Current image captioning methods are usually trained via (penalized) maximum likelihood estimation. However, the log-likelihood score of a caption does not correlate well with human assessments of quality. Standard syntactic evaluation metrics, such as BLEU, METEOR and ROUGE, are also not well correlated. The newer SPICE and CIDEr metrics are better correlated, but have traditionally been hard to optimize for. In this paper, we show how to use a policy gradient (PG) method to directly optimize a linear combination of SPICE and CIDEr (a combination we call SPIDEr): the SPICE score ensures our captions are semantically faithful to the image, while CIDEr score ensures our captions are syntactically fluent. The PG method we propose improves on the prior MIXER approach, by using Monte Carlo rollouts instead of mixing MLE training with PG. We show empirically that our algorithm leads to easier optimization and improved results compared to MIXER. Finally, we show that using our PG method we can optimize any of the metrics, including the proposed SPIDEr metric which results in image captions that are strongly preferred by human raters compared to captions generated by the same model but trained to optimize MLE or the COCO metrics.

Chest X-ray is the most common medical imaging exam used to assess multiple pathologies. Automated algorithms and tools have the potential to support the reading workflow, improve efficiency, and reduce reading errors. With the availability of large scale data sets, several methods have been proposed to classify pathologies on chest X-ray images. However, most methods report performance based on random image based splitting, ignoring the high probability of the same patient appearing in both training and test set. In addition, most methods fail to explicitly incorporate the spatial information of abnormalities or utilize the high resolution images. We propose a novel approach based on location aware Dense Networks (DNetLoc), whereby we incorporate both high-resolution image data and spatial information for abnormality classification. We evaluate our method on the largest data set reported in the community, containing a total of 86,876 patients and 297,541 chest X-ray images. We achieve (i) the best average AUC score for published training and test splits on the single benchmarking data set (ChestX-Ray14 [1]), and (ii) improved AUC scores when the pathology location information is explicitly used. To foster future research we demonstrate the limitations of the current benchmarking setup [1] and provide new reference patient-wise splits for the used data sets. This could support consistent and meaningful benchmarking of future methods on the largest publicly available data sets.

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