# Multi-Granularity Cross-modal Alignment for Generalized Medical Visual Representation Learning

arXiv: https://arxiv.org/abs/2210.06044 · HTML: https://mlsanity.com/paper/2210.06044/

## Key facts

- Cited by 159 papers in the map (data through 14 Oct 2026).
- Builds on 51 of its 83 references that are in the map.
- First posted on arXiv 12 Oct 2022.

## Builds on (most cited first, 30 of 51)

- [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)
- [An Image is Worth 16x16 Words: Transformers for Image Recognition at Scale](https://mlsanity.com/paper/2010.11929/) (2020)
- [U-Net: Convolutional Networks for Biomedical Image Segmentation](https://mlsanity.com/paper/1505.04597/) (2015)
- [Microsoft COCO: Common Objects in Context](https://mlsanity.com/paper/1405.0312/) (2014)
- [A Simple Framework for Contrastive Learning of Visual Representations](https://mlsanity.com/paper/2002.05709/) (2020)
- [ImageNet Large Scale Visual Recognition Challenge](https://mlsanity.com/paper/1409.0575/) (2014)
- [Representation Learning with Contrastive Predictive Coding](https://mlsanity.com/paper/1807.03748/) (2018)
- [Momentum Contrast for Unsupervised Visual Representation Learning](https://mlsanity.com/paper/1911.05722/) (2019)
- [Batch Normalization: Accelerating Deep Network Training by Reducing Internal Covariate Shift](https://mlsanity.com/paper/1502.03167/) (2015)
- [SGDR: Stochastic Gradient Descent with Warm Restarts](https://mlsanity.com/paper/1608.03983/) (2016)
- [Bootstrap your own latent: A new approach to self-supervised Learning](https://mlsanity.com/paper/2006.07733/) (2020)
- [The Cityscapes Dataset for Semantic Urban Scene Understanding](https://mlsanity.com/paper/1604.01685/) (2016)
- [BLIP: Bootstrapping Language-Image Pre-training for Unified Vision-Language Understanding and Generation](https://mlsanity.com/paper/2201.12086/) (2022)
- [Unsupervised Learning of Visual Features by Contrasting Cluster Assignments](https://mlsanity.com/paper/2006.09882/) (2020)
- [YOLOv3: An Incremental Improvement](https://mlsanity.com/paper/1804.02767/) (2018)
- [Sinkhorn Distances: Lightspeed Computation of Optimal Transportation Distances](https://mlsanity.com/paper/1306.0895/) (2013)
- [Improved Baselines with Momentum Contrastive Learning](https://mlsanity.com/paper/2003.04297/) (2020)
- [LXMERT: Learning Cross-Modality Encoder Representations from Transformers](https://mlsanity.com/paper/1908.07490/) (2019)
- [Show, Attend and Tell: Neural Image Caption Generation with Visual Attention](https://mlsanity.com/paper/1502.03044/) (2015)
- [CheXpert: A Large Chest Radiograph Dataset with Uncertainty Labels and Expert Comparison](https://mlsanity.com/paper/1901.07031/) (2019)
- [Rethinking Semantic Segmentation from a Sequence-to-Sequence Perspective with Transformers](https://mlsanity.com/paper/2012.15840/) (2020)
- [Publicly Available Clinical BERT Embeddings](https://mlsanity.com/paper/1904.03323/) (2019)
- [ChestX-ray8: Hospital-scale Chest X-ray Database and Benchmarks on Weakly-Supervised Classification and Localization of Common Thorax Diseases](https://mlsanity.com/paper/1705.02315/) (2017)
- [VL-BERT: Pre-training of Generic Visual-Linguistic Representations](https://mlsanity.com/paper/1908.08530/) (2019)
- [Contrastive Learning of Medical Visual Representations from Paired Images and Text](https://mlsanity.com/paper/2010.00747/) (2020)
- [Prototypical Contrastive Learning of Unsupervised Representations](https://mlsanity.com/paper/2005.04966/) (2020)
- [A Survey on Contrastive Self-supervised Learning](https://mlsanity.com/paper/2011.00362/) (2020)
- [GroupViT: Semantic Segmentation Emerges from Text Supervision](https://mlsanity.com/paper/2202.11094/) (2022)

## Built on by (most cited first, 30 of 159)

- [A Comprehensive Survey of Scientific Large Language Models and Their Applications in Scientific Discovery](https://mlsanity.com/paper/2406.10833/) (2024)
- [A Foundation Language-Image Model of the Retina (FLAIR): Encoding Expert Knowledge in Text Supervision](https://mlsanity.com/paper/2308.07898/) (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)
- [Med-UniC: Unifying Cross-Lingual Medical Vision-Language Pre-Training by Diminishing Bias](https://mlsanity.com/paper/2305.19894/) (2023)
- [PRIOR: Prototype Representation Joint Learning from Medical Images and Reports](https://mlsanity.com/paper/2307.12577/) (2023)
- [Generative Text-Guided 3D Vision-Language Pretraining for Unified Medical Image Segmentation](https://mlsanity.com/paper/2306.04811/) (2023)
- [Improving fine-grained understanding in image-text pre-training](https://mlsanity.com/paper/2401.09865/) (2024)
- [M-FLAG: Medical Vision-Language Pre-training with Frozen Language Models and Latent Space Geometry Optimization](https://mlsanity.com/paper/2307.08347/) (2023)
- [Enhanced Contrastive Learning with Multi-view Longitudinal Data for Chest X-ray Report Generation](https://mlsanity.com/paper/2502.20056/) (2025)
- [CLIP in Medical Imaging: A Survey](https://mlsanity.com/paper/2312.07353/) (2023)
- [CARZero: Cross-Attention Alignment for Radiology Zero-Shot Classification](https://mlsanity.com/paper/2402.17417/) (2024)
- [Towards Unifying Medical Vision-and-Language Pre-training via Soft Prompts](https://mlsanity.com/paper/2302.08958/) (2023)
- [Enhancing Representation in Radiography-Reports Foundation Model: A Granular Alignment Algorithm Using Masked Contrastive Learning](https://mlsanity.com/paper/2309.05904/) (2023)
- [Continual Self-supervised Learning: Towards Universal Multi-modal Medical Data Representation Learning](https://mlsanity.com/paper/2311.17597/) (2023)
- [HERGen: Elevating Radiology Report Generation with Longitudinal Data](https://mlsanity.com/paper/2407.15158/) (2024)
- [Decomposing Disease Descriptions for Enhanced Pathology Detection: A Multi-Aspect Vision-Language Pre-training Framework](https://mlsanity.com/paper/2403.07636/) (2024)
- [Fine-Grained Image-Text Alignment in Medical Imaging Enables Explainable Cyclic Image-Report Generation](https://mlsanity.com/paper/2312.08078/) (2023)
- [EVA-X: A Foundation Model for General Chest X-ray Analysis with Self-supervised Learning](https://mlsanity.com/paper/2405.05237/) (2024)
- [Medical Vision Language Pretraining: A survey](https://mlsanity.com/paper/2312.06224/) (2023)
- [IMITATE: Clinical Prior Guided Hierarchical Vision-Language Pre-training](https://mlsanity.com/paper/2310.07355/) (2023)
- [MLIP: Enhancing Medical Visual Representation with Divergence Encoder and Knowledge-guided Contrastive Learning](https://mlsanity.com/paper/2402.02045/) (2024)
- [Multi-modal Vision Pre-training for Medical Image Analysis](https://mlsanity.com/paper/2410.10604/) (2024)
- [Multi-task Paired Masking with Alignment Modeling for Medical Vision-Language Pre-training](https://mlsanity.com/paper/2305.07920/) (2023)
- [Has Multimodal Learning Delivered Universal Intelligence in Healthcare? A Comprehensive Survey](https://mlsanity.com/paper/2408.12880/) (2024)
- [ChEX: Interactive Localization and Region Description in Chest X-rays](https://mlsanity.com/paper/2404.15770/) (2024)
- [Anatomical Structure-Guided Medical Vision-Language Pre-training](https://mlsanity.com/paper/2403.09294/) (2024)
- [Towards Foundation Models and Few-Shot Parameter-Efficient Fine-Tuning for Volumetric Organ Segmentation](https://mlsanity.com/paper/2303.17051/) (2023)
- [Brant-X: A Unified Physiological Signal Alignment Framework](https://mlsanity.com/paper/2409.00122/) (2024)
- [Learning Multiscale Consistency for Self-supervised Electron Microscopy Instance Segmentation](https://mlsanity.com/paper/2308.09917/) (2023)

## Abstract (arXiv)

Learning medical visual representations directly from paired radiology reports has become an emerging topic in representation learning. However, existing medical image-text joint learning methods are limited by instance or local supervision analysis, ignoring disease-level semantic correspondences. In this paper, we present a novel Multi-Granularity Cross-modal Alignment (MGCA) framework for generalized medical visual representation learning by harnessing the naturally exhibited semantic correspondences between medical image and radiology reports at three different levels, i.e., pathological region-level, instance-level, and disease-level. Specifically, we first incorporate the instance-wise alignment module by maximizing the agreement between image-report pairs. Further, for token-wise alignment, we introduce a bidirectional cross-attention strategy to explicitly learn the matching between fine-grained visual tokens and text tokens, followed by contrastive learning to align them. More important, to leverage the high-level inter-subject relationship semantic (e.g., disease) correspondences, we design a novel cross-modal disease-level alignment paradigm to enforce the cross-modal cluster assignment consistency. Extensive experimental results on seven downstream medical image datasets covering image classification, object detection, and semantic segmentation tasks demonstrate the stable and superior performance of our framework.