K. Kenthapadi
Famous AuthorPublications
CheXmix: Unified Generative Pretraining for Vision Language Models in Medical Imaging
Recent medical multimodal foundation models are built as multimodal LLMs (MLLMs) by connecting a CLIP-pretrained vision encoder to an LLM using LLaVA-style finetuning. This two-stage, decoupled approach introduces a projection layer that can distort visual features. This is especially concerning in medical imaging where subtle cues are essential for accurate diagnoses. In contrast, early-fusion generative approaches such as Chameleon eliminate the projection bottleneck by processing image and text tokens within a single unified sequence, enabling joint representation learning that leverages the inductive priors of language models. We present CheXmix, a unified early-fusion generative model trained on a large corpus of chest X-rays paired with radiology reports. We expand on Chameleon's autoregressive framework by introducing a two-stage multimodal generative pretraining strategy that combines the representational strengths of masked autoencoders with MLLMs. The resulting models are highly flexible, supporting both discriminative and generative tasks at both coarse and fine-grained scales. Our approach outperforms well-established generative models across all masking ratios by 6.0% and surpasses CheXagent by 8.6% on AUROC at high image masking ratios on the CheXpert classification task. We further inpaint images over 51.0% better than text-only generative models and outperform CheXagent by 45% on the GREEN metric for radiology report generation. These results demonstrate that CheXmix captures fine-grained information across a broad spectrum of chest X-ray tasks. Our code is at: https://github.com/StanfordMIMI/CheXmix.
Cite-While-You-Generate: Training-Free Evidence Attribution for Multimodal Clinical Summarization
Trustworthy clinical summarization requires not only fluent generation but also transparency about where each statement comes from. We propose a training-free framework for generation-time source attribution that leverages decoder attentions to directly cite supporting text spans or images, overcoming the limitations of post-hoc or retraining-based methods. We introduce two strategies for multimodal attribution: a raw image mode, which directly uses image patch attentions, and a caption-as-span mode, which substitutes images with generated captions to enable purely text-based alignment. Evaluations on two representative domains: clinician-patient dialogues (CliConSummation) and radiology reports (MIMIC-CXR), show that our approach consistently outperforms embedding-based and self-attribution baselines, improving both text-level and multimodal attribution accuracy (e.g., +15% F1 over embedding baselines). Caption-based attribution achieves competitive performance with raw-image attention while being more lightweight and practical. These findings highlight attention-guided attribution as a promising step toward interpretable and deployable clinical summarization systems.