Scholarlink

<p>Chest radiographs (CXRs) are among the most common tests in medicine; automated interpretation may reduce radiologists’ workload and expand access. Deep learning multi-task and foundation models have shown strong CXR interpretation performance but are vulnerable to shortcut learning, where spurious correlations drive decision-making. We introduce RoentMod, a counterfactual image editing framework that generates realistic CXRs with user-specified and synthetic pathology while maintaining the original anatomical features. RoentMod combines an open-source medical image generator (RoentGen) with an image-to-image modification model without retraining. In reader studies of RoentMod-produced images, 93% appeared realistic, 89–99% correctly incorporated the specified finding, and all preserved native anatomy comparable to real follow-up CXRs. Using RoentMod, we demonstrate that state-of-the-art multi-task and foundation models frequently exploit off-target pathology as shortcuts, limiting their specificity. Incorporating RoentMod-generated counterfactual images during training mitigated this vulnerability, improving model discrimination across multiple pathologies by 3–19% AUC in internal validation and by 1–11% for 5 out of 6 tested pathologies in external testing. These findings establish RoentMod as a tool to probe and correct shortcut learning in medical AI. By enabling controlled counterfactual interventions, RoentMod enhances the robustness and interpretability of CXR interpretation models and provides a strategy to improve medical imaging models.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

RoentMod: a synthetic chest X-ray modification model to identify and correct image interpretation model shortcuts

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年3月6日

查看全文
  • Lauren H. Cooke,
  • Matthias Jung,
  • Jan M. Brendel,
  • Nora M. Kerkovits,
  • Borek Foldyna,
  • Michael T. Lu,
  • Vineet K. Raghu

摘要

Chest radiographs (CXRs) are among the most common tests in medicine; automated interpretation may reduce radiologists’ workload and expand access. Deep learning multi-task and foundation models have shown strong CXR interpretation performance but are vulnerable to shortcut learning, where spurious correlations drive decision-making. We introduce RoentMod, a counterfactual image editing framework that generates realistic CXRs with user-specified and synthetic pathology while maintaining the original anatomical features. RoentMod combines an open-source medical image generator (RoentGen) with an image-to-image modification model without retraining. In reader studies of RoentMod-produced images, 93% appeared realistic, 89–99% correctly incorporated the specified finding, and all preserved native anatomy comparable to real follow-up CXRs. Using RoentMod, we demonstrate that state-of-the-art multi-task and foundation models frequently exploit off-target pathology as shortcuts, limiting their specificity. Incorporating RoentMod-generated counterfactual images during training mitigated this vulnerability, improving model discrimination across multiple pathologies by 3–19% AUC in internal validation and by 1–11% for 5 out of 6 tested pathologies in external testing. These findings establish RoentMod as a tool to probe and correct shortcut learning in medical AI. By enabling controlled counterfactual interventions, RoentMod enhances the robustness and interpretability of CXR interpretation models and provides a strategy to improve medical imaging models.