提升心电图与超声心动图文本对齐,尤其改善罕见病检测效果。
EchoBridge: Long-Tail-Aware ECG-Echocardiography Text Alignment for Echocardiography-Derived Cardiac Findings

- 设计共享-私有投影和自适应原型边界,分离模态特征并增强对齐
- 在多个数据集上显著提升罕见病检测的AUC、PRC和F1指标
- 适合关注医疗多模态对齐与低频疾病诊断的研究者
标准化的超声心动图结论为学习心电图中与超声相关的心脏异常表征提供了有效监督。全局心电图-文本对齐可能混杂模态特异性因素,而心脏异常的长尾分布导致低频病症的正样本稀疏。本文提出EchoBridge,包含互补共享-私有投影(CSPP)与自适应原型边界校准(APBC)。CSPP将各模态映射至共享与辅助私有投影,通过模态内正交性减少方向冗余,并双向对齐归一化共享投影;APBC在共享超球面上组织类特定原型,引入基于训练频率的自适应角度边界与球面Riesz排斥力。我们在EchoNext-Mini及独立的PKUPH和SHTMU队列上,采用四种协议评估:无下游分类器训练的提示推理、域内冻结线性探测、目标域跨中心冻结线性探测、源域仅跨中心迁移,并辅以发现级分析。结果显示,相比最强基线,EchoBridge在无需分类器的AUROC、AUPRC和F1上分别提升7.88、5.61和4.54点,且在所有域内与目标域探测预算及两组源域仅迁移场景中均取得最高点估计。发现级分析表明,多数病症(包括多个低频瓣膜病变)均有增益。
原文摘要 · Abstract (English)
Standardized echocardiography conclusions provide meaningful supervision for learning ECG representations of echocardiography-derived cardiac findings. Global ECG--text alignment may entangle modality-specific factors, while long-tailed finding distributions provide sparse positive supervision for low-prevalence conditions. We propose EchoBridge with Complementary Shared--Private Projection (CSPP) and Adaptive Prototype Boundary Calibration (APBC). CSPP maps each modality into shared and auxiliary private projections, reduces directional redundancy via within-modality orthogonality, and bidirectionally aligns normalized shared projections. APBC organizes the shared hypersphere with class-specific prototypes, training-frequency-adaptive angular margins, and spherical Riesz repulsion. We evaluate EchoBridge on EchoNext-Mini and independent PKUPH and SHTMU cohorts under four protocols: prompt-based inference without downstream classifier training, in-domain frozen linear probing, target-domain cross-center frozen linear probing, and source-only cross-center transfer, supplemented by finding-specific analyses. EchoBridge improves classifier-free AUROC, AUPRC, and F1 over the strongest baselines by 7.88, 5.61, and 4.54 points, respectively, and achieves the highest point estimates across all in-domain and target-domain probing budgets and both source-only transfer cohorts. Finding-specific analyses show gains for most conditions, including several low-prevalence valvular findings.
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