Cross-modal Clinical Graph Transformer for Ophthalmic Report Generation

Automatic generation of ophthalmic reports using datadriven neural networks has great potential in clinical practice. When writing a report, ophthalmologists make inferences with prior clinical knowledge. This knowledge has been neglected in prior medical report generation methods. To endow models with the capability of incorporating expert knowledge, we propose a Cross-modal clinical Graph Transformer (CGT) for ophthalmic report generation (ORG), in which clinical relation triples are injected into the visual features as prior knowledge to drive the decoding procedure. However, two major common Knowledge Noise (KN) issues may affect models' effectiveness. 1) Existing general biomedical knowledge bases such as the UMLS may not align meaningfully to the specific context and language of the report, limiting their utility for knowledge injection. 2) Incorporating too much knowledge may divert the visual features from their correct meaning. To overcome these limitations, we design an automatic information extraction scheme based on natural language processing to obtain clinical entities and relations directly from in-domain training reports. Given a set of ophthalmic images, our CGT first restores a sub-graph from the clinical graph and injects the restored triples into visual features. Then visible matrix is employed during the encoding procedure to limit the impact of knowledge. Finally, reports are predicted by the encoded cross-modal features via a Transformer decoder. Extensive experiments on the large-scale FFA-IR benchmark demonstrate that the proposed CGT is able to outperform previous benchmark methods and achieve state-of-the-art performances.