# Learning to Exploit Temporal Structure for Biomedical Vision-Language Processing

arXiv: https://arxiv.org/abs/2301.04558 · HTML: https://mlsanity.com/paper/2301.04558/

## Key facts

- Cited by 211 papers in the map (data through 14 Oct 2026).
- Builds on 52 of its 88 references that are in the map.
- First posted on arXiv 11 Jan 2023.

## Builds on (most cited first, 30 of 52)

- [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)
- [Language Models are Few-Shot Learners](https://mlsanity.com/paper/2005.14165/) (2020)
- [An Image is Worth 16x16 Words: Transformers for Image Recognition at Scale](https://mlsanity.com/paper/2010.11929/) (2020)
- [Sentence-BERT: Sentence Embeddings using Siamese BERT-Networks](https://mlsanity.com/paper/1908.10084/) (2019)
- [Representation Learning with Contrastive Predictive Coding](https://mlsanity.com/paper/1807.03748/) (2018)
- [End-to-End Object Detection with Transformers](https://mlsanity.com/paper/2005.12872/) (2020)
- [Layer Normalization](https://mlsanity.com/paper/1607.06450/) (2016)
- [Flamingo: a Visual Language Model for Few-Shot Learning](https://mlsanity.com/paper/2204.14198/) (2022)
- [BLIP: Bootstrapping Language-Image Pre-training for Unified Vision-Language Understanding and Generation](https://mlsanity.com/paper/2201.12086/) (2022)
- [Scaling Up Visual and Vision-Language Representation Learning With Noisy Text Supervision](https://mlsanity.com/paper/2102.05918/) (2021)
- [Finetuned Language Models Are Zero-Shot Learners](https://mlsanity.com/paper/2109.01652/) (2021)
- [Align before Fuse: Vision and Language Representation Learning with Momentum Distillation](https://mlsanity.com/paper/2107.07651/) (2021)
- [CheXpert: A Large Chest Radiograph Dataset with Uncertainty Labels and Expert Comparison](https://mlsanity.com/paper/1901.07031/) (2019)
- [CoCa: Contrastive Captioners are Image-Text Foundation Models](https://mlsanity.com/paper/2205.01917/) (2022)
- [Domain-Specific Language Model Pretraining for Biomedical Natural Language Processing](https://mlsanity.com/paper/2007.15779/) (2020)
- [Quantifying Attention Flow in Transformers](https://mlsanity.com/paper/2005.00928/) (2020)
- [FLAVA: A Foundational Language And Vision Alignment Model](https://mlsanity.com/paper/2112.04482/) (2021)
- [Contrastive Learning of Medical Visual Representations from Paired Images and Text](https://mlsanity.com/paper/2010.00747/) (2020)
- [FILIP: Fine-grained Interactive Language-Image Pre-Training](https://mlsanity.com/paper/2111.07783/) (2021)
- [ConViT: Improving Vision Transformers with Soft Convolutional Inductive Biases](https://mlsanity.com/paper/2103.10697/) (2021)
- [VLMo: Unified Vision-Language Pre-Training with Mixture-of-Modality-Experts](https://mlsanity.com/paper/2111.02358/) (2021)
- [Generating Radiology Reports via Memory-driven Transformer](https://mlsanity.com/paper/2010.16056/) (2020)
- [Debiased Contrastive Learning](https://mlsanity.com/paper/2007.00224/) (2020)
- [VirTex: Learning Visual Representations from Textual Annotations](https://mlsanity.com/paper/2006.06666/) (2020)
- [Making the Most of Text Semantics to Improve Biomedical Vision--Language Processing](https://mlsanity.com/paper/2204.09817/) (2022)
- [CheXbert: Combining Automatic Labelers and Expert Annotations for Accurate Radiology Report Labeling Using BERT](https://mlsanity.com/paper/2004.09167/) (2020)
- [Generating Wikipedia by Summarizing Long Sequences](https://mlsanity.com/paper/1801.10198/) (2018)

## Built on by (most cited first, 30 of 211)

- [Towards Generalist Biomedical AI](https://mlsanity.com/paper/2307.14334/) (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)
- [Vision-Language Models for Medical Report Generation and Visual Question Answering: A Review](https://mlsanity.com/paper/2403.02469/) (2024)
- [CheXpert Plus: Augmenting a Large Chest X-ray Dataset with Text Radiology Reports, Patient Demographics and Additional Image Formats](https://mlsanity.com/paper/2405.19538/) (2024)
- [A Comprehensive Survey of Scientific Large Language Models and Their Applications in Scientific Discovery](https://mlsanity.com/paper/2406.10833/) (2024)
- [Foundational Models in Medical Imaging: A Comprehensive Survey and Future Vision](https://mlsanity.com/paper/2310.18689/) (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)
- [MedBLIP: Bootstrapping Language-Image Pre-training from 3D Medical Images and Texts](https://mlsanity.com/paper/2305.10799/) (2023)
- [Towards a clinically accessible radiology foundation model: open-access and lightweight, with automated evaluation](https://mlsanity.com/paper/2403.08002/) (2024)
- [MedGemma 1.5 Technical Report](https://mlsanity.com/paper/2604.05081/) (2026)
- [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)
- [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)
- [BrainSegFounder: Towards 3D Foundation Models for Neuroimage Segmentation](https://mlsanity.com/paper/2406.10395/) (2024)
- [A Systematic Evaluation of GPT-4V's Multimodal Capability for Medical Image Analysis](https://mlsanity.com/paper/2310.20381/) (2023)
- [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)
- [HERGen: Elevating Radiology Report Generation with Longitudinal Data](https://mlsanity.com/paper/2407.15158/) (2024)
- [Exploring the Boundaries of GPT-4 in Radiology](https://mlsanity.com/paper/2310.14573/) (2023)
- [How Far Are We From AGI: Are LLMs All We Need?](https://mlsanity.com/paper/2405.10313/) (2024)
- [Libra: Leveraging Temporal Images for Biomedical Radiology Analysis](https://mlsanity.com/paper/2411.19378/) (2024)
- [RadEdit: stress-testing biomedical vision models via diffusion image editing](https://mlsanity.com/paper/2312.12865/) (2023)
- [MiniGPT-Med: Large Language Model as a General Interface for Radiology Diagnosis](https://mlsanity.com/paper/2407.04106/) (2024)
- [Decomposing Disease Descriptions for Enhanced Pathology Detection: A Multi-Aspect Vision-Language Pre-training Framework](https://mlsanity.com/paper/2403.07636/) (2024)
- [An X-Ray Is Worth 15 Features: Sparse Autoencoders for Interpretable Radiology Report Generation](https://mlsanity.com/paper/2410.03334/) (2024)
- [Longitudinal Data and a Semantic Similarity Reward for Chest X-Ray Report Generation](https://mlsanity.com/paper/2307.09758/) (2023)
- [Medical Vision Language Pretraining: A survey](https://mlsanity.com/paper/2312.06224/) (2023)

## Abstract (arXiv)

Self-supervised learning in vision-language processing exploits semantic alignment between imaging and text modalities. Prior work in biomedical VLP has mostly relied on the alignment of single image and report pairs even though clinical notes commonly refer to prior images. This does not only introduce poor alignment between the modalities but also a missed opportunity to exploit rich self-supervision through existing temporal content in the data. In this work, we explicitly account for prior images and reports when available during both training and fine-tuning. Our approach, named BioViL-T, uses a CNN-Transformer hybrid multi-image encoder trained jointly with a text model. It is designed to be versatile to arising challenges such as pose variations and missing input images across time. The resulting model excels on downstream tasks both in single- and multi-image setups, achieving state-of-the-art performance on (I) progression classification, (II) phrase grounding, and (III) report generation, whilst offering consistent improvements on disease classification and sentence-similarity tasks. We release a novel multi-modal temporal benchmark dataset, MS-CXR-T, to quantify the quality of vision-language representations in terms of temporal semantics. Our experimental results show the advantages of incorporating prior images and reports to make most use of the data.