Content based image retrieval is highly relevant in medical imaging, since it makes vast amounts of imaging data accessible for comparison during diagnosis. Finding image similarity measures that reflect diagnostically relevant relationships is challenging, since the overall appearance variability is high compared to often subtle signatures of diseases. To learn models that capture the relationship between semantic clinical information and image elements at scale, we have to rely on data generated during clinical routine (images and radiology reports), since expert annotation is prohibitively costly. Here we show that re-mapping visual features extracted from medical imaging data based on weak labels that can be found in corresponding radiology reports creates descriptions of local image content capturing clinically relevant information. We show that these semantic profiles enable higher recall and precision during retrieval compared to visual features, and that we can even map semantic terms describing clinical findings from radiology reports to localized image volume areas.