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Register a new userUsing Radiomics as Prior Knowledge for Thorax Disease Classification and Localization in Chest X-rays
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Added by
Yan Han
Publication date
2020
fields
Informatics Engineering
and research's language is
English
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Chest X-ray becomes one of the most common medical diagnoses due to its noninvasiveness. The number of chest X-ray images has skyrocketed, but reading chest X-rays still have been manually performed by radiologists, which creates huge burnouts and delays. Traditionally, radiomics, as a subfield of radiology that can extract a large number of quantitative features from medical images, demonstrates its potential to facilitate medical imaging diagnosis before the deep learning era. In this paper, we develop an end-to-end framework, ChexRadiNet, that can utilize the radiomics features to improve the abnormality classification performance. Specifically, ChexRadiNet first applies a light-weight but efficient triplet-attention mechanism to classify the chest X-rays and highlight the abnormal regions. Then it uses the generated class activation map to extract radiomic features, which further guides our model to learn more robust image features. After a number of iterations and with the help of radiomic features, our framework can converge to more accurate image regions. We evaluate the ChexRadiNet framework using three public datasets: NIH ChestX-ray, CheXpert, and MIMIC-CXR. We find that ChexRadiNet outperforms the state-of-the-art on both disease detection (0.843 in AUC) and localization (0.679 in T(IoU) = 0.1). We will make the code publicly available at https://github.com/bionlplab/lung_disease_detection_amia2021, with the hope that this method can facilitate the development of automatic systems with a higher-level understanding of the radiological world.
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Building a highly accurate predictive model for these tasks usually requires a large number of manually annotated labels and pixel regions (bounding boxes) of abnormalities. However, it is expensive to acquire such annotations, especially the bounding boxes. Recently, contrastive learning has shown strong promise in leveraging unlabeled natural images to produce highly generalizable and discriminative features. However, extending its power to the medical image domain is under-explored and highly non-trivial, since medical images are much less amendable to data augmentations. In contrast, their domain knowledge, as well as multi-modality information, is often crucial. To bridge this gap, we propose an end-to-end semi-supervised cross-modal contrastive learning framework, that simultaneously performs disease classification and localization tasks. The key knob of our framework is a unique positive sampling approach tailored for the medical images, by seamlessly integrating radiomic features as an auxiliary modality. Specifically, we first apply an image encoder to classify the chest X-rays and to generate the image features. We next leverage Grad-CAM to highlight the crucial (abnormal) regions for chest X-rays (even when unannotated), from which we extract radiomic features. The radiomic features are then passed through another dedicated encoder to act as the positive sample for the image features generated from the same chest X-ray. In this way, our framework constitutes a feedback loop for image and radiomic modality features to mutually reinforce each other. Their contrasting yields cross-modality representations that are both robust and interpretable. Extensive experiments on the NIH Chest X-ray dataset demonstrate that our approach outperforms existing baselines in both classification and localization tasks.
We systematically evaluate the performance of deep learning models in the presence of diseases not labeled for or present during training. First, we evaluate whether deep learning models trained on a subset of diseases (seen diseases) can detect the presence of any one of a larger set of diseases. We find that models tend to falsely classify diseases outside of the subset (unseen diseases) as no disease. Second, we evaluate whether models trained on seen diseases can detect seen diseases when co-occurring with diseases outside the subset (unseen diseases). We find that models are still able to detect seen diseases even when co-occurring with unseen diseases. Third, we evaluate whether feature representations learned by models may be used to detect the presence of unseen diseases given a small labeled set of unseen diseases. We find that the penultimate layer of the deep neural network provides useful features for unseen disease detection. Our results can inform the safe clinical deployment of deep learning models trained on a non-exhaustive set of disease classes.
This paper considers the task of thorax disease classification on chest X-ray images. Existing methods generally use the global image as input for network learning. Such a strategy is limited in two aspects. 1) A thorax disease usually happens in (small) localized areas which are disease specific. Training CNNs using global image may be affected by the (excessive) irrelevant noisy areas. 2) Due to the poor alignment of some CXR images, the existence of irregular borders hinders the network performance. In this paper, we address the above problems by proposing a three-branch attention guided convolution neural network (AG-CNN). AG-CNN 1) learns from disease-specific regions to avoid noise and improve alignment, 2) also integrates a global branch to compensate the lost discriminative cues by local branch. Specifically, we first learn a global CNN branch using global images. Then, guided by the attention heat map generated from the global branch, we inference a mask to crop a discriminative region from the global image. The local region is used for training a local CNN branch. Lastly, we concatenate the last pooling layers of both the global and local branches for fine-tuning the fusion branch. The Comprehensive experiment is conducted on the ChestX-ray14 dataset. We first report a strong global baseline producing an average AUC of 0.841 with ResNet-50 as backbone. After combining the local cues with the global information, AG-CNN improves the average AUC to 0.868. While DenseNet-121 is used, the average AUC achieves 0.871, which is a new state of the art in the community.
Image representation is a fundamental task in computer vision. However, most of the existing approaches for image representation ignore the relations between images and consider each input image independently. Intuitively, relations between images can help to understand the images and maintain model consistency over related images. In this paper, we consider modeling the image-level relations to generate more informative image representations, and propose ImageGCN, an end-to-end graph convolutional network framework for multi-relational image modeling. We also apply ImageGCN to chest X-ray (CXR) images where rich relational information is available for disease identification. Unlike previous image representation models, ImageGCN learns the representation of an image using both its original pixel features and the features of related images. Besides learning informative representations for images, ImageGCN can also be used for object detection in a weakly supervised manner. The Experimental results on ChestX-ray14 dataset demonstrate that ImageGCN can outperform respective baselines in both disease identification and localization tasks and can achieve comparable and often better results than the state-of-the-art methods.
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.
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