Diagnostic Captioning (DC) automatically generates a diagnostic text from one or more medical images (e.g., X-rays, MRIs) of a patient. Treated as a draft, the generated text may assist clinicians, by providing an initial estimation of the patient's condition, speeding up and helping safeguard the diagnostic process. The accuracy of a diagnostic text, however, strongly depends on how well the key medical conditions depicted in the images are expressed. We propose a new data-driven guided decoding method that incorporates medical information, in the form of existing tags capturing key conditions of the image(s), into the beam search of the diagnostic text generation process. We evaluate the proposed method on two medical datasets using four DC systems that range from generic image-to-text systems with CNN encoders and RNN decoders to pre-trained Large Language Models. The latter can also be used in few- and zero-shot learning scenarios. In most cases, the proposed mechanism improves performance with respect to all evaluation measures. We provide an open-source implementation of the proposed method at https://github.com/nlpaueb/dmmcs.

Medical report generation demands automatic creation of coherent and precise descriptions for medical images. However, the scarcity of labelled medical image-report pairs poses formidable challenges in developing large-scale neural networks capable of harnessing the potential of artificial intelligence, exemplified by large language models. This study builds upon the state-of-the-art vision-language pre-training and fine-tuning approach, BLIP-2, to customize general large-scale foundation models. Integrating adapter tuning and a medical knowledge enhancement loss, our model significantly improves accuracy and coherence. Validation on the dataset of ImageCLEFmedical 2023 demonstrates our model's prowess, achieving the best-averaged results against several state-of-the-art methods. Significant improvements in ROUGE and CIDEr underscore our method's efficacy, highlighting promising outcomes for the rapid medical-domain adaptation of the vision-language foundation models in addressing challenges posed by data scarcity.