M. Kimhi
Publications
CXR-Retrieve: Compositional Text-to-Image Retrieval in Chest Radiography
Large chest radiography archives are difficult to search because most studies are paired only with free-text reports rather than structured clinical annotations. Vision-language models offer a natural interface for text-to-image retrieval, but current biomedical models are primarily optimized for report-to-image matching rather than for satisfying short clinical search queries. This creates an objective mismatch: a model may retrieve images related to words in the query while failing to satisfy the full clinical constraint, especially for conjunctions and negations such as ``atelectasis and no pneumonia.'' We introduce CXR-Retrieve, a structured benchmark for compositional chest X-ray text-to-image retrieval. The benchmark contains 5,159 test images from the official test-split of MIMIC-CXR-JPG and 145 textual queries spanning single and conjunction findings, both positive and negative. Relevance is defined by whether a retrieved image satisfies all asserted pathology constraints, rather than by whether it matches a paired report. We further propose a label-aware contrastive fine-tuning objective for clinical retrieval. Our method attracts image-text pairs with compatible asserted pathology constraints, including shared confirmed absences, while explicitly repelling contradictory pairs. Starting from the in-domain CXR-CLIP checkpoint, our method improves Precision@5 over CXR-CLIP by 8.5 percentage points on two-pathology conjunctions and by 22.0 percentage points on negation queries. These results show that reliable chest X-ray retrieval requires training objectives that model not only which findings are mentioned, but also how they are clinically asserted.
Look Where It Matters: High-Resolution Crops Retrieval for Efficient VLMs
Vision-language models (VLMs) typically process images at a native high-resolution, forcing a trade-off between accuracy and computational efficiency: high-resolution inputs capture fine details but incur significant computational costs, while low-resolution inputs advocate for efficiency, they potentially miss critical visual information, like small text. We present AwaRes, a spatial-on-demand framework that resolves this accuracy-efficiency trade-off by operating on a low-resolution global view and using tool-calling to retrieve only high-resolution segments needed for a given query. We construct supervised data automatically: a judge compares low- vs.\ high-resolution answers to label whether cropping is needed, and an oracle grounding model localizes the evidence for the correct answer, which we map to a discrete crop set to form multi-turn tool-use trajectories. We train our framework with cold-start SFT followed by multi-turn GRPO with a composite reward that combines semantic answer correctness with explicit crop-cost penalties. Project page: https://nimrodshabtay.github.io/AwaRes