KG-CMI: Knowledge graph enhanced cross-Mamba interaction for medical visual question answering
Authors: Xianyao Zheng, Hong Yu, Hui Cui, Changming Sun, Xiangyu Li, Ran Su, Leyi Wei, Jia Zhou, Junbo Wang, Qiangguo Jin
Organizations: School of Software, Northwestern Polytechnical University, Shaanxi, China · Tianjin Central Hospital of Gynecology Obstetrics, Tianjin, China · Department of Computer Science and Information Technology, La Trobe University, Melbourne, Australia · CSIRO Data61, Sydney, Australia · School of Computer Science and Technology, Harbin Institute of Technology, Harbin, China · School of Computer Software, Tianjin University, Tianjin, China · Centre for Artificial Intelligence driven Drug Discovery, Faculty of Applied Science, Macao Polytechnic University, Macao SAR, China · Department of Cardiology, Tianjin Chest Hospital, Tianjin, China · Yangtze River Delta Research Institute of Northwestern Polytechnical University, Taicang, China
Medical visual question answering (Med-VQA) is a crucial multimodal task in clinical decision support and telemedicine. Recent methods fail to fully leverage domain-specific medical knowledge, making it difficult to accurately associate lesion features in medical images with key diagnostic criteria. Additionally, classification-based approaches typically rely on predefined answer sets. Treating Med-VQA as a simple classification problem limits its ability to adapt to the diversity of free-form answers and may overlook detailed semantic information in those answers. To address these challenges, we propose a knowledge graph enhanced cross-Mamba interaction (KG-CMI) framework, which consists of a fine-grained cross-modal feature alignment (FCFA) module, a knowledge graph embedding (KGE) module, a cross-modal interaction representation (CMIR) module, and a free-form answer enhanced multi-task learning (FAMT) module. The KG-CMI learns cross-modal feature representations for images and texts by effectively integrating professional medical knowledge through a graph, establishing associations between lesion features and disease knowledge. Moreover, FAMT leverages auxiliary knowledge from open-ended questions, improving the model's capability for open-ended Med-VQA. Experimental results demonstrate that KG-CMI outperforms existing state-of-the-art methods on three Med-VQA datasets, i.e., VQA-RAD, SLAKE, and OVQA. Additionally, we conduct interpretability experiments to further validate the framework's effectiveness.
Figures & tables
Fig. 1: The overall architecture of KG-CMI. (a) Fine-grained visual-text feature alignment, (b) Knowledge graph embedding, (c) Cross-modal interaction representation, and (d) Free-form answer enhanced multi-task learning.
Fig. 2: The detailed structure of the question-aware Q-Former (QQ-former).
Fig. 3: Preconstruct a knowledge graph. In the graph, the green circle represent a global node, orange boxes represent organ-level entities, and blue boxes represent key findings.
Fig. 4: The detailed structure of the cross-modal Mamba (CMM) block.
Fig. 5: The detailed structure of the Auxiliary head (AHead).
Method
SLAKE
VQA-RAD
OVQA
Open
Closed
Overall
Open
Closed
Overall
Open
Closed
Overall
M2I2 [ 8 ]
73.21 ± 0.25
89.50 ± 0.12
77.60 ± 0.18
48.78 ± 0.30
82.71 ± 0.15
69.16 ± 0.21
36.02 ± 0.45
72.38 ± 0.32
57.89 ± 0.28
MUMC [ 7 ]
75.04 ± 0.22
93.27 ± 0.10
82.19 ± 0.15
62.57 ± 0.28
84.19 ± 0.14
75.61 ± 0.19
39.05 ± 0.42
75.87 ± 0.30
61.20 ± 0.25
M3AE [ 32 ]
80.78 ± 0.18
87.65 ± 0.14
83.47 ± 0.12
63.50 ± 0.25
85.42 ± 0.11
76.72 ± 0.16
61.65 ± 0.38
84.37 ± 0.15
75.32 ± 0.22
UnICLAM ∗ [ 36 ]
81.10
85.70
83.10
59.80
82.60
73.20
-
-
-
MEVF ∗ [ 11 ]
-
-
-
37.41
75.60
60.42
34.69
74.21
58.46
TABLE I: Performance comparison (ACC, %) with state-of-the-art methods on the SLAKE, VQA-RAD, and OVQA datasets. Results for methods without an asterisk are reported as Mean ± Standard Deviation. The best values are in bold . Improvements over the second-best results are highlighted in red .
Type
QQ-F
CMCL
KGE
CMM
AHead
SLAKE
VQA-RAD
OVQA
Open
Closed
Overall
Open
Closed
Overall
Open
Closed
Overall
Baseline
80.31
85.25
82.25
60.52
78.31
71.25
61.65
84.37
75.32
Addition
✓
80.45
86.20
82.58
65.34
79.78
74.11
68.95
83.56
77.74
✓
80.72
85.96
82.77
64.77
80.51
74.33
66.09
84.42
77.07
✓
81.78
85.47
83.12
68.11
83.25
77.11
69.11
84.24
78.48
✓
81.49
85.96
83.24
65.34
79.41
73.88
68.07
83.74
77.48
TABLE II: Performances of ablation study on multiple datasets. QQ-F denotes the QQ-Former module.
Fig. 6: Performance comparisons of different η and θ values on three datasets.
Dataset
Method
BLEU-1
BLEU-4
METEOR
CIDEr
SLAKE
MUMC [ 7 ]
0.421
0.285
0.242
1.125
M3AE [ 32 ]
0.452
0.312
0.265
1.218
KG-CMI
0.485
0.342
0.291
1.424
VQA-RAD
MUMC [ 7 ]
0.385
0.212
0.195
0.852
M3AE [ 32 ]
0.402
0.235
0.210
0.925
KG-CMI
0.438
0.268
0.235
1.085
TABLE III: Performance comparison of open-ended answers using NLG metrics.
α
Open
Closed
Overall
β
Open
Closed
Overall
0.1
67.87
82.10
77.62
0.1
67.05
80.32
75.75
0.2
68.18
84.11
78.21
0.2
67.87
82.10
77.62
0.3
66.50
83.77
76.24
0.3
68.18
84.11
78.21
0.4
68.02
79.84
75.51
0.4
66.50
83.77
76.24
0.5
67.34
78.64
73.89
0.5
68.02
80.05
75.92
TABLE IV: Comparisons of different α and β values on the VQA-RAD dataset.
Layers
SLAKE
VQA-RAD
OVQA
1 (Default)
84.26
78.21
79.58
2
84.38
78.05
79.62
3
84.41
77.89
79.55
TABLE V: Performance comparison of different QQ-Former layer depths (results on overall ACC %).
Num
SLAKE
VQA-RAD
OVQA
1
83.52
77.45
78.10
2 (Default)
84.26
78.21
79.58
3
84.15
77.92
79.61
4
83.98
77.58
79.45
TABLE VI: Impact of CMM Block number ( Num ) variation on performance (Results in Overall ACC %).
Fig. 7: Visual saliency maps for representative methods.
Interaction Module
SLAKE
VQA-RAD
OVQA
FLOPs (G)
Transformer-CA
83.11
77.45
75.47
18.2
CMM (Ours)
84.26
78.21
79.58
13.8
TABLE VII: Empirical comparison between CMM and Cross-Attention (CA).
GAT Layers
SLAKE
VQA-RAD
OVQA
1 (Default)
84.26
78.21
79.58
2
84.12
77.95
79.42
3
83.89
77.58
79.21
TABLE VIII: Sensitivity analysis of GAT layer depth (Results in Overall ACC %).
Fig. 8: Analysis of failure cases and prediction probability comparison between our approach and M3AE for open-ended and closed-ended questions with answer labels.
National Engineering Laboratory for Integrated Aero-Space-Ground-Ocean Big Data Application Technology, School of Computer Science and Engineering, Northwestern Polytechnical University, Xi’an 710072, China · Southern Medical University · Westlake University
School of Computer Science and Engineering, Nanjing University of Science and Technology · State Key Laboratory of Intelligent Manufacturing of Advanced Construction Machinery · Department of Electrical and Computer Engineering, Sungkyunkwan University +1
Department of Radiation Oncology and Winship Cancer Institute, Emory University School of Medicine, Atlanta, 30322, GA, USA · Department of Biostatistics and Bioinformatics, Emory University, Atlanta, 30322, GA, USA