Medical Vision-Language Pretraining (MedVLP) shows promise in learning generalizable and transferable visual representations from paired and unpaired medical images and reports. MedVLP can provide useful features to downstream tasks and facilitate adapting task-specific models to new setups using fewer examples. However, existing MedVLP methods often differ in terms of datasets, preprocessing, and finetuning implementations. This pose great challenges in evaluating how well a MedVLP method generalizes to various clinically-relevant tasks due to the lack of unified, standardized, and comprehensive benchmark. To fill this gap, we propose BenchX, a unified benchmark framework that enables head-to-head comparison and systematical analysis between MedVLP methods using public chest X-ray datasets. Specifically, BenchX is composed of three components: 1) Comprehensive datasets covering nine datasets and four medical tasks; 2) Benchmark suites to standardize data preprocessing, train-test splits, and parameter selection; 3) Unified finetuning protocols that accommodate heterogeneous MedVLP methods for consistent task adaptation in classification, segmentation, and report generation, respectively. Utilizing BenchX, we establish baselines for nine state-of-the-art MedVLP methods and found that the performance of some early MedVLP methods can be enhanced to surpass more recent ones, prompting a revisiting of the developments and conclusions from prior works in MedVLP.

In medical healthcare, obtaining detailed annotations is challenging, highlighting the need for robust Vision-Language Models (VLMs). Pretrained VLMs enable fine-tuning on small datasets or zero-shot inference, achieving performance comparable to task-specific models. Contrastive learning (CL) is a key paradigm for training VLMs but inherently requires large batch sizes for effective learning, making it computationally demanding and often limited to well-resourced institutions. Moreover, with limited data in healthcare, it is important to prioritize knowledge extraction from both data and models during training to improve performance. Therefore, we focus on leveraging the momentum method combined with distillation to simultaneously address computational efficiency and knowledge exploitation. Our contributions can be summarized as follows: (1) leveraging momentum self-distillation to enhance multimodal learning, and (2) integrating momentum mechanisms with gradient accumulation to enlarge the effective batch size without increasing resource consumption. Our method attains competitive performance with state-of-the-art (SOTA) approaches in zero-shot classification, while providing a substantial boost in the few-shot adaption, achieving over 90% AUC-ROC and improving retrieval tasks by 2-3%. Importantly, our method achieves high training efficiency with a single GPU while maintaining reasonable training time. Our approach aims to advance efficient multimodal learning by reducing resource requirements while improving performance over SOTA methods. The implementation of our method is available at https://github.com/phphuc612/MSD .

Medical Vision-Language Pretraining (MedVLP) shows promise in learning generalizable and transferable visual representations from paired and unpaired medical images and reports. MedVLP can provide useful features to downstream tasks and facilitate adapting task-specific models to new setups using fewer examples. However, existing MedVLP methods often differ in terms of datasets, preprocessing, and finetuning implementations. This pose great challenges in evaluating how well a MedVLP method generalizes to various clinically-relevant tasks due to the lack of unified, standardized, and comprehensive benchmark. To fill this gap, we propose BenchX, a unified benchmark framework that enables head-to-head comparison and systematical analysis between MedVLP methods using public chest X-ray datasets. Specifically, BenchX is composed of three components: 1) Comprehensive datasets covering nine datasets and four medical tasks; 2) Benchmark suites to standardize data preprocessing, train-test splits, and parameter selection; 3) Unified finetuning protocols that accommodate heterogeneous MedVLP methods for consistent task adaptation in classification, segmentation, and report generation, respectively.