Medical image retrieval is a valuable field for supporting clinical decision-making, yet current methods primarily support 2D images and require fully annotated queries, limiting clinical flexibility. To address this, we propose RadiomicsRetrieval, a 3D content-based retrieval framework bridging handcrafted radiomics descriptors with deep learning-based embeddings at the tumor level. Unlike existing 2D approaches, RadiomicsRetrieval fully exploits volumetric data to leverage richer spatial context in medical images. We employ a promptable segmentation model (e.g., SAM) to derive tumor-specific image embeddings, which are aligned with radiomics features extracted from the same tumor via contrastive learning. These representations are further enriched by anatomical positional embedding (APE). As a result, RadiomicsRetrieval enables flexible querying based on shape, location, or partial feature sets. Extensive experiments on both lung CT and brain MRI public datasets demonstrate that radiomics features significantly enhance retrieval specificity, while APE provides global anatomical context essential for location-based searches. Notably, our framework requires only minimal user prompts (e.g., a single point), minimizing segmentation overhead and supporting diverse clinical scenarios. The capability to query using either image embeddings or selected radiomics attributes highlights its adaptability, potentially benefiting diagnosis, treatment planning, and research on large-scale medical imaging repositories. Our code is available at https://github.com/nainye/RadiomicsRetrieval.
Performance evaluation for Content-Based Image Retrieval (CBIR) remains a crucial but unsolved problem today especially in the medical domain. Various evaluation metrics have been discussed in the literature to solve this problem. Most of the existing metrics (e.g., precision, recall) are adapted from classification tasks which require manual labels as ground truth. However, such labels are often expensive and unavailable in specific thematic domains. Furthermore, medical images are usually associated with (radiological) case reports or annotated with descriptive captions in literature figures, such text contains information that can help to assess CBIR.Several researchers have argued that the medical concepts hidden in the text can serve as the basis for CBIR evaluation purpose. However, these works often consider these medical concepts as independent and isolated labels while in fact the subtle relationships between various concepts are neglected. In this work, we introduce the use of knowledge graphs to measure the distance between various medical concepts and propose a novel relevance measure for the evaluation of CBIR by defining an approximate matching-based relevance score between two sets of medical concepts which allows us to indirectly measure the similarity between medical images.We quantitatively demonstrate the effectiveness and feasibility of our relevance measure using a public dataset.
As artificial intelligence and digital medicine increasingly permeate healthcare systems, robust governance frameworks are essential to ensure ethical, secure, and effective implementation. In this context, medical image retrieval becomes a critical component of clinical data management, playing a vital role in decision-making and safeguarding patient information. Existing methods usually learn hash functions using bottleneck features, which fail to produce representative hash codes from blended embeddings. Although contrastive hashing has shown superior performance, current approaches often treat image retrieval as a classification task, using category labels to create positive/negative pairs. Moreover, many methods fail to address the out-of-distribution (OOD) issue when models encounter external OOD queries or adversarial attacks. In this work, we propose a novel method to consolidate knowledge of hierarchical features and optimisation functions. We formulate the knowledge consolidation by introducing Depth-aware Representation Fusion (DaRF) and Structure-aware Contrastive Hashing (SCH). DaRF adaptively integrates shallow and deep representations into blended features, and SCH incorporates image fingerprints to enhance the adaptability of positive/negative pairings. These blended features further facilitate OOD detection and content-based recommendation, contributing to a secure AI-driven healthcare environment. Moreover, we present a content-guided ranking to improve the robustness and reproducibility of retrieval results. Our comprehensive assessments demonstrate that the proposed method could effectively recognise OOD samples and significantly outperform existing approaches in medical image retrieval (p<0.05). In particular, our method achieves a 5.6-38.9% improvement in mean Average Precision on the anatomical radiology dataset.
Developing advanced medical imaging retrieval systems is challenging due to the varying definitions of `similar images' across different medical contexts. This challenge is compounded by the lack of large-scale, high-quality medical imaging retrieval datasets and benchmarks. In this paper, we propose a novel methodology that leverages dense radiology reports to define image-wise similarity ordering at multiple granularities in a scalable and fully automatic manner. Using this approach, we construct two comprehensive medical imaging retrieval datasets: MIMIC-IR for Chest X-rays and CTRATE-IR for CT scans, providing detailed image-image ranking annotations conditioned on diverse anatomical structures. Furthermore, we develop two retrieval systems, RadIR-CXR and model-ChestCT, which demonstrate superior performance in traditional image-image and image-report retrieval tasks. These systems also enable flexible, effective image retrieval conditioned on specific anatomical structures described in text, achieving state-of-the-art results on 77 out of 78 metrics.
Foundation models (FMs) have shown transformative potential in radiology by performing diverse, complex tasks across imaging modalities. Here, we developed CT-FM, a large-scale 3D image-based pre-trained model designed explicitly for various radiological tasks. CT-FM was pre-trained using 148,000 computed tomography (CT) scans from the Imaging Data Commons through label-agnostic contrastive learning. We evaluated CT-FM across four categories of tasks, namely, whole-body and tumor segmentation, head CT triage, medical image retrieval, and semantic understanding, showing superior performance against state-of-the-art models. Beyond quantitative success, CT-FM demonstrated the ability to cluster regions anatomically and identify similar anatomical and structural concepts across scans. Furthermore, it remained robust across test-retest settings and indicated reasonable salient regions attached to its embeddings. This study demonstrates the value of large-scale medical imaging foundation models and by open-sourcing the model weights, code, and data, aims to support more adaptable, reliable, and interpretable AI solutions in radiology.
Medical image understanding requires meticulous examination of fine visual details, with particular regions requiring additional attention. While radiologists build such expertise over years of experience, it is challenging for AI models to learn where to look with limited amounts of training data. This limitation results in unsatisfying robustness in medical image understanding. To address this issue, we propose Diffusion-based Feature Augmentation (DAug), a portable method that improves a perception model's performance with a generative model's output. Specifically, we extend a radiology image to multiple channels, with the additional channels being the heatmaps of regions where diseases tend to develop. A diffusion-based image-to-image translation model was used to generate such heatmaps conditioned on selected disease classes. Our method is motivated by the fact that generative models learn the distribution of normal and abnormal images, and such knowledge is complementary to image understanding tasks. In addition, we propose the Image-Text-Class Hybrid Contrastive learning to utilize both text and class labels. With two novel approaches combined, our method surpasses baseline models without changing the model architecture, and achieves state-of-the-art performance on both medical image retrieval and classification tasks.
That datasets that are used in todays research are especially vast in the medical field. Different types of medical images such as X-rays, MRI, CT scan etc. take up large amounts of space. This volume of data introduces challenges like accessing and retrieving specific images due to the size of the database. An efficient image retrieval system is essential as the database continues to grow to save time and resources. In this paper, we propose an approach to medical image retrieval using DenseNet for feature extraction and use FAISS for similarity search. DenseNet is well-suited for feature extraction in complex medical images and FAISS enables efficient handling of high-dimensional data in large-scale datasets. Unlike existing methods focused solely on classification accuracy, our method prioritizes both retrieval speed and diagnostic relevance, addressing a critical gap in real-time case comparison for radiologists. We applied the classification of breast cancer images using the BIRADS system. We utilized DenseNet's powerful feature representation and FAISSs efficient indexing capabilities to achieve high precision and recall in retrieving relevant images for diagnosis. We experimented on a dataset of 2006 images from the Categorized Digital Database for Low Energy and Subtracted Contrast Enhanced Spectral Mammography (CDD-CESM) images available on The Cancer Imaging Archive (TCIA). Our method outperforms conventional retrieval techniques, achieving a precision of 80% at k=5 for BIRADS classification. The dataset includes annotated CESM images and medical reports, providing a comprehensive foundation for our research.
In this work, we present MedImageInsight, an open-source medical imaging embedding model. MedImageInsight is trained on medical images with associated text and labels across a diverse collection of domains, including X-Ray, CT, MRI, dermoscopy, OCT, fundus photography, ultrasound, histopathology, and mammography. Rigorous evaluations demonstrate MedImageInsight's ability to achieve state-of-the-art (SOTA) or human expert level performance across classification, image-image search, and fine-tuning tasks. Specifically, on public datasets, MedImageInsight achieves SOTA in CT 3D medical image retrieval, as well as SOTA in disease classification and search for chest X-ray, dermatology, and OCT imaging. Furthermore, MedImageInsight achieves human expert performance in bone age estimation (on both public and partner data), as well as AUC above 0.9 in most other domains. When paired with a text decoder, MedImageInsight achieves near SOTA level single image report findings generation with less than 10\% the parameters of other models. Compared to fine-tuning GPT-4o with only MIMIC-CXR data for the same task, MedImageInsight outperforms in clinical metrics, but underperforms on lexical metrics where GPT-4o sets a new SOTA. Importantly for regulatory purposes, MedImageInsight can generate ROC curves, adjust sensitivity and specificity based on clinical need, and provide evidence-based decision support through image-image search (which can also enable retrieval augmented generation). In an independent clinical evaluation of image-image search in chest X-ray, MedImageInsight outperformed every other publicly available foundation model evaluated by large margins (over 6 points AUC), and significantly outperformed other models in terms of AI fairness (across age and gender). We hope releasing MedImageInsight will help enhance collective progress in medical imaging AI research and development.
Medical image retrieval refers to the task of finding similar images for given query images in a database, with applications such as diagnosis support. While traditional medical image retrieval relied on clinical metadata, content-based medical image retrieval (CBMIR) depends on image features, which can be extracted automatically or semi-automatically. Many approaches have been proposed for CBMIR, and among them, using pre-trained convolutional neural networks (CNNs) is a widely utilized approach. However, considering the recent advances in the development of foundation models for various computer vision tasks, their application for CBMIR can also be investigated. In this study, we used several pre-trained feature extractors from well-known pre-trained CNNs and pre-trained foundation models and investigated the CBMIR performance on eight types of two-dimensional (2D) and three-dimensional (3D) medical images. Furthermore, we investigated the effect of image size on the CBMIR performance. Our results show that, overall, for the 2D datasets, foundation models deliver superior performance by a large margin compared to CNNs, with the general-purpose self-supervised model for computational pathology (UNI) providing the best overall performance across all datasets and image sizes. For 3D datasets, CNNs and foundation models deliver more competitive performance, with contrastive learning from captions for histopathology model (CONCH) achieving the best overall performance. Moreover, our findings confirm that while using larger image sizes (especially for 2D datasets) yields slightly better performance, competitive CBMIR performance can still be achieved even with smaller image sizes. Our codes to reproduce the results are available at: https://github.com/masih4/MedImageRetrieval.
The burgeoning integration of 3D medical imaging into healthcare has led to a substantial increase in the workload of medical professionals. To assist clinicians in their diagnostic processes and alleviate their workload, the development of a robust system for retrieving similar case studies presents a viable solution. While the concept holds great promise, the field of 3D medical text-image retrieval is currently limited by the absence of robust evaluation benchmarks and curated datasets. To remedy this, our study presents a groundbreaking dataset, {BIMCV-R}, which includes an extensive collection of 8,069 3D CT volumes, encompassing over 2 million slices, paired with their respective radiological reports. Expanding upon the foundational work of our dataset, we craft a retrieval strategy, MedFinder. This approach employs a dual-stream network architecture, harnessing the potential of large language models to advance the field of medical image retrieval beyond existing text-image retrieval solutions. It marks our preliminary step towards developing a system capable of facilitating text-to-image, image-to-text, and keyword-based retrieval tasks. Our project is available at \url{https://huggingface.co/datasets/cyd0806/BIMCV-R}.
Content-based image retrieval (CBIR) has the potential to significantly improve diagnostic aid and medical research in radiology. Current CBIR systems face limitations due to their specialization to certain pathologies, limiting their utility. In response, we propose using vision foundation models as powerful and versatile off-the-shelf feature extractors for content-based medical image retrieval. By benchmarking these models on a comprehensive dataset of 1.6 million 2D radiological images spanning four modalities and 161 pathologies, we identify weakly-supervised models as superior, achieving a P@1 of up to 0.594. This performance not only competes with a specialized model but does so without the need for fine-tuning. Our analysis further explores the challenges in retrieving pathological versus anatomical structures, indicating that accurate retrieval of pathological features presents greater difficulty. Despite these challenges, our research underscores the vast potential of foundation models for CBIR in radiology, proposing a shift towards versatile, general-purpose medical image retrieval systems that do not require specific tuning.
The increasing use of medical imaging in healthcare settings presents a significant challenge due to the increasing workload for radiologists, yet it also offers opportunity for enhancing healthcare outcomes if effectively leveraged. 3D image retrieval holds potential to reduce radiologist workloads by enabling clinicians to efficiently search through diagnostically similar or otherwise relevant cases, resulting in faster and more precise diagnoses. However, the field of 3D medical image retrieval is still emerging, lacking established evaluation benchmarks, comprehensive datasets, and thorough studies. This paper attempts to bridge this gap by introducing a novel benchmark for 3D Medical Image Retrieval (3D-MIR) that encompasses four different anatomies imaged with computed tomography. Using this benchmark, we explore a diverse set of search strategies that use aggregated 2D slices, 3D volumes, and multi-modal embeddings from popular multi-modal foundation models as queries. Quantitative and qualitative assessments of each approach are provided alongside an in-depth discussion that offers insight for future research. To promote the advancement of this field, our benchmark, dataset, and code are made publicly available.
A wide range of imaging techniques and data formats available for medical images make accurate retrieval from image databases challenging. Efficient retrieval systems are crucial in advancing medical research, enabling large-scale studies and innovative diagnostic tools. Thus, addressing the challenges of medical image retrieval is essential for the continued enhancement of healthcare and research. In this study, we evaluated the feasibility of employing four state-of-the-art pretrained models for medical image retrieval at modality, body region, and organ levels and compared the results of two similarity indexing approaches. Since the employed networks take 2D images, we analyzed the impacts of weighting and sampling strategies to incorporate 3D information during retrieval of 3D volumes. We showed that medical image retrieval is feasible using pretrained networks without any additional training or fine-tuning steps. Using pretrained embeddings, we achieved a recall of 1 for various tasks at modality, body region, and organ level.
This paper addresses complex challenges in histopathological image analysis through three key contributions. Firstly, it introduces a fast patch selection method, FPS, for whole-slide image (WSI) analysis, significantly reducing computational cost while maintaining accuracy. Secondly, it presents PathDino, a lightweight histopathology feature extractor with a minimal configuration of five Transformer blocks and only 9 million parameters, markedly fewer than alternatives. Thirdly, it introduces a rotation-agnostic representation learning paradigm using self-supervised learning, effectively mitigating overfitting. We also show that our compact model outperforms existing state-of-the-art histopathology-specific vision transformers on 12 diverse datasets, including both internal datasets spanning four sites (breast, liver, skin, and colorectal) and seven public datasets (PANDA, CAMELYON16, BRACS, DigestPath, Kather, PanNuke, and WSSS4LUAD). Notably, even with a training dataset of 6 million histopathology patches from The Cancer Genome Atlas (TCGA), our approach demonstrates an average 8.5% improvement in patch-level majority vote performance. These contributions provide a robust framework for enhancing image analysis in digital pathology, rigorously validated through extensive evaluation. Project Page: https://kimialabmayo.github.io/PathDino-Page/
Digital pathology has revolutionized cancer diagnosis by leveraging Content-Based Medical Image Retrieval (CBMIR) for analyzing histopathological Whole Slide Images (WSIs). CBMIR enables searching for similar content, enhancing diagnostic reliability and accuracy. In 2020, breast and prostate cancer constituted 11.7% and 14.1% of cases, respectively, as reported by the Global Cancer Observatory (GCO). The proposed Unsupervised CBMIR (UCBMIR) replicates the traditional cancer diagnosis workflow, offering a dependable method to support pathologists in WSI-based diagnostic conclusions. This approach alleviates pathologists' workload, potentially enhancing diagnostic efficiency. To address the challenge of the lack of labeled histopathological images in CBMIR, a customized unsupervised Convolutional Auto Encoder (CAE) was developed, extracting 200 features per image for the search engine component. UCBMIR was evaluated using widely-used numerical techniques in CBMIR, alongside visual evaluation and comparison with a classifier. The validation involved three distinct datasets, with an external evaluation demonstrating its effectiveness. UCBMIR outperformed previous studies, achieving a top 5 recall of 99% and 80% on BreaKHis and SICAPv2, respectively, using the first evaluation technique. Precision rates of 91% and 70% were achieved for BreaKHis and SICAPv2, respectively, using the second evaluation technique. Furthermore, UCBMIR demonstrated the capability to identify various patterns in patches, achieving an 81% accuracy in the top 5 when tested on an external image from Arvaniti.
We introduce a novel Region-based contrastive pretraining for Medical Image Retrieval (RegionMIR) that demonstrates the feasibility of medical image retrieval with similar anatomical regions. RegionMIR addresses two major challenges for medical image retrieval i) standardization of clinically relevant searching criteria (e.g., anatomical, pathology-based), and ii) localization of anatomical area of interests that are semantically meaningful. In this work, we propose an ROI image retrieval image network that retrieves images with similar anatomy by extracting anatomical features (via bounding boxes) and evaluate similarity between pairwise anatomy-categorized features between the query and the database of images using contrastive learning. ROI queries are encoded using a contrastive-pretrained encoder that was fine-tuned for anatomy classification, which generates an anatomical-specific latent space for region-correlated image retrieval. During retrieval, we compare the anatomically encoded query to find similar features within a feature database generated from training samples, and retrieve images with similar regions from training samples. We evaluate our approach on both anatomy classification and image retrieval tasks using the Chest ImaGenome Dataset. Our proposed strategy yields an improvement over state-of-the-art pretraining and co-training strategies, from 92.24 to 94.12 (2.03%) classification accuracy in anatomies. We qualitatively evaluate the image retrieval performance demonstrating generalizability across multiple anatomies with different morphology.
The paper proposes a Federated Content-Based Medical Image Retrieval (FedCBMIR) platform that utilizes Federated Learning (FL) to address the challenges of acquiring a diverse medical data set for training CBMIR models. CBMIR assists pathologists in diagnosing breast cancer more rapidly by identifying similar medical images and relevant patches in prior cases compared to traditional cancer detection methods. However, CBMIR in histopathology necessitates a pool of Whole Slide Images (WSIs) to train to extract an optimal embedding vector that leverages search engine performance, which may not be available in all centers. The strict regulations surrounding data sharing in medical data sets also hinder research and model development, making it difficult to collect a rich data set. The proposed FedCBMIR distributes the model to collaborative centers for training without sharing the data set, resulting in shorter training times than local training. FedCBMIR was evaluated in two experiments with three scenarios on BreaKHis and Camelyon17 (CAM17). The study shows that the FedCBMIR method increases the F1-Score (F1S) of each client to 98%, 96%, 94%, and 97% in the BreaKHis experiment with a generalized model of four magnifications and does so in 6.30 hours less time than total local training. FedCBMIR also achieves 98% accuracy with CAM17 in 2.49 hours less training time than local training, demonstrating that our FedCBMIR is both fast and accurate for both pathologists and engineers. In addition, our FedCBMIR provides similar images with higher magnification for non-developed countries where participate in the worldwide FedCBMIR with developed countries to facilitate mitosis measuring in breast cancer diagnosis. We evaluate this scenario by scattering BreaKHis into four centers with different magnifications.
The amount of medical images stored in hospitals is increasing faster than ever; however, utilizing the accumulated medical images has been limited. This is because existing content-based medical image retrieval (CBMIR) systems usually require example images to construct query vectors; nevertheless, example images cannot always be prepared. Besides, there can be images with rare characteristics that make it difficult to find similar example images, which we call isolated samples. Here, we introduce a novel sketch-based medical image retrieval (SBMIR) system that enables users to find images of interest without example images. The key idea lies in feature decomposition of medical images, whereby the entire feature of a medical image can be decomposed into and reconstructed from normal and abnormal features. By extending this idea, our SBMIR system provides an easy-to-use two-step graphical user interface: users first select a template image to specify a normal feature and then draw a semantic sketch of the disease on the template image to represent an abnormal feature. Subsequently, it integrates the two kinds of input to construct a query vector and retrieves reference images with the closest reference vectors. Using two datasets, ten healthcare professionals with various clinical backgrounds participated in the user test for evaluation. As a result, our SBMIR system enabled users to overcome previous challenges, including image retrieval based on fine-grained image characteristics, image retrieval without example images, and image retrieval for isolated samples. Our SBMIR system achieves flexible medical image retrieval on demand, thereby expanding the utility of medical image databases.
Broadspread use of medical imaging devices with digital storage has paved the way for curation of substantial data repositories. Fast access to image samples with similar appearance to suspected cases can help establish a consulting system for healthcare professionals, and improve diagnostic procedures while minimizing processing delays. However, manual querying of large data repositories is labor intensive. Content-based image retrieval (CBIR) offers an automated solution based on dense embedding vectors that represent image features to allow quantitative similarity assessments. Triplet learning has emerged as a powerful approach to recover embeddings in CBIR, albeit traditional loss functions ignore the dynamic relationship between opponent image classes. Here, we introduce a triplet-learning method for automated querying of medical image repositories based on a novel Opponent Class Adaptive Margin (OCAM) loss. OCAM uses a variable margin value that is updated continually during the course of training to maintain optimally discriminative representations. CBIR performance of OCAM is compared against state-of-the-art loss functions for representational learning on three public databases (gastrointestinal disease, skin lesion, lung disease). Comprehensive experiments in each application domain demonstrate the superior performance of OCAM against baselines.
Content-based medical image retrieval is an important diagnostic tool that improves the explainability of computer-aided diagnosis systems and provides decision making support to healthcare professionals. Medical imaging data, such as radiology images, are often multimorbidity; a single sample may have more than one pathology present. As such, image retrieval systems for the medical domain must be designed for the multi-label scenario. In this paper, we propose a novel multi-label metric learning method that can be used for both classification and content-based image retrieval. In this way, our model is able to support diagnosis by predicting the presence of diseases and provide evidence for these predictions by returning samples with similar pathological content to the user. In practice, the retrieved images may also be accompanied by pathology reports, further assisting in the diagnostic process. Our method leverages proxy feature vectors, enabling the efficient learning of a robust feature space in which the distance between feature vectors can be used as a measure of the similarity of those samples. Unlike existing proxy-based methods, training samples are able to assign to multiple proxies that span multiple class labels. This multi-label proxy assignment results in a feature space that encodes the complex relationships between diseases present in medical imaging data. Our method outperforms state-of-the-art image retrieval systems and a set of baseline approaches. We demonstrate the efficacy of our approach to both classification and content-based image retrieval on two multimorbidity radiology datasets.