Renal transplantation emerges as the most effective solution for end-stage renal disease. Occurring from complex causes, a substantial risk of transplant chronic dysfunction persists and may lead to graft loss. Medical imaging plays a substantial role in renal transplant monitoring in clinical practice. However, graft supervision is multi-disciplinary, notably joining nephrology, urology, and radiology, while identifying robust biomarkers from such high-dimensional and complex data for prognosis is challenging. In this work, taking inspiration from the recent success of Large Language Models (LLMs), we propose MEDIMP -- Medical Images and Prompts -- a model to learn meaningful multi-modal representations of renal transplant Dynamic Contrast-Enhanced Magnetic Resonance Imaging (DCE MRI) by incorporating structural clinicobiological data after translating them into text prompts. MEDIMP is based on contrastive learning from joint text-image paired embeddings to perform this challenging task. Moreover, we propose a framework that generates medical prompts using automatic textual data augmentations from LLMs. Our goal is to learn meaningful manifolds of renal transplant DCE MRI, interesting for the prognosis of the transplant or patient status (2, 3, and 4 years after the transplant), fully exploiting the available multi-modal data in the most efficient way. Extensive experiments and comparisons with other renal transplant representation learning methods with limited data prove the effectiveness of MEDIMP in a relevant clinical setting, giving new directions toward medical prompts. Our code is available at https://github.com/leomlck/MEDIMP.
翻译:肾移植是终末期肾脏疾病的最有效解决方案之一。然而,由于复杂原因,肾移植慢性功能障碍的重大风险仍然存在,可能导致移植物丧失功能。在临床实践中,医学影像在肾移植监测中扮演着重要角色。然而,移植监测是一项多学科任务,尤其是结合肾病学、泌尿学和放射学,而从这种高维复杂数据中识别强有力的生物标记以进行预后分析具有挑战性。在这项工作中,我们受到大型语音模型(LLM)的最近成功的启发并提出MEDIMP--医学图像和提示。该模型利用结构临床生物数据,将其转化为文本提示,通过联合文本-图像嵌入的对比学习方法,学习肾移植动态对比增强核磁共振成像(DCE MRI)的有意义的多模态表示。此外,我们提出一种框架,利用LLM进行自动文本数据增强来生成医学提示。我们的目标是以最高效的方式充分利用可用的多模态数据,学习与肾移植DCE MRI相关的有意义的流形,以预测移植物或患者状态(移植后2、3和4年),并在相关的临床背景中与其他肾移植表征学习方法进行了广泛实验和比较,证明了MEDIMP的有效性,并开拓了医学提示的新方向。我们的代码在https://github.com/leomlck/MEDIMP上公开。