# Making the Most of Text Semantics to Improve Biomedical Vision--Language Processing

arXiv: https://arxiv.org/abs/2204.09817 · HTML: https://mlsanity.com/paper/2204.09817/

## Key facts

- Cited by 339 papers in the map (data through 14 Oct 2026).
- Builds on 59 of its 92 references that are in the map.
- First posted on arXiv 21 Apr 2022.

## Builds on (most cited first, 30 of 59)

- [Attention Is All You Need](https://mlsanity.com/paper/1706.03762/) (2017)
- [Deep Residual Learning for Image Recognition](https://mlsanity.com/paper/1512.03385/) (2015)
- [BERT: Pre-training of Deep Bidirectional Transformers for Language Understanding](https://mlsanity.com/paper/1810.04805/) (2018)
- [Learning Transferable Visual Models From Natural Language Supervision](https://mlsanity.com/paper/2103.00020/) (2021)
- [U-Net: Convolutional Networks for Biomedical Image Segmentation](https://mlsanity.com/paper/1505.04597/) (2015)
- [RoBERTa: A Robustly Optimized BERT Pretraining Approach](https://mlsanity.com/paper/1907.11692/) (2019)
- [A Simple Framework for Contrastive Learning of Visual Representations](https://mlsanity.com/paper/2002.05709/) (2020)
- [Faster R-CNN: Towards Real-Time Object Detection with Region Proposal Networks](https://mlsanity.com/paper/1506.01497/) (2015)
- [Representation Learning with Contrastive Predictive Coding](https://mlsanity.com/paper/1807.03748/) (2018)
- [Batch Normalization: Accelerating Deep Network Training by Reducing Internal Covariate Shift](https://mlsanity.com/paper/1502.03167/) (2015)
- [YOLOv3: An Incremental Improvement](https://mlsanity.com/paper/1804.02767/) (2018)
- [ViLBERT: Pretraining Task-Agnostic Visiolinguistic Representations for Vision-and-Language Tasks](https://mlsanity.com/paper/1908.02265/) (2019)
- [HuggingFace's Transformers: State-of-the-art Natural Language Processing](https://mlsanity.com/paper/1910.03771/) (2019)
- [SimCSE: Simple Contrastive Learning of Sentence Embeddings](https://mlsanity.com/paper/2104.08821/) (2021)
- [BioBERT: a pre-trained biomedical language representation model for biomedical text mining](https://mlsanity.com/paper/1901.08746/) (2019)
- [Google's Neural Machine Translation System: Bridging the Gap between Human and Machine Translation](https://mlsanity.com/paper/1609.08144/) (2016)
- [CheXpert: A Large Chest Radiograph Dataset with Uncertainty Labels and Expert Comparison](https://mlsanity.com/paper/1901.07031/) (2019)
- [Flickr30k Entities: Collecting Region-to-Phrase Correspondences for Richer Image-to-Sentence Models](https://mlsanity.com/paper/1505.04870/) (2015)
- [VisualBERT: A Simple and Performant Baseline for Vision and Language](https://mlsanity.com/paper/1908.03557/) (2019)
- [Multi-Scale Context Aggregation by Dilated Convolutions](https://mlsanity.com/paper/1511.07122/) (2015)
- [Domain-Specific Language Model Pretraining for Biomedical Natural Language Processing](https://mlsanity.com/paper/2007.15779/) (2020)
- [Publicly Available Clinical BERT Embeddings](https://mlsanity.com/paper/1904.03323/) (2019)
- [VL-BERT: Pre-training of Generic Visual-Linguistic Representations](https://mlsanity.com/paper/1908.08530/) (2019)
- [Generation and Comprehension of Unambiguous Object Descriptions](https://mlsanity.com/paper/1511.02283/) (2015)
- [Contrastive Learning of Medical Visual Representations from Paired Images and Text](https://mlsanity.com/paper/2010.00747/) (2020)
- [Large Batch Training of Convolutional Networks](https://mlsanity.com/paper/1708.03888/) (2017)
- [DenseCLIP: Language-Guided Dense Prediction with Context-Aware Prompting](https://mlsanity.com/paper/2112.01518/) (2021)
- [Unicoder-VL: A Universal Encoder for Vision and Language by Cross-modal Pre-training](https://mlsanity.com/paper/1908.06066/) (2019)
- [Supervision Exists Everywhere: A Data Efficient Contrastive Language-Image Pre-training Paradigm](https://mlsanity.com/paper/2110.05208/) (2021)
- [Generating Radiology Reports via Memory-driven Transformer](https://mlsanity.com/paper/2010.16056/) (2020)

## Built on by (most cited first, 30 of 339)

- [LLaVA-Med: Training a Large Language-and-Vision Assistant for Biomedicine in One Day](https://mlsanity.com/paper/2306.00890/) (2023)
- [BiomedCLIP: a multimodal biomedical foundation model pretrained from fifteen million scientific image-text pairs](https://mlsanity.com/paper/2303.00915/) (2023)
- [Learning to Exploit Temporal Structure for Biomedical Vision-Language Processing](https://mlsanity.com/paper/2301.04558/) (2023)
- [Generalist Foundation Models from a Multimodal Dataset for 3D Computed Tomography](https://mlsanity.com/paper/2403.17834/) (2024)
- [MedKLIP: Medical Knowledge Enhanced Language-Image Pre-Training in Radiology](https://mlsanity.com/paper/2301.02228/) (2023)
- [MAIRA-2: Grounded Radiology Report Generation](https://mlsanity.com/paper/2406.04449/) (2024)
- [Exploring scalable medical image encoders beyond text supervision](https://mlsanity.com/paper/2401.10815/) (2024)
- [Knowledge-enhanced Visual-Language Pre-training on Chest Radiology Images](https://mlsanity.com/paper/2302.14042/) (2023)
- [CT2Rep: Automated Radiology Report Generation for 3D Medical Imaging](https://mlsanity.com/paper/2403.06801/) (2024)
- [A Comprehensive Survey of Scientific Large Language Models and Their Applications in Scientific Discovery](https://mlsanity.com/paper/2406.10833/) (2024)
- [Adapting Pretrained Vision-Language Foundational Models to Medical Imaging Domains](https://mlsanity.com/paper/2210.04133/) (2022)
- [CXR-CLIP: Toward Large Scale Chest X-ray Language-Image Pre-training](https://mlsanity.com/paper/2310.13292/) (2023)
- [Foundation Model for Advancing Healthcare: Challenges, Opportunities, and Future Directions](https://mlsanity.com/paper/2404.03264/) (2024)
- [Advancing Radiograph Representation Learning with Masked Record Modeling](https://mlsanity.com/paper/2301.13155/) (2023)
- [Foundation Model for Endoscopy Video Analysis via Large-scale Self-supervised Pre-train](https://mlsanity.com/paper/2306.16741/) (2023)
- [MAIRA-1: A specialised large multimodal model for radiology report generation](https://mlsanity.com/paper/2311.13668/) (2023)
- [RaTEScore: A Metric for Radiology Report Generation](https://mlsanity.com/paper/2406.16845/) (2024)
- [Med-UniC: Unifying Cross-Lingual Medical Vision-Language Pre-Training by Diminishing Bias](https://mlsanity.com/paper/2305.19894/) (2023)
- [A Comprehensive Survey of Foundation Models in Medicine](https://mlsanity.com/paper/2406.10729/) (2024)
- [PRIOR: Prototype Representation Joint Learning from Medical Images and Reports](https://mlsanity.com/paper/2307.12577/) (2023)
- [Toward Visual Grounding: A Survey](https://mlsanity.com/paper/2412.20206/) (2024)
- [Generative Text-Guided 3D Vision-Language Pretraining for Unified Medical Image Segmentation](https://mlsanity.com/paper/2306.04811/) (2023)
- [Med3DVLM: An Efficient Vision-Language Model for 3D Medical Image Analysis](https://mlsanity.com/paper/2503.20047/) (2025)
- [M-FLAG: Medical Vision-Language Pre-training with Frozen Language Models and Latent Space Geometry Optimization](https://mlsanity.com/paper/2307.08347/) (2023)
- [Automated Radiology Report Generation: A Review of Recent Advances](https://mlsanity.com/paper/2405.10842/) (2024)
- [Enhanced Contrastive Learning with Multi-view Longitudinal Data for Chest X-ray Report Generation](https://mlsanity.com/paper/2502.20056/) (2025)
- [MedSyn: Text-guided Anatomy-aware Synthesis of High-Fidelity 3D CT Images](https://mlsanity.com/paper/2310.03559/) (2023)
- [SleepFM: Multi-modal Representation Learning for Sleep Across Brain Activity, ECG and Respiratory Signals](https://mlsanity.com/paper/2405.17766/) (2024)
- [Robust and Interpretable Medical Image Classifiers via Concept Bottleneck Models](https://mlsanity.com/paper/2310.03182/) (2023)
- [CLIP in Medical Imaging: A Survey](https://mlsanity.com/paper/2312.07353/) (2023)

## Abstract (arXiv)

Multi-modal data abounds in biomedicine, such as radiology images and reports. Interpreting this data at scale is essential for improving clinical care and accelerating clinical research. Biomedical text with its complex semantics poses additional challenges in vision--language modelling compared to the general domain, and previous work has used insufficiently adapted models that lack domain-specific language understanding. In this paper, we show that principled textual semantic modelling can substantially improve contrastive learning in self-supervised vision--language processing. We release a language model that achieves state-of-the-art results in radiology natural language inference through its improved vocabulary and novel language pretraining objective leveraging semantics and discourse characteristics in radiology reports. Further, we propose a self-supervised joint vision--language approach with a focus on better text modelling. It establishes new state of the art results on a wide range of publicly available benchmarks, in part by leveraging our new domain-specific language model. We release a new dataset with locally-aligned phrase grounding annotations by radiologists to facilitate the study of complex semantic modelling in biomedical vision--language processing. A broad evaluation, including on this new dataset, shows that our contrastive learning approach, aided by textual-semantic modelling, outperforms prior methods in segmentation tasks, despite only using a global-alignment objective.