# Anatomical Structure-Guided Medical Vision-Language Pre-training

arXiv: https://arxiv.org/abs/2403.09294 · HTML: https://mlsanity.com/paper/2403.09294/

## Key facts

- Cited by 18 papers in the map (data through 14 Oct 2026).
- Placed in Medical vision-language models, one of 16 directions in Multimodal LLMs / vision-language models.
- Builds on 22 of its 27 references that are in the map.
- First posted on arXiv 14 Mar 2024.

## Placed in

- Multimodal LLMs / vision-language models / [Medical vision-language models](https://mlsanity.com/mllm/medical-vision-language-models/)

## Builds on (most cited first, 22 of 22)

- [Deep Residual Learning for Image Recognition](https://mlsanity.com/paper/1512.03385/) (2015)
- [Learning Transferable Visual Models From Natural Language Supervision](https://mlsanity.com/paper/2103.00020/) (2021)
- [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)
- [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)
- [SGDR: Stochastic Gradient Descent with Warm Restarts](https://mlsanity.com/paper/1608.03983/) (2016)
- [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)
- [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)
- [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)
- [Contrastive Learning of Medical Visual Representations from Paired Images and Text](https://mlsanity.com/paper/2010.00747/) (2020)
- [RadGraph: Extracting Clinical Entities and Relations from Radiology Reports](https://mlsanity.com/paper/2106.14463/) (2021)
- [COVID-Net: A Tailored Deep Convolutional Neural Network Design for Detection of COVID-19 Cases from Chest X-Ray Images](https://mlsanity.com/paper/2003.09871/) (2020)
- [Multi-Granularity Cross-modal Alignment for Generalized Medical Visual Representation Learning](https://mlsanity.com/paper/2210.06044/) (2022)
- [MedKLIP: Medical Knowledge Enhanced Language-Image Pre-Training in Radiology](https://mlsanity.com/paper/2301.02228/) (2023)
- [Knowledge-enhanced Visual-Language Pre-training on Chest Radiology Images](https://mlsanity.com/paper/2302.14042/) (2023)
- [Chest ImaGenome Dataset for Clinical Reasoning](https://mlsanity.com/paper/2108.00316/) (2021)
- [Advancing Radiograph Representation Learning with Masked Record Modeling](https://mlsanity.com/paper/2301.13155/) (2023)

## Built on by (most cited first, 18 of 18)

- [Large-scale and Fine-grained Vision-language Pre-training for Enhanced CT Image Understanding](https://mlsanity.com/paper/2501.14548/) (2025)
- [Self-eXplainable AI for Medical Image Analysis: A Survey and New Outlooks](https://mlsanity.com/paper/2410.02331/) (2024)
- [Boosting Vision Semantic Density with Anatomy Normality Modeling for Medical Vision-language Pre-training](https://mlsanity.com/paper/2508.03742/) (2025)
- [DuSSS: Dual Semantic Similarity-Supervised Vision-Language Model for Semi-Supervised Medical Image Segmentation](https://mlsanity.com/paper/2412.12492/) (2024)
- [AOR: Anatomical Ontology-Guided Reasoning for Medical Large Multimodal Model in Chest X-Ray Interpretation](https://mlsanity.com/paper/2505.02830/) (2025)
- [Pre-training on High Definition X-ray Images: An Experimental Study](https://mlsanity.com/paper/2404.17926/) (2024)
- [MedGround: Bridging the Evidence Gap in Medical Vision-Language Models with Verified Grounding Data](https://mlsanity.com/paper/2601.06847/) (2026)
- [Text-Promptable Propagation for Referring Medical Image Sequence Segmentation](https://mlsanity.com/paper/2502.11093/) (2025)
- [Anatomy-VLM: A Fine-grained Vision-Language Model for Medical Interpretation](https://mlsanity.com/paper/2511.08402/) (2025)
- [Grounded Knowledge-Enhanced Medical Vision-Language Pre-training for Chest X-Ray](https://mlsanity.com/paper/2404.14750/) (2024)
- [Recent Advances in Medical Image Classification](https://mlsanity.com/paper/2506.04129/) (2025)
- [Meta-Entity Driven Triplet Mining for Aligning Medical Vision-Language Models](https://mlsanity.com/paper/2504.15929/) (2025)
- [Improving Medical Visual Representation Learning with Pathological-level Cross-Modal Alignment and Correlation Exploration](https://mlsanity.com/paper/2506.10573/) (2025)
- [Multimodal Medical Image Classification via Synergistic Learning Pre-training](https://mlsanity.com/paper/2509.17492/) (2025)
- [Human Knowledge Integrated Multi-modal Learning for Single Source Domain Generalization](https://mlsanity.com/paper/2603.12369/) (2026)
- [MedP-CLIP: Medical CLIP with Region-Aware Prompt Integration](https://mlsanity.com/paper/2604.11197/) (2026)
- [EasyLens: A Training-Free Plug-and-Play Subtle-Lesion Representation Amplifier for Medical Vision-Language Models](https://mlsanity.com/paper/2606.06379/) (2026)
- [CheXGround: Anatomical Region Tokens for Grounded Longitudinal Chest X-ray Interpretation](https://mlsanity.com/paper/2608.30758/) (2026)

## Abstract (arXiv)

Learning medical visual representations through vision-language pre-training has reached remarkable progress. Despite the promising performance, it still faces challenges, i.e., local alignment lacks interpretability and clinical relevance, and the insufficient internal and external representation learning of image-report pairs. To address these issues, we propose an Anatomical Structure-Guided (ASG) framework. Specifically, we parse raw reports into triplets <anatomical region, finding, existence>, and fully utilize each element as supervision to enhance representation learning. For anatomical region, we design an automatic anatomical region-sentence alignment paradigm in collaboration with radiologists, considering them as the minimum semantic units to explore fine-grained local alignment. For finding and existence, we regard them as image tags, applying an image-tag recognition decoder to associate image features with their respective tags within each sample and constructing soft labels for contrastive learning to improve the semantic association of different image-report pairs. We evaluate the proposed ASG framework on two downstream tasks, including five public benchmarks. Experimental results demonstrate that our method outperforms the state-of-the-art methods.