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Andrea Agostini

Publications and source records attributed to Andrea Agostini.

9 recordsLinked to original sources

Reading the Whole Heart: Latent-Attention Masked Autoencoders for Multimodal Cardiac Representation Learning

Cardiovascular diagnosis rests on integrating complementary modalities, like ECG, echocardiography, chest radiographs, and clinical variables, each capturing distinct but correlated aspects of cardiac physiology. Yet most medical foundation models remain modality-specific, combining modalities only for finetuning or post-training. This discards the cross-modal evidence clinicians naturally integrate and ignores the structure within each modality. We introduce Latent-Attention Masked Autoencoders (LAMAE), a multimodal, structure-aware masked autoencoder that jointly learns patient-level representations during self-supervised pretraining. Rather than fusing modalities post hoc, LAMAE exchanges information directly in the latent space through a shared latent-attention module operating over a study-view-entity hierarchy, enabling aggregation of variable observations and graceful handling of missing modalities. Pretrained on over 1.2 million MIMIC-IV hospital stays, LAMAE outperforms modality-specific pretraining and strong contrastive and vision-language baselines across multimodal hospital-stay tasks, such as in-hospital mortality, ICD-10 and DRG coding, and length of stay, while remaining competitive on unimodal tasks. These gains persist even when only a single modality is available at test time, showing that modeling both intra- and inter-modal structure yields more robust, transferable representations.

cs.AI

Bowel Obstruction Detection and Localization on Abdominal CT with Deep Learning

Bowel obstruction is a common and potentially life-threatening gastrointestinal condition. In the face of rising diagnostic workloads, the automated diagnosis of bowel obstruction on CT scans supports radiologists by accelerating detection and improving patient outcomes. In this work, we propose a deep learning framework with a multi-task objective that jointly detects bowel obstruction and localizes its transition zone. Additionally, we extend the method with an inherently interpretable classification method that locates the suspected transition point within a slice. It does so by learning a probabilistic selection mask that faithfully bases the classifier's prediction solely on a small image region. The proposed method is evaluated on an internal dataset comprising 1,427 abdominal CTs. Here, the model achieves an obstruction detection test accuracy of 93% and a Hit@10 transition zone localization of 95%. As the first method to reliably localize the transition zone, this marks a significant step towards the automated identification of this critical clinical landmark.

cs.CV

Foundation Model for Cardiac Time Series via Masked Latent Attention

Electrocardiograms (ECGs) are among the most widely available clinical signals and play a central role in cardiovascular diagnosis. While recent foundation models (FMs) have shown promise for learning transferable ECG representations, most existing pretraining approaches treat leads as independent channels and fail to explicitly leverage their strong structural redundancy. We introduce the latent attention masked autoencoder (LAMAE) FM that directly exploits this structure by learning cross-lead connection mechanisms during self-supervised pretraining. Our approach models higher-order interactions across leads through latent attention, enabling permutation-invariant aggregation and adaptive weighting of lead-specific representations. We provide empirical evidence on the Mimic-IV-ECG database that leveraging the cross-lead connection constitutes an effective form of structural supervision, improving representation quality and transferability. Our method shows strong performance in predicting ICD-10 codes, outperforming independent-lead masked modeling and alignment-based baselines.

cs.LG

Beyond Independent Frames: Latent Attention Masked Autoencoders for Multi-View Echocardiography

Echocardiography is a widely used modality for cardiac assessment due to its non-invasive and cost-effective nature, but the sparse and heterogeneous spatiotemporal views of the heart pose distinct challenges. Existing masked autoencoder (MAE) approaches typically process images or short clips independently, failing to capture the inherent multi-view structure required for coherent cardiac representation. We introduce Latent Attention Masked Autoencoder (LAMAE), a foundation model architecture tailored to the multi-view nature of medical imaging. LAMAE augments the standard MAE with a latent attention module that enables information exchange across frames and views directly in latent space. This allows the model to aggregate variable-length sequences and distinct views, reconstructing a holistic representation of cardiac function from partial observations. We pretrain LAMAE on MIMIC-IV-ECHO, a large-scale, uncurated dataset reflecting real-world clinical variability. To the best of our knowledge, we present the first results for predicting ICD-10 codes from MIMIC-IV-ECHO videos. Furthermore, we empirically demonstrate that representations learned from adult data transfer effectively to pediatric cohorts despite substantial anatomical differences. These results provide evidence that incorporating structural priors, such as multi-view attention, yields significantly more robust and transferable representations.

cs.CV

Structure is Supervision: Multiview Masked Autoencoders for Radiology

Building robust medical machine learning systems requires pretraining strategies that exploit the intrinsic structure present in clinical data. We introduce Multiview Masked Autoencoder (MVMAE), a self-supervised framework that leverages the natural multi-view organization of radiology studies to learn view-invariant and disease-relevant representations. MVMAE combines masked image reconstruction with cross-view alignment, transforming clinical redundancy across projections into a powerful self-supervisory signal. We further extend this approach with MVMAE-V2T, which incorporates radiology reports as an auxiliary text-based learning signal to enhance semantic grounding while preserving fully vision-based inference. Evaluated on a downstream disease classification task on three large-scale public datasets, MIMIC-CXR, CheXpert, and PadChest, MVMAE consistently outperforms supervised and vision-language baselines. Furthermore, MVMAE-V2T provides additional gains, particularly in low-label regimes where structured textual supervision is most beneficial. Together, these results establish the importance of structural and textual supervision as complementary paths toward scalable, clinically grounded medical foundation models.

cs.CV

Leveraging the Structure of Medical Data for Improved Representation Learning

Building generalizable medical AI systems requires pretraining strategies that are data-efficient and domain-aware. Unlike internet-scale corpora, clinical datasets such as MIMIC-CXR offer limited image counts and scarce annotations, but exhibit rich internal structure through multi-view imaging. We propose a self-supervised framework that leverages the inherent structure of medical datasets. Specifically, we treat paired chest X-rays (i.e., frontal and lateral views) as natural positive pairs, learning to reconstruct each view from sparse patches while aligning their latent embeddings. Our method requires no textual supervision and produces informative representations. Evaluated on MIMIC-CXR, we show strong performance compared to supervised objectives and baselines being trained without leveraging structure. This work provides a lightweight, modality-agnostic blueprint for domain-specific pretraining where data is structured but scarce

cs.CV

Unity by Diversity: Improved Representation Learning in Multimodal VAEs

Variational Autoencoders for multimodal data hold promise for many tasks in data analysis, such as representation learning, conditional generation, and imputation. Current architectures either share the encoder output, decoder input, or both across modalities to learn a shared representation. Such architectures impose hard constraints on the model. In this work, we show that a better latent representation can be obtained by replacing these hard constraints with a soft constraint. We propose a new mixture-of-experts prior, softly guiding each modality's latent representation towards a shared aggregate posterior. This approach results in a superior latent representation and allows each encoding to preserve information better from its uncompressed original features. In extensive experiments on multiple benchmark datasets and two challenging real-world datasets, we show improved learned latent representations and imputation of missing data modalities compared to existing methods.

cs.LG

Weakly-Supervised Multimodal Learning on MIMIC-CXR

Multimodal data integration and label scarcity pose significant challenges for machine learning in medical settings. To address these issues, we conduct an in-depth evaluation of the newly proposed Multimodal Variational Mixture-of-Experts (MMVM) VAE on the challenging MIMIC-CXR dataset. Our analysis demonstrates that the MMVM VAE consistently outperforms other multimodal VAEs and fully supervised approaches, highlighting its strong potential for real-world medical applications.

cs.LG

Multi-Armed Bandit Problem with Temporally-Partitioned Rewards: When Partial Feedback Counts

There is a rising interest in industrial online applications where data becomes available sequentially. Inspired by the recommendation of playlists to users where their preferences can be collected during the listening of the entire playlist, we study a novel bandit setting, namely Multi-Armed Bandit with Temporally-Partitioned Rewards (TP-MAB), in which the stochastic reward associated with the pull of an arm is partitioned over a finite number of consecutive rounds following the pull. This setting, unexplored so far to the best of our knowledge, is a natural extension of delayed-feedback bandits to the case in which rewards may be dilated over a finite-time span after the pull instead of being fully disclosed in a single, potentially delayed round. We provide two algorithms to address TP-MAB problems, namely, TP-UCB-FR and TP-UCB-EW, which exploit the partial information disclosed by the reward collected over time. We show that our algorithms provide better asymptotical regret upper bounds than delayed-feedback bandit algorithms when a property characterizing a broad set of reward structures of practical interest, namely alpha-smoothness, holds. We also empirically evaluate their performance across a wide range of settings, both synthetically generated and from a real-world media recommendation problem.

cs.LG