利用患者元数据提升视网膜图像分析,无需临床报告即可实现精准诊断。
PRETI: Patient-Aware Retinal Foundation Model via Metadata-Guided Representation Learning
- 通过可学习的元数据嵌入动态优化年龄性别等信息表示
- 在多种疾病和生物标志物预测上达到当前最优性能
- 适合关注医学影像与患者信息融合的科研与临床团队
视网膜基础模型通过自监督学习显著降低了对标注数据的依赖,并实现了良好的泛化能力。现有方法多依赖临床报告提升理解,但报告获取成本高、难度大。相比之下,年龄、性别等元数据广泛可用,有助于分析疾病进展。为此,我们提出PRETI,一种结合元数据感知学习与鲁棒自监督表示学习的视网膜基础模型。引入可学习元数据嵌入(LME),动态优化元数据表示;构建患者级数据对,关联同一患者的图像以增强对非临床差异的鲁棒性。为进一步优化视网膜图像表示,提出视网膜感知自适应掩码(RAAM),在视网膜区域选择性掩码并动态调整掩码比例。PRETI同时捕捉全局结构与细粒度病灶特征,在自建与公开数据集上均取得领先性能,验证了元数据引导基础模型在视网膜疾病分析中的重要性。代码与预训练模型已开源。
原文摘要 · Abstract (English)
Retinal foundation models have significantly advanced retinal image analysis by leveraging self-supervised learning to reduce dependence on labeled data while achieving strong generalization. Many recent approaches enhance retinal image understanding using report supervision, but obtaining clinical reports is often costly and challenging. In contrast, metadata (e.g., age, gender) is widely available and serves as a valuable resource for analyzing disease progression. To effectively incorporate patient-specific information, we propose PRETI, a retinal foundation model that integrates metadata-aware learning with robust self-supervised representation learning. We introduce Learnable Metadata Embedding (LME), which dynamically refines metadata representations. Additionally, we construct patient-level data pairs, associating images from the same individual to improve robustness against non-clinical variations. To further optimize retinal image representation, we propose Retina-Aware Adaptive Masking (RAAM), a strategy that selectively applies masking within the retinal region and dynamically adjusts the masking ratio during training. PRETI captures both global structures and fine-grained pathological details, resulting in superior diagnostic performance. Extensive experiments demonstrate that PRETI achieves state-of-the-art results across diverse diseases and biomarker predictions using in-house and public data, indicating the importance of metadata-guided foundation models in retinal disease analysis. Our code and pretrained model are available at https://github.com/MICV-yonsei/PRETI
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