# Cardiovascular Disease Detection from Multi-View Chest X-rays with BI-Mamba

arXiv: https://arxiv.org/abs/2405.18533 · HTML: https://mlsanity.com/paper/2405.18533/

## Key facts

- Cited by 9 papers in the map (data through 14 Oct 2026).
- Placed in Mamba for medical image analysis, one of 10 directions in State-space sequence models (S4, Mamba).
- Builds on 16 of its 26 references that are in the map.
- First posted on arXiv 28 May 2024.

## Placed in

- State-space sequence models (S4, Mamba) / [Mamba for medical image analysis](https://mlsanity.com/ssm/mamba-for-medical-image-analysis/)

## Builds on (most cited first, 16 of 16)

- [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)
- [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)
- [Swin Transformer: Hierarchical Vision Transformer using Shifted Windows](https://mlsanity.com/paper/2103.14030/) (2021)
- [DINOv2: Learning Robust Visual Features without Supervision](https://mlsanity.com/paper/2304.07193/) (2023)
- [Mamba: Linear-Time Sequence Modeling with Selective State Spaces](https://mlsanity.com/paper/2312.00752/) (2023)
- [Efficiently Modeling Long Sequences with Structured State Spaces](https://mlsanity.com/paper/2111.00396/) (2021)
- [Vision Mamba: Efficient Visual Representation Learning with Bidirectional State Space Model](https://mlsanity.com/paper/2401.09417/) (2024)
- [U-Mamba: Enhancing Long-range Dependency for Biomedical Image Segmentation](https://mlsanity.com/paper/2401.04722/) (2024)
- [Multi-view analysis of unregistered medical images using cross-view transformers](https://mlsanity.com/paper/2103.11390/) (2021)
- [Large Scale Automated Reading of Frontal and Lateral Chest X-Rays using Dual Convolutional Neural Networks](https://mlsanity.com/paper/1804.07839/) (2018)
- [CheXFusion: Effective Fusion of Multi-View Features using Transformers for Long-Tailed Chest X-Ray Classification](https://mlsanity.com/paper/2308.03968/) (2023)
- [When Neural Networks Fail to Generalize? A Model Sensitivity Perspective](https://mlsanity.com/paper/2212.00850/) (2022)
- [Deep Learning Predicts Cardiovascular Disease Risks from Lung Cancer Screening Low Dose Computed Tomography](https://mlsanity.com/paper/2008.06997/) (2020)
- [Spectral Adversarial MixUp for Few-Shot Unsupervised Domain Adaptation](https://mlsanity.com/paper/2309.01207/) (2023)

## Built on by (most cited first, 9 of 9)

- [Chest X-ray Foundation Model with Global and Local Representations Integration](https://mlsanity.com/paper/2502.05142/) (2025)
- [XFMamba: Cross-Fusion Mamba for Multi-View Medical Image Classification](https://mlsanity.com/paper/2503.02619/) (2025)
- [Xray2Xray: World Model from Chest X-rays with Volumetric Context](https://mlsanity.com/paper/2506.19055/) (2025)
- [X2CT-CLIP: Enable Multi-Abnormality Detection in Computed Tomography from Chest Radiography via Tri-Modal Contrastive Learning](https://mlsanity.com/paper/2503.02162/) (2025)
- [MambaFlow: A Mamba-Centric Architecture for End-to-End Optical Flow Estimation](https://mlsanity.com/paper/2503.07046/) (2025)
- [Diversity-enhanced Collaborative Mamba for Semi-supervised Medical Image Segmentation](https://mlsanity.com/paper/2508.13712/) (2025)
- [MCM: Mamba-based Cardiac Motion Tracking using Sequential Images in MRI](https://mlsanity.com/paper/2507.17678/) (2025)
- [How to Build Robust, Scalable Models for GSV-Based Indicators in Neighborhood Research](https://mlsanity.com/paper/2601.06443/) (2026)
- [OTCHA: Optimal Transport-driven Confidence-aware Latent Hub Alignment for Multi-View Medical Image Classification](https://mlsanity.com/paper/2606.19838/) (2026)

## Abstract (arXiv)

Accurate prediction of Cardiovascular disease (CVD) risk in medical imaging is central to effective patient health management. Previous studies have demonstrated that imaging features in computed tomography (CT) can help predict CVD risk. However, CT entails notable radiation exposure, which may result in adverse health effects for patients. In contrast, chest X-ray emits significantly lower levels of radiation, offering a safer option. This rationale motivates our investigation into the feasibility of using chest X-ray for predicting CVD risk. Convolutional Neural Networks (CNNs) and Transformers are two established network architectures for computer-aided diagnosis. However, they struggle to model very high resolution chest X-ray due to the lack of large context modeling power or quadratic time complexity. Inspired by state space sequence models (SSMs), a new class of network architectures with competitive sequence modeling power as Transfomers and linear time complexity, we propose Bidirectional Image Mamba (BI-Mamba) to complement the unidirectional SSMs with opposite directional information. BI-Mamba utilizes parallel forward and backwark blocks to encode longe-range dependencies of multi-view chest X-rays. We conduct extensive experiments on images from 10,395 subjects in National Lung Screening Trail (NLST). Results show that BI-Mamba outperforms ResNet-50 and ViT-S with comparable parameter size, and saves significant amount of GPU memory during training. Besides, BI-Mamba achieves promising performance compared with previous state of the art in CT, unraveling the potential of chest X-ray for CVD risk prediction.