Show, tell and summarise: learning to generate and summarise radiology findings from medical images

Radiology plays a vital role in health care by viewing the human body for diagnosis, monitoring, and treatment of medical problems. In radiology practice, radiologists routinely examine medical images such as chest X-rays and describe their findings in the form of radiology reports. However, this task of reading medical images and summarising its insights is time consuming, tedious, and error-prone, which often represents a bottleneck in the clinical diagnosis process. A computer-aided diagnosis system which can automatically generate radiology reports from medical images can be of great significance in reducing workload, reducing diagnostic errors, speeding up clinical workflow, and helping to alleviate any shortage of radiologists. Existing research in radiology report generation focuses on generating the concatenation of the findings and impression sections. Also, existing work ignores important differences between normal and abnormal radiology reports. The text of normal and abnormal reports differs in style and it is difficult for a single model to learn both the text style and learn to transition from findings to impression. To alleviate these challenges, we propose a Show, Tell and Summarise model that first generates findings from chest X-rays and then summarises them to provide impression section. The proposed work generates the findings and impression sections separately, overcoming the limitation of previous research. Also, we use separate models for generating normal and abnormal radiology reports which provide true insight of model’s performance. Experimental results on the publicly available IU-CXR dataset show the effectiveness of our proposed model. Finally, we highlight limitations in the radiology report generation research and present recommendations for future work.

[1]  Li Fei-Fei,et al.  ImageNet: A large-scale hierarchical image database , 2009, CVPR.

[2]  Alon Lavie,et al.  METEOR: An Automatic Metric for MT Evaluation with Improved Correlation with Human Judgments , 2005, IEEvaluation@ACL.

[3]  Jiebo Luo,et al.  Image Captioning with Semantic Attention , 2016, 2016 IEEE Conference on Computer Vision and Pattern Recognition (CVPR).

[4]  Tao Xu,et al.  Multimodal Recurrent Model with Attention for Automated Radiology Report Generation , 2018, MICCAI.

[5]  Christopher D. Manning,et al.  Get To The Point: Summarization with Pointer-Generator Networks , 2017, ACL.

[6]  Li Fei-Fei,et al.  DenseCap: Fully Convolutional Localization Networks for Dense Captioning , 2015, 2016 IEEE Conference on Computer Vision and Pattern Recognition (CVPR).

[7]  Xinlei Chen,et al.  Microsoft COCO Captions: Data Collection and Evaluation Server , 2015, ArXiv.

[8]  Min Sun,et al.  A Unified Model for Extractive and Abstractive Summarization using Inconsistency Loss , 2018, ACL.

[9]  Jian Sun,et al.  Deep Residual Learning for Image Recognition , 2015, 2016 IEEE Conference on Computer Vision and Pattern Recognition (CVPR).

[10]  Ronald M. Summers,et al.  Interleaved text/image Deep Mining on a large-scale radiology database , 2015, 2015 IEEE Conference on Computer Vision and Pattern Recognition (CVPR).

[11]  Yoshua Bengio,et al.  Show, Attend and Tell: Neural Image Caption Generation with Visual Attention , 2015, ICML.

[12]  Shivajirao M. Jadhav,et al.  Deep convolutional neural network based medical image classification for disease diagnosis , 2019, Journal of Big Data.

[13]  Jeffrey Pennington,et al.  GloVe: Global Vectors for Word Representation , 2014, EMNLP.

[14]  Dorin Comaniciu,et al.  Learning to recognize Abnormalities in Chest X-Rays with Location-Aware Dense Networks , 2018, CIARP.

[15]  Geoffrey E. Hinton,et al.  Deep Learning , 2015, Nature.

[16]  Li Yao,et al.  Learning to diagnose from scratch by exploiting dependencies among labels , 2017, ArXiv.

[17]  Georg Langs,et al.  Predicting Semantic Descriptions from Medical Images with Convolutional Neural Networks , 2015, IPMI.

[18]  Lin Yang,et al.  MDNet: A Semantically and Visually Interpretable Medical Image Diagnosis Network , 2017, 2017 IEEE Conference on Computer Vision and Pattern Recognition (CVPR).

[19]  Yuan Yu,et al.  TensorFlow: A system for large-scale machine learning , 2016, OSDI.

[20]  Pengtao Xie,et al.  On the Automatic Generation of Medical Imaging Reports , 2017, ACL.

[21]  Lukasz Kaiser,et al.  Attention is All you Need , 2017, NIPS.

[22]  Vicente Ordonez,et al.  Im2Text: Describing Images Using 1 Million Captioned Photographs , 2011, NIPS.

[23]  Fei-Fei Li,et al.  Deep visual-semantic alignments for generating image descriptions , 2014, 2015 IEEE Conference on Computer Vision and Pattern Recognition (CVPR).

[24]  Chenxi Liu,et al.  Attention Correctness in Neural Image Captioning , 2016, AAAI.

[25]  Len Hamey,et al.  Modality Classification and Concept Detection in Medical Images Using Deep Transfer Learning , 2018, 2018 International Conference on Image and Vision Computing New Zealand (IVCNZ).

[26]  Sergey Ioffe,et al.  Rethinking the Inception Architecture for Computer Vision , 2015, 2016 IEEE Conference on Computer Vision and Pattern Recognition (CVPR).

[27]  Steven Horng,et al.  MIMIC-CXR, a de-identified publicly available database of chest radiographs with free-text reports , 2019, Scientific Data.

[28]  Lucas M Bachmann,et al.  Automated deep learning design for medical image classification by health-care professionals with no coding experience: a feasibility study. , 2019, The Lancet. Digital health.

[29]  John D. Kelleher,et al.  Generating Diverse and Meaningful Captions - Unsupervised Specificity Optimization for Image Captioning , 2018, ICANN.

[30]  François Laviolette,et al.  Domain-Adversarial Training of Neural Networks , 2015, J. Mach. Learn. Res..

[31]  Pavel Kisilev,et al.  Medical Image Description Using Multi-task-loss CNN , 2016, LABELS/DLMIA@MICCAI.

[32]  Cyrus Rashtchian,et al.  Every Picture Tells a Story: Generating Sentences from Images , 2010, ECCV.

[33]  C. Lawrence Zitnick,et al.  CIDEr: Consensus-based image description evaluation , 2014, 2015 IEEE Conference on Computer Vision and Pattern Recognition (CVPR).

[34]  Michael Grass,et al.  Comparison of Deep Learning Approaches for Multi-Label Chest X-Ray Classification , 2018, Scientific Reports.

[35]  Andrew Y. Ng,et al.  CheXNet: Radiologist-Level Pneumonia Detection on Chest X-Rays with Deep Learning , 2017, ArXiv.

[36]  Md. Zakir Hossain,et al.  A Comprehensive Survey of Deep Learning for Image Captioning , 2018, ACM Comput. Surv..

[37]  Peter Young,et al.  Framing Image Description as a Ranking Task: Data, Models and Evaluation Metrics , 2013, J. Artif. Intell. Res..

[38]  Qinghua Zheng,et al.  Automatic Generation of Medical Imaging Diagnostic Report with Hierarchical Recurrent Neural Network , 2019, 2019 IEEE International Conference on Data Mining (ICDM).

[39]  Alexander M. Rush,et al.  Bottom-Up Abstractive Summarization , 2018, EMNLP.

[40]  Yejin Choi,et al.  Composing Simple Image Descriptions using Web-scale N-grams , 2011, CoNLL.

[41]  Pingkun Yan,et al.  Reinforced Transformer for Medical Image Captioning , 2019, MLMI@MICCAI.

[42]  Meng Zhou,et al.  Understanding and Generating Ultrasound Image Description , 2018, Journal of Computer Science and Technology.

[43]  Yifan Yu,et al.  CheXpert: A Large Chest Radiograph Dataset with Uncertainty Labels and Expert Comparison , 2019, AAAI.

[44]  Qi Wu,et al.  Medical image classification using synergic deep learning , 2019, Medical Image Anal..

[45]  Ronald M. Summers,et al.  Learning to Read Chest X-Rays: Recurrent Neural Cascade Model for Automated Image Annotation , 2016, 2016 IEEE Conference on Computer Vision and Pattern Recognition (CVPR).

[46]  Clement J. McDonald,et al.  Preparing a collection of radiology examinations for distribution and retrieval , 2015, J. Am. Medical Informatics Assoc..

[47]  Xiaojun Wan,et al.  Abstractive Document Summarization with a Graph-Based Attentional Neural Model , 2017, ACL.

[48]  Jon Kleinberg,et al.  Transfusion: Understanding Transfer Learning for Medical Imaging , 2019, NeurIPS.

[49]  Boaz Ophir,et al.  From medical image to automatic medical report generation , 2015, IBM J. Res. Dev..

[50]  Jonathan Krause,et al.  A Hierarchical Approach for Generating Descriptive Image Paragraphs , 2016, 2017 IEEE Conference on Computer Vision and Pattern Recognition (CVPR).

[51]  Yoshua Bengio,et al.  Neural Machine Translation by Jointly Learning to Align and Translate , 2014, ICLR.

[52]  Eugene Charniak,et al.  Nonparametric Method for Data-driven Image Captioning , 2014, ACL.

[53]  Samy Bengio,et al.  Show and tell: A neural image caption generator , 2014, 2015 IEEE Conference on Computer Vision and Pattern Recognition (CVPR).

[54]  Richard Socher,et al.  Neural Text Summarization: A Critical Evaluation , 2019, EMNLP.

[55]  Geoffrey E. Hinton,et al.  ImageNet classification with deep convolutional neural networks , 2012, Commun. ACM.

[56]  Lanfen Lin,et al.  Medical Image Classification Using Deep Learning , 2019 .

[57]  Louise I T Lee,et al.  The Current State of Artificial Intelligence in Medical Imaging and Nuclear Medicine , 2019, BJR open.

[58]  Ming-Wei Chang,et al.  BERT: Pre-training of Deep Bidirectional Transformers for Language Understanding , 2019, NAACL.

[59]  Ronald M. Summers,et al.  ChestX-ray: Hospital-Scale Chest X-ray Database and Benchmarks on Weakly Supervised Classification and Localization of Common Thorax Diseases , 2019, Deep Learning and Convolutional Neural Networks for Medical Imaging and Clinical Informatics.

[60]  Roger G. Mark,et al.  MIMIC-CXR: A large publicly available database of labeled chest radiographs , 2019, ArXiv.

[61]  Luke S. Zettlemoyer,et al.  Deep Contextualized Word Representations , 2018, NAACL.

[62]  Dumitru Erhan,et al.  Show and Tell: Lessons Learned from the 2015 MSCOCO Image Captioning Challenge , 2016, IEEE Transactions on Pattern Analysis and Machine Intelligence.

[63]  Alexander Schwing,et al.  Fast, Diverse and Accurate Image Captioning Guided by Part-Of-Speech , 2018, 2019 IEEE/CVF Conference on Computer Vision and Pattern Recognition (CVPR).

[64]  Ziba Gandomkar,et al.  Artificial Intelligence in medical imaging practice: looking to the future , 2019, Journal of medical radiation sciences.

[65]  Salim Roukos,et al.  Bleu: a Method for Automatic Evaluation of Machine Translation , 2002, ACL.

[66]  Xiaojun Wan,et al.  Generating Diverse and Descriptive Image Captions Using Visual Paraphrases , 2019, 2019 IEEE/CVF International Conference on Computer Vision (ICCV).

[67]  David Dagan Feng,et al.  An Ensemble of Fine-Tuned Convolutional Neural Networks for Medical Image Classification , 2017, IEEE Journal of Biomedical and Health Informatics.

[68]  Alex Alves Freitas,et al.  Automatic Text Summarization Using a Machine Learning Approach , 2002, SBIA.

[69]  Eric P. Xing,et al.  Hybrid Retrieval-Generation Reinforced Agent for Medical Image Report Generation , 2018, NeurIPS.

[70]  Minho Lee,et al.  Abstractive summarization of long texts by representing multiple compositionalities with temporal hierarchical pointer generator network , 2019, Neural Networks.

[71]  Franck Dernoncourt,et al.  A Discourse-Aware Attention Model for Abstractive Summarization of Long Documents , 2018, NAACL.

[72]  Christopher D. Manning,et al.  Learning to Summarize Radiology Findings , 2018, Louhi@EMNLP.

[73]  Stefan Carlsson,et al.  CNN Features Off-the-Shelf: An Astounding Baseline for Recognition , 2014, 2014 IEEE Conference on Computer Vision and Pattern Recognition Workshops.

[74]  Guilherme Del Fiol,et al.  Text summarization in the biomedical domain: A systematic review of recent research , 2014, J. Biomed. Informatics.

[75]  Dragomir R. Radev,et al.  Introduction to the Special Issue on Summarization , 2002, CL.

[76]  Eric P. Xing,et al.  Show, Describe and Conclude: On Exploiting the Structure Information of Chest X-ray Reports , 2019, ACL.

[77]  Fabrizio Silvestri,et al.  HEADS: Headline Generation as Sequence Prediction Using an Abstract Feature-Rich Space , 2015, NAACL.

[78]  Antonio Pertusa,et al.  PadChest: A large chest x-ray image dataset with multi-label annotated reports , 2019, Medical Image Anal..

[79]  Yejin Choi,et al.  Baby talk: Understanding and generating simple image descriptions , 2011, CVPR 2011.

[80]  Lei Zhang,et al.  Bottom-Up and Top-Down Attention for Image Captioning and Visual Question Answering , 2017, 2018 IEEE/CVF Conference on Computer Vision and Pattern Recognition.

[81]  Yasemin Altun,et al.  Overcoming the Lack of Parallel Data in Sentence Compression , 2013, EMNLP.

[82]  Sarvnaz Karimi,et al.  From Chest X-Rays to Radiology Reports: A Multimodal Machine Learning Approach , 2019, 2019 Digital Image Computing: Techniques and Applications (DICTA).