Recently, vision-language representation learning has made remarkable advancements in building up medical foundation models, holding immense potential for transforming the landscape of clinical research and medical care. The underlying hypothesis is that the rich knowledge embedded in radiology reports can effectively assist and guide the learning process, reducing the need for additional labels. However, these reports tend to be complex and sometimes even consist of redundant descriptions that make the representation learning too challenging to capture the key semantic information. This paper develops a novel iterative vision-language representation learning framework by proposing a key semantic knowledge-emphasized report refinement method. Particularly, raw radiology reports are refined to highlight the key information according to a constructed clinical dictionary and two model-optimized knowledge-enhancement metrics. The iterative framework is designed to progressively learn, starting from gaining a general understanding of the patient's condition based on raw reports and gradually refines and extracts critical information essential to the fine-grained analysis tasks. The effectiveness of the proposed framework is validated on various downstream medical image analysis tasks, including disease classification, region-of-interest segmentation, and phrase grounding. Our framework surpasses seven state-of-the-art methods in both fine-tuning and zero-shot settings, demonstrating its encouraging potential for different clinical applications.

通过提出强调关键语义知识的报告细化方法，本文开发了一种新颖的迭代式视觉-语言表示学习框架，从而对原始放射学报告进行细化，突出显示关键信息，并逐渐提取对细粒度分析任务至关重要的关键信息，从而验证了该框架在各种下游医学图像分析任务中的有效性，并展示了其在不同临床应用中的鼓舞人心的潜力。

强化视觉-语言基础模型：关键语义知识强调的报告优化