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Register a new userInterpreting chest X-rays via CNNs that exploit hierarchical disease dependencies and uncertainty labels
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Chest radiography is one of the most common types of diagnostic radiology exams, which is critical for screening and diagnosis of many different thoracic diseases. Specialized algorithms have been developed to detect several specific pathologies such as lung nodule or lung cancer. However, accurately detecting the presence of multiple diseases from chest X-rays (CXRs) is still a challenging task. This paper presents a supervised multi-label classification framework based on deep convolutional neural networks (CNNs) for predicting the risk of 14 common thoracic diseases. We tackle this problem by training state-of-the-art CNNs that exploit dependencies among abnormality labels. We also propose to use the label smoothing technique for a better handling of uncertain samples, which occupy a significant portion of almost every CXR dataset. Our model is trained on over 200,000 CXRs of the recently released CheXpert dataset and achieves a mean area under the curve (AUC) of 0.940 in predicting 5 selected pathologies from the validation set. This is the highest AUC score yet reported to date. The proposed method is also evaluated on the independent test set of the CheXpert competition, which is composed of 500 CXR studies annotated by a panel of 5 experienced radiologists. The performance is on average better than 2.6 out of 3 other individual radiologists with a mean AUC of 0.930, which ranks first on the CheXpert leaderboard at the time of writing this paper.
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The chest X-rays (CXRs) is one of the views most commonly ordered by radiologists (NHS),which is critical for diagnosis of many different thoracic diseases. Accurately detecting thepresence of multiple diseases from CXRs is still a challenging task. We present a multi-labelclassification framework based on deep convolutional neural networks (CNNs) for diagnos-ing the presence of 14 common thoracic diseases and observations. Specifically, we trained astrong set of CNNs that exploit dependencies among abnormality labels and used the labelsmoothing regularization (LSR) for a better handling of uncertain samples. Our deep net-works were trained on over 200,000 CXRs of the recently released CheXpert dataset (Irvinandal., 2019) and the final model, which was an ensemble of the best performing networks,achieved a mean area under the curve (AUC) of 0.940 in predicting 5 selected pathologiesfrom the validation set. To the best of our knowledge, this is the highest AUC score yetreported to date. More importantly, the proposed method was also evaluated on an inde-pendent test set of the CheXpert competition, containing 500 CXR studies annotated by apanel of 5 experienced radiologists. The reported performance was on average better than2.6 out of 3 other individual radiologists with a mean AUC of 0.930, which had led to thecurrent state-of-the-art performance on the CheXpert test set.
In this work, we exploit the unsupervised domain adaptation problem for radiology image interpretation across domains. Specifically, we study how to adapt the disease recognition model from a labeled source domain to an unlabeled target domain, so as to reduce the effort of labeling each new dataset. To address the shortcoming of cross-domain, unpaired image-to-image translation methods which typically ignore class-specific semantics, we propose a task-driven, discriminatively trained, cycle-consistent generative adversarial network, termed TUNA-Net. It is able to preserve 1) low-level details, 2) high-level semantic information and 3) mid-level feature representation during the image-to-image translation process, to favor the target disease recognition task. The TUNA-Net framework is general and can be readily adapted to other learning tasks. We evaluate the proposed framework on two public chest X-ray datasets for pneumonia recognition. The TUNA-Net model can adapt labeled adult chest X-rays in the source domain such that they appear as if they were drawn from pediatric X-rays in the unlabeled target domain, while preserving the disease semantics. Extensive experiments show the superiority of the proposed method as compared to state-of-the-art unsupervised domain adaptation approaches. Notably, TUNA-Net achieves an AUC of 96.3% for pediatric pneumonia classification, which is very close to that of the supervised approach (98.1%), but without the need for labels on the target domain.
The superior performance of CNN on medical image analysis heavily depends on the annotation quality, such as the number of labeled image, the source of image, and the expert experience. The annotation requires great expertise and labour. To deal with the high inter-rater variability, the study of imperfect label has great significance in medical image segmentation tasks. In this paper, we present a novel cascaded robust learning framework for chest X-ray segmentation with imperfect annotation. Our model consists of three independent network, which can effectively learn useful information from the peer networks. The framework includes two stages. In the first stage, we select the clean annotated samples via a model committee setting, the networks are trained by minimizing a segmentation loss using the selected clean samples. In the second stage, we design a joint optimization framework with label correction to gradually correct the wrong annotation and improve the network performance. We conduct experiments on the public chest X-ray image datasets collected by Shenzhen Hospital. The results show that our methods could achieve a significant improvement on the accuracy in segmentation tasks compared to the previous methods.
The use of smartphones to take photographs of chest x-rays represents an appealing solution for scaled deployment of deep learning models for chest x-ray interpretation. However, the performance of chest x-ray algorithms on photos of chest x-rays has not been thoroughly investigated. In this study, we measured the diagnostic performance for 8 different chest x-ray models when applied to photos of chest x-rays. All models were developed by different groups and submitted to the CheXpert challenge, and re-applied to smartphone photos of x-rays in the CheXphoto dataset without further tuning. We found that several models had a drop in performance when applied to photos of chest x-rays, but even with this drop, some models still performed comparably to radiologists. Further investigation could be directed towards understanding how different model training procedures may affect model generalization to photos of chest x-rays.
Recent advances in training deep learning models have demonstrated the potential to provide accurate chest X-ray interpretation and increase access to radiology expertise. However, poor generalization due to data distribution shifts in clinical settings is a key barrier to implementation. In this study, we measured the diagnostic performance for 8 different chest X-ray models when applied to (1) smartphone photos of chest X-rays and (2) external datasets without any finetuning. All models were developed by different groups and submitted to the CheXpert challenge, and re-applied to test datasets without further tuning. We found that (1) on photos of chest X-rays, all 8 models experienced a statistically significant drop in task performance, but only 3 performed significantly worse than radiologists on average, and (2) on the external set, none of the models performed statistically significantly worse than radiologists, and five models performed statistically significantly better than radiologists. Our results demonstrate that some chest X-ray models, under clinically relevant distribution shifts, were comparable to radiologists while other models were not. Future work should investigate aspects of model training procedures and dataset collection that influence generalization in the presence of data distribution shifts.
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