# Grounded Knowledge-Enhanced Medical Vision-Language Pre-training for Chest X-Ray

arXiv: https://arxiv.org/abs/2404.14750 · HTML: https://mlsanity.com/paper/2404.14750/

## Key facts

- Cited by 2 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 34 of its 49 references that are in the map.
- First posted on arXiv 23 Apr 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, 30 of 34)

- [An Image is Worth 16x16 Words: Transformers for Image Recognition at Scale](https://mlsanity.com/paper/2010.11929/) (2020)
- [Masked Autoencoders Are Scalable Vision Learners](https://mlsanity.com/paper/2111.06377/) (2021)
- [BLIP: Bootstrapping Language-Image Pre-training for Unified Vision-Language Understanding and Generation](https://mlsanity.com/paper/2201.12086/) (2022)
- [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)
- [SciBERT: A Pretrained Language Model for Scientific Text](https://mlsanity.com/paper/1903.10676/) (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)
- [MIMIC-CXR-JPG, a large publicly available database of labeled chest radiographs](https://mlsanity.com/paper/1901.07042/) (2019)
- [SLAKE: A Semantically-Labeled Knowledge-Enhanced Dataset for Medical Visual Question Answering](https://mlsanity.com/paper/2102.09542/) (2021)
- [Generating Radiology Reports via Memory-driven Transformer](https://mlsanity.com/paper/2010.16056/) (2020)
- [Making the Most of Text Semantics to Improve Biomedical Vision--Language Processing](https://mlsanity.com/paper/2204.09817/) (2022)
- [Bilinear Attention Networks](https://mlsanity.com/paper/1805.07932/) (2018)
- [Stacked Attention Networks for Image Question Answering](https://mlsanity.com/paper/1511.02274/) (2015)
- [Cross-modal Memory Networks for Radiology Report Generation](https://mlsanity.com/paper/2204.13258/) (2022)
- [Exploring and Distilling Posterior and Prior Knowledge for Radiology Report Generation](https://mlsanity.com/paper/2106.06963/) (2021)
- [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)
- [When Radiology Report Generation Meets Knowledge Graph](https://mlsanity.com/paper/2002.08277/) (2020)
- [Knowledge-enhanced Visual-Language Pre-training on Chest Radiology Images](https://mlsanity.com/paper/2302.14042/) (2023)
- [Multi-modal Factorized Bilinear Pooling with Co-Attention Learning for Visual Question Answering](https://mlsanity.com/paper/1708.01471/) (2017)
- [Multi-Modal Masked Autoencoders for Medical Vision-and-Language Pre-Training](https://mlsanity.com/paper/2209.07098/) (2022)
- [Multi-modal Understanding and Generation for Medical Images and Text via Vision-Language Pre-Training](https://mlsanity.com/paper/2105.11333/) (2021)
- [Joint Learning of Localized Representations from Medical Images and Reports](https://mlsanity.com/paper/2112.02889/) (2021)
- [Generalized Radiograph Representation Learning via Cross-supervision between Images and Free-text Radiology Reports](https://mlsanity.com/paper/2111.03452/) (2021)
- [Advancing Radiograph Representation Learning with Masked Record Modeling](https://mlsanity.com/paper/2301.13155/) (2023)
- [Overcoming Data Limitation in Medical Visual Question Answering](https://mlsanity.com/paper/1909.11867/) (2019)
- [Cross-modal Prototype Driven Network for Radiology Report Generation](https://mlsanity.com/paper/2207.04818/) (2022)
- [PRIOR: Prototype Representation Joint Learning from Medical Images and Reports](https://mlsanity.com/paper/2307.12577/) (2023)
- [M-FLAG: Medical Vision-Language Pre-training with Frozen Language Models and Latent Space Geometry Optimization](https://mlsanity.com/paper/2307.08347/) (2023)

## Built on by (most cited first, 2 of 2)

- [KG-CMI: Knowledge graph enhanced cross-Mamba interaction for medical visual question answering](https://mlsanity.com/paper/2604.00601/) (2026)
- [A 3D SAM-Based Progressive Prompting Framework for Multi-Task Segmentation of Radiotherapy-induced Normal Tissue Injuries in Limited-Data Settings](https://mlsanity.com/paper/2604.13367/) (2026)

## Abstract (arXiv)

Medical foundation models have the potential to revolutionize healthcare by providing robust and generalized representations of medical data. Medical vision-language pre-training has emerged as a promising approach for learning domain-general representations of medical image and text. Current algorithms that exploit global and local alignment between medical image and text could however be marred by redundant information in medical data. To address this issue, we propose a grounded knowledge-enhanced medical vision-language pre-training (GK-MVLP) framework for chest X-ray. In this framework, medical knowledge was grounded to the appropriate anatomical regions by using a transformer-based grounded knowledge-enhanced module for fine-grained alignment between textural features of medical knowledge and the corresponding anatomical region-level visual features. The performance of GK-MVLP was competitive with or exceeded the state of the art on downstream image understanding tasks (chest X-ray disease classification, disease localization), generative task (report generation), and vision-language understanding task (medical visual question-answering). Our results demonstrate the advantage of incorporating grounding mechanism to remove biases and improve the alignment between chest X-ray image and radiology report.