Clinically Aware Synthetic Image Generation for Concept Coverage in Chest X-ray Models

Fuente: arXiv
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Autores principales: Rafferty, Amy, Ramaesh, Rishi, Rajan, Ajitha
Formato: Preprint
Publicado: 2026
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author Rafferty, Amy
Ramaesh, Rishi
Rajan, Ajitha
author_facet Rafferty, Amy
Ramaesh, Rishi
Rajan, Ajitha
contents Deep learning models for chest X-ray diagnosis are constrained by limited coverage of clinically meaningful concept combinations in publicly available training datasets. While synthetic image generation has been explored to increase data diversity, existing methods rarely enforce clinical or anatomical constraints, limiting utility for improving model reliability. We propose CARPA, a clinically aware and anatomically grounded framework for synthetic chest X-ray generation that applies targeted perturbations to clinical concept vectors while preserving anatomical structure. By producing anatomically faithful synthetic images with controlled concept insertions and deletions, CARPA expands clinically relevant concept coverage. We evaluate CARPA across seven backbone architectures by fine-tuning models on synthetic subsets and testing on a held-out MIMIC-CXR benchmark. Compared to prior concept perturbation approaches, fine-tuning on CARPA-generated images consistently improves precision-recall performance, reduces predictive uncertainty, and improves model calibration. Structural and semantic analyses demonstrate high anatomical fidelity, strong concept alignment, and low semantic uncertainty. Evaluation by two expert radiologists further confirms realism and clinical agreement. Together, these results show that anatomically grounded concept perturbations enable more effective use of synthetic data, improving both performance and reliability of chest X-ray classification models and supporting safer clinical deployment.
format Preprint
id arxiv_https___arxiv_org_abs_2603_15525
institution arXiv
publishDate 2026
record_format arxiv
spellingShingle Clinically Aware Synthetic Image Generation for Concept Coverage in Chest X-ray Models
Rafferty, Amy
Ramaesh, Rishi
Rajan, Ajitha
Computer Vision and Pattern Recognition
Human-Computer Interaction
Deep learning models for chest X-ray diagnosis are constrained by limited coverage of clinically meaningful concept combinations in publicly available training datasets. While synthetic image generation has been explored to increase data diversity, existing methods rarely enforce clinical or anatomical constraints, limiting utility for improving model reliability. We propose CARPA, a clinically aware and anatomically grounded framework for synthetic chest X-ray generation that applies targeted perturbations to clinical concept vectors while preserving anatomical structure. By producing anatomically faithful synthetic images with controlled concept insertions and deletions, CARPA expands clinically relevant concept coverage. We evaluate CARPA across seven backbone architectures by fine-tuning models on synthetic subsets and testing on a held-out MIMIC-CXR benchmark. Compared to prior concept perturbation approaches, fine-tuning on CARPA-generated images consistently improves precision-recall performance, reduces predictive uncertainty, and improves model calibration. Structural and semantic analyses demonstrate high anatomical fidelity, strong concept alignment, and low semantic uncertainty. Evaluation by two expert radiologists further confirms realism and clinical agreement. Together, these results show that anatomically grounded concept perturbations enable more effective use of synthetic data, improving both performance and reliability of chest X-ray classification models and supporting safer clinical deployment.
title Clinically Aware Synthetic Image Generation for Concept Coverage in Chest X-ray Models
topic Computer Vision and Pattern Recognition
Human-Computer Interaction
url https://arxiv.org/abs/2603.15525