Self-supervised Multi-modal Training from Uncurated Image and Reports Enables Zero-shot Oversight Artificial Intelligence in Radiology

Oversight AI is an emerging concept in radiology where the AI forms a symbiosis with radiologists by continuously supporting radiologists in their decision-making. Recent advances in vision-language models sheds a light on the long-standing problems of the oversight AI by the understanding both visual and textual concepts and their semantic correspondences. However, there have been limited successes in the application of vision-language models in the medical domain, as the current vision-language models and learning strategies for photographic images and captions call for the web-scale data corpus of image and text pairs which was not often feasible in the medical domain. To address this, here we present a model dubbed Medical Cross-attention Vision-Language model (Medical X-VL), leveraging the key components to be tailored for the medical domain. Our medical X-VL model is based on the following components: self-supervised uni-modal models in medical domain and fusion encoder to bridge them, momentum distillation, sentence-wise contrastive learning for medical reports, and the sentence similarity-adjusted hard negative mining. We experimentally demonstrated that our model enables various zero-shot tasks for oversight AI, ranging from the zero-shot classification to zero-shot error correction. Our model outperformed the current state-of-the-art models in two different medical image database, suggesting the novel clinical usage of our oversight AI model for monitoring human errors. Our method was especially successful in the data-limited setting, which is frequently encountered in the clinics, suggesting the potential widespread applicability in medical domain.