radiology data, overlooking valuable information from patient health records, particularly from emergency departments. Utilising the MIMIC-CXR and MIMIC-IV-ED datasets, we incorporate detailed patient information such as aperiodic vital signs, medications, and clinical history to enhance diagnostic accuracy. We introduce a novel approach to transform these heterogeneous data sources into embeddings that prompt a multimodal language model, significantly enhancing the diagnostic accuracy of generated radiology reports. Our comprehensive evaluation demonstrates the benefits of using a broader set of patient data, underscoring the potential for enhanced diagnostic capabilities and better patient outcomes through the integration of multimodal data in CXR report generation.

Automatic medical report generation (MRG) is of great research value as it has the potential to relieve radiologists from the heavy burden of report writing. Despite recent advancements, accurate MRG remains challenging due to the need for precise clinical understanding and the identification of clinical findings. Moreover, the imbalanced distribution of diseases makes the challenge even more pronounced, as rare diseases are underrepresented in training data, making their diagnostic performance unreliable. To address these challenges, we propose diagnosis-driven prompts for medical report generation (PromptMRG), a novel framework that aims to improve the diagnostic accuracy of MRG with the guidance of diagnosis-aware prompts. Specifically, PromptMRG is based on encoder-decoder architecture with an extra disease classification branch. When generating reports, the diagnostic results from the classification branch are converted into token prompts to explicitly guide the generation process. To further improve the diagnostic accuracy, we design cross-modal feature enhancement, which retrieves similar reports from the database to assist the diagnosis of a query image by leveraging the knowledge from a pre-trained CLIP. Moreover, the disease imbalanced issue is addressed by applying an adaptive logit-adjusted loss to the classification branch based on the individual learning status of each disease, which overcomes the barrier of text decoder's inability to manipulate disease distributions. Experiments on two MRG benchmarks show the effectiveness of the proposed method, where it obtains state-of-the-art clinical efficacy performance on both datasets.

Text-to-Image models such as Stable Diffusion have shown impressive image generation synthesis, thanks to the utilization of large-scale datasets. However, these datasets may contain sexually explicit, copyrighted, or undesirable content, which allows the model to directly generate them. Given that retraining these large models on individual concept deletion requests is infeasible, fine-tuning algorithms have been developed to tackle concept erasing in diffusion models. While these algorithms yield good concept erasure, they all present one of the following issues: 1) the corrupted feature space yields synthesis of disintegrated objects, 2) the initially synthesized content undergoes a divergence in both spatial structure and semantics in the generated images, and 3) sub-optimal training updates heighten the model's susceptibility to utility harm. These issues severely degrade the original utility of generative models. In this work, we present a new approach that solves all of these challenges. We take inspiration from the concept of classifier guidance and propose a surgical update on the classifier guidance term while constraining the drift of the unconditional score term. Furthermore, our algorithm empowers the user to select an alternative to the erasing concept, allowing for more controllability. Our experimental results show that our algorithm not only erases the target concept effectively but also preserves the model's generation capability.

In this paper, we focus on the problem of Medical Visual Question Answering (MedVQA), which is crucial in efficiently interpreting medical images with vital clinic-relevant information. Firstly, we reframe the problem of MedVQA as a generation task that naturally follows the human-machine interaction, we propose a generative-based model for medical visual understanding by aligning visual information from a pre-trained vision encoder with a large language model. Secondly, we establish a scalable pipeline to construct a large-scale medical visual question-answering dataset, named PMC-VQA, which contains 227k VQA pairs of 149k images that cover various modalities or diseases. Thirdly, we pre-train our proposed model on PMC-VQA and then fine-tune it on multiple public benchmarks, e.g., VQA-RAD and SLAKE, outperforming existing work by a large margin. Additionally, we propose a test set that has undergone manual verification, which is significantly more challenging, even the best models struggle to solve.

Large-scale text-to-image generative models have been a revolutionary breakthrough in the evolution of generative AI, allowing us to synthesize diverse images that convey highly complex visual concepts. However, a pivotal challenge in leveraging such models for real-world content creation tasks is providing users with control over the generated content. In this paper, we present a new framework that takes text-to-image synthesis to the realm of image-to-image translation -- given a guidance image and a target text prompt, our method harnesses the power of a pre-trained text-to-image diffusion model to generate a new image that complies with the target text, while preserving the semantic layout of the source image. Specifically, we observe and empirically demonstrate that fine-grained control over the generated structure can be achieved by manipulating spatial features and their self-attention inside the model. This results in a simple and effective approach, where features extracted from the guidance image are directly injected into the generation process of the target image, requiring no training or fine-tuning and applicable for both real or generated guidance images. We demonstrate high-quality results on versatile text-guided image translation tasks, including translating sketches, rough drawings and animations into realistic images, changing of the class and appearance of objects in a given image, and modifications of global qualities such as lighting and color.

Text-to-image generation models are powerful but difficult to use. Users craft specific prompts to get better images, though the images can be repetitive. This paper proposes a Prompt Expansion framework that helps users generate high-quality, diverse images with less effort. The Prompt Expansion model takes a text query as input and outputs a set of expanded text prompts that are optimized such that when passed to a text-to-image model, generates a wider variety of appealing images. We conduct a human evaluation study that shows that images generated through Prompt Expansion are more aesthetically pleasing and diverse than those generated by baseline methods. Overall, this paper presents a novel and effective approach to improving the text-to-image generation experience.

Text-to-image generation has made significant advancements with the introduction of text-to-image diffusion models. These models typically consist of a language model that interprets user prompts and a vision model that generates corresponding images. As language and vision models continue to progress in their respective domains, there is a great potential in exploring the replacement of components in text-to-image diffusion models with more advanced counterparts. A broader research objective would therefore be to investigate the integration of any two unrelated language and generative vision models for text-to-image generation. In this paper, we explore this objective and propose LaVi-Bridge, a pipeline that enables the integration of diverse pre-trained language models and generative vision models for text-to-image generation. By leveraging LoRA and adapters, LaVi-Bridge offers a flexible and plug-and-play approach without requiring modifications to the original weights of the language and vision models. Our pipeline is compatible with various language models and generative vision models, accommodating different structures. Within this framework, we demonstrate that incorporating superior modules, such as more advanced language models or generative vision models, results in notable improvements in capabilities like text alignment or image quality. Extensive evaluations have been conducted to verify the effectiveness of LaVi-Bridge. Code is available at https://github.com/ShihaoZhaoZSH/LaVi-Bridge.

The Segment Anything Model (SAM) has achieved remarkable successes in the realm of natural image segmentation, but its deployment in the medical imaging sphere has encountered challenges. Specifically, the model struggles with medical images that feature low contrast, faint boundaries, intricate morphologies, and small-sized objects. To address these challenges and enhance SAM's performance in the medical domain, we introduce a comprehensive modification. Firstly, we incorporate a frozen Convolutional Neural Network (CNN) branch as an image encoder, which synergizes with SAM's original Vision Transformer (ViT) encoder through a novel variational attention fusion module. This integration bolsters the model's capability to capture local spatial information, which is often paramount in medical imagery. Moreover, to further optimize SAM for medical imaging, we introduce feature and position adapters within the ViT branch, refining the encoder's representations. We see that compared to current prompting strategies to fine-tune SAM for ultrasound medical segmentation, the use of text descriptions that serve as text prompts for SAM helps significantly improve the performance. Leveraging ChatGPT's natural language understanding capabilities, we generate prompts that offer contextual information and guidance to SAM, enabling it to better understand the nuances of ultrasound medical images and improve its segmentation accuracy. Our method, in its entirety, represents a significant stride towards making universal image segmentation models more adaptable and efficient in the medical domain.

The creation of high-quality human-labeled image-caption datasets presents a significant bottleneck in the development of Visual-Language Models (VLMs). We propose a novel approach that leverages the strengths of Large Language Models (LLMs) and image generation models to create synthetic image-text pairs for efficient and effective VLM training. Our method employs pretraining a text-to-image model to synthesize image embeddings starting from captions generated by an LLM. These synthetic pairs are then used to train a VLM. Extensive experiments demonstrate that the VLM trained with synthetic data exhibits comparable performance on image captioning, while requiring a fraction of the data used by models trained solely on human-annotated data. In particular, we outperform the baseline by 17% through augmentation with a synthetic dataset. Furthermore, we show that synthesizing in the image embedding space is 25% faster than in the pixel space. This research introduces a promising technique for generating large-scale, customizable image datasets, leading to enhanced VLM performance and wider applicability across various domains, all with improved data efficiency and resource utilization.

Medicine is inherently multimodal, with rich data modalities spanning text, imaging, genomics, and more. Generalist biomedical artificial intelligence (AI) systems that flexibly encode, integrate, and interpret this data at scale can potentially enable impactful applications ranging from scientific discovery to care delivery. To enable the development of these models, we first curate MultiMedBench, a new multimodal biomedical benchmark. MultiMedBench encompasses 14 diverse tasks such as medical question answering, mammography and dermatology image interpretation, radiology report generation and summarization, and genomic variant calling. We then introduce Med-PaLM Multimodal (Med-PaLM M), our proof of concept for a generalist biomedical AI system. Med-PaLM M is a large multimodal generative model that flexibly encodes and interprets biomedical data including clinical language, imaging, and genomics with the same set of model weights. Med-PaLM M reaches performance competitive with or exceeding the state of the art on all MultiMedBench tasks, often surpassing specialist models by a wide margin. We also report examples of zero-shot generalization to novel medical concepts and tasks, positive transfer learning across tasks, and emergent zero-shot medical reasoning. To further probe the capabilities and limitations of Med-PaLM M, we conduct a radiologist evaluation of model-generated (and human) chest X-ray reports and observe encouraging performance across model scales. In a side-by-side ranking on 246 retrospective chest X-rays, clinicians express a pairwise preference for Med-PaLM M reports over those produced by radiologists in up to 40.50% of cases, suggesting potential clinical utility. While considerable work is needed to validate these models in real-world use cases, our results represent a milestone towards the development of generalist biomedical AI systems.

Recent advances in text-to-image diffusion models have enabled the photorealistic generation of images from text prompts. Despite the great progress, existing models still struggle to generate compositional multi-concept images naturally, limiting their ability to visualize human imagination. While several recent works have attempted to address this issue, they either introduce additional training or adopt guidance at inference time. In this work, we consider a more ambitious goal: natural multi-concept generation using a pre-trained diffusion model, and with almost no extra cost. To achieve this goal, we identify the limitations in the text embeddings used for the pre-trained text-to-image diffusion models. Specifically, we observe concept dominance and non-localized contribution that severely degrade multi-concept generation performance. We further design a minimal low-cost solution that overcomes the above issues by tweaking (not re-training) the text embeddings for more realistic multi-concept text-to-image generation. Our Correction by Similarities method tweaks the embedding of concepts by collecting semantic features from most similar tokens to localize the contribution. To avoid mixing features of concepts, we also apply Cross-Token Non-Maximum Suppression, which excludes the overlap of contributions from different concepts. Experiments show that our approach outperforms previous methods in text-to-image, image manipulation, and personalization tasks, despite not introducing additional training or inference costs to the diffusion steps.

Recent text-to-image generation models like DreamBooth have made remarkable progress in generating highly customized images of a target subject, by fine-tuning an ``expert model'' for a given subject from a few examples. However, this process is expensive, since a new expert model must be learned for each subject. In this paper, we present SuTI, a Subject-driven Text-to-Image generator that replaces subject-specific fine tuning with in-context learning. Given a few demonstrations of a new subject, SuTI can instantly generate novel renditions of the subject in different scenes, without any subject-specific optimization. SuTI is powered by apprenticeship learning, where a single apprentice model is learned from data generated by a massive number of subject-specific expert models. Specifically, we mine millions of image clusters from the Internet, each centered around a specific visual subject. We adopt these clusters to train a massive number of expert models, each specializing in a different subject. The apprentice model SuTI then learns to imitate the behavior of these fine-tuned experts. SuTI can generate high-quality and customized subject-specific images 20x faster than optimization-based SoTA methods. On the challenging DreamBench and DreamBench-v2, our human evaluation shows that SuTI significantly outperforms existing models like InstructPix2Pix, Textual Inversion, Imagic, Prompt2Prompt, Re-Imagen and DreamBooth, especially on the subject and text alignment aspects.

We present Imagen, a text-to-image diffusion model with an unprecedented degree of photorealism and a deep level of language understanding. Imagen builds on the power of large transformer language models in understanding text and hinges on the strength of diffusion models in high-fidelity image generation. Our key discovery is that generic large language models (e.g. T5), pretrained on text-only corpora, are surprisingly effective at encoding text for image synthesis: increasing the size of the language model in Imagen boosts both sample fidelity and image-text alignment much more than increasing the size of the image diffusion model. Imagen achieves a new state-of-the-art FID score of 7.27 on the COCO dataset, without ever training on COCO, and human raters find Imagen samples to be on par with the COCO data itself in image-text alignment. To assess text-to-image models in greater depth, we introduce DrawBench, a comprehensive and challenging benchmark for text-to-image models. With DrawBench, we compare Imagen with recent methods including VQ-GAN+CLIP, Latent Diffusion Models, and DALL-E 2, and find that human raters prefer Imagen over other models in side-by-side comparisons, both in terms of sample quality and image-text alignment. See https://imagen.research.google/ for an overview of the results.

One critical prerequisite for faithful text-to-image generation is the accurate understanding of text inputs. Existing methods leverage the text encoder of the CLIP model to represent input prompts. However, the pre-trained CLIP model can merely encode English with a maximum token length of 77. Moreover, the model capacity of the text encoder from CLIP is relatively limited compared to Large Language Models (LLMs), which offer multilingual input, accommodate longer context, and achieve superior text representation. In this paper, we investigate LLMs as the text encoder to improve the language understanding in text-to-image generation. Unfortunately, training text-to-image generative model with LLMs from scratch demands significant computational resources and data. To this end, we introduce a three-stage training pipeline that effectively and efficiently integrates the existing text-to-image model with LLMs. Specifically, we propose a lightweight adapter that enables fast training of the text-to-image model using the textual representations from LLMs. Extensive experiments demonstrate that our model supports not only multilingual but also longer input context with superior image generation quality.

Large pre-trained vision-language models have shown great prominence in transferring pre-acquired knowledge to various domains and downstream tasks with appropriate prompting or tuning. Existing prevalent tuning methods can be generally categorized into three genres: 1) prompt engineering by creating suitable prompt texts, which is time-consuming and requires domain expertise; 2) or simply fine-tuning the whole model, which is extremely inefficient; 3) prompt tuning through parameterized prompt embeddings with the text encoder. Nevertheless, all methods rely on the text encoder for bridging the modality gap between vision and language. In this work, we question the necessity of the cumbersome text encoder for a more lightweight and efficient tuning paradigm as well as more representative prompt embeddings closer to the image representations. To achieve this, we propose a Concept Embedding Search (ConES) approach by optimizing prompt embeddings -- without the need of the text encoder -- to capture the 'concept' of the image modality through a variety of task objectives. By dropping the text encoder, we are able to significantly speed up the learning process, \eg, from about an hour to just ten minutes in our experiments for personalized text-to-image generation without impairing the generation quality. Moreover, our proposed approach is orthogonal to current existing tuning methods since the searched concept embeddings can be further utilized in the next stage of fine-tuning the pre-trained large models for boosting performance. Extensive experiments show that our approach can beat the prompt tuning and textual inversion methods in a variety of downstream tasks including objection detection, instance segmentation, and image generation. Our approach also shows better generalization capability for unseen concepts in specialized domains, such as the medical domain.

Recent breakthroughs in text-to-image models have opened up promising research avenues in personalized image generation, enabling users to create diverse images of a specific subject using natural language prompts. However, existing methods often suffer from performance degradation when given only a single reference image. They tend to overfit the input, producing highly similar outputs regardless of the text prompt. This paper addresses the challenge of one-shot personalization by mitigating overfitting, enabling the creation of controllable images through text prompts. Specifically, we propose a selective fine-tuning strategy that focuses on the text encoder. Furthermore, we introduce three key techniques to enhance personalization performance: (1) augmentation tokens to encourage feature disentanglement and alleviate overfitting, (2) a knowledge-preservation loss to reduce language drift and promote generalizability across diverse prompts, and (3) SNR-weighted sampling for efficient training. Extensive experiments demonstrate that our approach efficiently generates high-quality, diverse images using only a single reference image while significantly reducing memory and storage requirements.

Training text-to-image models with web scale image-text pairs enables the generation of a wide range of visual concepts from text. However, these pre-trained models often face challenges when it comes to generating highly aesthetic images. This creates the need for aesthetic alignment post pre-training. In this paper, we propose quality-tuning to effectively guide a pre-trained model to exclusively generate highly visually appealing images, while maintaining generality across visual concepts. Our key insight is that supervised fine-tuning with a set of surprisingly small but extremely visually appealing images can significantly improve the generation quality. We pre-train a latent diffusion model on 1.1 billion image-text pairs and fine-tune it with only a few thousand carefully selected high-quality images. The resulting model, Emu, achieves a win rate of 82.9% compared with its pre-trained only counterpart. Compared to the state-of-the-art SDXLv1.0, Emu is preferred 68.4% and 71.3% of the time on visual appeal on the standard PartiPrompts and our Open User Input benchmark based on the real-world usage of text-to-image models. In addition, we show that quality-tuning is a generic approach that is also effective for other architectures, including pixel diffusion and masked generative transformer models.

We present Corgi, a novel method for text-to-image generation. Corgi is based on our proposed shifted diffusion model, which achieves better image embedding generation from input text. Unlike the baseline diffusion model used in DALL-E 2, our method seamlessly encodes prior knowledge of the pre-trained CLIP model in its diffusion process by designing a new initialization distribution and a new transition step of the diffusion. Compared to the strong DALL-E 2 baseline, our method performs better in generating image embedding from the text in terms of both efficiency and effectiveness, resulting in better text-to-image generation. Extensive large-scale experiments are conducted and evaluated in terms of both quantitative measures and human evaluation, indicating a stronger generation ability of our method compared to existing ones. Furthermore, our model enables semi-supervised and language-free training for text-to-image generation, where only part or none of the images in the training dataset have an associated caption. Trained with only 1.7% of the images being captioned, our semi-supervised model obtains FID results comparable to DALL-E 2 on zero-shot text-to-image generation evaluated on MS-COCO. Corgi also achieves new state-of-the-art results across different datasets on downstream language-free text-to-image generation tasks, outperforming the previous method, Lafite, by a large margin.

Text-to-Image (T2I) models are capable of generating high-quality artistic creations and visual content. However, existing research and evaluation standards predominantly focus on image realism and shallow text-image alignment, lacking a comprehensive assessment of complex semantic understanding and world knowledge integration in text to image generation. To address this challenge, we propose WISE, the first benchmark specifically designed for World Knowledge-Informed Semantic Evaluation. WISE moves beyond simple word-pixel mapping by challenging models with 1000 meticulously crafted prompts across 25 sub-domains in cultural common sense, spatio-temporal reasoning, and natural science. To overcome the limitations of traditional CLIP metric, we introduce WiScore, a novel quantitative metric for assessing knowledge-image alignment. Through comprehensive testing of 20 models (10 dedicated T2I models and 10 unified multimodal models) using 1,000 structured prompts spanning 25 subdomains, our findings reveal significant limitations in their ability to effectively integrate and apply world knowledge during image generation, highlighting critical pathways for enhancing knowledge incorporation and application in next-generation T2I models. Code and data are available at https://github.com/PKU-YuanGroup/WISE.

A key aspect of text-to-image personalization methods is the manner in which the target concept is represented within the generative process. This choice greatly affects the visual fidelity, downstream editability, and disk space needed to store the learned concept. In this paper, we explore a new text-conditioning space that is dependent on both the denoising process timestep (time) and the denoising U-Net layers (space) and showcase its compelling properties. A single concept in the space-time representation is composed of hundreds of vectors, one for each combination of time and space, making this space challenging to optimize directly. Instead, we propose to implicitly represent a concept in this space by optimizing a small neural mapper that receives the current time and space parameters and outputs the matching token embedding. In doing so, the entire personalized concept is represented by the parameters of the learned mapper, resulting in a compact, yet expressive, representation. Similarly to other personalization methods, the output of our neural mapper resides in the input space of the text encoder. We observe that one can significantly improve the convergence and visual fidelity of the concept by introducing a textual bypass, where our neural mapper additionally outputs a residual that is added to the output of the text encoder. Finally, we show how one can impose an importance-based ordering over our implicit representation, providing users control over the reconstruction and editability of the learned concept using a single trained model. We demonstrate the effectiveness of our approach over a range of concepts and prompts, showing our method's ability to generate high-quality and controllable compositions without fine-tuning any parameters of the generative model itself.

Text-to-Image (T2I) generation methods based on diffusion model have garnered significant attention in the last few years. Although these image synthesis methods produce visually appealing results, they frequently exhibit spelling errors when rendering text within the generated images. Such errors manifest as missing, incorrect or extraneous characters, thereby severely constraining the performance of text image generation based on diffusion models. To address the aforementioned issue, this paper proposes a novel approach for text image generation, utilizing a pre-trained diffusion model (i.e., Stable Diffusion [27]). Our approach involves the design and training of a light-weight character-level text encoder, which replaces the original CLIP encoder and provides more robust text embeddings as conditional guidance. Then, we fine-tune the diffusion model using a large-scale dataset, incorporating local attention control under the supervision of character-level segmentation maps. Finally, by employing an inference stage refinement process, we achieve a notably high sequence accuracy when synthesizing text in arbitrarily given images. Both qualitative and quantitative results demonstrate the superiority of our method to the state of the art. Furthermore, we showcase several potential applications of the proposed UDiffText, including text-centric image synthesis, scene text editing, etc. Code and model will be available at https://github.com/ZYM-PKU/UDiffText .

Contrastive pretraining on parallel image-text data has attained great success in vision-language processing (VLP), as exemplified by CLIP and related methods. However, prior explorations tend to focus on general domains in the web. Biomedical images and text are rather different, but publicly available datasets are small and skew toward chest X-ray, thus severely limiting progress. In this paper, we conducted by far the largest study on biomedical VLP, using 15 million figure-caption pairs extracted from biomedical research articles in PubMed Central. Our dataset (PMC-15M) is two orders of magnitude larger than existing biomedical image-text datasets such as MIMIC-CXR, and spans a diverse range of biomedical images. The standard CLIP method is suboptimal for the biomedical domain. We propose BiomedCLIP with domain-specific adaptations tailored to biomedical VLP. We conducted extensive experiments and ablation studies on standard biomedical imaging tasks from retrieval to classification to visual question-answering (VQA). BiomedCLIP established new state of the art in a wide range of standard datasets, substantially outperformed prior VLP approaches. Surprisingly, BiomedCLIP even outperformed radiology-specific state-of-the-art models such as BioViL on radiology-specific tasks such as RSNA pneumonia detection, thus highlighting the utility in large-scale pretraining across all biomedical image types. We will release our models at https://aka.ms/biomedclip to facilitate future research in biomedical VLP.

Trustworthiness is essential for the precise and interpretable application of artificial intelligence (AI) in medical imaging. Traditionally, precision and interpretability have been addressed as separate tasks, namely medical image analysis and explainable AI, each developing its own models independently. In this study, for the first time, we investigate the development of a unified medical vision-language pre-training model that can achieve both accurate analysis and interpretable understanding of medical images across various modalities. To build the model, we construct MedConcept-23M, a large-scale dataset comprising 23 million medical image-text pairs extracted from 6.2 million scientific articles, enriched with concepts from the Unified Medical Language System (UMLS). Based on MedConcept-23M, we introduce ConceptCLIP, a medical AI model utilizing concept-enhanced contrastive language-image pre-training. The pre-training of ConceptCLIP involves two primary components: image-text alignment learning (IT-Align) and patch-concept alignment learning (PC-Align). This dual alignment strategy enhances the model's capability to associate specific image regions with relevant concepts, thereby improving both the precision of analysis and the interpretability of the AI system. We conducted extensive experiments on 5 diverse types of medical image analysis tasks, spanning 51 subtasks across 10 image modalities, with the broadest range of downstream tasks. The results demonstrate the effectiveness of the proposed vision-language pre-training model. Further explainability analysis across 6 modalities reveals that ConceptCLIP achieves superior performance, underscoring its robust ability to advance explainable AI in medical imaging. These findings highlight ConceptCLIP's capability in promoting trustworthy AI in the field of medicine.

We present DreamBooth3D, an approach to personalize text-to-3D generative models from as few as 3-6 casually captured images of a subject. Our approach combines recent advances in personalizing text-to-image models (DreamBooth) with text-to-3D generation (DreamFusion). We find that naively combining these methods fails to yield satisfactory subject-specific 3D assets due to personalized text-to-image models overfitting to the input viewpoints of the subject. We overcome this through a 3-stage optimization strategy where we jointly leverage the 3D consistency of neural radiance fields together with the personalization capability of text-to-image models. Our method can produce high-quality, subject-specific 3D assets with text-driven modifications such as novel poses, colors and attributes that are not seen in any of the input images of the subject.

Over 85 million computed tomography (CT) scans are performed annually in the US, of which approximately one quarter focus on the abdomen. Given the current radiologist shortage, there is a large impetus to use artificial intelligence to alleviate the burden of interpreting these complex imaging studies. Prior state-of-the-art approaches for automated medical image interpretation leverage vision language models (VLMs). However, current medical VLMs are generally limited to 2D images and short reports, and do not leverage electronic health record (EHR) data for supervision. We introduce Merlin - a 3D VLM that we train using paired CT scans (6+ million images from 15,331 CTs), EHR diagnosis codes (1.8+ million codes), and radiology reports (6+ million tokens). We evaluate Merlin on 6 task types and 752 individual tasks. The non-adapted (off-the-shelf) tasks include zero-shot findings classification (31 findings), phenotype classification (692 phenotypes), and zero-shot cross-modal retrieval (image to findings and image to impressions), while model adapted tasks include 5-year disease prediction (6 diseases), radiology report generation, and 3D semantic segmentation (20 organs). We perform internal validation on a test set of 5,137 CTs, and external validation on 7,000 clinical CTs and on two public CT datasets (VerSe, TotalSegmentator). Beyond these clinically-relevant evaluations, we assess the efficacy of various network architectures and training strategies to depict that Merlin has favorable performance to existing task-specific baselines. We derive data scaling laws to empirically assess training data needs for requisite downstream task performance. Furthermore, unlike conventional VLMs that require hundreds of GPUs for training, we perform all training on a single GPU.

Generating and editing images from open domain text prompts is a challenging task that heretofore has required expensive and specially trained models. We demonstrate a novel methodology for both tasks which is capable of producing images of high visual quality from text prompts of significant semantic complexity without any training by using a multimodal encoder to guide image generations. We demonstrate on a variety of tasks how using CLIP [37] to guide VQGAN [11] produces higher visual quality outputs than prior, less flexible approaches like DALL-E [38], GLIDE [33] and Open-Edit [24], despite not being trained for the tasks presented. Our code is available in a public repository.

Medical vision-and-language pre-training provides a feasible solution to extract effective vision-and-language representations from medical images and texts. However, few studies have been dedicated to this field to facilitate medical vision-and-language understanding. In this paper, we propose a self-supervised learning paradigm with multi-modal masked autoencoders (M^3AE), which learn cross-modal domain knowledge by reconstructing missing pixels and tokens from randomly masked images and texts. There are three key designs to make this simple approach work. First, considering the different information densities of vision and language, we adopt different masking ratios for the input image and text, where a considerably larger masking ratio is used for images. Second, we use visual and textual features from different layers to perform the reconstruction to deal with different levels of abstraction in visual and language. Third, we develop different designs for vision and language decoders (i.e., a Transformer for vision and a multi-layer perceptron for language). To perform a comprehensive evaluation and facilitate further research, we construct a medical vision-and-language benchmark including three tasks. Experimental results demonstrate the effectiveness of our approach, where state-of-the-art results are achieved on all downstream tasks. Besides, we conduct further analysis to better verify the effectiveness of different components of our approach and various settings of pre-training. The source code is available at~https://github.com/zhjohnchan/M3AE.

Text-to-image synthesis has recently attracted widespread attention due to rapidly improving quality and numerous practical applications. However, the language understanding capabilities of text-to-image models are still poorly understood, which makes it difficult to reason about prompt formulations that a given model would understand well. In this work, we measure the capability of popular text-to-image models to understand hypernymy, or the "is-a" relation between words. We design two automatic metrics based on the WordNet semantic hierarchy and existing image classifiers pretrained on ImageNet. These metrics both enable broad quantitative comparison of linguistic capabilities for text-to-image models and offer a way of finding fine-grained qualitative differences, such as words that are unknown to models and thus are difficult for them to draw. We comprehensively evaluate popular text-to-image models, including GLIDE, Latent Diffusion, and Stable Diffusion, showing how our metrics can provide a better understanding of the individual strengths and weaknesses of these models.

Diffusion-based text-to-image models have demonstrated impressive achievements in diversity and aesthetics but struggle to generate images with legible visual texts. Existing backbone models have limitations such as misspelling, failing to generate texts, and lack of support for Chinese text, but their development shows promising potential. In this paper, we propose a series of methods, aiming to empower backbone models to generate visual texts in English and Chinese. We first conduct a preliminary study revealing that Byte Pair Encoding (BPE) tokenization and the insufficient learning of cross-attention modules restrict the performance of the backbone models. Based on these observations, we make the following improvements: (1) We design a mixed granularity input strategy to provide more suitable text representations; (2) We propose to augment the conventional training objective with three glyph-aware training losses, which enhance the learning of cross-attention modules and encourage the model to focus on visual texts. Through experiments, we demonstrate that our methods can effectively empower backbone models to generate semantic relevant, aesthetically appealing, and accurate visual text images, while maintaining their fundamental image generation quality.

Image description datasets play a crucial role in the advancement of various applications such as image understanding, text-to-image generation, and text-image retrieval. Currently, image description datasets primarily originate from two sources. One source is the scraping of image-text pairs from the web. Despite their abundance, these descriptions are often of low quality and noisy. Another is through human labeling. Datasets such as COCO are generally very short and lack details. Although detailed image descriptions can be annotated by humans, the high annotation cost limits the feasibility. These limitations underscore the need for more efficient and scalable methods to generate accurate and detailed image descriptions. In this paper, we propose an innovative framework termed Image Textualization (IT), which automatically produces high-quality image descriptions by leveraging existing multi-modal large language models (MLLMs) and multiple vision expert models in a collaborative manner, which maximally convert the visual information into text. To address the current lack of benchmarks for detailed descriptions, we propose several benchmarks for comprehensive evaluation, which verifies the quality of image descriptions created by our framework. Furthermore, we show that LLaVA-7B, benefiting from training on IT-curated descriptions, acquire improved capability to generate richer image descriptions, substantially increasing the length and detail of their output with less hallucination.

The field of advanced text-to-image generation is witnessing the emergence of unified frameworks that integrate powerful text encoders, such as CLIP and T5, with Diffusion Transformer backbones. Although there have been efforts to control output images with additional conditions, like canny and depth map, a comprehensive framework for arbitrary text-image interleaved control is still lacking. This gap is especially evident when attempting to merge concepts or visual elements from multiple images in the generation process. To mitigate the gap, we conducted preliminary experiments showing that large multimodal models (LMMs) offer an effective shared representation space, where image and text can be well-aligned to serve as a condition for external diffusion models. Based on this discovery, we propose Dream Engine, an efficient and unified framework designed for arbitrary text-image interleaved control in image generation models. Building on powerful text-to-image models like SD3.5, we replace the original text-only encoders by incorporating versatile multimodal information encoders such as QwenVL. Our approach utilizes a two-stage training paradigm, consisting of joint text-image alignment and multimodal interleaved instruction tuning. Our experiments demonstrate that this training method is effective, achieving a 0.69 overall score on the GenEval benchmark, and matching the performance of state-of-the-art text-to-image models like SD3.5 and FLUX.

We present Muse, a text-to-image Transformer model that achieves state-of-the-art image generation performance while being significantly more efficient than diffusion or autoregressive models. Muse is trained on a masked modeling task in discrete token space: given the text embedding extracted from a pre-trained large language model (LLM), Muse is trained to predict randomly masked image tokens. Compared to pixel-space diffusion models, such as Imagen and DALL-E 2, Muse is significantly more efficient due to the use of discrete tokens and requiring fewer sampling iterations; compared to autoregressive models, such as Parti, Muse is more efficient due to the use of parallel decoding. The use of a pre-trained LLM enables fine-grained language understanding, translating to high-fidelity image generation and the understanding of visual concepts such as objects, their spatial relationships, pose, cardinality etc. Our 900M parameter model achieves a new SOTA on CC3M, with an FID score of 6.06. The Muse 3B parameter model achieves an FID of 7.88 on zero-shot COCO evaluation, along with a CLIP score of 0.32. Muse also directly enables a number of image editing applications without the need to fine-tune or invert the model: inpainting, outpainting, and mask-free editing. More results are available at https://muse-model.github.io

Large-scale diffusion-based generative models have led to breakthroughs in text-conditioned high-resolution image synthesis. Starting from random noise, such text-to-image diffusion models gradually synthesize images in an iterative fashion while conditioning on text prompts. We find that their synthesis behavior qualitatively changes throughout this process: Early in sampling, generation strongly relies on the text prompt to generate text-aligned content, while later, the text conditioning is almost entirely ignored. This suggests that sharing model parameters throughout the entire generation process may not be ideal. Therefore, in contrast to existing works, we propose to train an ensemble of text-to-image diffusion models specialized for different synthesis stages. To maintain training efficiency, we initially train a single model, which is then split into specialized models that are trained for the specific stages of the iterative generation process. Our ensemble of diffusion models, called eDiff-I, results in improved text alignment while maintaining the same inference computation cost and preserving high visual quality, outperforming previous large-scale text-to-image diffusion models on the standard benchmark. In addition, we train our model to exploit a variety of embeddings for conditioning, including the T5 text, CLIP text, and CLIP image embeddings. We show that these different embeddings lead to different behaviors. Notably, the CLIP image embedding allows an intuitive way of transferring the style of a reference image to the target text-to-image output. Lastly, we show a technique that enables eDiff-I's "paint-with-words" capability. A user can select the word in the input text and paint it in a canvas to control the output, which is very handy for crafting the desired image in mind. The project page is available at https://deepimagination.cc/eDiff-I/

Text-to-image generative models have recently attracted considerable interest, enabling the synthesis of high-quality images from textual prompts. However, these models often lack the capability to generate specific subjects from given reference images or to synthesize novel renditions under varying conditions. Methods like DreamBooth and Subject-driven Text-to-Image (SuTI) have made significant progress in this area. Yet, both approaches primarily focus on enhancing similarity to reference images and require expensive setups, often overlooking the need for efficient training and avoiding overfitting to the reference images. In this work, we present the lambda-Harmonic reward function, which provides a reliable reward signal and enables early stopping for faster training and effective regularization. By combining the Bradley-Terry preference model, the lambda-Harmonic reward function also provides preference labels for subject-driven generation tasks. We propose Reward Preference Optimization (RPO), which offers a simpler setup (requiring only 3% of the negative samples used by DreamBooth) and fewer gradient steps for fine-tuning. Unlike most existing methods, our approach does not require training a text encoder or optimizing text embeddings and achieves text-image alignment by fine-tuning only the U-Net component. Empirically, lambda-Harmonic proves to be a reliable approach for model selection in subject-driven generation tasks. Based on preference labels and early stopping validation from the lambda-Harmonic reward function, our algorithm achieves a state-of-the-art CLIP-I score of 0.833 and a CLIP-T score of 0.314 on DreamBench.

Multimodal machine translation (MMT) simultaneously takes the source sentence and a relevant image as input for translation. Since there is no paired image available for the input sentence in most cases, recent studies suggest utilizing powerful text-to-image generation models to provide image inputs. Nevertheless, synthetic images generated by these models often follow different distributions compared to authentic images. Consequently, using authentic images for training and synthetic images for inference can introduce a distribution shift, resulting in performance degradation during inference. To tackle this challenge, in this paper, we feed synthetic and authentic images to the MMT model, respectively. Then we minimize the gap between the synthetic and authentic images by drawing close the input image representations of the Transformer Encoder and the output distributions of the Transformer Decoder. Therefore, we mitigate the distribution disparity introduced by the synthetic images during inference, thereby freeing the authentic images from the inference process.Experimental results show that our approach achieves state-of-the-art performance on the Multi30K En-De and En-Fr datasets, while remaining independent of authentic images during inference.

This paper introduces BiMediX2, a bilingual (Arabic-English) Bio-Medical EXpert Large Multimodal Model (LMM) with a unified architecture that integrates text and visual modalities, enabling advanced image understanding and medical applications. BiMediX2 leverages the Llama3.1 architecture and integrates text and visual capabilities to facilitate seamless interactions in both English and Arabic, supporting text-based inputs and multi-turn conversations involving medical images. The model is trained on an extensive bilingual healthcare dataset consisting of 1.6M samples of diverse medical interactions for both text and image modalities, mixed in Arabic and English. We also propose the first bilingual GPT-4o based medical LMM benchmark named BiMed-MBench. BiMediX2 is benchmarked on both text-based and image-based tasks, achieving state-of-the-art performance across several medical benchmarks. It outperforms recent state-of-the-art models in medical LLM evaluation benchmarks. Our model also sets a new benchmark in multimodal medical evaluations with over 9% improvement in English and over 20% in Arabic evaluations. Additionally, it surpasses GPT-4 by around 9% in UPHILL factual accuracy evaluations and excels in various medical Visual Question Answering, Report Generation, and Report Summarization tasks. The project page including source code and the trained model, is available at https://github.com/mbzuai-oryx/BiMediX2.

Recent advances in text-to-image (T2I) generation have shown remarkable success in producing high-quality images from text. However, existing T2I models show decayed performance in compositional image generation involving multiple objects and intricate relationships. We attribute this problem to limitations in existing datasets of image-text pairs, which lack precise inter-object relationship annotations with prompts only. To address this problem, we construct LAION-SG, a large-scale dataset with high-quality structural annotations of scene graphs (SG), which precisely describe attributes and relationships of multiple objects, effectively representing the semantic structure in complex scenes. Based on LAION-SG, we train a new foundation model SDXL-SG to incorporate structural annotation information into the generation process. Extensive experiments show advanced models trained on our LAION-SG boast significant performance improvements in complex scene generation over models on existing datasets. We also introduce CompSG-Bench, a benchmark that evaluates models on compositional image generation, establishing a new standard for this domain.

The scaling laws and extraordinary performance of large foundation models motivate the development and utilization of such models in biomedicine. However, despite early promising results on some biomedical benchmarks, there are still major challenges that need to be addressed before these models can be used in real-world clinics. Frontier general-domain models such as GPT-4V still have significant performance gaps in multimodal biomedical applications. More importantly, less-acknowledged pragmatic issues, including accessibility, model cost, and tedious manual evaluation make it hard for clinicians to use state-of-the-art large models directly on private patient data. Here, we explore training open-source small multimodal models (SMMs) to bridge competency gaps for unmet clinical needs in radiology. To maximize data efficiency, we adopt a modular approach by incorporating state-of-the-art pre-trained models for image and text modalities, and focusing on training a lightweight adapter to ground each modality to the text embedding space, as exemplified by LLaVA-Med. For training, we assemble a large dataset of over 697 thousand radiology image-text pairs. For evaluation, we propose CheXprompt, a GPT-4-based metric for factuality evaluation, and demonstrate its parity with expert evaluation. For best practice, we conduct a systematic ablation study on various choices in data engineering and multimodal training. The resulting LlaVA-Rad (7B) model attains state-of-the-art results on standard radiology tasks such as report generation and cross-modal retrieval, even outperforming much larger models such as GPT-4V and Med-PaLM M (84B). The inference of LlaVA-Rad is fast and can be performed on a single V100 GPU in private settings, offering a promising state-of-the-art tool for real-world clinical applications.

In the healthcare domain, summarizing medical questions posed by patients is critical for improving doctor-patient interactions and medical decision-making. Although medical data has grown in complexity and quantity, the current body of research in this domain has primarily concentrated on text-based methods, overlooking the integration of visual cues. Also prior works in the area of medical question summarisation have been limited to the English language. This work introduces the task of multimodal medical question summarization for codemixed input in a low-resource setting. To address this gap, we introduce the Multimodal Medical Codemixed Question Summarization MMCQS dataset, which combines Hindi-English codemixed medical queries with visual aids. This integration enriches the representation of a patient's medical condition, providing a more comprehensive perspective. We also propose a framework named MedSumm that leverages the power of LLMs and VLMs for this task. By utilizing our MMCQS dataset, we demonstrate the value of integrating visual information from images to improve the creation of medically detailed summaries. This multimodal strategy not only improves healthcare decision-making but also promotes a deeper comprehension of patient queries, paving the way for future exploration in personalized and responsive medical care. Our dataset, code, and pre-trained models will be made publicly available.

Visual Language Models (VLMs) have demonstrated impressive capabilities in visual grounding tasks. However, their effectiveness in the medical domain, particularly for abnormality detection and localization within medical images, remains underexplored. A major challenge is the complex and abstract nature of medical terminology, which makes it difficult to directly associate pathological anomaly terms with their corresponding visual features. In this work, we introduce a novel approach to enhance VLM performance in medical abnormality detection and localization by leveraging decomposed medical knowledge. Instead of directly prompting models to recognize specific abnormalities, we focus on breaking down medical concepts into fundamental attributes and common visual patterns. This strategy promotes a stronger alignment between textual descriptions and visual features, improving both the recognition and localization of abnormalities in medical images.We evaluate our method on the 0.23B Florence-2 base model and demonstrate that it achieves comparable performance in abnormality grounding to significantly larger 7B LLaVA-based medical VLMs, despite being trained on only 1.5% of the data used for such models. Experimental results also demonstrate the effectiveness of our approach in both known and previously unseen abnormalities, suggesting its strong generalization capabilities.

Large Language Models (LLMs) have garnered significant attention for their advancements in natural language processing, demonstrating unparalleled prowess in text comprehension and generation. Yet, the simultaneous generation of images with coherent textual narratives remains an evolving frontier. In response, we introduce an innovative interleaved vision-and-language generation technique anchored by the concept of "generative vokens," acting as the bridge for harmonized image-text outputs. Our approach is characterized by a distinctive two-staged training strategy focusing on description-free multimodal generation, where the training requires no comprehensive descriptions of images. To bolster model integrity, classifier-free guidance is incorporated, enhancing the effectiveness of vokens on image generation. Our model, MiniGPT-5, exhibits substantial improvement over the baseline Divter model on the MMDialog dataset and consistently delivers superior or comparable multimodal outputs in human evaluations on the VIST dataset, highlighting its efficacy across diverse benchmarks.

Learning medical visual representations directly from paired radiology reports has become an emerging topic in representation learning. However, existing medical image-text joint learning methods are limited by instance or local supervision analysis, ignoring disease-level semantic correspondences. In this paper, we present a novel Multi-Granularity Cross-modal Alignment (MGCA) framework for generalized medical visual representation learning by harnessing the naturally exhibited semantic correspondences between medical image and radiology reports at three different levels, i.e., pathological region-level, instance-level, and disease-level. Specifically, we first incorporate the instance-wise alignment module by maximizing the agreement between image-report pairs. Further, for token-wise alignment, we introduce a bidirectional cross-attention strategy to explicitly learn the matching between fine-grained visual tokens and text tokens, followed by contrastive learning to align them. More important, to leverage the high-level inter-subject relationship semantic (e.g., disease) correspondences, we design a novel cross-modal disease-level alignment paradigm to enforce the cross-modal cluster assignment consistency. Extensive experimental results on seven downstream medical image datasets covering image classification, object detection, and semantic segmentation tasks demonstrate the stable and superior performance of our framework.

Current medical artificial intelligence systems are often limited to narrow applications, hindering their widespread adoption in clinical practice. To address this limitation, we propose MedVersa, a generalist learner that enables flexible learning and tasking for medical image interpretation. By leveraging a large language model as a learnable orchestrator, MedVersa can learn from both visual and linguistic supervision, support multimodal inputs, and perform real-time task specification. This versatility allows MedVersa to adapt to various clinical scenarios and perform multifaceted medical image analysis. We introduce MedInterp, the largest multimodal dataset to date for medical image interpretation, consisting of over 13 million annotated instances spanning 11 tasks across 3 modalities, to support the development of MedVersa. Our experiments demonstrate that MedVersa achieves state-of-the-art performance in 9 tasks, sometimes outperforming specialist counterparts by over 10%. MedVersa is the first to showcase the viability of multimodal generative medical AI in implementing multimodal outputs, inputs, and dynamic task specification, highlighting its potential as a multifunctional system for comprehensive medical image analysis. This generalist approach to medical image interpretation paves the way for more adaptable and efficient AI-assisted clinical decision-making.

In this paper, we present MoMA: an open-vocabulary, training-free personalized image model that boasts flexible zero-shot capabilities. As foundational text-to-image models rapidly evolve, the demand for robust image-to-image translation grows. Addressing this need, MoMA specializes in subject-driven personalized image generation. Utilizing an open-source, Multimodal Large Language Model (MLLM), we train MoMA to serve a dual role as both a feature extractor and a generator. This approach effectively synergizes reference image and text prompt information to produce valuable image features, facilitating an image diffusion model. To better leverage the generated features, we further introduce a novel self-attention shortcut method that efficiently transfers image features to an image diffusion model, improving the resemblance of the target object in generated images. Remarkably, as a tuning-free plug-and-play module, our model requires only a single reference image and outperforms existing methods in generating images with high detail fidelity, enhanced identity-preservation and prompt faithfulness. Our work is open-source, thereby providing universal access to these advancements.

Based on recent advanced diffusion models, Text-to-image (T2I) generation models have demonstrated their capabilities in generating diverse and high-quality images. However, leveraging their potential for real-world content creation, particularly in providing users with precise control over the image generation result, poses a significant challenge. In this paper, we propose an innovative training-free pipeline that extends existing text-to-image generation models to incorporate a sketch as an additional condition. To generate new images with a layout and structure closely resembling the input sketch, we find that these core features of a sketch can be tracked with the cross-attention maps of diffusion models. We introduce latent optimization, a method that refines the noisy latent at each intermediate step of the generation process using cross-attention maps to ensure that the generated images closely adhere to the desired structure outlined in the reference sketch. Through latent optimization, our method enhances the fidelity and accuracy of image generation, offering users greater control and customization options in content creation.

We introduce LlamaGen, a new family of image generation models that apply original ``next-token prediction'' paradigm of large language models to visual generation domain. It is an affirmative answer to whether vanilla autoregressive models, e.g., Llama, without inductive biases on visual signals can achieve state-of-the-art image generation performance if scaling properly. We reexamine design spaces of image tokenizers, scalability properties of image generation models, and their training data quality. The outcome of this exploration consists of: (1) An image tokenizer with downsample ratio of 16, reconstruction quality of 0.94 rFID and codebook usage of 97% on ImageNet benchmark. (2) A series of class-conditional image generation models ranging from 111M to 3.1B parameters, achieving 2.18 FID on ImageNet 256x256 benchmarks, outperforming the popular diffusion models such as LDM, DiT. (3) A text-conditional image generation model with 775M parameters, from two-stage training on LAION-COCO and high aesthetics quality images, demonstrating competitive performance of visual quality and text alignment. (4) We verify the effectiveness of LLM serving frameworks in optimizing the inference speed of image generation models and achieve 326% - 414% speedup. We release all models and codes to facilitate open-source community of visual generation and multimodal foundation models.

Radiology report generation (RRG) aims to automatically generate free-text descriptions from clinical radiographs, e.g., chest X-Ray images. RRG plays an essential role in promoting clinical automation and presents significant help to provide practical assistance for inexperienced doctors and alleviate radiologists' workloads. Therefore, consider these meaningful potentials, research on RRG is experiencing explosive growth in the past half-decade, especially with the rapid development of deep learning approaches. Existing studies perform RRG from the perspective of enhancing different modalities, provide insights on optimizing the report generation process with elaborated features from both visual and textual information, and further facilitate RRG with the cross-modal interactions among them. In this paper, we present a comprehensive review of deep learning-based RRG from various perspectives. Specifically, we firstly cover pivotal RRG approaches based on the task-specific features of radiographs, reports, and the cross-modal relations between them, and then illustrate the benchmark datasets conventionally used for this task with evaluation metrics, subsequently analyze the performance of different approaches and finally offer our summary on the challenges and the trends in future directions. Overall, the goal of this paper is to serve as a tool for understanding existing literature and inspiring potential valuable research in the field of RRG.

Medical information retrieval (MIR) is essential for retrieving relevant medical knowledge from diverse sources, including electronic health records, scientific literature, and medical databases. However, achieving effective zero-shot dense retrieval in the medical domain poses substantial challenges due to the lack of relevance-labeled data. In this paper, we introduce a novel approach called Self-Learning Hypothetical Document Embeddings (SL-HyDE) to tackle this issue. SL-HyDE leverages large language models (LLMs) as generators to generate hypothetical documents based on a given query. These generated documents encapsulate key medical context, guiding a dense retriever in identifying the most relevant documents. The self-learning framework progressively refines both pseudo-document generation and retrieval, utilizing unlabeled medical corpora without requiring any relevance-labeled data. Additionally, we present the Chinese Medical Information Retrieval Benchmark (CMIRB), a comprehensive evaluation framework grounded in real-world medical scenarios, encompassing five tasks and ten datasets. By benchmarking ten models on CMIRB, we establish a rigorous standard for evaluating medical information retrieval systems. Experimental results demonstrate that SL-HyDE significantly surpasses existing methods in retrieval accuracy while showcasing strong generalization and scalability across various LLM and retriever configurations. CMIRB data and evaluation code are publicly available at: https://github.com/CMIRB-benchmark/CMIRB.

Text-to-image diffusion models have demonstrated an impressive ability to produce high-quality outputs. However, they often struggle to accurately follow fine-grained spatial information in an input text. To this end, we propose a compositional approach for text-to-image generation based on two stages. In the first stage, we design a diffusion-based generative model to produce one or more aligned intermediate representations (such as depth or segmentation maps) conditioned on text. In the second stage, we map these representations, together with the text, to the final output image using a separate diffusion-based generative model. Our findings indicate that such compositional approach can improve image generation, resulting in a notable improvement in FID score and a comparable CLIP score, when compared to the standard non-compositional baseline.

Image generation abilities of text-to-image diffusion models have significantly advanced, yielding highly photo-realistic images from descriptive text and increasing the viability of leveraging synthetic images to train computer vision models. To serve as effective training data, generated images must be highly realistic while also sufficiently diverse within the support of the target data distribution. Yet, state-of-the-art conditional image generation models have been primarily optimized for creative applications, prioritizing image realism and prompt adherence over conditional diversity. In this paper, we investigate how to improve the diversity of generated images with the goal of increasing their effectiveness to train downstream image classification models, without fine-tuning the image generation model. We find that conditioning the generation process on an augmented real image and text prompt produces generations that serve as effective synthetic datasets for downstream training. Conditioning on real training images contextualizes the generation process to produce images that are in-domain with the real image distribution, while data augmentations introduce visual diversity that improves the performance of the downstream classifier. We validate augmentation-conditioning on a total of five established long-tail and few-shot image classification benchmarks and show that leveraging augmentations to condition the generation process results in consistent improvements over the state-of-the-art on the long-tailed benchmark and remarkable gains in extreme few-shot regimes of the remaining four benchmarks. These results constitute an important step towards effectively leveraging synthetic data for downstream training.

Text-conditioned image generation models have recently achieved astonishing results in image quality and text alignment and are consequently employed in a fast-growing number of applications. Since they are highly data-driven, relying on billion-sized datasets randomly scraped from the web, they also reproduce inappropriate human behavior. Specifically, we demonstrate inappropriate degeneration on a large-scale for various generative text-to-image models, thus motivating the need for monitoring and moderating them at deployment. To this end, we evaluate mitigation strategies at inference to suppress the generation of inappropriate content. Our findings show that we can use models' representations of the world's ugliness to align them with human preferences.

Conversational generative AI has demonstrated remarkable promise for empowering biomedical practitioners, but current investigations focus on unimodal text. Multimodal conversational AI has seen rapid progress by leveraging billions of image-text pairs from the public web, but such general-domain vision-language models still lack sophistication in understanding and conversing about biomedical images. In this paper, we propose a cost-efficient approach for training a vision-language conversational assistant that can answer open-ended research questions of biomedical images. The key idea is to leverage a large-scale, broad-coverage biomedical figure-caption dataset extracted from PubMed Central, use GPT-4 to self-instruct open-ended instruction-following data from the captions, and then fine-tune a large general-domain vision-language model using a novel curriculum learning method. Specifically, the model first learns to align biomedical vocabulary using the figure-caption pairs as is, then learns to master open-ended conversational semantics using GPT-4 generated instruction-following data, broadly mimicking how a layperson gradually acquires biomedical knowledge. This enables us to train a Large Language and Vision Assistant for BioMedicine (LLaVA-Med) in less than 15 hours (with eight A100s). LLaVA-Med exhibits excellent multimodal conversational capability and can follow open-ended instruction to assist with inquiries about a biomedical image. On three standard biomedical visual question answering datasets, LLaVA-Med outperforms previous supervised state-of-the-art on certain metrics. To facilitate biomedical multimodal research, we will release our instruction-following data and the LLaVA-Med model.

Visual text evokes an image in a person's mind, while non-visual text fails to do so. A method to automatically detect visualness in text will unlock the ability to augment text with relevant images, as neural text-to-image generation and retrieval models operate on the implicit assumption that the input text is visual in nature. We curate a dataset of 3,620 English sentences and their visualness scores provided by multiple human annotators. Additionally, we use documents that contain text and visual assets to create a distantly supervised corpus of document text and associated images. We also propose a fine-tuning strategy that adapts large vision-language models like CLIP that assume a one-to-one correspondence between text and image to the task of scoring text visualness from text input alone. Our strategy involves modifying the model's contrastive learning objective to map text identified as non-visual to a common NULL image while matching visual text to their corresponding images in the document. We evaluate the proposed approach on its ability to (i) classify visual and non-visual text accurately, and (ii) attend over words that are identified as visual in psycholinguistic studies. Empirical evaluation indicates that our approach performs better than several heuristics and baseline models for the proposed task. Furthermore, to highlight the importance of modeling the visualness of text, we conduct qualitative analyses of text-to-image generation systems like DALL-E.

Interleaved text-and-image generation has been an intriguing research direction, where the models are required to generate both images and text pieces in an arbitrary order. Despite the emerging advancements in interleaved generation, the progress in its evaluation still significantly lags behind. Existing evaluation benchmarks do not support arbitrarily interleaved images and text for both inputs and outputs, and they only cover a limited number of domains and use cases. Also, current works predominantly use similarity-based metrics which fall short in assessing the quality in open-ended scenarios. To this end, we introduce InterleavedBench, the first benchmark carefully curated for the evaluation of interleaved text-and-image generation. InterleavedBench features a rich array of tasks to cover diverse real-world use cases. In addition, we present InterleavedEval, a strong reference-free metric powered by GPT-4o to deliver accurate and explainable evaluation. We carefully define five essential evaluation aspects for InterleavedEval, including text quality, perceptual quality, image coherence, text-image coherence, and helpfulness, to ensure a comprehensive and fine-grained assessment. Through extensive experiments and rigorous human evaluation, we show that our benchmark and metric can effectively evaluate the existing models with a strong correlation with human judgments surpassing previous reference-based metrics. We also provide substantial findings and insights to foster future research in interleaved generation and its evaluation.

Text-to-image models offer a new level of creative flexibility by allowing users to guide the image generation process through natural language. However, using these models to consistently portray the same subject across diverse prompts remains challenging. Existing approaches fine-tune the model to teach it new words that describe specific user-provided subjects or add image conditioning to the model. These methods require lengthy per-subject optimization or large-scale pre-training. Moreover, they struggle to align generated images with text prompts and face difficulties in portraying multiple subjects. Here, we present ConsiStory, a training-free approach that enables consistent subject generation by sharing the internal activations of the pretrained model. We introduce a subject-driven shared attention block and correspondence-based feature injection to promote subject consistency between images. Additionally, we develop strategies to encourage layout diversity while maintaining subject consistency. We compare ConsiStory to a range of baselines, and demonstrate state-of-the-art performance on subject consistency and text alignment, without requiring a single optimization step. Finally, ConsiStory can naturally extend to multi-subject scenarios, and even enable training-free personalization for common objects.

Vision-language pre-training for chest X-rays has made significant strides, primarily by utilizing paired radiographs and radiology reports. However, existing approaches often face challenges in encoding medical knowledge effectively. While radiology reports provide insights into the current disease manifestation, medical definitions (as used by contemporary methods) tend to be overly abstract, creating a gap in knowledge. To address this, we propose DeViDe, a novel transformer-based method that leverages radiographic descriptions from the open web. These descriptions outline general visual characteristics of diseases in radiographs, and when combined with abstract definitions and radiology reports, provide a holistic snapshot of knowledge. DeViDe incorporates three key features for knowledge-augmented vision language alignment: First, a large-language model-based augmentation is employed to homogenise medical knowledge from diverse sources. Second, this knowledge is aligned with image information at various levels of granularity. Third, a novel projection layer is proposed to handle the complexity of aligning each image with multiple descriptions arising in a multi-label setting. In zero-shot settings, DeViDe performs comparably to fully supervised models on external datasets and achieves state-of-the-art results on three large-scale datasets. Additionally, fine-tuning DeViDe on four downstream tasks and six segmentation tasks showcases its superior performance across data from diverse distributions.

Large Language Models (LLMs), known for their versatility in textual data, are increasingly being explored for their potential to enhance medical image segmentation, a crucial task for accurate diagnostic imaging. This study explores enhancing Vision Transformers (ViTs) for medical image segmentation by integrating pre-trained LLM transformer blocks. Our approach, which incorporates a frozen LLM transformer block into the encoder of a ViT-based model, leads to substantial improvements in segmentation performance across various medical imaging modalities. We propose a Hybrid Attention Mechanism that combines global and local feature learning with a Multi-Scale Fusion Block for aggregating features across different scales. The enhanced model shows significant performance gains, including an average Dice score increase from 0.74 to 0.79 and improvements in accuracy, precision, and the Jaccard Index. These results demonstrate the effectiveness of LLM-based transformers in refining medical image segmentation, highlighting their potential to significantly boost model accuracy and robustness. The source code and our implementation are available at: https://bit.ly/3zf2CVs

Recent text-to-image (T2I) generation models have achieved remarkable results by training on billion-scale datasets, following a `bigger is better' paradigm that prioritizes data quantity over quality. We challenge this established paradigm by demonstrating that strategic data augmentation of small, well-curated datasets can match or outperform models trained on massive web-scraped collections. Using only ImageNet enhanced with well-designed text and image augmentations, we achieve a +2 overall score over SD-XL on GenEval and +5 on DPGBench while using just 1/10th the parameters and 1/1000th the training images. Our results suggest that strategic data augmentation, rather than massive datasets, could offer a more sustainable path forward for T2I generation.

In this report, we introduce SciFive, a domain-specific T5 model that has been pre-trained on large biomedical corpora. Our model outperforms the current SOTA methods (i.e. BERT, BioBERT, Base T5) on tasks in named entity relation, relation extraction, natural language inference, and question-answering. We show that text-generation methods have significant potential in a broad array of biomedical NLP tasks, particularly those requiring longer, more complex outputs. Our results support the exploration of more difficult text generation tasks and the development of new methods in this area

Customization of text-to-image models enables users to insert custom concepts and generate the concepts in unseen settings. Existing methods either rely on costly test-time optimization or train encoders on single-image training datasets without multi-image supervision, leading to worse image quality. We propose a simple approach that addresses both limitations. We first leverage existing text-to-image models and 3D datasets to create a high-quality Synthetic Customization Dataset (SynCD) consisting of multiple images of the same object in different lighting, backgrounds, and poses. We then propose a new encoder architecture based on shared attention mechanisms that better incorporate fine-grained visual details from input images. Finally, we propose a new inference technique that mitigates overexposure issues during inference by normalizing the text and image guidance vectors. Through extensive experiments, we show that our model, trained on the synthetic dataset with the proposed encoder and inference algorithm, outperforms existing tuning-free methods on standard customization benchmarks.

Personalizing generative models offers a way to guide image generation with user-provided references. Current personalization methods can invert an object or concept into the textual conditioning space and compose new natural sentences for text-to-image diffusion models. However, representing and editing specific visual attributes such as material, style, and layout remains a challenge, leading to a lack of disentanglement and editability. To address this problem, we propose a novel approach that leverages the step-by-step generation process of diffusion models, which generate images from low to high frequency information, providing a new perspective on representing, generating, and editing images. We develop the Prompt Spectrum Space P*, an expanded textual conditioning space, and a new image representation method called \sysname. ProSpect represents an image as a collection of inverted textual token embeddings encoded from per-stage prompts, where each prompt corresponds to a specific generation stage (i.e., a group of consecutive steps) of the diffusion model. Experimental results demonstrate that P* and ProSpect offer better disentanglement and controllability compared to existing methods. We apply ProSpect in various personalized attribute-aware image generation applications, such as image-guided or text-driven manipulations of materials, style, and layout, achieving previously unattainable results from a single image input without fine-tuning the diffusion models. Our source code is available athttps://github.com/zyxElsa/ProSpect.

Multimodal large language models (MLLMs) hold significant potential in the medical field, but their capabilities are often limited by insufficient data in certain medical domains, highlighting the need for understanding what kinds of images can be used by MLLMs for generalization. Current research suggests that multi-task training outperforms single-task as different tasks can benefit each other, but they often overlook the internal relationships within these tasks, providing limited guidance on selecting datasets to enhance specific tasks. To analyze this phenomenon, we attempted to employ compositional generalization (CG)-the ability of models to understand novel combinations by recombining learned elements-as a guiding framework. Since medical images can be precisely defined by Modality, Anatomical area, and Task, naturally providing an environment for exploring CG. Therefore, we assembled 106 medical datasets to create Med-MAT for comprehensive experiments. The experiments confirmed that MLLMs can use CG to understand unseen medical images and identified CG as one of the main drivers of the generalization observed in multi-task training. Additionally, further studies demonstrated that CG effectively supports datasets with limited data and delivers consistent performance across different backbones, highlighting its versatility and broad applicability. Med-MAT is publicly available at https://github.com/FreedomIntelligence/Med-MAT.

Obtaining large pre-trained models that can be fine-tuned to new tasks with limited annotated samples has remained an open challenge for medical imaging data. While pre-trained deep networks on ImageNet and vision-language foundation models trained on web-scale data are prevailing approaches, their effectiveness on medical tasks is limited due to the significant domain shift between natural and medical images. To bridge this gap, we introduce LVM-Med, the first family of deep networks trained on large-scale medical datasets. We have collected approximately 1.3 million medical images from 55 publicly available datasets, covering a large number of organs and modalities such as CT, MRI, X-ray, and Ultrasound. We benchmark several state-of-the-art self-supervised algorithms on this dataset and propose a novel self-supervised contrastive learning algorithm using a graph-matching formulation. The proposed approach makes three contributions: (i) it integrates prior pair-wise image similarity metrics based on local and global information; (ii) it captures the structural constraints of feature embeddings through a loss function constructed via a combinatorial graph-matching objective; and (iii) it can be trained efficiently end-to-end using modern gradient-estimation techniques for black-box solvers. We thoroughly evaluate the proposed LVM-Med on 15 downstream medical tasks ranging from segmentation and classification to object detection, and both for the in and out-of-distribution settings. LVM-Med empirically outperforms a number of state-of-the-art supervised, self-supervised, and foundation models. For challenging tasks such as Brain Tumor Classification or Diabetic Retinopathy Grading, LVM-Med improves previous vision-language models trained on 1 billion masks by 6-7% while using only a ResNet-50.

Synthetic image generation has recently experienced significant improvements in domains such as natural image or art generation. However, the problem of figure and diagram generation remains unexplored. A challenging aspect of generating figures and diagrams is effectively rendering readable texts within the images. To alleviate this problem, we present OCR-VQGAN, an image encoder, and decoder that leverages OCR pre-trained features to optimize a text perceptual loss, encouraging the architecture to preserve high-fidelity text and diagram structure. To explore our approach, we introduce the Paper2Fig100k dataset, with over 100k images of figures and texts from research papers. The figures show architecture diagrams and methodologies of articles available at arXiv.org from fields like artificial intelligence and computer vision. Figures usually include text and discrete objects, e.g., boxes in a diagram, with lines and arrows that connect them. We demonstrate the effectiveness of OCR-VQGAN by conducting several experiments on the task of figure reconstruction. Additionally, we explore the qualitative and quantitative impact of weighting different perceptual metrics in the overall loss function. We release code, models, and dataset at https://github.com/joanrod/ocr-vqgan.

Developing generative models for interleaved image-text data has both research and practical value. It requires models to understand the interleaved sequences and subsequently generate images and text. However, existing attempts are limited by the issue that the fixed number of visual tokens cannot efficiently capture image details, which is particularly problematic in the multi-image scenarios. To address this, this paper presents MM-Interleaved, an end-to-end generative model for interleaved image-text data. It introduces a multi-scale and multi-image feature synchronizer module, allowing direct access to fine-grained image features in the previous context during the generation process. MM-Interleaved is end-to-end pre-trained on both paired and interleaved image-text corpora. It is further enhanced through a supervised fine-tuning phase, wherein the model improves its ability to follow complex multi-modal instructions. Experiments demonstrate the versatility of MM-Interleaved in recognizing visual details following multi-modal instructions and generating consistent images following both textual and visual conditions. Code and models are available at https://github.com/OpenGVLab/MM-Interleaved.

Groundbreaking advancements in text-to-image generation have recently been achieved with the emergence of diffusion models. These models exhibit a remarkable ability to generate highly artistic and intricately detailed images based on textual prompts. However, obtaining desired generation outcomes often necessitates repetitive trials of manipulating text prompts just like casting spells on a magic mirror, and the reason behind that is the limited capability of semantic understanding inherent in current image generation models. Specifically, existing diffusion models encode the text prompt input with a pre-trained encoder structure, which is usually trained on a limited number of image-caption pairs. The state-of-the-art large language models (LLMs) based on the decoder-only structure have shown a powerful semantic understanding capability as their architectures are more suitable for training on very large-scale unlabeled data. In this work, we propose to enhance text-to-image diffusion models by borrowing the strength of semantic understanding from large language models, and devise a simple yet effective adapter to allow the diffusion models to be compatible with the decoder-only structure. Meanwhile, we also provide a supporting theoretical analysis with various architectures (e.g., encoder-only, encoder-decoder, and decoder-only), and conduct extensive empirical evaluations to verify its effectiveness. The experimental results show that the enhanced models with our adapter module are superior to the stat-of-the-art models in terms of text-to-image generation quality and reliability.

Recent advancements in language models (LMs) have led to the emergence of powerful models such as Small LMs (e.g., T5) and Large LMs (e.g., GPT-4). These models have demonstrated exceptional capabilities across a wide range of tasks, such as name entity recognition (NER) in the general domain. (We define SLMs as pre-trained models with fewer parameters compared to models like GPT-3/3.5/4, such as T5, BERT, and others.) Nevertheless, their efficacy in the medical section remains uncertain and the performance of medical NER always needs high accuracy because of the particularity of the field. This paper aims to provide a thorough investigation to compare the performance of LMs in medical few-shot NER and answer How far is LMs from 100\% Few-shot NER in Medical Domain, and moreover to explore an effective entity recognizer to help improve the NER performance. Based on our extensive experiments conducted on 16 NER models spanning from 2018 to 2023, our findings clearly indicate that LLMs outperform SLMs in few-shot medical NER tasks, given the presence of suitable examples and appropriate logical frameworks. Despite the overall superiority of LLMs in few-shot medical NER tasks, it is important to note that they still encounter some challenges, such as misidentification, wrong template prediction, etc. Building on previous findings, we introduce a simple and effective method called RT (Retrieving and Thinking), which serves as retrievers, finding relevant examples, and as thinkers, employing a step-by-step reasoning process. Experimental results show that our proposed RT framework significantly outperforms the strong open baselines on the two open medical benchmark datasets

Recent text-to-image generative models can generate high-fidelity images from text inputs, but the quality of these generated images cannot be accurately evaluated by existing evaluation metrics. To address this issue, we introduce Human Preference Dataset v2 (HPD v2), a large-scale dataset that captures human preferences on images from a wide range of sources. HPD v2 comprises 798,090 human preference choices on 430,060 pairs of images, making it the largest dataset of its kind. The text prompts and images are deliberately collected to eliminate potential bias, which is a common issue in previous datasets. By fine-tuning CLIP on HPD v2, we obtain Human Preference Score v2 (HPS v2), a scoring model that can more accurately predict text-generated images' human preferences. Our experiments demonstrate that HPS v2 generalizes better than previous metrics across various image distributions and is responsive to algorithmic improvements of text-to-image generative models, making it a preferable evaluation metric for these models. We also investigate the design of the evaluation prompts for text-to-image generative models, to make the evaluation stable, fair and easy-to-use. Finally, we establish a benchmark for text-to-image generative models using HPS v2, which includes a set of recent text-to-image models from the academia, community and industry. The code and dataset is / will be available at https://github.com/tgxs002/HPSv2.

The text-to-image synthesis by diffusion models has recently shown remarkable performance in generating high-quality images. Although performs well for simple texts, the models may get confused when faced with complex texts that contain multiple objects or spatial relationships. To get the desired images, a feasible way is to manually adjust the textual descriptions, i.e., narrating the texts or adding some words, which is labor-consuming. In this paper, we propose a framework to learn the proper textual descriptions for diffusion models through prompt learning. By utilizing the quality guidance and the semantic guidance derived from the pre-trained diffusion model, our method can effectively learn the prompts to improve the matches between the input text and the generated images. Extensive experiments and analyses have validated the effectiveness of the proposed method.

Personalized text-to-image generation models enable users to create images that depict their individual possessions in diverse scenes, finding applications in various domains. To achieve the personalization capability, existing methods rely on finetuning a text-to-image foundation model on a user's custom dataset, which can be non-trivial for general users, resource-intensive, and time-consuming. Despite attempts to develop finetuning-free methods, their generation quality is much lower compared to their finetuning counterparts. In this paper, we propose Joint-Image Diffusion (\jedi), an effective technique for learning a finetuning-free personalization model. Our key idea is to learn the joint distribution of multiple related text-image pairs that share a common subject. To facilitate learning, we propose a scalable synthetic dataset generation technique. Once trained, our model enables fast and easy personalization at test time by simply using reference images as input during the sampling process. Our approach does not require any expensive optimization process or additional modules and can faithfully preserve the identity represented by any number of reference images. Experimental results show that our model achieves state-of-the-art generation quality, both quantitatively and qualitatively, significantly outperforming both the prior finetuning-based and finetuning-free personalization baselines.