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Mar 14

Unleashing the Potential of Large Language Models for Text-to-Image Generation through Autoregressive Representation Alignment

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.

Learning to Generate Semantic Layouts for Higher Text-Image Correspondence in Text-to-Image Synthesis

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

Towards Unifying Medical Vision-and-Language Pre-training via Soft Prompts

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.

LLM-CXR: Instruction-Finetuned LLM for CXR Image Understanding and Generation

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.

GenerateCT: Text-Guided 3D Chest CT Generation

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.

A Survey of Medical Vision-and-Language Applications and Their Techniques

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.

ChatCAD: Interactive Computer-Aided Diagnosis on Medical Image using Large Language Models

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.

RoentGen: Vision-Language Foundation Model for Chest X-ray Generation

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%.

MedSyn: Text-guided Anatomy-aware Synthesis of High-Fidelity 3D CT Images

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.

Contrastive Learning of Medical Visual Representations from Paired Images and Text

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.

MedTrinity-25M: A Large-scale Multimodal Dataset with Multigranular Annotations for Medicine

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.

Enhancing Detail Preservation for Customized Text-to-Image Generation: A Regularization-Free Approach

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.

ITI-GEN: Inclusive Text-to-Image Generation

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.

CLIPSyntel: CLIP and LLM Synergy for Multimodal Question Summarization in Healthcare

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

A Textbook Remedy for Domain Shifts: Knowledge Priors for Medical Image Analysis

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.

A Survey and Taxonomy of Adversarial Neural Networks for Text-to-Image Synthesis

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.

Accuracy of a Vision-Language Model on Challenging Medical Cases

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.

Align, Reason and Learn: Enhancing Medical Vision-and-Language Pre-training with Knowledge

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.

Learned representation-guided diffusion models for large-image generation

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.

Generating Images with Multimodal Language Models

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.

Refining Text-to-Image Generation: Towards Accurate Training-Free Glyph-Enhanced Image Generation

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

Intensive Vision-guided Network for Radiology Report 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.

Leveraging Unpaired Data for Vision-Language Generative Models via Cycle Consistency

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.

UniMed-CLIP: Towards a Unified Image-Text Pretraining Paradigm for Diverse Medical Imaging Modalities

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.

Re-Imagen: Retrieval-Augmented Text-to-Image Generator

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.

A Multi-View Joint Learning Framework for Embedding Clinical Codes and Text Using Graph Neural Networks

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.

FreeCustom: Tuning-Free Customized Image Generation for Multi-Concept Composition

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.

Visual Text Generation in the Wild

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.

MedImageInsight: An Open-Source Embedding Model for General Domain Medical Imaging

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.

Medical mT5: An Open-Source Multilingual Text-to-Text LLM for The Medical Domain

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.

Guide3D: Create 3D Avatars from Text and Image Guidance

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.

Text2MDT: Extracting Medical Decision Trees from Medical Texts

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.

LightGen: Efficient Image Generation through Knowledge Distillation and Direct Preference Optimization

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

Med-EASi: Finely Annotated Dataset and Models for Controllable Simplification of Medical Texts

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.

GMAI-VL & GMAI-VL-5.5M: A Large Vision-Language Model and A Comprehensive Multimodal Dataset Towards General Medical AI

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.

Toffee: Efficient Million-Scale Dataset Construction for Subject-Driven Text-to-Image Generation

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.

Structural Entities Extraction and Patient Indications Incorporation for Chest X-ray Report Generation

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.

Medical Graph RAG: Towards Safe Medical Large Language Model via Graph Retrieval-Augmented Generation

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

LSMS: Language-guided Scale-aware MedSegmentor for Medical Image Referring Segmentation

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.

TextAtlas5M: A Large-scale Dataset for Dense Text Image Generation

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.

LLMs-in-the-loop Part-1: Expert Small AI Models for Bio-Medical Text Translation

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.

Interpretable Bilingual Multimodal Large Language Model for Diverse Biomedical Tasks

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.

DreamCreature: Crafting Photorealistic Virtual Creatures from Imagination

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.

Coupling AI and Citizen Science in Creation of Enhanced Training Dataset for Medical Image Segmentation

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.

Vision-Language Generative Model for View-Specific Chest X-ray Generation

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.

Discriminative Class Tokens for Text-to-Image Diffusion Models

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

Image Regeneration: Evaluating Text-to-Image Model via Generating Identical Image with Multimodal Large Language Models

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.

LLaVA Needs More Knowledge: Retrieval Augmented Natural Language Generation with Knowledge Graph for Explaining Thoracic Pathologies

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.

KITTEN: A Knowledge-Intensive Evaluation of Image Generation on Visual Entities

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.

MedMax: Mixed-Modal Instruction Tuning for Training Biomedical Assistants

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.

Making the Most of Text Semantics to Improve Biomedical Vision--Language Processing

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.

GlyphDraw: Seamlessly Rendering Text with Intricate Spatial Structures in Text-to-Image Generation

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

Bora: Biomedical Generalist Video Generation Model

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.

Harmonizing Visual Text Comprehension and Generation

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.

RAD-DINO: Exploring Scalable Medical Image Encoders Beyond Text Supervision

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.

Scaling Rectified Flow Transformers for High-Resolution Image Synthesis

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.

Zero-shot spatial layout conditioning for text-to-image diffusion models

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.

A Framework For Image Synthesis Using Supervised Contrastive Learning

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

PromptMRG: Diagnosis-Driven Prompts for Medical 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.

All but One: Surgical Concept Erasing with Model Preservation in Text-to-Image Diffusion Models

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.

Plug-and-Play Diffusion Features for Text-Driven Image-to-Image Translation

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.

Bridging Different Language Models and Generative Vision Models for Text-to-Image Generation

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.

CC-SAM: SAM with Cross-feature Attention and Context for Ultrasound Image Segmentation

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.

Towards Generalist Biomedical AI

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.

Multi-Concept T2I-Zero: Tweaking Only The Text Embeddings and Nothing Else

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.

Subject-driven Text-to-Image Generation via Apprenticeship Learning

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.

ConES: Concept Embedding Search for Parameter Efficient Tuning Large Vision Language Models

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.

A Neural Space-Time Representation for Text-to-Image Personalization

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.

UDiffText: A Unified Framework for High-quality Text Synthesis in Arbitrary Images via Character-aware Diffusion Models

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 .

Large-Scale Domain-Specific Pretraining for Biomedical Vision-Language Processing

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.

ConceptCLIP: Towards Trustworthy Medical AI via Concept-Enhanced Contrastive Langauge-Image Pre-training

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.

Merlin: A Vision Language Foundation Model for 3D Computed Tomography

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.

Multi-Modal Masked Autoencoders for Medical Vision-and-Language Pre-Training

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.

Image Textualization: An Automatic Framework for Creating Accurate and Detailed Image Descriptions

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.

Multimodal Representation Alignment for Image Generation: Text-Image Interleaved Control Is Easier Than You Think

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.

eDiff-I: Text-to-Image Diffusion Models with an Ensemble of Expert Denoisers

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/

Subject-driven Text-to-Image Generation via Preference-based Reinforcement Learning

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.

BiMediX2: Bio-Medical EXpert LMM for Diverse Medical Modalities

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.

Towards a clinically accessible radiology foundation model: open-access and lightweight, with automated evaluation

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.

MedSumm: A Multimodal Approach to Summarizing Code-Mixed Hindi-English Clinical Queries

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.

Enhancing Abnormality Grounding for Vision Language Models with Knowledge Descriptions

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.

Multi-Granularity Cross-modal Alignment for Generalized Medical Visual Representation Learning

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.

A Systematic Review of Deep Learning-based Research on Radiology Report Generation

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.

AutoMIR: Effective Zero-Shot Medical Information Retrieval without Relevance Labels

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.

Augmented Conditioning Is Enough For Effective Training Image Generation

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.

LLaVA-Med: Training a Large Language-and-Vision Assistant for Biomedicine in One Day

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.

Learning the Visualness of Text Using Large Vision-Language Models

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.

Holistic Evaluation for Interleaved Text-and-Image Generation

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.

DeViDe: Faceted medical knowledge for improved medical vision-language pre-training

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.

ProSpect: Prompt Spectrum for Attribute-Aware Personalization of Diffusion Models

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.

On the Compositional Generalization of Multimodal LLMs for Medical Imaging

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.

LVM-Med: Learning Large-Scale Self-Supervised Vision Models for Medical Imaging via Second-order Graph Matching

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.

Decoder-Only LLMs are Better Controllers for Diffusion Models

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.

How far is Language Model from 100% Few-shot Named Entity Recognition in Medical Domain

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

Human Preference Score v2: A Solid Benchmark for Evaluating Human Preferences of Text-to-Image Synthesis

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.

JeDi: Joint-Image Diffusion Models for Finetuning-Free Personalized Text-to-Image Generation

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.