From Embeddings to Accuracy: Comparing Foundation Models for Radiographic Classification.

Foundation models, pre-trained on extensive datasets, have significantly advanced machine learning by providing robust and transferable embeddings applicable to various domains, including medical imaging diagnostics. This study evaluates the utility of embeddings derived from both general-purpose an...

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Publicado en:Journal of Imaging Informatics in Medicine Vol. 39; no. 4; pp. 3196 - 3208
Autores principales: Li, Xue, Merkow, Jameson, Codella, Noel C. F., Santamaria-Pang, Alberto, Sangani, Naiteek, Ersoy, Alexander, Burt, Christopher, Garrett, John W., Bruce, Richard J., Warner, Joshua D., Bradshaw, Tyler, Tarapov, Ivan, Lungren, Matthew P., McMillan, Alan B.
Formato: diagnostic images research tables/charts Journal Article
Publicado: Springer Nature Aug2026
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Aug2026
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      pub: Springer Nature
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        10.1007/s10278-025-01747-5
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        atl: From Embeddings to Accuracy: Comparing Foundation Models for Radiographic Classification.
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        au:
          Li, Xue
          Merkow, Jameson
          Codella, Noel C. F.
          Santamaria-Pang, Alberto
          Sangani, Naiteek
          Ersoy, Alexander
          Burt, Christopher
          Garrett, John W.
          Bruce, Richard J.
          Warner, Joshua D.
          Bradshaw, Tyler
          Tarapov, Ivan
          Lungren, Matthew P.
          McMillan, Alan B.
        affil: https://ror.org/01y2jtd41 Department of Radiology, University of Wisconsin-Madison, Madison, WI, USA
      sug:
        subj:
          Radiography Classification
          Classification Algorithms
          Convolutional Neural Networks
          Tube Placement Determination
          Human
          Funding Source
          Wisconsin
          Male
          Female
          Infant, Newborn
          Infant
          Child, Preschool
          Child
          Adolescence
          Adult
          Middle Age
          Aged
          Aged, 80 and Over
          Comparative Studies
          Wilcoxon Signed Rank Test
          Kruskal-Wallis Test
          Post Hoc Analysis
          Machine Learning Algorithms
          Logistic Regression
          Support Vector Machine
          Random Forest
          Sex Factors
          Age Factors
          Infant, Newborn: birth-1 month
          Infant: 1-23 months
          Child, Preschool: 2-5 years
          Child: 6-12 years
          Adolescent: 13-18 years
          Adult: 19-44 years
          Middle Aged: 45-64 years
          Aged: 65+ years
          Aged, 80 & over
          Male
          Female
      ab: Foundation models, pre-trained on extensive datasets, have significantly advanced machine learning by providing robust and transferable embeddings applicable to various domains, including medical imaging diagnostics. This study evaluates the utility of embeddings derived from both general-purpose and medical domain-specific foundation models for training lightweight adapter models in multi-class radiography classification, focusing specifically on tube placement assessment and related findings, with comparison to the end-to-end training of an established convolutional neural network. A dataset comprising 8842 radiographs classified into seven distinct categories was employed to extract embeddings using seven foundation models: DenseNet121, BiomedCLIP, Med-Flamingo, MedImageInsight, MedSigLIP, Rad-DINO, and CXR-Foundation. Adapter models were subsequently trained using classical machine learning algorithms, including K-nearest neighbors (KNN), logistic regression (LR), support vector machines (SVM), random forest (RF), and multi-layer perceptron (MLP). Among these combinations, MedImageInsight embeddings paired with an SVM or MLP adapter yielded the highest mean area under the curve (mAUC) at 93.1%, followed closely by MedSigLIP with MLP (91.0%), Rad-DINO with SVM (90.7%), and CXR-Foundation with LR (88.6%), achieving a higher mAUC score than a fully finetuned convolutional neural network, DenseNet121 (87.2%). In comparison, BiomedCLIP and DenseNet121 exhibited moderate performance with SVM, obtaining mAUC scores of 82.8% and 81.1%, respectively, whereas Med-Flamingo delivered the lowest performance at 78.5% when combined with RF. Significant differences were found between each embedding model and MedImageInsight using the Wilcoxon signed-rank test at the significance level 0.05 (before Bonferroni correction). Notably, most adapter models demonstrated computational efficiency, achieving training within minutes and inference within seconds on CPU, underscoring their practicality for clinical applications. Furthermore, fairness analysis on adapters trained on MedImageInsight-derived embeddings indicated minimal disparities, with gender differences in performance within 1.8% and standard deviations across age groups not exceeding 1.4%. Further analysis indicated there is no significant difference across gender and age at a significance level of 0.05. These findings confirm that foundation model embeddings—especially those from MedImageInsight—facilitate accurate, computationally efficient, and equitable diagnostic classification using lightweight adapters for radiographic image analysis.
      pubtype: Academic Journal
      doctype:
        diagnostic images
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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