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Metal artefact reduction sequences for a piezoelectric bone conduction implant using a realistic head phantom in MRI

Industry standards require medical device manufacturers to perform implant-induced artefact testing in phantoms at a pre-clinical stage to define the extent of artefacts that can be expected during MRI. Once a device is commercially available, studies on volunteers, cadavers or patients are performed to investigate implant-induced artefacts and artefact reduction methods more in-depth. This study describes the design and evaluation of a realistic head phantom for pre-clinical implant-induced artefact testing in a relevant environment. A case study is performed where a state-of-the-art piezoelectric bone conduction implant is used in the 1.5 T and 3 T MRI environments. Images were acquired using clinical and novel metal artefact reducing (MARS) sequences at both field strengths. Artefact width and length were measured in a healthy volunteer and compared with artefact sizes obtained in the phantom. Artefact sizes are reported that are similar in shape between the phantom and a volunteer, yet with dimensions differing up to 20% between both. When the implant magnet is removed, the artefact size can be reduced below a diameter of 5 cm, whilst the presence of an implant magnet and splint creates higher artefacts up to 20 cm in diameter. Pulse sequences have been altered to reduce the scan time up to 7 minutes, while preserving the image quality. These results show that the anthropomorphic phantom can be used at a preclinical stage to provide clinically relevant images, illustrating the impact of the artefact on important brain structures.

Reshaping Free-Text Radiology Notes Into Structured Reports With Generative Transformers

BACKGROUND: Radiology reports are typically written in a free-text format, making clinical information difficult to extract and use. Recently the adoption of structured reporting (SR) has been recommended by various medical societies thanks to the advantages it offers, e.g. standardization, completeness and information retrieval. We propose a pipeline to extract information from free-text radiology reports, that fits with the items of the reference SR registry proposed by a national society of interventional and medical radiology, focusing on CT staging of patients with lymphoma. METHODS: Our work aims to leverage the potential of Natural Language Processing (NLP) and Transformer-based models to deal with automatic SR registry filling. With the availability of 174 radiology reports, we investigate a rule-free generative Question Answering approach based on a domain-specific version of T5 (IT5). Two strategies (batch-truncation and ex-post combination) are implemented to comply with the model's context length limitations. Performance is evaluated in terms of strict accuracy, F1, and format accuracy, and compared with the widely used GPT-3.5 Large Language Model. A 5-point Likert scale questionnaire is used to collect human-expert feedback on the similarity between medical annotations and generated answers. RESULTS: The combination of fine-tuning and batch splitting allows IT5 to achieve notable results; it performs on par with GPT-3.5 albeit its size being a thousand times smaller in terms of parameters. Human-based assessment scores show a high correlation (Spearman's correlation coefficients>0.88, p-values<0.001) with AI performance metrics (F1) and confirm the superior ability of LLMs (i.e., GPT-3.5, 175B of parameters) in generating plausible human-like statements.

ChiMed-GPT: A Chinese Medical Large Language Model with Full Training Regime and Better Alignment to Human Preferences

Recently, the increasing demand for superior medical services has highlighted the discrepancies in the medical infrastructure. With big data, especially texts, forming the foundation of medical services, there is an exigent need for effective natural language processing (NLP) solutions tailored to the healthcare domain. Conventional approaches leveraging pre-trained models present promising results in this domain and current large language models (LLMs) offer advanced foundation for medical text processing. However, most medical LLMs are trained only with supervised fine-tuning (SFT), even though it efficiently empowers LLMs to understand and respond to medical instructions but is ineffective in learning domain knowledge and aligning with human preference. Another engineering barrier that prevents current medical LLM from better text processing ability is their restricted context length (e.g., 2,048 tokens), making it hard for the LLMs to process long context, which is frequently required in the medical domain. In this work, we propose ChiMed-GPT, a new benchmark LLM designed explicitly for Chinese medical domain, with enlarged context length to 4,096 tokens and undergoes a comprehensive training regime with pre-training, SFT, and RLHF. Evaluations on real-world tasks including information extraction, question answering, and dialogue generation demonstrate ChiMed-GPT's superior performance over general domain LLMs. Furthermore, we analyze possible biases through prompting ChiMed-GPT to perform attitude scales regarding discrimination of patients, so as to contribute to further responsible development of LLMs in the medical domain. The code and model are released at https://github.com/synlp/ChiMed-GPT.

Ruler: A Model-Agnostic Method to Control Generated Length for Large Language Models

The instruction-following ability of large language models enables humans to interact with AI agents in a natural way. However, when required to generate responses of a specific length, large language models often struggle to meet users' needs due to their inherent difficulty in accurately perceiving numerical constraints. To explore the ability of large language models to control the length of generated responses, we propose the Target Length Generation Task (TLG) and design two metrics, Precise Match (PM) and Flexible Match (FM) to evaluate the model's performance in adhering to specified response lengths. Furthermore, we introduce a novel, model-agnostic approach called Ruler, which employs Meta Length Tokens (MLTs) to enhance the instruction-following ability of large language models under length-constrained instructions. Specifically, Ruler equips LLMs with the ability to generate responses of a specified length based on length constraints within the instructions. Moreover, Ruler can automatically generate appropriate MLT when length constraints are not explicitly provided, demonstrating excellent versatility and generalization. Comprehensive experiments show the effectiveness of Ruler across different LLMs on Target Length Generation Task, e.g., at All Level 27.97 average gain on PM, 29.57 average gain on FM. In addition, we conduct extensive ablation experiments to further substantiate the efficacy and generalization of Ruler. Our code and data is available at https://github.com/Geaming2002/Ruler.

Length-Controlled AlpacaEval: A Simple Way to Debias Automatic Evaluators

LLM-based auto-annotators have become a key component of the LLM development process due to their cost-effectiveness and scalability compared to human-based evaluation. However, these auto-annotators can introduce complex biases that are hard to remove. Even simple, known confounders such as preference for longer outputs remain in existing automated evaluation metrics. We propose a simple regression analysis approach for controlling biases in auto-evaluations. As a real case study, we focus on reducing the length bias of AlpacaEval, a fast and affordable benchmark for chat LLMs that uses LLMs to estimate response quality. Despite being highly correlated with human preferences, AlpacaEval is known to favor models that generate longer outputs. We introduce a length-controlled AlpacaEval that aims to answer the counterfactual question: "What would the preference be if the model's and baseline's output had the same length?". To achieve this, we first fit a generalized linear model to predict the biased output of interest (auto-annotator preferences) based on the mediators we want to control for (length difference) and other relevant features. We then obtain length-controlled preferences by predicting preferences while conditioning the GLM with a zero difference in lengths. Length-controlling not only improves the robustness of the metric to manipulations in model verbosity, we also find that it increases the Spearman correlation with LMSYS' Chatbot Arena from 0.94 to 0.98. We release the code and leaderboard at https://tatsu-lab.github.io/alpaca_eval/ .