# Chest X-ray Foundation Model with Global and Local Representations Integration

arXiv: https://arxiv.org/abs/2502.05142 · HTML: https://mlsanity.com/paper/2502.05142/

## Key facts

- Cited by 6 papers in the map (data through 14 Oct 2026).
- Builds on 35 of its 59 references that are in the map.
- First posted on arXiv 7 Feb 2025.

## Builds on (most cited first, 30 of 35)

- [Learning Transferable Visual Models From Natural Language Supervision](https://mlsanity.com/paper/2103.00020/) (2021)
- [A Simple Framework for Contrastive Learning of Visual Representations](https://mlsanity.com/paper/2002.05709/) (2020)
- [DINOv2: Learning Robust Visual Features without Supervision](https://mlsanity.com/paper/2304.07193/) (2023)
- [Masked Autoencoders Are Scalable Vision Learners](https://mlsanity.com/paper/2111.06377/) (2021)
- [Emerging Properties in Self-Supervised Vision Transformers](https://mlsanity.com/paper/2104.14294/) (2021)
- [Bootstrap your own latent: A new approach to self-supervised Learning](https://mlsanity.com/paper/2006.07733/) (2020)
- [A ConvNet for the 2020s](https://mlsanity.com/paper/2201.03545/) (2022)
- [BEiT: BERT Pre-Training of Image Transformers](https://mlsanity.com/paper/2106.08254/) (2021)
- [An Empirical Study of Training Self-Supervised Vision Transformers](https://mlsanity.com/paper/2104.02057/) (2021)
- [CheXpert: A Large Chest Radiograph Dataset with Uncertainty Labels and Expert Comparison](https://mlsanity.com/paper/1901.07031/) (2019)
- [LLaVA-Med: Training a Large Language-and-Vision Assistant for Biomedicine in One Day](https://mlsanity.com/paper/2306.00890/) (2023)
- [Unified Perceptual Parsing for Scene Understanding](https://mlsanity.com/paper/1807.10221/) (2018)
- [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)
- [iBOT: Image BERT Pre-Training with Online Tokenizer](https://mlsanity.com/paper/2111.07832/) (2021)
- [EVA: Exploring the Limits of Masked Visual Representation Learning at Scale](https://mlsanity.com/paper/2211.07636/) (2022)
- [Revisiting Feature Prediction for Learning Visual Representations from Video](https://mlsanity.com/paper/2404.08471/) (2024)
- [BiomedCLIP: a multimodal biomedical foundation model pretrained from fifteen million scientific image-text pairs](https://mlsanity.com/paper/2303.00915/) (2023)
- [CheXNet: Radiologist-Level Pneumonia Detection on Chest X-Rays with Deep Learning](https://mlsanity.com/paper/1711.05225/) (2017)
- [PadChest: A large chest x-ray image dataset with multi-label annotated reports](https://mlsanity.com/paper/1901.07441/) (2019)
- [VinDr-CXR: An open dataset of chest X-rays with radiologist's annotations](https://mlsanity.com/paper/2012.15029/) (2020)
- [Exploring scalable medical image encoders beyond text supervision](https://mlsanity.com/paper/2401.10815/) (2024)
- [Advancing Multimodal Medical Capabilities of Gemini](https://mlsanity.com/paper/2405.03162/) (2024)
- [Does CLIP Benefit Visual Question Answering in the Medical Domain as Much as it Does in the General Domain?](https://mlsanity.com/paper/2112.13906/) (2021)
- [BIMCV COVID-19+: a large annotated dataset of RX and CT images from COVID-19 patients](https://mlsanity.com/paper/2006.01174/) (2020)
- [A Vision-Language Foundation Model to Enhance Efficiency of Chest X-ray Interpretation](https://mlsanity.com/paper/2401.12208/) (2024)
- [Delving into Masked Autoencoders for Multi-Label Thorax Disease Classification](https://mlsanity.com/paper/2210.12843/) (2022)
- [CheXtransfer: Performance and Parameter Efficiency of ImageNet Models for Chest X-Ray Interpretation](https://mlsanity.com/paper/2101.06871/) (2021)
- [MedAug: Contrastive learning leveraging patient metadata improves representations for chest X-ray interpretation](https://mlsanity.com/paper/2102.10663/) (2021)
- [EVA-X: A Foundation Model for General Chest X-ray Analysis with Self-supervised Learning](https://mlsanity.com/paper/2405.05237/) (2024)
- [VinDr-RibCXR: A Benchmark Dataset for Automatic Segmentation and Labeling of Individual Ribs on Chest X-rays](https://mlsanity.com/paper/2107.01327/) (2021)

## Built on by (most cited first, 6 of 6)

- [Xray2Xray: World Model from Chest X-rays with Volumetric Context](https://mlsanity.com/paper/2506.19055/) (2025)
- [X-WIN: Building Chest Radiograph World Model via Predictive Sensing](https://mlsanity.com/paper/2511.14918/) (2025)
- [Vision Foundation Models in Radiology: A Scoping Review of Data, Methodology, Evaluation and Clinical Translation](https://mlsanity.com/paper/2607.07219/) (2026)
- [Evidential Reasoning Advances Interpretable Real-World Disease Screening](https://mlsanity.com/paper/2605.15171/) (2026)
- [Med-RADIO: Reducing All Medical Domains Into One via Multi-Teacher Distillation](https://mlsanity.com/paper/2609.37682/) (2026)
- [X-Ragent: Tool-Augmented Reinforcement Learning for Evidence-Grounded Chest X-Ray Reasoning](https://mlsanity.com/paper/2610.16811/) (2026)

## Abstract (arXiv)

Chest X-ray (CXR) is the most frequently ordered imaging test, supporting diverse clinical tasks from thoracic disease detection to postoperative monitoring. However, task-specific classification models are limited in scope, require costly labeled data, and lack generalizability to out-of-distribution datasets. To address these challenges, we introduce CheXFound, a self-supervised vision foundation model that learns robust CXR representations and generalizes effectively across a wide range of downstream tasks. We pretrain CheXFound on a curated CXR-1M dataset, comprising over one million unique CXRs from publicly available sources. We propose a Global and Local Representations Integration (GLoRI) module for downstream adaptations, by incorporating disease-specific local features with global image features for enhanced performance in multilabel classification. Our experimental results show that CheXFound outperforms state-of-the-art models in classifying 40 disease findings across different prevalence levels on the CXR-LT 24 dataset and exhibits superior label efficiency on downstream tasks with limited training data. Additionally, CheXFound achieved significant improvements on new tasks with out-of-distribution datasets, including opportunistic cardiovascular disease risk estimation and mortality prediction. These results highlight CheXFound's strong generalization capabilities, enabling diverse adaptations with improved label efficiency. The project source code is publicly available at https://github.com/RPIDIAL/CheXFound.