# Cross-Modal Clustering-Guided Negative Sampling for Self-Supervised Joint Learning from Medical Images and Reports

arXiv: https://arxiv.org/abs/2506.11674 · HTML: https://mlsanity.com/paper/2506.11674/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 35 of its 44 references that are in the map.
- First posted on arXiv 13 Jun 2025.

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

- [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)
- [A Simple Framework for Contrastive Learning of Visual Representations](https://mlsanity.com/paper/2002.05709/) (2020)
- [Representation Learning with Contrastive Predictive Coding](https://mlsanity.com/paper/1807.03748/) (2018)
- [Momentum Contrast for Unsupervised Visual Representation Learning](https://mlsanity.com/paper/1911.05722/) (2019)
- [Masked Autoencoders Are Scalable Vision Learners](https://mlsanity.com/paper/2111.06377/) (2021)
- [Exploring Simple Siamese Representation Learning](https://mlsanity.com/paper/2011.10566/) (2020)
- [BEiT: BERT Pre-Training of Image Transformers](https://mlsanity.com/paper/2106.08254/) (2021)
- [Improved Baselines with Momentum Contrastive Learning](https://mlsanity.com/paper/2003.04297/) (2020)
- [Barlow Twins: Self-Supervised Learning via Redundancy Reduction](https://mlsanity.com/paper/2103.03230/) (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)
- [SimMIM: A Simple Framework for Masked Image Modeling](https://mlsanity.com/paper/2111.09886/) (2021)
- [VICReg: Variance-Invariance-Covariance Regularization for Self-Supervised Learning](https://mlsanity.com/paper/2105.04906/) (2021)
- [Publicly Available Clinical BERT Embeddings](https://mlsanity.com/paper/1904.03323/) (2019)
- [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)
- [MedCLIP: Contrastive Learning from Unpaired Medical Images and Text](https://mlsanity.com/paper/2210.10163/) (2022)
- [Unified Vision-Language Pre-Training for Image Captioning and VQA](https://mlsanity.com/paper/1909.11059/) (2019)
- [Self-Supervised Pre-Training of Swin Transformers for 3D Medical Image Analysis](https://mlsanity.com/paper/2111.14791/) (2021)
- [Contrastive Clustering](https://mlsanity.com/paper/2009.09687/) (2020)
- [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)
- [A Survey on Self-supervised Learning: Algorithms, Applications, and Future Trends](https://mlsanity.com/paper/2301.05712/) (2023)
- [Multi-Granularity Cross-modal Alignment for Generalized Medical Visual Representation Learning](https://mlsanity.com/paper/2210.06044/) (2022)
- [Deep Graph Clustering via Dual Correlation Reduction](https://mlsanity.com/paper/2112.14772/) (2021)
- [Joint Learning of Localized Representations from Medical Images and Reports](https://mlsanity.com/paper/2112.02889/) (2021)
- [Self Pre-training with Masked Autoencoders for Medical Image Classification and Segmentation](https://mlsanity.com/paper/2203.05573/) (2022)
- [Graph Contrastive Clustering](https://mlsanity.com/paper/2104.01429/) (2021)
- [Twin Contrastive Learning for Online Clustering](https://mlsanity.com/paper/2210.11680/) (2022)

## Abstract (arXiv)

Learning medical visual representations directly from paired images and reports through multimodal self-supervised learning has emerged as a novel and efficient approach to digital diagnosis in recent years. However, existing models suffer from several severe limitations. 1) neglecting the selection of negative samples, resulting in the scarcity of hard negatives and the inclusion of false negatives; 2) focusing on global feature extraction, but overlooking the fine-grained local details that are crucial for medical image recognition tasks; and 3) contrastive learning primarily targets high-level features but ignoring low-level details which are essential for accurate medical analysis. Motivated by these critical issues, this paper presents a Cross-Modal Cluster-Guided Negative Sampling (CM-CGNS) method with two-fold ideas. First, it extends the k-means clustering used for local text features in the single-modal domain to the multimodal domain through cross-modal attention. This improvement increases the number of negative samples and boosts the model representation capability. Second, it introduces a Cross-Modal Masked Image Reconstruction (CM-MIR) module that leverages local text-to-image features obtained via cross-modal attention to reconstruct masked local image regions. This module significantly strengthens the model's cross-modal information interaction capabilities and retains low-level image features essential for downstream tasks. By well handling the aforementioned limitations, the proposed CM-CGNS can learn effective and robust medical visual representations suitable for various recognition tasks. Extensive experimental results on classification, detection, and segmentation tasks across five downstream datasets show that our method outperforms state-of-the-art approaches on multiple metrics, verifying its superior performance.