Although deep learning-based computer-aided diagnosis systems have recently achieved expert-level performance, developing a robust deep learning model requires large, high-quality data with manual annotation, which is expensive to obtain. This situation poses the problem that the chest x-rays collected annually in hospitals cannot be used due to the lack of manual labeling by experts, especially in deprived areas. To address this, here we present a novel deep learning framework that uses knowledge distillation through self-supervised learning and self-training, which shows that the performance of the original model trained with a small number of labels can be gradually improved with more unlabeled data. Experimental results show that the proposed framework maintains impressive robustness against a real-world environment and has general applicability to several diagnostic tasks such as tuberculosis, pneumothorax, and COVID-19. Notably, we demonstrated that our model performs even better than those trained with the same amount of labeled data. The proposed framework has a great potential for medical imaging, where plenty of data is accumulated every year, but ground truth annotations are expensive to obtain.
Finding diseases from an X-ray image is an important yet highly challenging task. Current methods for solving this task exploit various characteristics of the chest X-ray image, but one of the most important characteristics is still missing: the necessity of comparison between related regions in an image. In this paper, we present Attend-and-Compare Module (ACM) for capturing the difference between an object of interest and its corresponding context. We show that explicit difference modeling can be very helpful in tasks that require direct comparison between locations from afar. This module can be plugged into existing deep learning models. For evaluation, we apply our module to three chest X-ray recognition tasks and COCO object detection & segmentation tasks and observe consistent improvements across tasks. The code is available at https://github.com/mk-minchul/attend-and-compare.