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.

Radiology report summarization is a growing area of research. Given the Findings and/or Background sections 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. Recent efforts have released systems that achieve promising performance as measured by widely used summarization metrics such as BLEU and ROUGE. However, the research area of radiology report summarization currently faces two important limitations. First, most of the results are reported on private datasets. This limitation prevents the ability to reproduce results and fairly compare different systems and solutions. Secondly, to the best of our knowledge, most research is carried out on chest X-rays. To palliate these two limitations, we propose a radiology report summarization (RadSum) challenge on i) a new dataset of eleven different modalities and anatomies pairs based on the MIMIC-III database ii) a multimodal report summarization dataset based on MIMIC-CXR enhanced with a brand-new test-set from Stanford Hospital. In total, we received 112 submissions across 11 teams.

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.

There is a growing need to model interactions between data modalities (e.g., vision, language) — both to improve AI predictions on existing tasks and to enable new applications. In the recent field of multimodal medical AI, integrating multiple modalities has gained widespread popularity as multimodal models have proven to improve performance, robustness, require less training samples and add complementary information. To improve technical reproducibility and transparency for multimodal medical tasks as well as speed up progress across medical AI, we present ViLMedic, a Vision-and-Language medical library. As of 2022, the library contains a dozen reference implementations replicating the state-of-the-art results for problems that range from medical visual question answering and radiology report generation to multimodal representation learning on widely adopted medical datasets. In addition, ViLMedic hosts a model-zoo with more than twenty pretrained models for the above tasks designed to be extensible by researchers but also simple for practitioners. Ultimately, we hope our reproducible pipelines can enable clinical translation and create real impact. The library is available at https://github.com/jbdel/vilmedic.

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.

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. However, existing report generation systems, despite achieving high performances on natural language generation metrics such as CIDEr or BLEU, still suffer from incomplete and inconsistent generations. Here we introduce two new simple rewards to encourage the generation of factually complete and consistent radiology reports: one that encourages the system to generate radiology domain entities consistent with the reference, and one that uses natural language inference to encourage these entities to be described in inferentially consistent ways. We combine these with the novel use of an existing semantic equivalence metric (BERTScore). We further propose a report generation system that optimizes these rewards via reinforcement learning. On two open radiology report datasets, our system substantially improved the F1 score of a clinical information extraction performance by +22.1 (Delta +63.9%). We further show via a human evaluation and a qualitative analysis that our system leads to generations that are more factually complete and consistent compared to the baselines.

The MEDIQA 2021 shared tasks at the BioNLP 2021 workshop addressed three tasks on summarization for medical text: (i) a question summarization task aimed at exploring new approaches to understanding complex real-world consumer health queries, (ii) a multi-answer summarization task that targeted aggregation of multiple relevant answers to a biomedical question into one concise and relevant answer, and (iii) a radiology report summarization task addressing the development of clinically relevant impressions from radiology report findings. Thirty-five teams participated in these shared tasks with sixteen working notes submitted (fifteen accepted) describing a wide variety of models developed and tested on the shared and external datasets. In this paper, we describe the tasks, the datasets, the models and techniques developed by various teams, the results of the evaluation, and a study of correlations among various summarization evaluation measures. We hope that these shared tasks will bring new research and insights in biomedical text summarization and evaluation.

Neural abstractive summarization models are able to generate summaries which have high overlap with human references. However, existing models are not optimized for factual correctness, a critical metric in real-world applications. In this work, we develop a general framework where we evaluate the factual correctness of a generated summary by fact-checking it automatically against its reference using an information extraction module. We further propose a training strategy which optimizes a neural summarization model with a factual correctness reward via reinforcement learning. We apply the proposed method to the summarization of radiology reports, where factual correctness is a key requirement. On two separate datasets collected from hospitals, we show via both automatic and human evaluation that the proposed approach substantially improves the factual correctness and overall quality of outputs over a competitive neural summarization system, producing radiology summaries that approach the quality of human-authored ones.