Daily Papers

Reasoning is a critical frontier for advancing medical image analysis, where transparency and trustworthiness play a central role in both clinician trust and regulatory approval. Although Medical Visual Language Models (VLMs) show promise for radiological tasks, most existing VLMs merely produce final answers without revealing the underlying reasoning. To address this gap, we introduce MedVLM-R1, a medical VLM that explicitly generates natural language reasoning to enhance transparency and trustworthiness. Instead of relying on supervised fine-tuning (SFT), which often suffers from overfitting to training distributions and fails to foster genuine reasoning, MedVLM-R1 employs a reinforcement learning framework that incentivizes the model to discover human-interpretable reasoning paths without using any reasoning references. Despite limited training data (600 visual question answering samples) and model parameters (2B), MedVLM-R1 boosts accuracy from 55.11% to 78.22% across MRI, CT, and X-ray benchmarks, outperforming larger models trained on over a million samples. It also demonstrates robust domain generalization under out-of-distribution tasks. By unifying medical image analysis with explicit reasoning, MedVLM-R1 marks a pivotal step toward trustworthy and interpretable AI in clinical practice.

The chest X-ray is one of the most commonly accessible radiological examinations for screening and diagnosis of many lung diseases. A tremendous number of X-ray imaging studies accompanied by radiological reports are accumulated and stored in many modern hospitals' Picture Archiving and Communication Systems (PACS). On the other side, it is still an open question how this type of hospital-size knowledge database containing invaluable imaging informatics (i.e., loosely labeled) can be used to facilitate the data-hungry deep learning paradigms in building truly large-scale high precision computer-aided diagnosis (CAD) systems. In this paper, we present a new chest X-ray database, namely "ChestX-ray8", which comprises 108,948 frontal-view X-ray images of 32,717 unique patients with the text-mined eight disease image labels (where each image can have multi-labels), from the associated radiological reports using natural language processing. Importantly, we demonstrate that these commonly occurring thoracic diseases can be detected and even spatially-located via a unified weakly-supervised multi-label image classification and disease localization framework, which is validated using our proposed dataset. Although the initial quantitative results are promising as reported, deep convolutional neural network based "reading chest X-rays" (i.e., recognizing and locating the common disease patterns trained with only image-level labels) remains a strenuous task for fully-automated high precision CAD systems. Data download link: https://nihcc.app.box.com/v/ChestXray-NIHCC

Deep learning methods have shown outstanding classification accuracy in medical imaging problems, which is largely attributed to the availability of large-scale datasets manually annotated with clean labels. However, given the high cost of such manual annotation, new medical imaging classification problems may need to rely on machine-generated noisy labels extracted from radiology reports. Indeed, many Chest X-ray (CXR) classifiers have already been modelled from datasets with noisy labels, but their training procedure is in general not robust to noisy-label samples, leading to sub-optimal models. Furthermore, CXR datasets are mostly multi-label, so current noisy-label learning methods designed for multi-class problems cannot be easily adapted. In this paper, we propose a new method designed for the noisy multi-label CXR learning, which detects and smoothly re-labels samples from the dataset, which is then used to train common multi-label classifiers. The proposed method optimises a bag of multi-label descriptors (BoMD) to promote their similarity with the semantic descriptors produced by BERT models from the multi-label image annotation. Our experiments on diverse noisy multi-label training sets and clean testing sets show that our model has state-of-the-art accuracy and robustness in many CXR multi-label classification benchmarks.

The integration of deep learning systems into the medical domain has been hindered by the resource-intensive process of data annotation and the inability of these systems to generalize to different data distributions. Foundation models, which are models pre-trained on large datasets, have emerged as a solution to reduce reliance on annotated data and enhance model generalizability and robustness. DINOv2, an open-source foundation model pre-trained with self-supervised learning on 142 million curated natural images, excels in extracting general-purpose visual representations, exhibiting promising capabilities across various vision tasks. Nevertheless, a critical question remains unanswered regarding DINOv2's adaptability to radiological imaging, and the clarity on whether its features are sufficiently general to benefit radiology image analysis is yet to be established. Therefore, this study comprehensively evaluates DINOv2 for radiology, conducting over 100 experiments across diverse modalities (X-ray, CT, and MRI). Tasks include disease classification and organ segmentation on both 2D and 3D images, evaluated under different settings like kNN, few-shot learning, linear-probing, end-to-end fine-tuning, and parameter-efficient fine-tuning, to measure the effectiveness and generalizability of the DINOv2 feature embeddings. Comparative analyses with established medical image analysis models, U-Net and TransUnet for segmentation, and CNN and ViT models pre-trained via supervised, weakly supervised, and self-supervised learning for classification, reveal DINOv2's superior performance in segmentation tasks and competitive results in disease classification. The findings contribute insights to potential avenues for optimizing pre-training strategies for medical imaging and enhancing the broader understanding of DINOv2's role in bridging the gap between natural and radiological image analysis.

Multimodal learning aims to build models that can process and relate information from multiple modalities. Despite years of development in this field, it still remains challenging to design a unified network for processing various modalities (e.g. natural language, 2D images, 3D point clouds, audio, video, time series, tabular data) due to the inherent gaps among them. In this work, we propose a framework, named Meta-Transformer, that leverages a frozen encoder to perform multimodal perception without any paired multimodal training data. In Meta-Transformer, the raw input data from various modalities are mapped into a shared token space, allowing a subsequent encoder with frozen parameters to extract high-level semantic features of the input data. Composed of three main components: a unified data tokenizer, a modality-shared encoder, and task-specific heads for downstream tasks, Meta-Transformer is the first framework to perform unified learning across 12 modalities with unpaired data. Experiments on different benchmarks reveal that Meta-Transformer can handle a wide range of tasks including fundamental perception (text, image, point cloud, audio, video), practical application (X-Ray, infrared, hyperspectral, and IMU), and data mining (graph, tabular, and time-series). Meta-Transformer indicates a promising future for developing unified multimodal intelligence with transformers. Code will be available at https://github.com/invictus717/MetaTransformer

Automatic security inspection using computer vision technology is a challenging task in real-world scenarios due to various factors, including intra-class variance, class imbalance, and occlusion. Most of the previous methods rarely solve the cases that the prohibited items are deliberately hidden in messy objects due to the lack of large-scale datasets, restricted their applications in real-world scenarios. Towards real-world prohibited item detection, we collect a large-scale dataset, named as PIDray, which covers various cases in real-world scenarios for prohibited item detection, especially for deliberately hidden items. With an intensive amount of effort, our dataset contains 12 categories of prohibited items in 47,677 X-ray images with high-quality annotated segmentation masks and bounding boxes. To the best of our knowledge, it is the largest prohibited items detection dataset to date. Meanwhile, we design the selective dense attention network (SDANet) to construct a strong baseline, which consists of the dense attention module and the dependency refinement module. The dense attention module formed by the spatial and channel-wise dense attentions, is designed to learn the discriminative features to boost the performance. The dependency refinement module is used to exploit the dependencies of multi-scale features. Extensive experiments conducted on the collected PIDray dataset demonstrate that the proposed method performs favorably against the state-of-the-art methods, especially for detecting the deliberately hidden items.

Deep neural networks have been extensively applied in the medical domain for various tasks, including image classification, segmentation, and landmark detection. However, their application is often hindered by data scarcity, both in terms of available annotations and images. This study introduces a novel application of denoising diffusion probabilistic models (DDPMs) to the landmark detection task, specifically addressing the challenge of limited annotated data in x-ray imaging. Our key innovation lies in leveraging DDPMs for self-supervised pre-training in landmark detection, a previously unexplored approach in this domain. This method enables accurate landmark detection with minimal annotated training data (as few as 50 images), surpassing both ImageNet supervised pre-training and traditional self-supervised techniques across three popular x-ray benchmark datasets. To our knowledge, this work represents the first application of diffusion models for self-supervised learning in landmark detection, which may offer a valuable pre-training approach in few-shot regimes, for mitigating data scarcity.

Radiography imaging protocols focus on particular body regions, therefore producing images of great similarity and yielding recurrent anatomical structures across patients. To exploit this structured information, we propose the use of Space-aware Memory Queues for In-painting and Detecting anomalies from radiography images (abbreviated as SQUID). We show that SQUID can taxonomize the ingrained anatomical structures into recurrent patterns; and in the inference, it can identify anomalies (unseen/modified patterns) in the image. SQUID surpasses 13 state-of-the-art methods in unsupervised anomaly detection by at least 5 points on two chest X-ray benchmark datasets measured by the Area Under the Curve (AUC). Additionally, we have created a new dataset (DigitAnatomy), which synthesizes the spatial correlation and consistent shape in chest anatomy. We hope DigitAnatomy can prompt the development, evaluation, and interpretability of anomaly detection methods.

The global ramifications of the COVID-19 pandemic remain significant, exerting persistent pressure on nations even three years after its initial outbreak. Deep learning models have shown promise in improving COVID-19 diagnostics but require diverse and larger-scale datasets to improve performance. In this paper, we introduce COVIDx CXR-4, an expanded multi-institutional open-source benchmark dataset for chest X-ray image-based computer-aided COVID-19 diagnostics. COVIDx CXR-4 expands significantly on the previous COVIDx CXR-3 dataset by increasing the total patient cohort size by greater than 2.66 times, resulting in 84,818 images from 45,342 patients across multiple institutions. We provide extensive analysis on the diversity of the patient demographic, imaging metadata, and disease distributions to highlight potential dataset biases. To the best of the authors' knowledge, COVIDx CXR-4 is the largest and most diverse open-source COVID-19 CXR dataset and is made publicly available as part of an open initiative to advance research to aid clinicians against the COVID-19 disease.

Radiologists play a crucial role by translating medical images into medical reports. However, the field faces staffing shortages and increasing workloads. While automated approaches using vision-language models (VLMs) show promise as assistants, they require exceptionally high accuracy. Most current VLMs in radiology rely solely on supervised fine-tuning (SFT). Meanwhile, in the general domain, additional preference fine-tuning has become standard practice. The challenge in radiology lies in the prohibitive cost of obtaining radiologist feedback. We propose a scalable automated preference alignment technique for VLMs in radiology, focusing on chest X-ray (CXR) report generation. Our method leverages publicly available datasets with an LLM-as-a-Judge mechanism, eliminating the need for additional expert radiologist feedback. We evaluate and benchmark five direct alignment algorithms (DAAs). Our results show up to a 57.4% improvement in average GREEN scores, a LLM-based metric for evaluating CXR reports, and a 9.2% increase in an average across six metrics (domain specific and general), compared to the SFT baseline. We study reward overoptimization via length exploitation, with reports lengthening by up to 3.2x. To assess a potential alignment tax, we benchmark on six additional diverse tasks, finding no significant degradations. A reader study involving four board-certified radiologists indicates win rates of up to 0.62 over the SFT baseline, while significantly penalizing verbosity. Our analysis provides actionable insights for the development of VLMs in high-stakes fields like radiology.

Automated multi-label chest X-rays (CXR) image classification has achieved substantial progress in clinical diagnosis via utilizing sophisticated deep learning approaches. However, most deep models have high computational demands, which makes them less feasible for compact devices with low computational requirements. To overcome this problem, we propose a knowledge distillation (KD) strategy to create the compact deep learning model for the real-time multi-label CXR image classification. We study different alternatives of CNNs and Transforms as the teacher to distill the knowledge to a smaller student. Then, we employed explainable artificial intelligence (XAI) to provide the visual explanation for the model decision improved by the KD. Our results on three benchmark CXR datasets show that our KD strategy provides the improved performance on the compact student model, thus being the feasible choice for many limited hardware platforms. For instance, when using DenseNet161 as the teacher network, EEEA-Net-C2 achieved an AUC of 83.7%, 87.1%, and 88.7% on the ChestX-ray14, CheXpert, and PadChest datasets, respectively, with fewer parameters of 4.7 million and computational cost of 0.3 billion FLOPS.

Chest X-rays (CXRs) are the most frequently performed imaging test in clinical practice. Recent advances in the development of vision-language foundation models (FMs) give rise to the possibility of performing automated CXR interpretation, which can assist physicians with clinical decision-making and improve patient outcomes. However, developing FMs that can accurately interpret CXRs is challenging due to the (1) limited availability of large-scale vision-language datasets in the medical image domain, (2) lack of vision and language encoders that can capture the complexities of medical data, and (3) absence of evaluation frameworks for benchmarking the abilities of FMs on CXR interpretation. In this work, we address these challenges by first introducing CheXinstruct - a large-scale instruction-tuning dataset curated from 28 publicly-available datasets. We then present CheXagent - an instruction-tuned FM capable of analyzing and summarizing CXRs. To build CheXagent, we design a clinical large language model (LLM) for parsing radiology reports, a vision encoder for representing CXR images, and a network to bridge the vision and language modalities. Finally, we introduce CheXbench - a novel benchmark designed to systematically evaluate FMs across 8 clinically-relevant CXR interpretation tasks. Extensive quantitative evaluations and qualitative reviews with five expert radiologists demonstrate that CheXagent outperforms previously-developed general- and medical-domain FMs on CheXbench tasks. Furthermore, in an effort to improve model transparency, we perform a fairness evaluation across factors of sex, race and age to highlight potential performance disparities. Our project is at https://stanford-aimi.github.io/chexagent.html.

Medical Vision-Language Pretraining (MedVLP) shows promise in learning generalizable and transferable visual representations from paired and unpaired medical images and reports. MedVLP can provide useful features to downstream tasks and facilitate adapting task-specific models to new setups using fewer examples. However, existing MedVLP methods often differ in terms of datasets, preprocessing, and finetuning implementations. This pose great challenges in evaluating how well a MedVLP method generalizes to various clinically-relevant tasks due to the lack of unified, standardized, and comprehensive benchmark. To fill this gap, we propose BenchX, a unified benchmark framework that enables head-to-head comparison and systematical analysis between MedVLP methods using public chest X-ray datasets. Specifically, BenchX is composed of three components: 1) Comprehensive datasets covering nine datasets and four medical tasks; 2) Benchmark suites to standardize data preprocessing, train-test splits, and parameter selection; 3) Unified finetuning protocols that accommodate heterogeneous MedVLP methods for consistent task adaptation in classification, segmentation, and report generation, respectively. Utilizing BenchX, we establish baselines for nine state-of-the-art MedVLP methods and found that the performance of some early MedVLP methods can be enhanced to surpass more recent ones, prompting a revisiting of the developments and conclusions from prior works in MedVLP. Our code are available at https://github.com/yangzhou12/BenchX.

Chest X-rays (CXRs) play an integral role in driving critical decisions in disease management and patient care. While recent innovations have led to specialized models for various CXR interpretation tasks, these solutions often operate in isolation, limiting their practical utility in clinical practice. We present MedRAX, the first versatile AI agent that seamlessly integrates state-of-the-art CXR analysis tools and multimodal large language models into a unified framework. MedRAX dynamically leverages these models to address complex medical queries without requiring additional training. To rigorously evaluate its capabilities, we introduce ChestAgentBench, a comprehensive benchmark containing 2,500 complex medical queries across 7 diverse categories. Our experiments demonstrate that MedRAX achieves state-of-the-art performance compared to both open-source and proprietary models, representing a significant step toward the practical deployment of automated CXR interpretation systems. Data and code have been publicly available at https://github.com/bowang-lab/MedRAX

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

The field of Explainable Artificial Intelligence (XAI) aims to build explainable and interpretable machine learning (or deep learning) methods without sacrificing prediction performance. Convolutional Neural Networks (CNNs) have been successful in making predictions, especially in image classification. However, these famous deep learning models use tens of millions of parameters based on a large number of pre-trained filters which have been repurposed from previous data sets. We propose a novel Interaction-based Convolutional Neural Network (ICNN) that does not make assumptions about the relevance of local information. Instead, we use a model-free Influence Score (I-score) to directly extract the influential information from images to form important variable modules. We demonstrate that the proposed method produces state-of-the-art prediction performance of 99.8% on a real-world data set classifying COVID-19 Chest X-ray images without sacrificing the explanatory power of the model. This proposed design can efficiently screen COVID-19 patients before human diagnosis, and will be the benchmark for addressing future XAI problems in large-scale data sets.

Electronic Health Records (EHRs), which contain patients' medical histories in various multi-modal formats, often overlook the potential for joint reasoning across imaging and table modalities underexplored in current EHR Question Answering (QA) systems. In this paper, we introduce EHRXQA, a novel multi-modal question answering dataset combining structured EHRs and chest X-ray images. To develop our dataset, we first construct two uni-modal resources: 1) The MIMIC- CXR-VQA dataset, our newly created medical visual question answering (VQA) benchmark, specifically designed to augment the imaging modality in EHR QA, and 2) EHRSQL (MIMIC-IV), a refashioned version of a previously established table-based EHR QA dataset. By integrating these two uni-modal resources, we successfully construct a multi-modal EHR QA dataset that necessitates both uni-modal and cross-modal reasoning. To address the unique challenges of multi-modal questions within EHRs, we propose a NeuralSQL-based strategy equipped with an external VQA API. This pioneering endeavor enhances engagement with multi-modal EHR sources and we believe that our dataset can catalyze advances in real-world medical scenarios such as clinical decision-making and research. EHRXQA is available at https://github.com/baeseongsu/ehrxqa.

The rapid and accurate detection of COVID-19 cases is critical for timely treatment and preventing the spread of the disease. In this study, a two-stage feature extraction framework using eight state-of-the-art pre-trained deep Convolutional Neural Networks (CNNs) and an autoencoder is proposed to determine the health conditions of patients (COVID-19, Normal, Viral Pneumonia) based on chest X-rays. The X-ray scans are divided into four equally sized sections and analyzed by deep pre-trained CNNs. Subsequently, an autoencoder with three hidden layers is trained to extract reproductive features from the concatenated ouput of CNNs. To evaluate the performance of the proposed framework, three different classifiers, which are single-layer perceptron (SLP), multi-layer perceptron (MLP), and support vector machine (SVM) are used. Furthermore, the deep CNN architectures are used to create benchmark models and trained on the same dataset for comparision. The proposed framework outperforms other frameworks wih pre-trained feature extractors in binary classification and shows competitive results in three-class classification. The proposed methodology is task-independent and suitable for addressing various problems. The results show that the discriminative features are a subset of the reproductive features, suggesting that extracting task-independent features is superior to the extraction only task-based features. The flexibility and task-independence of the reproductive features make the conceptive information approach more favorable. The proposed methodology is novel and shows promising results for analyzing medical image data.

The SYNTAX score has become a widely used measure of coronary disease severity , crucial in selecting the optimal mode of revascularization. This paper introduces a new medical regression and classification problem - automatically estimating SYNTAX score from coronary angiography. Our study presents a comprehensive dataset of 1,844 patients, featuring a balanced distribution of individuals with zero and non-zero scores. This dataset includes a first-of-its-kind, complete coronary angiography samples captured through a multi-view X-ray video, allowing one to observe coronary arteries from multiple perspectives. Furthermore, we present a novel, fully automatic end-to-end method for estimating the SYNTAX. For such a difficult task, we have achieved a solid coefficient of determination R2 of 0.51 in score predictions.

Large-scale Vision-Language Models (LVLMs) have significantly advanced with text-aligned vision inputs. They have made remarkable progress in computer vision tasks by aligning text modality with vision inputs. There are also endeavors to incorporate multi-vision sensors beyond RGB, including thermal, depth, and medical X-ray images. However, we observe that current LVLMs view images taken from multi-vision sensors as if they were in the same RGB domain without considering the physical characteristics of multi-vision sensors. They fail to convey the fundamental multi-vision sensor information from the dataset and the corresponding contextual knowledge properly. Consequently, alignment between the information from the actual physical environment and the text is not achieved correctly, making it difficult to answer complex sensor-related questions that consider the physical environment. In this paper, we aim to establish a multi-vision Sensor Perception And Reasoning benchmarK called SPARK that can reduce the fundamental multi-vision sensor information gap between images and multi-vision sensors. We generated 6,248 vision-language test samples automatically to investigate multi-vision sensory perception and multi-vision sensory reasoning on physical sensor knowledge proficiency across different formats, covering different types of sensor-related questions. We utilized these samples to assess ten leading LVLMs. The results showed that most models displayed deficiencies in multi-vision sensory reasoning to varying extents. Codes and data are available at https://github.com/top-yun/SPARK

In this work we address the problem of landmark-based segmentation for anatomical structures. We propose HybridGNet, an encoder-decoder neural architecture which combines standard convolutions for image feature encoding, with graph convolutional neural networks to decode plausible representations of anatomical structures. We benchmark the proposed architecture considering other standard landmark and pixel-based models for anatomical segmentation in chest x-ray images, and found that HybridGNet is more robust to image occlusions. We also show that it can be used to construct landmark-based segmentations from pixel level annotations. Our experimental results suggest that HybridGNet produces accurate and anatomically plausible landmark-based segmentations, by naturally incorporating shape constraints within the decoding process via spectral convolutions.

X-ray is widely applied for transmission imaging due to its stronger penetration than natural light. When rendering novel view X-ray projections, existing methods mainly based on NeRF suffer from long training time and slow inference speed. In this paper, we propose a 3D Gaussian splatting-based framework, namely X-Gaussian, for X-ray novel view synthesis. Firstly, we redesign a radiative Gaussian point cloud model inspired by the isotropic nature of X-ray imaging. Our model excludes the influence of view direction when learning to predict the radiation intensity of 3D points. Based on this model, we develop a Differentiable Radiative Rasterization (DRR) with CUDA implementation. Secondly, we customize an Angle-pose Cuboid Uniform Initialization (ACUI) strategy that directly uses the parameters of the X-ray scanner to compute the camera information and then uniformly samples point positions within a cuboid enclosing the scanned object. Experiments show that our X-Gaussian outperforms state-of-the-art methods by 6.5 dB while enjoying less than 15% training time and over 73x inference speed. The application on sparse-view CT reconstruction also reveals the practical values of our method. Code and models will be publicly available at https://github.com/caiyuanhao1998/X-Gaussian . A video demo of the training process visualization is at https://www.youtube.com/watch?v=gDVf_Ngeghg .

X-ray observations are essential for understanding the multimessenger emission mechanisms of active galactic nuclei (AGN). Blazars, a subset of AGN whose X-ray emission predominantly originates from relativistic jets, have been proposed as promising high-energy neutrino sources. In this work, we study the candidate neutrino-emitting blazar 5BZB J0630-24064, which has been observed over multiple epochs with the XMM-Newton, NuSTAR, Neil Gehrels Swift-XRT, and eROSITA observatories. Analysis of the X-ray spectra in the 2.0-10.0 keV band shows significant variability, with high flux states adhering to a power-law model indicative of jet emission. However, during low-flux states, the spectrum reveals an additional component at hard-X-rays, indicating a transition from jet-dominated to multi-component X-ray emission, possibly associated with hadronic processes. To investigate this spectral evolution, we tested various models and found it to be consistent with corona emission or photoionised absorption processes typically observed in obscured AGN. The identification of the X-ray spectral variability in 5BZB J0630-24064, combined with its potential for neutrino production, opens new perspectives in multimessenger astrophysics of blazars highlighting the synergies between the mechanisms of the jet and the nuclear environment.

X-ray observing facilities, such as the Chandra X-ray Observatory and the eROSITA, have detected millions of astronomical sources associated with high-energy phenomena. The arrival of photons as a function of time follows a Poisson process and can vary by orders-of-magnitude, presenting obstacles for common tasks such as source classification, physical property derivation, and anomaly detection. Previous work has either failed to directly capture the Poisson nature of the data or only focuses on Poisson rate function reconstruction. In this work, we present Poisson Process AutoDecoder (PPAD). PPAD is a neural field decoder that maps fixed-length latent features to continuous Poisson rate functions across energy band and time via unsupervised learning. PPAD reconstructs the rate function and yields a representation at the same time. We demonstrate the efficacy of PPAD via reconstruction, regression, classification and anomaly detection experiments using the Chandra Source Catalog.

Active galactic nuclei (AGN) are powerful sources of panchromatic radiation. All AGN emit in X-rays, contributing around sim 5-10% of the AGN bolometric luminosity. The X-ray emitting region, popularly known as the corona, is geometrically and radiatively compact with a size typically lesssim 10 , R_{rm G} (gravitational radii). The rapid and extreme variability in X-rays also suggest that the corona must be a dynamic structure. Decades of X-ray studies have shed much light on the topic, but the nature and origin of AGN corona are still not clearly understood. This is mostly due to the complexities involved in several physical processes at play in the high-gravity, high-density and high-temperature region in the vicinity of the supermassive black hole (SMBH). It is still not clear how exactly the corona is energetically and physically sustained near a SMBH. The ubiquity of coronal emission in AGN points to their fundamental role in black hole accretion processes. In this review we discuss the X-ray observational properties of corona in radio quiet AGN.

X-ray images play a vital role in the intraoperative processes due to their high resolution and fast imaging speed and greatly promote the subsequent segmentation, registration and reconstruction. However, over-dosed X-rays superimpose potential risks to human health to some extent. Data-driven algorithms from volume scans to X-ray images are restricted by the scarcity of paired X-ray and volume data. Existing methods are mainly realized by modelling the whole X-ray imaging procedure. In this study, we propose a learning-based approach termed CT2X-GAN to synthesize the X-ray images in an end-to-end manner using the content and style disentanglement from three different image domains. Our method decouples the anatomical structure information from CT scans and style information from unpaired real X-ray images/ digital reconstructed radiography (DRR) images via a series of decoupling encoders. Additionally, we introduce a novel consistency regularization term to improve the stylistic resemblance between synthesized X-ray images and real X-ray images. Meanwhile, we also impose a supervised process by computing the similarity of computed real DRR and synthesized DRR images. We further develop a pose attention module to fully strengthen the comprehensive information in the decoupled content code from CT scans, facilitating high-quality multi-view image synthesis in the lower 2D space. Extensive experiments were conducted on the publicly available CTSpine1K dataset and achieved 97.8350, 0.0842 and 3.0938 in terms of FID, KID and defined user-scored X-ray similarity, respectively. In comparison with 3D-aware methods (pi-GAN, EG3D), CT2X-GAN is superior in improving the synthesis quality and realistic to the real X-ray images.

Understanding and interpreting dynamics of functional materials in situ is a grand challenge in physics and materials science due to the difficulty of experimentally probing materials at varied length and time scales. X-ray photon correlation spectroscopy (XPCS) is uniquely well-suited for characterizing materials dynamics over wide-ranging time scales, however spatial and temporal heterogeneity in material behavior can make interpretation of experimental XPCS data difficult. In this work we have developed an unsupervised deep learning (DL) framework for automated classification and interpretation of relaxation dynamics from experimental data without requiring any prior physical knowledge of the system behavior. We demonstrate how this method can be used to rapidly explore large datasets to identify samples of interest, and we apply this approach to directly correlate bulk properties of a model system to microscopic dynamics. Importantly, this DL framework is material and process agnostic, marking a concrete step towards autonomous materials discovery.

Chest X-ray imaging (CXR) is an important diagnostic tool used in hospitals to assess patient conditions and monitor changes over time. Generative models, specifically diffusion-based models, have shown promise in generating realistic synthetic X-rays. However, these models mainly focus on conditional generation using single-time-point data, i.e., typically CXRs taken at a specific time with their corresponding reports, limiting their clinical utility, particularly for capturing temporal changes. To address this limitation, we propose a novel framework, EHRXDiff, which predicts future CXR images by integrating previous CXRs with subsequent medical events, e.g., prescriptions, lab measures, etc. Our framework dynamically tracks and predicts disease progression based on a latent diffusion model, conditioned on the previous CXR image and a history of medical events. We comprehensively evaluate the performance of our framework across three key aspects, including clinical consistency, demographic consistency, and visual realism. We demonstrate that our framework generates high-quality, realistic future images that capture potential temporal changes, suggesting its potential for further development as a clinical simulation tool. This could offer valuable insights for patient monitoring and treatment planning in the medical field.

The Athena mission entered a redefinition phase in July 2022, driven by the imperative to reduce the mission cost at completion for the European Space Agency below an acceptable target, while maintaining the flagship nature of its science return. This notably called for a complete redesign of the X-ray Integral Field Unit (X-IFU) cryogenic architecture towards a simpler active cooling chain. Passive cooling via successive radiative panels at spacecraft level is now used to provide a 50 K thermal environment to an X-IFU owned cryostat. 4.5 K cooling is achieved via a single remote active cryocooler unit, while a multi-stage Adiabatic Demagnetization Refrigerator ensures heat lift down to the 50 mK required by the detectors. Amidst these changes, the core concept of the readout chain remains robust, employing Transition Edge Sensor microcalorimeters and a SQUID-based Time-Division Multiplexing scheme. Noteworthy is the introduction of a slower pixel. This enables an increase in the multiplexing factor (from 34 to 48) without compromising the instrument energy resolution, hence keeping significant system margins to the new 4 eV resolution requirement. This allows reducing the number of channels by more than a factor two, and thus the resource demands on the system, while keeping a 4' field of view (compared to 5' before). In this article, we will give an overview of this new architecture, before detailing its anticipated performances. Finally, we will present the new X-IFU schedule, with its short term focus on demonstration activities towards a mission adoption in early 2027.

We investigate the properties of active galactic nuclei (AGNs) in the brightest submillimeter galaxies (SMGs) in the COSMOS field. We utilize the bright sample of ALMA/SCUBA-2 COSMOS Survey (AS2COSMOS), which consists of 260 SMGs with S_{870, mu m}=0.7--19.2,mJy at z=0--6. We perform optical to millimeter spectral energy distribution (SED) modeling for the whole sample. We identify 24 AGN-host galaxies from the SEDs. Supplemented by 23 X-ray detected AGNs (X-ray AGNs), we construct an overall sample of 40 AGN-host galaxies. The X-ray luminosity upper bounds indicate that the X-ray undetected SED-identified AGNs are likely to be nearly Compton thick or have unusually suppressed X-ray emission. From visual classification, we identify 25^{+6}_{-5}\% of the SMGs without AGNs as major merger candidates. This fraction is almost consistent with the general galaxy population at zsim2, suggesting that major mergers are not necessarily required for the enhanced star formation in SMGs. We also identify 47^{+16}_{-15}\% of the AGN hosts as major merger candidates, which is about twice as high as that in the SMGs without AGNs. This suggests that major mergers play a key role in triggering AGN activity in bright SMGs.

The X-ray polarization observations made possible with the Imaging X-ray Polarimetry Explorer (IXPE) offer new ways of probing high-energy emission processes in astrophysical jets from blazars. Here we report on the first X-ray polarization observation of the blazar S4 0954+65 in a high optical and X-ray state. During our multi-wavelength campaign on the source, we detected an optical flare whose peak coincided with the peak of an X-ray flare. This optical-X-ray flare most likely took place in a feature moving along the parsec-scale jet, imaged at 43 GHz by the Very Long Baseline Array. The 43 GHz polarization angle of the moving component underwent a rotation near the time of the flare. In the optical band, prior to the IXPE observation, we measured the polarization angle to be aligned with the jet axis. In contrast, during the optical flare the optical polarization angle was perpendicular to the jet axis; after the flare, it reverted to being parallel to the jet axis. Due to the smooth behavior of the optical polarization angle during the flare, we favor shocks as the main acceleration mechanism. We also infer that the ambient magnetic field lines in the jet were parallel to the jet position angle. The average degree of optical polarization during the IXPE observation was (14.3pm4.1)%. Despite the flare, we only detected an upper limit of 14% (at 3sigma level) on the X-ray polarization degree; although a reasonable assumption on the X-ray polarization angle results in an upper limit of 8.8% (3sigma). We model the spectral energy distribution (SED) and spectral polarization distribution (SPD) of S4 0954+65 with leptonic (synchrotron self-Compton) and hadronic (proton and pair synchrotron) models. The constraints we obtain with our combined multi-wavelength polarization observations and SED modeling tentatively disfavor hadronic models for the X-ray emission in S4 0954+65.

Blazars, a class of active galactic nuclei (AGN) powered by supermassive black holes, are known for their remarkable variability across multiple timescales and wavelengths. With advancements in both ground- and space-based telescopes, our understanding of AGN central engines has significantly improved. However, the mechanisms driving this variability remain elusive, and continue to fascinate both theorists and observers alike. The primary objective of this study is to constrain the X-ray variability properties of the TeV blazar PKS 2155-304. We conduct a comprehensive X-ray spectral and timing analysis, focusing on both long-term and intra-day variability. This analysis uses data from 22 epochs of XMM-Newton EPIC-pn observations, collected over 15 years (2000-2014). To investigate the variability of the source, we applied both timing and spectral analyses. For the timing analysis, we estimated fractional variability, variability amplitude, minimum variability timescales, flux distribution, and power spectral density (PSD). In the spectral analysis, we fitted the X-ray spectra using power-law, log-parabola, and broken power-law (BPL) models to determine the best-fitting parameters. Additionally, we studied the hardness ratio (HR). We observed moderate intra-day variability in most of the light curves. Seven out of the twenty-two observations showed a clear bimodal flux distribution, indicating the presence of two distinct flux states. Our analysis revealed a variable power-law PSD slope. Most HR plots did not show significant variation with flux, except for one observation (OBSID 0124930501), where HR increased with flux (Count/s). The fitted X-ray spectra favored the BPL model for the majority of observations. The findings of this work shed light on the intraday variability of blazars, providing insights into the non-thermal jet processes that drive the observed flux variations.

Chest X-Ray (CXR) report generation is a promising approach to improving the efficiency of CXR interpretation. However, a significant increase in diagnostic accuracy is required before that can be realised. Motivated by this, we propose a framework that is more inline with a radiologist's workflow by considering longitudinal data. Here, the decoder is additionally conditioned on the report from the subject's previous imaging study via a prompt. We also propose a new reward for reinforcement learning based on CXR-BERT, which computes the similarity between reports. We conduct experiments on the MIMIC-CXR dataset. The results indicate that longitudinal data improves CXR report generation. CXR-BERT is also shown to be a promising alternative to the current state-of-the-art reward based on RadGraph. This investigation indicates that longitudinal CXR report generation can offer a substantial increase in diagnostic accuracy. Our Hugging Face model is available at: https://huggingface.co/aehrc/cxrmate and code is available at: https://github.com/aehrc/cxrmate.

In this paper we propose a novel image representation called face X-ray for detecting forgery in face images. The face X-ray of an input face image is a greyscale image that reveals whether the input image can be decomposed into the blending of two images from different sources. It does so by showing the blending boundary for a forged image and the absence of blending for a real image. We observe that most existing face manipulation methods share a common step: blending the altered face into an existing background image. For this reason, face X-ray provides an effective way for detecting forgery generated by most existing face manipulation algorithms. Face X-ray is general in the sense that it only assumes the existence of a blending step and does not rely on any knowledge of the artifacts associated with a specific face manipulation technique. Indeed, the algorithm for computing face X-ray can be trained without fake images generated by any of the state-of-the-art face manipulation methods. Extensive experiments show that face X-ray remains effective when applied to forgery generated by unseen face manipulation techniques, while most existing face forgery detection or deepfake detection algorithms experience a significant performance drop.

The COVID-19 pandemic strained healthcare resources and prompted discussion about how machine learning can alleviate physician burdens and contribute to diagnosis. Chest x-rays (CXRs) are used for diagnosis of COVID-19, but few studies predict the severity of a patient's condition from CXRs. In this study, we produce a large COVID severity dataset by merging three sources and investigate the efficacy of transfer learning using ImageNet- and CXR-pretrained models and vision transformers (ViTs) in both severity regression and classification tasks. A pretrained DenseNet161 model performed the best on the three class severity prediction problem, reaching 80% accuracy overall and 77.3%, 83.9%, and 70% on mild, moderate and severe cases, respectively. The ViT had the best regression results, with a mean absolute error of 0.5676 compared to radiologist-predicted severity scores. The project's source code is publicly available.

Quality control is of vital importance during electronics production. As the methods of producing electronic circuits improve, there is an increasing chance of solder defects during assembling the printed circuit board (PCB). Many technologies have been incorporated for inspecting failed soldering, such as X-ray imaging, optical imaging, and thermal imaging. With some advanced algorithms, the new technologies are expected to control the production quality based on the digital images. However, current algorithms sometimes are not accurate enough to meet the quality control. Specialists are needed to do a follow-up checking. For automated X-ray inspection, joint of interest on the X-ray image is located by region of interest (ROI) and inspected by some algorithms. Some incorrect ROIs deteriorate the inspection algorithm. The high dimension of X-ray images and the varying sizes of image dimensions also challenge the inspection algorithms. On the other hand, recent advances on deep learning shed light on image-based tasks and are competitive to human levels. In this paper, deep learning is incorporated in X-ray imaging based quality control during PCB quality inspection. Two artificial intelligence (AI) based models are proposed and compared for joint defect detection. The noised ROI problem and the varying sizes of imaging dimension problem are addressed. The efficacy of the proposed methods are verified through experimenting on a real-world 3D X-ray dataset. By incorporating the proposed methods, specialist inspection workload is largely saved.

The advent of new generation radio telescopes is opening new possibilities on the classification and study of extragalactic high-energy sources, specially the underrepresented ones like radio galaxies. Among these, Giant Radio Galaxies (GRG, larger than 0.7 Mpc) are among the most extreme manifestations of the accretion/ejection processes on supermassive black holes. Our recent studies have shown that GRG can be up to four times more abundant in hard X-ray selected (i.e. from INTEGRAL/IBIS and Swift/BAT at >20 keV) samples and, most interestingly, the majority of them present signs of restarted radio activity. This makes them the ideal test-bed to study the so far unknown duty cycle of jets in active galactic nuclei. Open questions in the field include: How and when jets are restarted? How jets evolve and what's their dynamic? What is the jet's duty cycle and what triggers them? Our group has recently collected a wealth of radio data on these high-energy selected GRGs, allowing us to study their jet formation and evolution from the pc to kpc scales, across different activity epochs. In particular, thanks to our EVN large programme, we were able to probe the new radio phase in the core of these giants. Furthermore, we are devoting an effort to the exploitation of new radio surveys data for the discovery of new classes of counterparts of Fermi/LAT catalogues. In particular, we are unveiling the hidden population of radio galaxies associated with gamma-ray sources.

The discovery of an increasing variety of exoplanets in very close orbits around their host stars raised many questions about how stars and planets interact, and to which extent host stars' properties may be influenced by the presence of close-by companions. Understanding how the evolution of stars is impacted by the interactions with their planets is fundamental to disentangle their intrinsic evolution from Star-Planet Interactions (SPI)-induced phenomena. GJ 504 is a promising candidate for a star that underwent strong SPI. Its unusually short rotational period (3.4 days), while being in contrast with what is expected by single-star models, could result from the inward migration of a close-by, massive companion, pushed starward by tides. Moreover, its brighter X-ray luminosity may hint at a rejuvenation of the dynamo process sustaining the stellar magnetic field, consequent to the SPI-induced spin-up. We aim to study the evolution of GJ 504 and establish whether by invoking the engulfment of a planetary companion we can better reproduce its rotational period and X-ray luminosity. We simulate the past evolution assuming two different scenarios: 'Star without close-by planet', 'Star with close-by planet'. In the second scenario, we investigate how inward migration and planetary engulfment driven by tides spin up the stellar surface and rejuvenate its dynamo. We compare our tracks with rotational period and X-ray data collected from the all-sky surveys of the ROentgen Survey with an Imaging Telescope Array (eROSITA) on board the Russian Spektrum-Roentgen-Gamma mission (SRG). Despite the very uncertain stellar age, we found that the second evolutionary scenario is in better agreement with the short rotational period and the bright X-ray luminosity of GJ 504, thus strongly favouring the inward migration scenario over the one in which close-by planets have no tidal impact on the star.

The conversion from 2D X-ray to 3D shape holds significant potential for improving diagnostic efficiency and safety. However, existing reconstruction methods often rely on hand-crafted features, manual intervention, and prior knowledge, resulting in unstable shape errors and additional processing costs. In this paper, we introduce Swin-X2S, an end-to-end deep learning method for directly reconstructing 3D segmentation and labeling from 2D biplanar orthogonal X-ray images. Swin-X2S employs an encoder-decoder architecture: the encoder leverages 2D Swin Transformer for X-ray information extraction, while the decoder employs 3D convolution with cross-attention to integrate structural features from orthogonal views. A dimension-expanding module is introduced to bridge the encoder and decoder, ensuring a smooth conversion from 2D pixels to 3D voxels. We evaluate proposed method through extensive qualitative and quantitative experiments across nine publicly available datasets covering four anatomies (femur, hip, spine, and rib), with a total of 54 categories. Significant improvements over previous methods have been observed not only in the segmentation and labeling metrics but also in the clinically relevant parameters that are of primary concern in practical applications, which demonstrates the promise of Swin-X2S to provide an effective option for anatomical shape reconstruction in clinical scenarios. Code implementation is available at: https://github.com/liukuan5625/Swin-X2S.

A core sample of 59 unobscured type 1 AGNs with simultaneous XMM-Newton X-ray and UV observations is compiled from archive to probe the nature of soft X-ray excess (SE). In the first paper of this series, our focus centers on scrutinizing the spectral profile of the soft excess. Of the sources, approx 71% (42/59) exhibit powerlaw-like (po-like) soft excess, while approx 29% (17/59) exhibit blackbody-like (bb-like) soft excess. We show a cut-off powerlaw could uniformly characterize both types of soft excesses, with median Ecut of 1.40 keV for po-like and 0.14 keV for bb-like. For the first time, we report a robust and quantitative correlation between the SE profile and SE strength (the ratio of SE luminosity to that of the primary powerlaw continuum in 0.5 - 2.0 keV), indicating that stronger soft excess is more likely to be po-like, or effectively has a higher Ecut. This correlation cannot be explained by ionized disk reflection alone, which produces mostly bb-like soft excess (Ecut sim 0.1 keV) as revealed by relxilllp simulation. Remarkably, we show with simulations that a toy hybrid scenario, where both ionized disk reflection (relxilllp, with all reflection parameters fixed at default values except for ionization of the disk) and warm corona (compTT, with temperature fixed at 1 keV) contribute to the observed soft excess, can successfully reproduce the observed correlation. This highlights the ubiquitous hybrid nature of the soft X-ray excess in AGNs, and underscores the importance of considering both components while fitting the spectra of soft excess.

The rapid evolution of artificial intelligence, especially in large language models (LLMs), has significantly impacted various domains, including healthcare. In chest X-ray (CXR) analysis, previous studies have employed LLMs, but with limitations: either underutilizing the multi-tasking capabilities of LLMs or lacking clinical accuracy. This paper presents M4CXR, a multi-modal LLM designed to enhance CXR interpretation. The model is trained on a visual instruction-following dataset that integrates various task-specific datasets in a conversational format. As a result, the model supports multiple tasks such as medical report generation (MRG), visual grounding, and visual question answering (VQA). M4CXR achieves state-of-the-art clinical accuracy in MRG by employing a chain-of-thought prompting strategy, in which it identifies findings in CXR images and subsequently generates corresponding reports. The model is adaptable to various MRG scenarios depending on the available inputs, such as single-image, multi-image, and multi-study contexts. In addition to MRG, M4CXR performs visual grounding at a level comparable to specialized models and also demonstrates outstanding performance in VQA. Both quantitative and qualitative assessments reveal M4CXR's versatility in MRG, visual grounding, and VQA, while consistently maintaining clinical accuracy.

Reading and interpreting chest X-ray images is one of the most radiologist's routines. However, it still can be challenging, even for the most experienced ones. Therefore, we proposed a multi-model deep learning-based automated chest X-ray report generator system designed to assist radiologists in their work. The basic idea of the proposed system is by utilizing multi binary-classification models for detecting multi abnormalities, with each model responsible for detecting one abnormality, in a single image. In this study, we limited the radiology abnormalities detection to only cardiomegaly, lung effusion, and consolidation. The system generates a radiology report by performing the following three steps: image pre-processing, utilizing deep learning models to detect abnormalities, and producing a report. The aim of the image pre-processing step is to standardize the input by scaling it to 128x128 pixels and slicing it into three segments, which covers the upper, lower, and middle parts of the lung. After pre-processing, each corresponding model classifies the image, resulting in a 0 (zero) for no abnormality detected and a 1 (one) for the presence of an abnormality. The prediction outputs of each model are then concatenated to form a 'result code'. The 'result code' is used to construct a report by selecting the appropriate pre-determined sentence for each detected abnormality in the report generation step. The proposed system is expected to reduce the workload of radiologists and increase the accuracy of chest X-ray diagnosis.

Automated diagnosis prediction from medical images is a valuable resource to support clinical decision-making. However, such systems usually need to be trained on large amounts of annotated data, which often is scarce in the medical domain. Zero-shot methods address this challenge by allowing a flexible adaption to new settings with different clinical findings without relying on labeled data. Further, to integrate automated diagnosis in the clinical workflow, methods should be transparent and explainable, increasing medical professionals' trust and facilitating correctness verification. In this work, we introduce Xplainer, a novel framework for explainable zero-shot diagnosis in the clinical setting. Xplainer adapts the classification-by-description approach of contrastive vision-language models to the multi-label medical diagnosis task. Specifically, instead of directly predicting a diagnosis, we prompt the model to classify the existence of descriptive observations, which a radiologist would look for on an X-Ray scan, and use the descriptor probabilities to estimate the likelihood of a diagnosis. Our model is explainable by design, as the final diagnosis prediction is directly based on the prediction of the underlying descriptors. We evaluate Xplainer on two chest X-ray datasets, CheXpert and ChestX-ray14, and demonstrate its effectiveness in improving the performance and explainability of zero-shot diagnosis. Our results suggest that Xplainer provides a more detailed understanding of the decision-making process and can be a valuable tool for clinical diagnosis.

We present a labeled large-scale, high resolution chest x-ray dataset for the automated exploration of medical images along with their associated reports. This dataset includes more than 160,000 images obtained from 67,000 patients that were interpreted and reported by radiologists at Hospital San Juan Hospital (Spain) from 2009 to 2017, covering six different position views and additional information on image acquisition and patient demography. The reports were labeled with 174 different radiographic findings, 19 differential diagnoses and 104 anatomic locations organized as a hierarchical taxonomy and mapped onto standard Unified Medical Language System (UMLS) terminology. Of these reports, 27% were manually annotated by trained physicians and the remaining set was labeled using a supervised method based on a recurrent neural network with attention mechanisms. The labels generated were then validated in an independent test set achieving a 0.93 Micro-F1 score. To the best of our knowledge, this is one of the largest public chest x-ray database suitable for training supervised models concerning radiographs, and the first to contain radiographic reports in Spanish. The PadChest dataset can be downloaded from http://bimcv.cipf.es/bimcv-projects/padchest/.

Extraction of relevant pathological terms from radiology reports is important for correct image label generation and disease population studies. In this letter, we compare the performance of some known application program interface (APIs) for the task of thoracic abnormality extraction from radiology reports. We explored several medical domain specific annotation tools like Medical Text Indexer(MTI) with Non-MEDLINE and Mesh On Demand(MOD) options and generic Natural Language Understanding (NLU) API provided by the IBM cloud. Our results show that although MTI and MOD are intended for extracting medical terms, their performance is worst compared to generic extraction API like IBM NLU. Finally, we trained a DNN-based Named Entity Recognition (NER) model to extract the key concept words from radiology reports. Our model outperforms the medical specific and generic API performance by a large margin. Our results demonstrate the inadequacy of generic APIs for pathology extraction task and establish the importance of domain specific model training for improved results. We hope that these results motivate the research community to release larger de-identified radiology reports corpus for building high accuracy machine learning models for the important task of pathology extraction.

The polarization of an X-ray beam that produces electrons with velocity components perpendicular to the beam generates an azimuthal distribution of the ejected electrons. We present methods for simulating and for analyzing the angular dependence of electron detections which enable us to derive simple analytical expressions for useful statistical properties of observable data. The derivations are verified by simulations. While we confirm the results of previous work on this topic, we provide an extension needed for analytical treatment of the full range of possible polarization amplitudes.

We present a 70ks Chandra observation of the radio galaxy 3C293. This galaxy belongs to the class of molecular hydrogen emission galaxies (MOHEGs) that have very luminous emission from warm molecular hydrogen. In radio galaxies, the molecular gas appears to be heated by jet-driven shocks, but exactly how this mechanism works is still poorly understood. With Chandra, we observe X-ray emission from the jets within the host galaxy and along the 100 kpc radio jets. We model the X-ray spectra of the nucleus, the inner jets, and the X-ray features along the extended radio jets. Both the nucleus and the inner jets show evidence of 10^7 K shock-heated gas. The kinetic power of the jets is more than sufficient to heat the X-ray emitting gas within the host galaxy. The thermal X-ray and warm H2 luminosities of 3C293 are similar, indicating similar masses of X-ray hot gas and warm molecular gas. This is consistent with a picture where both derive from a multiphase, shocked interstellar medium (ISM). We find that radio-loud MOHEGs that are not brightest cluster galaxies (BCGs), like 3C293, typically have LH2/LX~1 and MH2/MX~1, whereas MOHEGs that are BCGs have LH2/LX~0.01 and MH2/MX~0.01. The more massive, virialized, hot atmosphere in BCGs overwhelms any direct X-ray emission from current jet-ISM interaction. On the other hand, LH2/LX~1 in the Spiderweb BCG at z=2, which resides in an unvirialized protocluster and hosts a powerful radio source. Over time, jet-ISM interaction may contribute to the establishment of a hot atmosphere in BCGs and other massive elliptical galaxies.

Our approach, which we call Embeddings for Language/Image-aligned X-Rays, or ELIXR, leverages a language-aligned image encoder combined or grafted onto a fixed LLM, PaLM 2, to perform a broad range of tasks. We train this lightweight adapter architecture using images paired with corresponding free-text radiology reports from the MIMIC-CXR dataset. ELIXR achieved state-of-the-art performance on zero-shot chest X-ray (CXR) classification (mean AUC of 0.850 across 13 findings), data-efficient CXR classification (mean AUCs of 0.893 and 0.898 across five findings (atelectasis, cardiomegaly, consolidation, pleural effusion, and pulmonary edema) for 1% (~2,200 images) and 10% (~22,000 images) training data), and semantic search (0.76 normalized discounted cumulative gain (NDCG) across nineteen queries, including perfect retrieval on twelve of them). Compared to existing data-efficient methods including supervised contrastive learning (SupCon), ELIXR required two orders of magnitude less data to reach similar performance. ELIXR also showed promise on CXR vision-language tasks, demonstrating overall accuracies of 58.7% and 62.5% on visual question answering and report quality assurance tasks, respectively. These results suggest that ELIXR is a robust and versatile approach to CXR AI.

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%.

Lung diseases remain a critical global health concern, and it's crucial to have accurate and quick ways to diagnose them. This work focuses on classifying different lung diseases into five groups: viral pneumonia, bacterial pneumonia, COVID, tuberculosis, and normal lungs. Employing advanced deep learning techniques, we explore a diverse range of models including CNN, hybrid models, ensembles, transformers, and Big Transfer. The research encompasses comprehensive methodologies such as hyperparameter tuning, stratified k-fold cross-validation, and transfer learning with fine-tuning.Remarkably, our findings reveal that the Xception model, fine-tuned through 5-fold cross-validation, achieves the highest accuracy of 96.21\%. This success shows that our methods work well in accurately identifying different lung diseases. The exploration of explainable artificial intelligence (XAI) methodologies further enhances our understanding of the decision-making processes employed by these models, contributing to increased trust in their clinical applications.

The study of jet-inflated X-ray cavities provides a powerful insight into the energetics of hot galactic atmospheres and radio-mechanical AGN feedback. By estimating the volumes of X-ray cavities, the total energy and thus also the corresponding mechanical jet power required for their inflation can be derived. Properly estimating their total extent is, however, non-trivial, prone to biases, nearly impossible for poor-quality data, and so far has been done manually by scientists. We present a novel and automated machine-learning pipeline called Cavity Detection Tool (CADET), developed to detect and estimate the sizes of X-ray cavities from raw Chandra images. The pipeline consists of a convolutional neural network trained for producing pixel-wise cavity predictions and a DBSCAN clustering algorithm, which decomposes the predictions into individual cavities. The convolutional network was trained using mock observations of early-type galaxies simulated to resemble real noisy Chandra-like images. The network's performance has been tested on simulated data obtaining an average cavity volume error of 14 % at an 89 % true-positive rate. For simulated images without any X-ray cavities inserted, we obtain a 5 % false-positive rate. When applied to real Chandra images, the pipeline recovered 91 out of 100 previously known X-ray cavities in nearby early-type galaxies and all 14 cavities in chosen galaxy clusters. Besides that, the CADET pipeline discovered 8 new cavity pairs in atmospheres of early-type galaxies and galaxy clusters (IC4765, NGC533, NGC2300, NGC3091, NGC4073, NGC4125, NGC4472, NGC5129) and a number of potential cavity candidates.

Tuberculosis (TB) is a chronic lung disease that occurs due to bacterial infection and is one of the top 10 leading causes of death. Accurate and early detection of TB is very important, otherwise, it could be life-threatening. In this work, we have detected TB reliably from the chest X-ray images using image pre-processing, data augmentation, image segmentation, and deep-learning classification techniques. Several public databases were used to create a database of 700 TB infected and 3500 normal chest X-ray images for this study. Nine different deep CNNs (ResNet18, ResNet50, ResNet101, ChexNet, InceptionV3, Vgg19, DenseNet201, SqueezeNet, and MobileNet), which were used for transfer learning from their pre-trained initial weights and trained, validated and tested for classifying TB and non-TB normal cases. Three different experiments were carried out in this work: segmentation of X-ray images using two different U-net models, classification using X-ray images, and segmented lung images. The accuracy, precision, sensitivity, F1-score, specificity in the detection of tuberculosis using X-ray images were 97.07 %, 97.34 %, 97.07 %, 97.14 % and 97.36 % respectively. However, segmented lungs for the classification outperformed than whole X-ray image-based classification and accuracy, precision, sensitivity, F1-score, specificity were 99.9 %, 99.91 %, 99.9 %, 99.9 %, and 99.52 % respectively. The paper also used a visualization technique to confirm that CNN learns dominantly from the segmented lung regions results in higher detection accuracy. The proposed method with state-of-the-art performance can be useful in the computer-aided faster diagnosis of tuberculosis.

The integration of artificial intelligence in image-guided interventions holds transformative potential, promising to extract 3D geometric and quantitative information from conventional 2D imaging modalities during complex procedures. Achieving this requires the rapid and precise alignment of 2D intraoperative images (e.g., X-ray) with 3D preoperative volumes (e.g., CT, MRI). However, current 2D/3D registration methods fail across the broad spectrum of procedures dependent on X-ray guidance: traditional optimization techniques require custom parameter tuning for each subject, whereas neural networks trained on small datasets do not generalize to new patients or require labor-intensive manual annotations, increasing clinical burden and precluding application to new anatomical targets. To address these challenges, we present xvr, a fully automated framework for training patient-specific neural networks for 2D/3D registration. xvr uses physics-based simulation to generate abundant high-quality training data from a patient's own preoperative volumetric imaging, thereby overcoming the inherently limited ability of supervised models to generalize to new patients and procedures. Furthermore, xvr requires only 5 minutes of training per patient, making it suitable for emergency interventions as well as planned procedures. We perform the largest evaluation of a 2D/3D registration algorithm on real X-ray data to date and find that xvr robustly generalizes across a diverse dataset comprising multiple anatomical structures, imaging modalities, and hospitals. Across surgical tasks, xvr achieves submillimeter-accurate registration at intraoperative speeds, improving upon existing methods by an order of magnitude. xvr is released as open-source software freely available at https://github.com/eigenvivek/xvr.

Since the release of the original CheXpert paper five years ago, CheXpert has become one of the most widely used and cited clinical AI datasets. The emergence of vision language models has sparked an increase in demands for sharing reports linked to CheXpert images, along with a growing interest among AI fairness researchers in obtaining demographic data. To address this, CheXpert Plus serves as a new collection of radiology data sources, made publicly available to enhance the scaling, performance, robustness, and fairness of models for all subsequent machine learning tasks in the field of radiology. CheXpert Plus is the largest text dataset publicly released in radiology, with a total of 36 million text tokens, including 13 million impression tokens. To the best of our knowledge, it represents the largest text de-identification effort in radiology, with almost 1 million PHI spans anonymized. It is only the second time that a large-scale English paired dataset has been released in radiology, thereby enabling, for the first time, cross-institution training at scale. All reports are paired with high-quality images in DICOM format, along with numerous image and patient metadata covering various clinical and socio-economic groups, as well as many pathology labels and RadGraph annotations. We hope this dataset will boost research for AI models that can further assist radiologists and help improve medical care. Data is available at the following URL: https://stanfordaimi.azurewebsites.net/datasets/5158c524-d3ab-4e02-96e9-6ee9efc110a1 Models are available at the following URL: https://github.com/Stanford-AIMI/chexpert-plus

The development of successful artificial intelligence models for chest X-ray analysis relies on large, diverse datasets with high-quality annotations. While several databases of chest X-ray images have been released, most include disease diagnosis labels but lack detailed pixel-level anatomical segmentation labels. To address this gap, we introduce an extensive chest X-ray multi-center segmentation dataset with uniform and fine-grain anatomical annotations for images coming from six well-known publicly available databases: CANDID-PTX, ChestX-ray8, Chexpert, MIMIC-CXR-JPG, Padchest, and VinDr-CXR, resulting in 676,803 segmentation masks. Our methodology utilizes the HybridGNet model to ensure consistent and high-quality segmentations across all datasets. Rigorous validation, including expert physician evaluation and automatic quality control, was conducted to validate the resulting masks. Additionally, we provide individualized quality indices per mask and an overall quality estimation per dataset. This dataset serves as a valuable resource for the broader scientific community, streamlining the development and assessment of innovative methodologies in chest X-ray analysis. The CheXmask dataset is publicly available at: https://physionet.org/content/chexmask-cxr-segmentation-data/.

We present Chandra ACIS imaging spectroscopy results for the extended (1.5"-8") hard X-ray emission of the Compton thick (CT) Seyfert NGC 5728. We find spectrally and spatially-resolved features in the Fe Kalpha complex (5.0-7.5 keV), redward and blueward of the neutral 6.4 keV line in the extended bicone. The [red, blue] features have [6.5sigma, 5.3sigma] significance, with an equivalent width = [2.0 keV, 2.5 keV], much higher than in the nuclear spectrum. These energies imply line-of-sight velocities of ~19,000-42,000 km s^{-1} for the red wing, and ~ -28,000 km s^{-1} for the blue wing, if the emission is due to neutral Fe Kalpha. These red and blue wings are radially extended ~6"(1.2 kpc), and ~5"(1 kpc), respectively, as confirmed by narrow-band X-ray imaging. Our models discard the possibility that the red wing could arise from a Compton shoulder, and show that the flux in the blue wing is unlikely to arise (at ~3sigma significance) from a blend of Fe Kbeta and highly ionized Fe lines.

TorchXRayVision is an open source software library for working with chest X-ray datasets and deep learning models. It provides a common interface and common pre-processing chain for a wide set of publicly available chest X-ray datasets. In addition, a number of classification and representation learning models with different architectures, trained on different data combinations, are available through the library to serve as baselines or feature extractors.

Spreading of COVID-19 virus has increased the efforts to provide testing kits. Not only the preparation of these kits had been hard, rare, and expensive but also using them is another issue. Results have shown that these kits take some crucial time to recognize the virus, in addition to the fact that they encounter with 30% loss. In this paper, we have studied the usage of x-ray pictures which are ubiquitous, for the classification of COVID-19 chest Xray images, by the existing convolutional neural networks (CNNs). We intend to train chest x-rays of infected and not infected ones with different CNNs architectures including VGG19, Densnet-121, and Xception. Training these architectures resulted in different accuracies which were much faster and more precise than usual ways of testing.

Scientific researchers frequently use the in situ synchrotron high-energy powder X-ray diffraction (XRD) technique to examine the crystallographic structures of materials in functional devices such as rechargeable battery materials. We propose a method for identifying artifacts in experimental XRD images. The proposed method uses deep learning convolutional neural network architectures, such as tunable U-Nets to identify the artifacts. In particular, the predicted artifacts are evaluated against the corresponding ground truth (manually implemented) using the overall true positive rate or recall. The result demonstrates that the U-Nets can consistently produce great recall performance at 92.4% on the test dataset, which is not included in the training, with a 34% reduction in average false positives in comparison to the conventional method. The U-Nets also reduce the time required to identify and separate artifacts by more than 50%. Furthermore, the exclusion of the artifacts shows major changes in the integrated 1D XRD pattern, enhancing further analysis of the post-processing XRD data.

Purpose: Recent advancements in large language models (LLMs) have expanded their capabilities in a multimodal fashion, potentially replicating the image interpretation of human radiologists. This study aimed to develop open-source multimodal large language model for interpreting chest X-ray images (CXR-LLaVA). We also examined the effect of prompt engineering and model parameters such as temperature and nucleus sampling. Materials and Methods: For training, we collected 659,287 publicly available CXRs: 417,336 CXRs had labels for certain radiographic abnormalities (dataset 1); 241,951 CXRs provided free-text radiology reports (dataset 2). After pre-training the Resnet50 as an image encoder, the contrastive language-image pre-training was used to align CXRs and corresponding radiographic abnormalities. Then, the Large Language Model Meta AI-2 was fine-tuned using dataset 2, which were refined using GPT-4, with generating various question answering scenarios. The code can be found at https://github.com/ECOFRI/CXR_LLaVA. Results: In the test set, we observed that the model's performance fluctuated based on its parameters. On average, it achieved F1 score of 0.34 for five pathologic findings (atelectasis, cardiomegaly, consolidation, edema, and pleural effusion), which was improved to 0.46 through prompt engineering. In the independent set, the model achieved an average F1 score of 0.30 for the same pathologic findings. Notably, for the pediatric chest radiograph dataset, which was unseen during training, the model differentiated abnormal radiographs with an F1 score ranging from 0.84 to 0.85. Conclusion: CXR-LLaVA demonstrates promising potential in CXR interpretation. Both prompt engineering and model parameter adjustments can play pivotal roles in interpreting CXRs.

Tuberculosis (TB) is caused by the bacterium Mycobacterium tuberculosis, primarily affecting the lungs. Early detection is crucial for improving treatment effectiveness and reducing transmission risk. Artificial intelligence (AI), particularly through image classification of chest X-rays, can assist in TB detection. However, class imbalance in TB chest X-ray datasets presents a challenge for accurate classification. In this paper, we propose a few-shot learning (FSL) approach using the Prototypical Network algorithm to address this issue. We compare the performance of ResNet-18, ResNet-50, and VGG16 in feature extraction from the TBX11K Chest X-ray dataset. Experimental results demonstrate classification accuracies of 98.93% for ResNet-18, 98.60% for ResNet-50, and 33.33% for VGG16. These findings indicate that the proposed method outperforms others in mitigating data imbalance, which is particularly beneficial for disease classification applications.

We present a systematic analysis of the radio properties of an X-ray selected sample of tidal disruption event (TDE) candidates discovered by the eROSITA telescope. We find radio sources coincident with half of the transient events (11 TDEs), with 8 radio sources showing statistically significant variability over a 6-month period. We model the radio spectra of 6 sources with sufficiently bright radio emission and find the sources show radio spectra consistent with optically thin synchrotron emission and radio outflow minimum radii of 10^{16}--10^{17} cm, velocities 0.01--0.05 c, and energies 10^{48}--10^{51} erg. On comparison with the radio properties of an optically-selected TDE sample at similar late times, we find no significant difference in the radio luminosity range or radio detection rate. We find a tentative positive trend with peak radio and X-ray luminosity, but require further observations to determine if this is real or due to observational bias due to the large range in distances of the events. Interestingly, none of the X-ray selected events show late rising radio emission, compared to 45% of radio-detected sources of an optically-selected sample that showed late rising radio emission. We propose that this may indicate that many TDEs launch radio outflows at or near peak X-ray luminosity, which can be significantly delayed from peak optical luminosity. This study presents the first systematic analysis of the radio properties of an X-ray selected sample of TDEs, and gives insight into the possible link between the physical processes that power X-ray and radio emission in TDEs.

Automated radiology report generation offers an effective solution to alleviate radiologists' workload. However, most existing methods focus primarily on single or fixed-view images to model current disease conditions, which limits diagnostic accuracy and overlooks disease progression. Although some approaches utilize longitudinal data to track disease progression, they still rely on single images to analyze current visits. To address these issues, we propose enhanced contrastive learning with Multi-view Longitudinal data to facilitate chest X-ray Report Generation, named MLRG. Specifically, we introduce a multi-view longitudinal contrastive learning method that integrates spatial information from current multi-view images and temporal information from longitudinal data. This method also utilizes the inherent spatiotemporal information of radiology reports to supervise the pre-training of visual and textual representations. Subsequently, we present a tokenized absence encoding technique to flexibly handle missing patient-specific prior knowledge, allowing the model to produce more accurate radiology reports based on available prior knowledge. Extensive experiments on MIMIC-CXR, MIMIC-ABN, and Two-view CXR datasets demonstrate that our MLRG outperforms recent state-of-the-art methods, achieving a 2.3% BLEU-4 improvement on MIMIC-CXR, a 5.5% F1 score improvement on MIMIC-ABN, and a 2.7% F1 RadGraph improvement on Two-view CXR.

Radiology reports are crucial for planning treatment strategies and enhancing doctor-patient communication, yet manually writing these reports is burdensome for radiologists. While automatic report generation offers a solution, existing methods often rely on single-view radiographs, limiting diagnostic accuracy. To address this problem, we propose MCL, a Multi-view enhanced Contrastive Learning method for chest X-ray report generation. Specifically, we first introduce multi-view enhanced contrastive learning for visual representation by maximizing agreements between multi-view radiographs and their corresponding report. Subsequently, to fully exploit patient-specific indications (e.g., patient's symptoms) for report generation, we add a transitional ``bridge" for missing indications to reduce embedding space discrepancies caused by their presence or absence. Additionally, we construct Multi-view CXR and Two-view CXR datasets from public sources to support research on multi-view report generation. Our proposed MCL surpasses recent state-of-the-art methods across multiple datasets, achieving a 5.0% F1 RadGraph improvement on MIMIC-CXR, a 7.3% BLEU-1 improvement on MIMIC-ABN, a 3.1% BLEU-4 improvement on Multi-view CXR, and an 8.2% F1 CheXbert improvement on Two-view CXR.

Inspired by the success of large language models (LLMs), there is growing research interest in developing LLMs in the medical domain to assist clinicians. However, for hospitals, using closed-source commercial LLMs involves privacy issues, and developing open-source public LLMs requires large-scale computational resources, which are usually limited, especially in resource-efficient regions and low-income countries. We propose an open-source Small Language and Vision Assistant (SLaVA-CXR) that can be used for Chest X-Ray report automation. To efficiently train a small assistant, we first propose the Re^3Training method, which simulates the cognitive development of radiologists and optimizes the model in the Recognition, Reasoning, and Reporting training manner. Then, we introduce a data synthesis method, RADEX, which can generate a high-quality and diverse training corpus with privacy regulation compliance. The extensive experiments show that our SLaVA-CXR built on a 2.7B backbone not only outperforms but also achieves 6 times faster inference efficiency than previous state-of-the-art larger models.

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

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.

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.

The outbreak of COVID-19 has shocked the entire world with its fairly rapid spread and has challenged different sectors. One of the most effective ways to limit its spread is the early and accurate diagnosing infected patients. Medical imaging, such as X-ray and Computed Tomography (CT), combined with the potential of Artificial Intelligence (AI), plays an essential role in supporting medical personnel in the diagnosis process. Thus, in this article five different deep learning models (ResNet18, ResNet34, InceptionV3, InceptionResNetV2 and DenseNet161) and their ensemble, using majority voting have been used to classify COVID-19, pneumoni{\ae} and healthy subjects using chest X-ray images. Multilabel classification was performed to predict multiple pathologies for each patient, if present. Firstly, the interpretability of each of the networks was thoroughly studied using local interpretability methods - occlusion, saliency, input X gradient, guided backpropagation, integrated gradients, and DeepLIFT, and using a global technique - neuron activation profiles. The mean Micro-F1 score of the models for COVID-19 classifications ranges from 0.66 to 0.875, and is 0.89 for the ensemble of the network models. The qualitative results showed that the ResNets were the most interpretable models. This research demonstrates the importance of using interpretability methods to compare different models before making a decision regarding the best performing model.

This large scale study focuses on quantifying what X-rays diagnostic prediction tasks generalize well across multiple different datasets. We present evidence that the issue of generalization is not due to a shift in the images but instead a shift in the labels. We study the cross-domain performance, agreement between models, and model representations. We find interesting discrepancies between performance and agreement where models which both achieve good performance disagree in their predictions as well as models which agree yet achieve poor performance. We also test for concept similarity by regularizing a network to group tasks across multiple datasets together and observe variation across the tasks. All code is made available online and data is publicly available: https://github.com/mlmed/torchxrayvision

The global outbreak of the Coronavirus 2019 (COVID-19) has overloaded worldwide healthcare systems. Computer-aided diagnosis for COVID-19 fast detection and patient triage is becoming critical. This paper proposes a novel self-knowledge distillation based self-supervised learning method for COVID-19 detection from chest X-ray images. Our method can use self-knowledge of images based on similarities of their visual features for self-supervised learning. Experimental results show that our method achieved an HM score of 0.988, an AUC of 0.999, and an accuracy of 0.957 on the largest open COVID-19 chest X-ray dataset.

In the field of eXplainable AI (XAI), robust "blackbox" algorithms such as Convolutional Neural Networks (CNNs) are known for making high prediction performance. However, the ability to explain and interpret these algorithms still require innovation in the understanding of influential and, more importantly, explainable features that directly or indirectly impact the performance of predictivity. A number of methods existing in literature focus on visualization techniques but the concepts of explainability and interpretability still require rigorous definition. In view of the above needs, this paper proposes an interaction-based methodology -- Influence Score (I-score) -- to screen out the noisy and non-informative variables in the images hence it nourishes an environment with explainable and interpretable features that are directly associated to feature predictivity. We apply the proposed method on a real world application in Pneumonia Chest X-ray Image data set and produced state-of-the-art results. We demonstrate how to apply the proposed approach for more general big data problems by improving the explainability and interpretability without sacrificing the prediction performance. The contribution of this paper opens a novel angle that moves the community closer to the future pipelines of XAI problems.

Anatomical segmentation is a fundamental task in medical image computing, generally tackled with fully convolutional neural networks which produce dense segmentation masks. These models are often trained with loss functions such as cross-entropy or Dice, which assume pixels to be independent of each other, thus ignoring topological errors and anatomical inconsistencies. We address this limitation by moving from pixel-level to graph representations, which allow to naturally incorporate anatomical constraints by construction. To this end, we introduce HybridGNet, an encoder-decoder neural architecture that leverages standard convolutions for image feature encoding and graph convolutional neural networks (GCNNs) to decode plausible representations of anatomical structures. We also propose a novel image-to-graph skip connection layer which allows localized features to flow from standard convolutional blocks to GCNN blocks, and show that it improves segmentation accuracy. The proposed architecture is extensively evaluated in a variety of domain shift and image occlusion scenarios, and audited considering different types of demographic domain shift. Our comprehensive experimental setup compares HybridGNet with other landmark and pixel-based models for anatomical segmentation in chest x-ray images, and shows that it produces anatomically plausible results in challenging scenarios where other models tend to fail.

The Gamma-ray detection from an astrophysical object indicates the presence of an extreme environment where high-energy radiation is produced. With the continuous monitoring of the Gamma-ray sky by the Fermi Large Area Telescope (LAT), leading to deeper sensitivity, the high-energy Gamma-ray emission has now been detected from a diverse class of jetted active galactic nuclei (AGN). Here, we present the results of a multiwavelength study of the radio source DA~362, which was reported to be a blazar candidate of uncertain type. However, it was recently identified as a bona fide compact symmetric object (CSO) based on its sub-kpc, bi-polar radio morphology, and lack of radio variability. This makes DA~362 the only fourth Gamma-ray emitting object of this enigmatic class of radio-loud AGN. Using five very long baseline interferometry observations covering 1996-2018, we found the jet separation velocity to be subluminal (v_{rm app}sim 0.2c), thus supporting its CSO nature. Its Fermi-LAT observations revealed a Gamma-ray flaring activity, a phenomenon never detected from the other three Gamma-ray detected CSOs. This object is bright in the near-infrared band but extremely faint in the optical-ultraviolet filters, hinting at possible obscuration. The Swift X-Ray Telescope observation of DA 362 reveals an extremely hard X-ray spectrum, though a strong claim cannot be made due to large uncertainties. We conclude that deeper observations are needed to probe the broadband properties of this enigmatic object and to understand the origin of high-energy Gamma-ray emission.

This paper investigates the use of deep learning approaches to estimate the femur caput-collum-diaphyseal (CCD) angle from X-ray images. The CCD angle is an important measurement in the diagnosis of hip problems, and correct prediction can help in the planning of surgical procedures. Manual measurement of this angle, on the other hand, can be time-intensive and vulnerable to inter-observer variability. In this paper, we present a deep-learning algorithm that can reliably estimate the femur CCD angle from X-ray images. To train and test the performance of our model, we employed an X-ray image dataset with associated femur CCD angle measurements. Furthermore, we built a prototype to display the resulting predictions and to allow the user to interact with the predictions. As this is happening in a sterile setting during surgery, we expanded our interface to the possibility of being used only by voice commands. Our results show that our deep learning model predicts the femur CCD angle on X-ray images with great accuracy, with a mean absolute error of 4.3 degrees on the left femur and 4.9 degrees on the right femur on the test dataset. Our results suggest that deep learning has the potential to give a more efficient and accurate technique for predicting the femur CCD angle, which might have substantial therapeutic implications for the diagnosis and management of hip problems.

In clinical radiology reports, doctors capture important information about the patient's health status. They convey their observations from raw medical imaging data about the inner structures of a patient. As such, formulating reports requires medical experts to possess wide-ranging knowledge about anatomical regions with their normal, healthy appearance as well as the ability to recognize abnormalities. This explicit grasp on both the patient's anatomy and their appearance is missing in current medical image-processing systems as annotations are especially difficult to gather. This renders the models to be narrow experts e.g. for identifying specific diseases. In this work, we recover this missing link by adding human anatomy into the mix and enable the association of content in medical reports to their occurrence in associated imagery (medical phrase grounding). To exploit anatomical structures in this scenario, we present a sophisticated automatic pipeline to gather and integrate human bodily structures from computed tomography datasets, which we incorporate in our PAXRay: A Projected dataset for the segmentation of Anatomical structures in X-Ray data. Our evaluation shows that methods that take advantage of anatomical information benefit heavily in visually grounding radiologists' findings, as our anatomical segmentations allow for up to absolute 50% better grounding results on the OpenI dataset as compared to commonly used region proposals. The PAXRay dataset is available at https://constantinseibold.github.io/paxray/.

We develop an algorithm that can detect pneumonia from chest X-rays at a level exceeding practicing radiologists. Our algorithm, CheXNet, is a 121-layer convolutional neural network trained on ChestX-ray14, currently the largest publicly available chest X-ray dataset, containing over 100,000 frontal-view X-ray images with 14 diseases. Four practicing academic radiologists annotate a test set, on which we compare the performance of CheXNet to that of radiologists. We find that CheXNet exceeds average radiologist performance on the F1 metric. We extend CheXNet to detect all 14 diseases in ChestX-ray14 and achieve state of the art results on all 14 diseases.

In this paper, we introduce a novel Multi-Modal Contrastive Pre-training Framework that synergistically combines X-rays, electrocardiograms (ECGs), and radiology/cardiology reports. Our approach leverages transformers to encode these diverse modalities into a unified representation space, aiming to enhance diagnostic accuracy and facilitate comprehensive patient assessments. We utilize LoRA-Peft to significantly reduce trainable parameters in the LLM and incorporate recent linear attention dropping strategy in the Vision Transformer(ViT) for smoother attention. Furthermore, we provide novel multimodal attention explanations and retrieval for our model. To the best of our knowledge, we are the first to propose an integrated model that combines X-ray, ECG, and Radiology/Cardiology Report with this approach. By utilizing contrastive loss, MoRE effectively aligns modality-specific features into a coherent embedding, which supports various downstream tasks such as zero-shot classification and multimodal retrieval. Employing our proposed methodology, we achieve state-of-the-art (SOTA) on the Mimic-IV, CheXpert, Edema Severity, and PtbXl downstream datasets, surpassing existing multimodal approaches. Our proposed framework shows significant improvements in capturing intricate inter-modal relationships and its robustness in medical diagnosis that establishes a framework for future research in multimodal learning in the healthcare sector.

Vision-language models (VLMs), such as CLIP and ALIGN, are generally trained on datasets consisting of image-caption pairs obtained from the web. However, real-world multimodal datasets, such as healthcare data, are significantly more complex: each image (e.g. X-ray) is often paired with text (e.g. physician report) that describes many distinct attributes occurring in fine-grained regions of the image. We refer to these samples as exhibiting high pairwise complexity, since each image-text pair can be decomposed into a large number of region-attribute pairings. The extent to which VLMs can capture fine-grained relationships between image regions and textual attributes when trained on such data has not been previously evaluated. The first key contribution of this work is to demonstrate through systematic evaluations that as the pairwise complexity of the training dataset increases, standard VLMs struggle to learn region-attribute relationships, exhibiting performance degradations of up to 37% on retrieval tasks. In order to address this issue, we introduce ViLLA as our second key contribution. ViLLA, which is trained to capture fine-grained region-attribute relationships from complex datasets, involves two components: (a) a lightweight, self-supervised mapping model to decompose image-text samples into region-attribute pairs, and (b) a contrastive VLM to learn representations from generated region-attribute pairs. We demonstrate with experiments across four domains (synthetic, product, medical, and natural images) that ViLLA outperforms comparable VLMs on fine-grained reasoning tasks, such as zero-shot object detection (up to 3.6 AP50 points on COCO and 0.6 mAP points on LVIS) and retrieval (up to 14.2 R-Precision points).

Wrist Fracture is the most common type of fracture with a high incidence rate. Conventional radiography (i.e. X-ray imaging) is used for wrist fracture detection routinely, but occasionally fracture delineation poses issues and an additional confirmation by computed tomography (CT) is needed for diagnosis. Recent advances in the field of Deep Learning (DL), a subfield of Artificial Intelligence (AI), have shown that wrist fracture detection can be automated using Convolutional Neural Networks. However, previous studies did not pay close attention to the difficult cases which can only be confirmed via CT imaging. In this study, we have developed and analyzed a state-of-the-art DL-based pipeline for wrist (distal radius) fracture detection -- DeepWrist, and evaluated it against one general population test set, and one challenging test set comprising only cases requiring confirmation by CT. Our results reveal that a typical state-of-the-art approach, such as DeepWrist, while having a near-perfect performance on the general independent test set, has a substantially lower performance on the challenging test set -- average precision of 0.99 (0.99-0.99) vs 0.64 (0.46-0.83), respectively. Similarly, the area under the ROC curve was of 0.99 (0.98-0.99) vs 0.84 (0.72-0.93), respectively. Our findings highlight the importance of a meticulous analysis of DL-based models before clinical use, and unearth the need for more challenging settings for testing medical AI systems.

Coronavirus disease (COVID-19) is a pandemic disease, which has already caused thousands of causalities and infected several millions of people worldwide. Any technological tool enabling rapid screening of the COVID-19 infection with high accuracy can be crucially helpful to healthcare professionals. The main clinical tool currently in use for the diagnosis of COVID-19 is the Reverse transcription polymerase chain reaction (RT-PCR), which is expensive, less-sensitive and requires specialized medical personnel. X-ray imaging is an easily accessible tool that can be an excellent alternative in the COVID-19 diagnosis. This research was taken to investigate the utility of artificial intelligence (AI) in the rapid and accurate detection of COVID-19 from chest X-ray images. The aim of this paper is to propose a robust technique for automatic detection of COVID-19 pneumonia from digital chest X-ray images applying pre-trained deep-learning algorithms while maximizing the detection accuracy. A public database was created by the authors combining several public databases and also by collecting images from recently published articles. The database contains a mixture of 423 COVID-19, 1485 viral pneumonia, and 1579 normal chest X-ray images. Transfer learning technique was used with the help of image augmentation to train and validate several pre-trained deep Convolutional Neural Networks (CNNs). The networks were trained to classify two different schemes: i) normal and COVID-19 pneumonia; ii) normal, viral and COVID-19 pneumonia with and without image augmentation. The classification accuracy, precision, sensitivity, and specificity for both the schemes were 99.7%, 99.7%, 99.7% and 99.55% and 97.9%, 97.95%, 97.9%, and 98.8%, respectively.

We introduce a novel framework for incorporating human expertise into algorithmic predictions. Our approach leverages human judgment to distinguish inputs which are algorithmically indistinguishable, or "look the same" to predictive algorithms. We argue that this framing clarifies the problem of human-AI collaboration in prediction tasks, as experts often form judgments by drawing on information which is not encoded in an algorithm's training data. Algorithmic indistinguishability yields a natural test for assessing whether experts incorporate this kind of "side information", and further provides a simple but principled method for selectively incorporating human feedback into algorithmic predictions. We show that this method provably improves the performance of any feasible algorithmic predictor and precisely quantify this improvement. We find empirically that although algorithms often outperform their human counterparts on average, human judgment can improve algorithmic predictions on specific instances (which can be identified ex-ante). In an X-ray classification task, we find that this subset constitutes nearly 30% of the patient population. Our approach provides a natural way of uncovering this heterogeneity and thus enabling effective human-AI collaboration.

Recent advances in 3D X-ray Computed Tomographic (CT) sensors have stimulated research efforts to unveil the extremely complex micro-scale processes that control the activity of soil microorganisms. Voxel-based description (up to hundreds millions voxels) of the pore space can be extracted, from grey level 3D CT scanner images, by means of simple image processing tools. Classical methods for numerical simulation of biological dynamics using mesh of voxels, such as Lattice Boltzmann Model (LBM), are too much time consuming. Thus, the use of more compact and reliable geometrical representations of pore space can drastically decrease the computational cost of the simulations. Several recent works propose basic analytic volume primitives (e.g. spheres, generalized cylinders, ellipsoids) to define a piece-wise approximation of pore space for numerical simulation of draining, diffusion and microbial decomposition. Such approaches work well but the drawback is that it generates approximation errors. In the present work, we study another alternative where pore space is described by means of geometrically relevant connected subsets of voxels (regions) computed from the curvilinear skeleton. Indeed, many works use the curvilinear skeleton (3D medial axis) for analyzing and partitioning 3D shapes within various domains (medicine, material sciences, petroleum engineering, etc.) but only a few ones in soil sciences. Within the context of soil sciences, most studies dealing with 3D medial axis focus on the determination of pore throats. Here, we segment pore space using curvilinear skeleton in order to achieve numerical simulation of microbial decomposition (including diffusion processes). We validate simulation outputs by comparison with other methods using different pore space geometrical representations (balls, voxels).

Low-mass X-ray binaries with a neutron star as the primary object show a complex array of phenomenology during outbursts. The observed variability in X-ray emission primarily arises from changes in the innermost regions of the accretion disk, neutron star surface, and corona. In this work, we present the results of a comprehensive X-ray spectral and timing analysis of the neutron star transient MAXI J1807+132 during its 2023 outburst using data from the NICER observatory. The outburst is marked by a very rapid rise in the count rate by about a factor of 20 in a day. The source undergoes full state transitions and displays hysteresis effect in the hardness and rms intensity diagrams. Spectral analysis with a three-component model is consistent with disk truncation during the hard states and reaching the last stable orbit during the intermediate and soft states. We discuss the different values of the last stable radius in the context of possible distance of the source and magnetic field strength. The characteristic frequencies throughout the hard and intermediate states are found to be strongly correlated with the inner radius of the disk. Together with the spectral and fast variability properties, we attempt to trace the evolution of the size of the corona along the outburst. Following the main outburst, the source undergoes a high amplitude reflare wherein it shows a complex behavior with relatively high variability (10 %), but low hardness.

Influenced by the complexity of volumetric imaging, there is a shortage of established datasets useful for benchmarking volumetric deep-learning models. As a consequence, new and existing models are not easily comparable, limiting the development of architectures optimized specifically for volumetric data. To counteract this trend, we introduce MozzaVID - a large, clean, and versatile volumetric classification dataset. Our dataset contains X-ray computed tomography (CT) images of mozzarella microstructure and enables the classification of 25 cheese types and 149 cheese samples. We provide data in three different resolutions, resulting in three dataset instances containing from 591 to 37,824 images. While being general-purpose, the dataset also facilitates investigating mozzarella structure properties. The structure of food directly affects its functional properties and thus its consumption experience. Understanding food structure helps tune the production and mimicking it enables sustainable alternatives to animal-derived food products. The complex and disordered nature of food structures brings a unique challenge, where a choice of appropriate imaging method, scale, and sample size is not trivial. With this dataset we aim to address these complexities, contributing to more robust structural analysis models. The dataset can be downloaded from: https://archive.compute.dtu.dk/files/public/projects/MozzaVID/.

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

Methods. We utilized the combined five SRG/eROSITA All-Sky Survey data (eRASS:5) to perform X-ray imaging and spectral analyses of the Centaurus cluster in various directions to large radii. Surface brightness (SB) profiles out to 2R_{200} were constructed. We acquired gas temperature, metallicity, and normalization per area profiles out to R_{200}. We compared our results with previous Centaurus studies, cluster outskirts measurements, and simulations. Comprehensive sky background analysis was done across the FoV, in particular, to assess the variation of the eROSITA Bubble emission that partially contaminates the field. Results. The processed X-ray images show the known sloshing-induced structures in the core. The core (rleq11~kpc) is better described with a 2T model than a 1T model. Here, we measured lower T from the cooler component (~1.0 keV) and higher Z (sim!1.6Z_odot), signifying an iron bias. In the intermediate radial range, we observed prominent SB and normalization per area excesses in the eastern sector (Cen 45 location), reaching out to R_{500}. Temperature enhancements near the location of Cen 45 imply that the gas is shock-heated due to the interaction with Cen 30, the significant excess behind Cen 45 center might be the tail/ram-pressure-stripped gas. We found good agreement between the outskirt temperatures with the profile from simulations and fit from Suzaku outskirts measurements. We detected significant SB emission to the sky background level out to R_{200} with a 3.5sigma and followed by 2.9sigma at 1.1R_{200}. The metallicity at R_{500}-R_{200} is low but within the ranges of other outskirts studies. Conclusions. We present the first measurement of ICM morphology and properties of Centaurus cluster sampling the whole azimuth beyond 30', increasing the probed volume by a factor of almost 30.

Multi-resolution spectro-temporal features of a speech signal represent how the brain perceives sounds by tuning cortical cells to different spectral and temporal modulations. These features produce a higher dimensional representation of the speech signals. The purpose of this paper is to evaluate how well the auditory cortex representation of speech signals contribute to estimate articulatory features of those corresponding signals. Since obtaining articulatory features from acoustic features of speech signals has been a challenging topic of interest for different speech communities, we investigate the possibility of using this multi-resolution representation of speech signals as acoustic features. We used U. of Wisconsin X-ray Microbeam (XRMB) database of clean speech signals to train a feed-forward deep neural network (DNN) to estimate articulatory trajectories of six tract variables. The optimal set of multi-resolution spectro-temporal features to train the model were chosen using appropriate scale and rate vector parameters to obtain the best performing model. Experiments achieved a correlation of 0.675 with ground-truth tract variables. We compared the performance of this speech inversion system with prior experiments conducted using Mel Frequency Cepstral Coefficients (MFCCs).

The Chandra Source Catalog (CSC) is a general purpose virtual X-ray astrophysics facility that provides access to a carefully selected set of generally useful quantities for individual X-ray sources, and is designed to satisfy the needs of a broad-based group of scientists, including those who may be less familiar with astronomical data analysis in the X-ray regime. The first release of the CSC includes information about 94,676 distinct X-ray sources detected in a subset of public ACIS imaging observations from roughly the first eight years of the Chandra mission. This release of the catalog includes point and compact sources with observed spatial extents <~ 30''. The catalog (1) provides access to the best estimates of the X-ray source properties for detected sources, with good scientific fidelity, and directly supports scientific analysis using the individual source data; (2) facilitates analysis of a wide range of statistical properties for classes of X-ray sources; and (3) provides efficient access to calibrated observational data and ancillary data products for individual X-ray sources, so that users can perform detailed further analysis using existing tools. The catalog includes real X-ray sources detected with flux estimates that are at least 3 times their estimated 1 sigma uncertainties in at least one energy band, while maintaining the number of spurious sources at a level of <~ 1 false source per field for a 100 ks observation. For each detected source, the CSC provides commonly tabulated quantities, including source position, extent, multi-band fluxes, hardness ratios, and variability statistics, derived from the observations in which the source is detected. In addition to these traditional catalog elements, for each X-ray source the CSC includes an extensive set of file-based data products that can be manipulated interactively.

Digitally reconstructed radiographs (DRRs) are simulated 2D X-ray images generated from 3D CT volumes, widely used in preoperative settings but limited in intraoperative applications due to computational bottlenecks, especially for accurate but heavy physics-based Monte Carlo methods. While analytical DRR renderers offer greater efficiency, they overlook anisotropic X-ray image formation phenomena, such as Compton scattering. We present a novel approach that marries realistic physics-inspired X-ray simulation with efficient, differentiable DRR generation using 3D Gaussian splatting (3DGS). Our direction-disentangled 3DGS (DDGS) method separates the radiosity contribution into isotropic and direction-dependent components, approximating complex anisotropic interactions without intricate runtime simulations. Additionally, we adapt the 3DGS initialization to account for tomography data properties, enhancing accuracy and efficiency. Our method outperforms state-of-the-art techniques in image accuracy. Furthermore, our DDGS shows promise for intraoperative applications and inverse problems such as pose registration, delivering superior registration accuracy and runtime performance compared to analytical DRR methods.

The increasing complexity of Artificial Intelligence models poses challenges to interpretability, particularly in the healthcare sector. This study investigates the impact of deep learning model complexity and Explainable AI (XAI) efficacy, utilizing four ResNet architectures (ResNet-18, 34, 50, 101). Through methodical experimentation on 4,369 lung X-ray images of COVID-19-infected and healthy patients, the research evaluates models' classification performance and the relevance of corresponding XAI explanations with respect to the ground-truth disease masks. Results indicate that the increase in model complexity is associated with a decrease in classification accuracy and AUC-ROC scores (ResNet-18: 98.4%, 0.997; ResNet-101: 95.9%, 0.988). Notably, in eleven out of twelve statistical tests performed, no statistically significant differences occurred between XAI quantitative metrics - Relevance Rank Accuracy and the proposed Positive Attribution Ratio - across trained models. These results suggest that increased model complexity does not consistently lead to higher performance or relevance of explanations for models' decision-making processes.

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

We present ReXGradient-160K, representing the largest publicly available chest X-ray dataset to date in terms of the number of patients. This dataset contains 160,000 chest X-ray studies with paired radiological reports from 109,487 unique patients across 3 U.S. health systems (79 medical sites). This comprehensive dataset includes multiple images per study and detailed radiology reports, making it particularly valuable for the development and evaluation of AI systems for medical imaging and automated report generation models. The dataset is divided into training (140,000 studies), validation (10,000 studies), and public test (10,000 studies) sets, with an additional private test set (10,000 studies) reserved for model evaluation on the ReXrank benchmark. By providing this extensive dataset, we aim to accelerate research in medical imaging AI and advance the state-of-the-art in automated radiological analysis. Our dataset will be open-sourced at https://huggingface.co/datasets/rajpurkarlab/ReXGradient-160K.

The intrabinary shocks (IBS) of spider pulsars emit non-thermal synchrotron X-rays from accelerated electrons and positrons in the shocked pulsar wind, likely energized by magnetic reconnection. In redback spider pulsars, the IBS typically wraps around the sub-stellar companion, leading to a near-normal IBS shock with relatively bright X-ray emission. The characteristic energies of radiating particles and the magnetic fields in the IBS suggest spectral features in the hard X-ray band. Here we perform joint soft-hard X-ray analyses of three redback pulsars, J1723-2837, J2215+5135, and J2339-0533, including new J2215 NuSTAR data. We identify a significant cooling break in J1723-2837 and a marginal break in J2215+5135, while placing constraints on the break energy in J2339-0533. Interpreting these as synchrotron cooling features allows us to estimate the IBS magnetic field B_{rm IBS} sim 40-100 G and place lower bounds on the maximum radiating electron energy. Our results constrain the magnetization of the pulsar wind as well as pair-production in millisecond pulsar magnetospheres.

Previous research on radiology report generation has made significant progress in terms of increasing the clinical accuracy of generated reports. In this paper, we emphasize another crucial quality that it should possess, i.e., inter-report consistency, which refers to the capability of generating consistent reports for semantically equivalent radiographs. This quality is even of greater significance than the overall report accuracy in terms of ensuring the system's credibility, as a system prone to providing conflicting results would severely erode users' trust. Regrettably, existing approaches struggle to maintain inter-report consistency, exhibiting biases towards common patterns and susceptibility to lesion variants. To address this issue, we propose ICON, which improves the inter-report consistency of radiology report generation. Aiming at enhancing the system's ability to capture the similarities in semantically equivalent lesions, our approach involves first extracting lesions from input images and examining their characteristics. Then, we introduce a lesion-aware mix-up augmentation technique to ensure that the representations of the semantically equivalent lesions align with the same attributes, by linearly interpolating them during the training phase. Extensive experiments on three publicly available chest X-ray datasets verify the effectiveness of our approach, both in terms of improving the consistency and accuracy of the generated reports.

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.

Medical imaging analysis plays a critical role in the diagnosis and treatment of various medical conditions. This paper focuses on chest X-ray images and their corresponding radiological reports. It presents a new model that learns a joint X-ray image & report representation. The model is based on a novel alignment scheme between the visual data and the text, which takes into account both local and global information. Furthermore, the model integrates domain-specific information of two types -- lateral images and the consistent visual structure of chest images. Our representation is shown to benefit three types of retrieval tasks: text-image retrieval, class-based retrieval, and phrase-grounding.