# Pre-training on High Definition X-ray Images: An Experimental Study

arXiv: https://arxiv.org/abs/2404.17926 · HTML: https://mlsanity.com/paper/2404.17926/

## Key facts

- Cited by 7 papers in the map (data through 14 Oct 2026).
- Builds on 57 of its 74 references that are in the map.
- First posted on arXiv 27 Apr 2024.

## Builds on (most cited first, 30 of 57)

- [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)
- [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)
- [Very Deep Convolutional Networks for Large-Scale Image Recognition](https://mlsanity.com/paper/1409.1556/) (2014)
- [RoBERTa: A Robustly Optimized BERT Pretraining Approach](https://mlsanity.com/paper/1907.11692/) (2019)
- [Swin Transformer: Hierarchical Vision Transformer using Shifted Windows](https://mlsanity.com/paper/2103.14030/) (2021)
- [A Simple Framework for Contrastive Learning of Visual Representations](https://mlsanity.com/paper/2002.05709/) (2020)
- [Masked Autoencoders Are Scalable Vision Learners](https://mlsanity.com/paper/2111.06377/) (2021)
- [CIDEr: Consensus-based Image Description Evaluation](https://mlsanity.com/paper/1411.5726/) (2014)
- [Show, Attend and Tell: Neural Image Caption Generation with Visual Attention](https://mlsanity.com/paper/1502.03044/) (2015)
- [Vision Mamba: Efficient Visual Representation Learning with Bidirectional State Space Model](https://mlsanity.com/paper/2401.09417/) (2024)
- [VMamba: Visual State Space Model](https://mlsanity.com/paper/2401.10166/) (2024)
- [CheXNet: Radiologist-Level Pneumonia Detection on Chest X-Rays with Deep Learning](https://mlsanity.com/paper/1711.05225/) (2017)
- [Generating Radiology Reports via Memory-driven Transformer](https://mlsanity.com/paper/2010.16056/) (2020)
- [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)
- [Large-scale Multi-Modal Pre-trained Models: A Comprehensive Survey](https://mlsanity.com/paper/2302.10035/) (2023)
- [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)
- [Hybrid Retrieval-Generation Reinforced Agent for Medical Image Report Generation](https://mlsanity.com/paper/1805.08298/) (2018)
- [Interactive and Explainable Region-guided Radiology Report Generation](https://mlsanity.com/paper/2304.08295/) (2023)
- [Knowledge-enhanced Visual-Language Pre-training on Chest Radiology Images](https://mlsanity.com/paper/2302.14042/) (2023)
- [Dynamic Graph Enhanced Contrastive Learning for Chest X-ray Report Generation](https://mlsanity.com/paper/2303.10323/) (2023)
- [Multi-Modal Masked Autoencoders for Medical Vision-and-Language Pre-Training](https://mlsanity.com/paper/2209.07098/) (2022)
- [Knowledge-driven Encode, Retrieve, Paraphrase for Medical Image Report Generation](https://mlsanity.com/paper/1903.10122/) (2019)
- [METransformer: Radiology Report Generation by Transformer with Multiple Learnable Expert Tokens](https://mlsanity.com/paper/2304.02211/) (2023)
- [PromptMRG: Diagnosis-Driven Prompts for Medical Report Generation](https://mlsanity.com/paper/2308.12604/) (2023)
- [CXR-CLIP: Toward Large Scale Chest X-ray Language-Image Pre-training](https://mlsanity.com/paper/2310.13292/) (2023)

## Built on by (most cited first, 7 of 7)

- [CXPMRG-Bench: Pre-training and Benchmarking for X-ray Medical Report Generation on CheXpert Plus Dataset](https://mlsanity.com/paper/2410.00379/) (2024)
- [R2GenCSR: Mining Contextual and Residual Information for LLMs-based Radiology Report Generation](https://mlsanity.com/paper/2408.09743/) (2024)
- [CM3AE: A Unified RGB Frame and Event-Voxel/-Frame Pre-training Framework](https://mlsanity.com/paper/2504.12576/) (2025)
- [R2GenKG: Hierarchical Multi-modal Knowledge Graph for LLM-based Radiology Report Generation](https://mlsanity.com/paper/2508.03426/) (2025)
- [EMRRG: Efficient Fine-Tuning Pre-trained X-ray Mamba Networks for Radiology Report Generation](https://mlsanity.com/paper/2510.16776/) (2025)
- [Vehicle-centric Perception via Multimodal Structured Pre-training](https://mlsanity.com/paper/2512.19934/) (2025)
- [REVA-PO: Stabilizing Reinforcement Learning for Chest X-ray Report Generation](https://mlsanity.com/paper/2607.10147/) (2026)

## Abstract (arXiv)

Existing X-ray based pre-trained vision models are usually conducted on a relatively small-scale dataset (less than 500k samples) with limited resolution (e.g., 224 × 224). However, the key to the success of self-supervised pre-training large models lies in massive training data, and maintaining high resolution in the field of X-ray images is the guarantee of effective solutions to difficult miscellaneous diseases. In this paper, we address these issues by proposing the first high-definition (1280 × 1280) X-ray based pre-trained foundation vision model on our newly collected large-scale dataset which contains more than 1 million X-ray images. Our model follows the masked auto-encoder framework which takes the tokens after mask processing (with a high rate) is used as input, and the masked image patches are reconstructed by the Transformer encoder-decoder network. More importantly, we introduce a novel context-aware masking strategy that utilizes the chest contour as a boundary for adaptive masking operations. We validate the effectiveness of our model on two downstream tasks, including X-ray report generation and disease recognition. Extensive experiments demonstrate that our pre-trained medical foundation vision model achieves comparable or even new state-of-the-art performance on downstream benchmark datasets. The source code and pre-trained models of this paper will be released on https://github.com/Event-AHU/MedicalImageAnalysis.