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Register a new userKnowledge Distillation with Adaptive Asymmetric Label Sharpening for Semi-supervised Fracture Detection in Chest X-rays
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Added by
Yirui Wang
Publication date
2020
fields
Informatics Engineering
and research's language is
English
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Exploiting available medical records to train high performance computer-aided diagnosis (CAD) models via the semi-supervised learning (SSL) setting is emerging to tackle the prohibitively high labor costs involved in large-scale medical image annotations. Despite the extensive attentions received on SSL, previous methods failed to 1) account for the low disease prevalence in medical records and 2) utilize the image-level diagnosis indicated from the medical records. Both issues are unique to SSL for CAD models. In this work, we propose a new knowledge distillation method that effectively exploits large-scale image-level labels extracted from the medical records, augmented with limited expert annotated region-level labels, to train a rib and clavicle fracture CAD model for chest X-ray (CXR). Our method leverages the teacher-student model paradigm and features a novel adaptive asymmetric label sharpening (AALS) algorithm to address the label imbalance problem that specially exists in medical domain. Our approach is extensively evaluated on all CXR (N = 65,845) from the trauma registry of anonymous hospital over a period of 9 years (2008-2016), on the most common rib and clavicle fractures. The experiment results demonstrate that our method achieves the state-of-the-art fracture detection performance, i.e., an area under receiver operating characteristic curve (AUROC) of 0.9318 and a free-response receiver operating characteristic (FROC) score of 0.8914 on the rib fractures, significantly outperforming previous approaches by an AUROC gap of 1.63% and an FROC improvement by 3.74%. Consistent performance gains are also observed for clavicle fracture detection.
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Hip and pelvic fractures are serious injuries with life-threatening complications. However, diagnostic errors of fractures in pelvic X-rays (PXRs) are very common, driving the demand for computer-aided diagnosis (CAD) solutions. A major challenge lies in the fact that fractures are localized patterns that require localized analyses. Unfortunately, the PXRs residing in hospital picture archiving and communication system do not typically specify region of interests. In this paper, we propose a two-stage hip and pelvic fracture detection method that executes localized fracture classification using weakly supervised ROI mining. The first stage uses a large capacity fully-convolutional network, i.e., deep with high levels of abstraction, in a multiple instance learning setting to automatically mine probable true positive and definite hard negative ROIs from the whole PXR in the training data. The second stage trains a smaller capacity model, i.e., shallower and more generalizable, with the mined ROIs to perform localized analyses to classify fractures. During inference, our method detects hip and pelvic fractures in one pass by chaining the probability outputs of the two stages together. We evaluate our method on 4 410 PXRs, reporting an area under the ROC curve value of 0.975, the highest among state-of-the-art fracture detection methods. Moreover, we show that our two-stage approach can perform comparably to human physicians (even outperforming emergency physicians and surgeons), in a preliminary reader study of 23 readers.
Multi-label image classification is a fundamental but challenging task towards general visual understanding. Existing methods found the region-level cues (e.g., features from RoIs) can facilitate multi-label classification. Nevertheless, such methods usually require laborious object-level annotations (i.e., object labels and bounding boxes) for effective learning of the object-level visual features. In this paper, we propose a novel and efficient deep framework to boost multi-label classification by distilling knowledge from weakly-supervised detection task without bounding box annotations. Specifically, given the image-level annotations, (1) we first develop a weakly-supervised detection (WSD) model, and then (2) construct an end-to-end multi-label image classification framework augmented by a knowledge distillation module that guides the classification model by the WSD model according to the class-level predictions for the whole image and the object-level visual features for object RoIs. The WSD model is the teacher model and the classification model is the student model. After this cross-task knowledge distillation, the performance of the classification model is significantly improved and the efficiency is maintained since the WSD model can be safely discarded in the test phase. Extensive experiments on two large-scale datasets (MS-COCO and NUS-WIDE) show that our framework achieves superior performances over the state-of-the-art methods on both performance and efficiency.
Knowledge Distillation (KD) has been used in image classification for model compression. However, rare studies apply this technology on single-stage object detectors. Focal loss shows that the accumulated errors of easily-classified samples dominate the overall loss in the training process. This problem is also encountered when applying KD in the detection task. For KD, the teacher-defined hard samples are far more important than any others. We propose ADL to address this issue by adaptively mimicking the teachers logits, with more attention paid on two types of hard samples: hard-to-learn samples predicted by teacher with low certainty and hard-to-mimic samples with a large gap between the teachers and the students prediction. ADL enlarges the distillation loss for hard-to-learn and hard-to-mimic samples and reduces distillation loss for the dominant easy samples, enabling distillation to work on the single-stage detector first time, even if the student and the teacher are identical. Besides, ADL is effective in both the supervised setting and the semi-supervised setting, even when the labeled data and unlabeled data are from different distributions. For distillation on unlabeled data, ADL achieves better performance than existing data distillation which simply utilizes hard targets, making the student detector surpass its teacher. On the COCO database, semi-supervised adaptive distillation (SAD) makes a student detector with a backbone of ResNet-50 surpasses its teacher with a backbone of ResNet-101, while the student has half of the teachers computation complexity. The code is avaiable at https://github.com/Tangshitao/Semi-supervised-Adaptive-Distillation
The training of deep learning models generally requires a large amount of annotated data for effective convergence and generalisation. However, obtaining high-quality annotations is a laboursome and expensive process due to the need of expert radiologists for the labelling task. The study of semi-supervised learning in medical image analysis is then of crucial importance given that it is much less expensive to obtain unlabelled images than to acquire images labelled by expert radiologists.Essentially, semi-supervised methods leverage large sets of unlabelled data to enable better training convergence and generalisation than if we use only the small set of labelled images.In this paper, we propose the Self-supervised Mean Teacher for Semi-supervised (S$^2$MTS$^2$) learning that combines self-supervised mean-teacher pre-training with semi-supervised fine-tuning. The main innovation of S$^2$MTS$^2$ is the self-supervised mean-teacher pre-training based on the joint contrastive learning, which uses an infinite number of pairs of positive query and key features to improve the mean-teacher representation. The model is then fine-tuned using the exponential moving average teacher framework trained with semi-supervised learning.We validate S$^2$MTS$^2$ on the thorax disease multi-label classification problem from the dataset Chest X-ray14, where we show that it outperforms the previous SOTA semi-supervised learning methods by a large margin.
Detecting anomalies in musculoskeletal radiographs is of paramount importance for large-scale screening in the radiology workflow. Supervised deep networks take for granted a large number of annotations by radiologists, which is often prohibitively very time-consuming to acquire. Moreover, supervised systems are tailored to closed set scenarios, e.g., trained models suffer from overfitting to previously seen rare anomalies at training. Instead, our approachs rationale is to use task agnostic pretext tasks to leverage unlabeled data based on a cross-sample similarity measure. Besides, we formulate a complex distribution of data from normal class within our framework to avoid a potential bias on the side of anomalies. Through extensive experiments, we show that our method outperforms baselines across unsupervised and self-supervised anomaly detection settings on a real-world medical dataset, the MURA dataset. We also provide rich ablation studies to analyze each training stages effect and loss terms on the final performance.
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