用报告指导训练,让AI诊断更懂临床概念。
TRACE: Training-time Report-guided and Clinically Ordered Concept Editing

- 训练时用报告引导概念修正,测试时仅需图像
- 在多个数据集上准确率超越现有方法,跨域鲁棒性强
- 适合医疗影像领域需要可解释性的研究与应用
乳腺超声诊断依赖于临床有意义的语义概念,但多数深度学习方法采用端到端图像到标签范式,缺乏可解释性与鲁棒性。尽管基于概念的方法前景可观,却常假设完全标注或推理时需多模态输入,严重限制实际应用。为此,我们提出训练时报告引导且临床有序的概念编辑框架TRACE,利用结构化放射科报告作为特权概念监督,同时支持测试时仅用图像进行诊断。TRACE通过教师引导的编辑机制,在恶性肿瘤感知的有序概念空间中优化图像生成的概念。针对标注不全问题,引入策略性概念缺失训练(SCMT),并训练一个仅用图像的自编辑器通过编辑蒸馏实现自主概念修正。此外,我们构建了包含图像、标签和结构化属性的增强型基准数据集BUSC。在多个数据集上的实验表明,相比现有方法,TRACE实现了更优性能与更强跨域鲁棒性。
原文摘要 · Abstract (English)
Breast ultrasound diagnosis relies on clinically meaningful semantic concepts, yet most deep learning methods adopt end-to-end image-to-label paradigms that lack interpretability and robustness. While concept-based approaches offer a promising alternative, they often assume complete annotations or require multimodal inputs at inference, which significantly limits their real-world applicability. To tackle these issues, we propose Training-time Report-guided and Clinically Ordered Concept Editing (TRACE), a training-time report-guided framework that leverages structured radiology reports as privileged concept supervision while enabling image-only diagnosis at test time. TRACE refines image-derived concepts through a teacher-guided editing mechanism within a malignancy-aware ordered concept space. To address incomplete annotations, we introduce Strategic Concept Missing Training (SCMT) and train an image-only self-editor via edit distillation for autonomous concept refinement. Besides, we introduce BUSC, a concept-enriched benchmark linking images, labels, and structured attributes. Experiments across multiple datasets demonstrate that TRACE achieves superior performance and improved cross-domain robustness compared to existing methods.
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