arXiv subjects

Jean-Benoit Delbrouck

Publications and source records attributed to Jean-Benoit Delbrouck.

At least 37 records · Page 2Linked to original sources

arXiv2025

Structuring Radiology Reports: Challenging LLMs with Lightweight Models

Radiology reports are critical for clinical decision-making but often lack a standardized format, limiting both human interpretability and machine learning (ML) applications. While large language models (LLMs) have shown strong capabilities in reformatting clinical text, their high computational requirements, lack of transparency, and data privacy concerns hinder practical deployment. To address these challenges, we explore lightweight encoder-decoder models (<300M parameters)-specifically T5 and BERT2BERT-for structuring radiology reports from the MIMIC-CXR and CheXpert Plus datasets. We benchmark these models against eight open-source LLMs (1B-70B), adapted using prefix prompting, in-context learning (ICL), and low-rank adaptation (LoRA) finetuning. Our best-performing lightweight model outperforms all LLMs adapted using prompt-based techniques on a human-annotated test set. While some LoRA-finetuned LLMs achieve modest gains over the lightweight model on the Findings section (BLEU 6.4%, ROUGE-L 4.8%, BERTScore 3.6%, F1-RadGraph 1.1%, GREEN 3.6%, and F1-SRR-BERT 4.3%), these improvements come at the cost of substantially greater computational resources. For example, LLaMA-3-70B incurred more than 400 times the inference time, cost, and carbon emissions compared to the lightweight model. These results underscore the potential of lightweight, task-specific models as sustainable and privacy-preserving solutions for structuring clinical text in resource-constrained healthcare settings.

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arXiv2025

Automated Structured Radiology Report Generation

Automated radiology report generation from chest X-ray (CXR) images has the potential to improve clinical efficiency and reduce radiologists' workload. However, most datasets, including the publicly available MIMIC-CXR and CheXpert Plus, consist entirely of free-form reports, which are inherently variable and unstructured. This variability poses challenges for both generation and evaluation: existing models struggle to produce consistent, clinically meaningful reports, and standard evaluation metrics fail to capture the nuances of radiological interpretation. To address this, we introduce Structured Radiology Report Generation (SRRG), a new task that reformulates free-text radiology reports into a standardized format, ensuring clarity, consistency, and structured clinical reporting. We create a novel dataset by restructuring reports using large language models (LLMs) following strict structured reporting desiderata. Additionally, we introduce SRR-BERT, a fine-grained disease classification model trained on 55 labels, enabling more precise and clinically informed evaluation of structured reports. To assess report quality, we propose F1-SRR-BERT, a metric that leverages SRR-BERT's hierarchical disease taxonomy to bridge the gap between free-text variability and structured clinical reporting. We validate our dataset through a reader study conducted by five board-certified radiologists and extensive benchmarking experiments.

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arXiv2025

GREEN: Generative Radiology Report Evaluation and Error Notation

Evaluating radiology reports is a challenging problem as factual correctness is extremely important due to the need for accurate medical communication about medical images. Existing automatic evaluation metrics either suffer from failing to consider factual correctness (e.g., BLEU and ROUGE) or are limited in their interpretability (e.g., F1CheXpert and F1RadGraph). In this paper, we introduce GREEN (Generative Radiology Report Evaluation and Error Notation), a radiology report generation metric that leverages the natural language understanding of language models to identify and explain clinically significant errors in candidate reports, both quantitatively and qualitatively. Compared to current metrics, GREEN offers: 1) a score aligned with expert preferences, 2) human interpretable explanations of clinically significant errors, enabling feedback loops with end-users, and 3) a lightweight open-source method that reaches the performance of commercial counterparts. We validate our GREEN metric by comparing it to GPT-4, as well as to error counts of 6 experts and preferences of 2 experts. Our method demonstrates not only higher correlation with expert error counts, but simultaneously higher alignment with expert preferences when compared to previous approaches.

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arXiv2024

A Vision-Language Foundation Model to Enhance Efficiency of Chest X-ray Interpretation

Over 1.4 billion chest X-rays (CXRs) are performed annually due to their cost-effectiveness as an initial diagnostic test. This scale of radiological studies provides a significant opportunity to streamline CXR interpretation and documentation. While foundation models are a promising solution, the lack of publicly available large-scale datasets and benchmarks inhibits their iterative development and real-world evaluation. To overcome these challenges, we constructed a large-scale dataset (CheXinstruct), which we utilized to train a vision-language foundation model (CheXagent). We systematically demonstrated competitive performance across eight distinct task types on our novel evaluation benchmark (CheXbench). Beyond technical validation, we assessed the real-world utility of CheXagent in directly drafting radiology reports. Our clinical assessment with eight radiologists revealed a 36% time saving for residents using CheXagent-drafted reports, while attending radiologists showed no significant time difference editing resident-drafted or CheXagent-drafted reports. The CheXagent-drafted reports improved the writing efficiency of both radiology residents and attending radiologists in 81% and 61% of cases, respectively, without loss of quality. Overall, we demonstrate that CheXagent can effectively perform a variety of CXR interpretation tasks and holds potential to assist radiologists in routine clinical workflows.

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arXiv2024

RaVL: Discovering and Mitigating Spurious Correlations in Fine-Tuned Vision-Language Models

Fine-tuned vision-language models (VLMs) often capture spurious correlations between image features and textual attributes, resulting in degraded zero-shot performance at test time. Existing approaches for addressing spurious correlations (i) primarily operate at the global image-level rather than intervening directly on fine-grained image features and (ii) are predominantly designed for unimodal settings. In this work, we present RaVL, which takes a fine-grained perspective on VLM robustness by discovering and mitigating spurious correlations using local image features rather than operating at the global image level. Given a fine-tuned VLM, RaVL first discovers spurious correlations by leveraging a region-level clustering approach to identify precise image features contributing to zero-shot classification errors. Then, RaVL mitigates the identified spurious correlation with a novel region-aware loss function that enables the VLM to focus on relevant regions and ignore spurious relationships during fine-tuning. We evaluate RaVL on 654 VLMs with various model architectures, data domains, and learned spurious correlations. Our results show that RaVL accurately discovers (191% improvement over the closest baseline) and mitigates (8.2% improvement on worst-group image classification accuracy) spurious correlations. Qualitative evaluations on general-domain and medical-domain VLMs confirm our findings.

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arXiv2024

Overview of the First Shared Task on Clinical Text Generation: RRG24 and "Discharge Me!"

Recent developments in natural language generation have tremendous implications for healthcare. For instance, state-of-the-art systems could automate the generation of sections in clinical reports to alleviate physician workload and streamline hospital documentation. To explore these applications, we present a shared task consisting of two subtasks: (1) Radiology Report Generation (RRG24) and (2) Discharge Summary Generation ("Discharge Me!"). RRG24 involves generating the 'Findings' and 'Impression' sections of radiology reports given chest X-rays. "Discharge Me!" involves generating the 'Brief Hospital Course' and 'Discharge Instructions' sections of discharge summaries for patients admitted through the emergency department. "Discharge Me!" submissions were subsequently reviewed by a team of clinicians. Both tasks emphasize the goal of reducing clinician burnout and repetitive workloads by generating documentation. We received 201 submissions from across 8 teams for RRG24, and 211 submissions from across 16 teams for "Discharge Me!".

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arXiv2024

CheXpert Plus: Augmenting a Large Chest X-ray Dataset with Text Radiology Reports, Patient Demographics and Additional Image Formats

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

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arXiv2024

Adapted Large Language Models Can Outperform Medical Experts in Clinical Text Summarization

Analyzing vast textual data and summarizing key information from electronic health records imposes a substantial burden on how clinicians allocate their time. Although large language models (LLMs) have shown promise in natural language processing (NLP), their effectiveness on a diverse range of clinical summarization tasks remains unproven. In this study, we apply adaptation methods to eight LLMs, spanning four distinct clinical summarization tasks: radiology reports, patient questions, progress notes, and doctor-patient dialogue. Quantitative assessments with syntactic, semantic, and conceptual NLP metrics reveal trade-offs between models and adaptation methods. A clinical reader study with ten physicians evaluates summary completeness, correctness, and conciseness; in a majority of cases, summaries from our best adapted LLMs are either equivalent (45%) or superior (36%) compared to summaries from medical experts. The ensuing safety analysis highlights challenges faced by both LLMs and medical experts, as we connect errors to potential medical harm and categorize types of fabricated information. Our research provides evidence of LLMs outperforming medical experts in clinical text summarization across multiple tasks. This suggests that integrating LLMs into clinical workflows could alleviate documentation burden, allowing clinicians to focus more on patient care.

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arXiv2023

ViLLA: Fine-Grained Vision-Language Representation Learning from Real-World Data

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).

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arXiv2023

Toward expanding the scope of radiology report summarization to multiple anatomies and modalities

Radiology report summarization (RRS) is a growing area of research. Given the Findings section of a radiology report, the goal is to generate a summary (called an Impression section) that highlights the key observations and conclusions of the radiology study. However, RRS currently faces essential limitations.First, many prior studies conduct experiments on private datasets, preventing reproduction of results and fair comparisons across different systems and solutions. Second, most prior approaches are evaluated solely on chest X-rays. To address these limitations, we propose a dataset (MIMIC-RRS) involving three new modalities and seven new anatomies based on the MIMIC-III and MIMIC-CXR datasets. We then conduct extensive experiments to evaluate the performance of models both within and across modality-anatomy pairs in MIMIC-RRS. In addition, we evaluate their clinical efficacy via RadGraph, a factual correctness metric.

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arXiv2023

RadAdapt: Radiology Report Summarization via Lightweight Domain Adaptation of Large Language Models

We systematically investigate lightweight strategies to adapt large language models (LLMs) for the task of radiology report summarization (RRS). Specifically, we focus on domain adaptation via pretraining (on natural language, biomedical text, or clinical text) and via discrete prompting or parameter-efficient fine-tuning. Our results consistently achieve best performance by maximally adapting to the task via pretraining on clinical text and fine-tuning on RRS examples. Importantly, this method fine-tunes a mere 0.32% of parameters throughout the model, in contrast to end-to-end fine-tuning (100% of parameters). Additionally, we study the effect of in-context examples and out-of-distribution (OOD) training before concluding with a radiologist reader study and qualitative analysis. Our findings highlight the importance of domain adaptation in RRS and provide valuable insights toward developing effective natural language processing solutions for clinical tasks.

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arXiv2022

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

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

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arXiv2022

Improving the Factual Correctness of Radiology Report Generation with Semantic Rewards

Neural image-to-text radiology report generation systems offer the potential to improve radiology reporting by reducing the repetitive process of report drafting and identifying possible medical errors. These systems have achieved promising performance as measured by widely used NLG metrics such as BLEU and CIDEr. However, the current systems face important limitations. First, they present an increased complexity in architecture that offers only marginal improvements on NLG metrics. Secondly, these systems that achieve high performance on these metrics are not always factually complete or consistent due to both inadequate training and evaluation. Recent studies have shown the systems can be substantially improved by using new methods encouraging 1) the generation of domain entities consistent with the reference and 2) describing these entities in inferentially consistent ways. So far, these methods rely on weakly-supervised approaches (rule-based) and named entity recognition systems that are not specific to the chest X-ray domain. To overcome this limitation, we propose a new method, the RadGraph reward, to further improve the factual completeness and correctness of generated radiology reports. More precisely, we leverage the RadGraph dataset containing annotated chest X-ray reports with entities and relations between entities. On two open radiology report datasets, our system substantially improves the scores up to 14.2% and 25.3% on metrics evaluating the factual correctness and completeness of reports.

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arXiv2022

Domino: Discovering Systematic Errors with Cross-Modal Embeddings

Machine learning models that achieve high overall accuracy often make systematic errors on important subsets (or slices) of data. Identifying underperforming slices is particularly challenging when working with high-dimensional inputs (e.g. images, audio), where important slices are often unlabeled. In order to address this issue, recent studies have proposed automated slice discovery methods (SDMs), which leverage learned model representations to mine input data for slices on which a model performs poorly. To be useful to a practitioner, these methods must identify slices that are both underperforming and coherent (i.e. united by a human-understandable concept). However, no quantitative evaluation framework currently exists for rigorously assessing SDMs with respect to these criteria. Additionally, prior qualitative evaluations have shown that SDMs often identify slices that are incoherent. In this work, we address these challenges by first designing a principled evaluation framework that enables a quantitative comparison of SDMs across 1,235 slice discovery settings in three input domains (natural images, medical images, and time-series data). Then, motivated by the recent development of powerful cross-modal representation learning approaches, we present Domino, an SDM that leverages cross-modal embeddings and a novel error-aware mixture model to discover and describe coherent slices. We find that Domino accurately identifies 36% of the 1,235 slices in our framework - a 12 percentage point improvement over prior methods. Further, Domino is the first SDM that can provide natural language descriptions of identified slices, correctly generating the exact name of the slice in 35% of settings.

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arXiv2020

Modulated Fusion using Transformer for Linguistic-Acoustic Emotion Recognition

This paper aims to bring a new lightweight yet powerful solution for the task of Emotion Recognition and Sentiment Analysis. Our motivation is to propose two architectures based on Transformers and modulation that combine the linguistic and acoustic inputs from a wide range of datasets to challenge, and sometimes surpass, the state-of-the-art in the field. To demonstrate the efficiency of our models, we carefully evaluate their performances on the IEMOCAP, MOSI, MOSEI and MELD dataset. The experiments can be directly replicated and the code is fully open for future researches.

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arXiv2020

A Transformer-based joint-encoding for Emotion Recognition and Sentiment Analysis

Understanding expressed sentiment and emotions are two crucial factors in human multimodal language. This paper describes a Transformer-based joint-encoding (TBJE) for the task of Emotion Recognition and Sentiment Analysis. In addition to use the Transformer architecture, our approach relies on a modular co-attention and a glimpse layer to jointly encode one or more modalities. The proposed solution has also been submitted to the ACL20: Second Grand-Challenge on Multimodal Language to be evaluated on the CMU-MOSEI dataset. The code to replicate the presented experiments is open-source: https://github.com/jbdel/MOSEI_UMONS.

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arXiv2019

Modulated Self-attention Convolutional Network for VQA

As new data-sets for real-world visual reasoning and compositional question answering are emerging, it might be needed to use the visual feature extraction as a end-to-end process during training. This small contribution aims to suggest new ideas to improve the visual processing of traditional convolutional network for visual question answering (VQA). In this paper, we propose to modulate by a linguistic input a CNN augmented with self-attention. We show encouraging relative improvements for future research in this direction.

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arXiv2019

Can adversarial training learn image captioning ?

Recently, generative adversarial networks (GAN) have gathered a lot of interest. Their efficiency in generating unseen samples of high quality, especially images, has improved over the years. In the field of Natural Language Generation (NLG), the use of the adversarial setting to generate meaningful sentences has shown to be difficult for two reasons: the lack of existing architectures to produce realistic sentences and the lack of evaluation tools. In this paper, we propose an adversarial architecture related to the conditional GAN (cGAN) that generates sentences according to a given image (also called image captioning). This attempt is the first that uses no pre-training or reinforcement methods. We also explain why our experiment settings can be safely evaluated and interpreted for further works.

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