Differential privacy (DP) has arisen as the gold standard in protecting an individual's privacy in datasets by adding calibrated noise to each data sample. While the application to categorical data is straightforward, its usability in the context of images has been limited. Contrary to categorical data the meaning of an image is inherent in the spatial correlation of neighboring pixels making the simple application of noise infeasible. Invertible Neural Networks (INN) have shown excellent generative performance while still providing the ability to quantify the exact likelihood. Their principle is based on transforming a complicated distribution into a simple one e.g. an image into a spherical Gaussian. We hypothesize that adding noise to the latent space of an INN can enable differentially private image modification. Manipulation of the latent space leads to a modified image while preserving important details. Further, by conditioning the INN on meta-data provided with the dataset we aim at leaving dimensions important for downstream tasks like classification untouched while altering other parts that potentially contain identifying information. We term our method content-aware differential privacy (CADP). We conduct experiments on publicly available benchmarking datasets as well as dedicated medical ones. In addition, we show the generalizability of our method to categorical data. The source code is publicly available at https://github.com/Cardio-AI/CADP.
With coronary artery disease (CAD) persisting to be one of the leading causes of death worldwide, interest in supporting physicians with algorithms to speed up and improve diagnosis is high. In clinical practice, the severeness of CAD is often assessed with a coronary CT angiography (CCTA) scan and manually graded with the CAD-Reporting and Data System (CAD-RADS) score. The clinical questions this score assesses are whether patients have CAD or not (rule-out) and whether they have severe CAD or not (hold-out). In this work, we reach new state-of-the-art performance for automatic CAD-RADS scoring. We propose using severity-based label encoding, test time augmentation (TTA) and model ensembling for a task-specific deep learning architecture. Furthermore, we introduce a novel task- and model-specific, heuristic coronary segment labeling, which subdivides coronary trees into consistent parts across patients. It is fast, robust, and easy to implement. We were able to raise the previously reported area under the receiver operating characteristic curve (AUC) from 0.914 to 0.942 in the rule-out and from 0.921 to 0.950 in the hold-out task respectively.
Cardiac Magnetic Resonance (CMR) images are widely used for cardiac diagnosis and ventricular assessment. Extracting specific landmarks like the right ventricular insertion points is of importance for spatial alignment and 3D modeling. The automatic detection of such landmarks has been tackled by multiple groups using Deep Learning, but relatively little attention has been paid to the failure cases of evaluation metrics in this field. In this work, we extended the public ACDC dataset with additional labels of the right ventricular insertion points and compare different variants of a heatmap-based landmark detection pipeline. In this comparison, we demonstrate very likely pitfalls of apparently simple detection and localisation metrics which highlights the importance of a clear detection strategy and the definition of an upper limit for localisation-based metrics. Our preliminary results indicate that a combination of different metrics is necessary, as they yield different winners for method comparison. Additionally, they highlight the need of a comprehensive metric description and evaluation standardisation, especially for the error cases where no metrics could be computed or where no lower/upper boundary of a metric exists. Code and labels: https://github.com/Cardio-AI/rvip_landmark_detection
Coronary CT angiography (CCTA) has established its role as a non-invasive modality for the diagnosis of coronary artery disease (CAD). The CAD-Reporting and Data System (CAD-RADS) has been developed to standardize communication and aid in decision making based on CCTA findings. The CAD-RADS score is determined by manual assessment of all coronary vessels and the grading of lesions within the coronary artery tree. We propose a bottom-up approach for fully-automated prediction of this score using deep-learning operating on a segment-wise representation of the coronary arteries. The method relies solely on a prior fully-automated centerline extraction and segment labeling and predicts the segment-wise stenosis degree and the overall calcification grade as auxiliary tasks in a multi-task learning setup. We evaluate our approach on a data collection consisting of 2,867 patients. On the task of identifying patients with a CAD-RADS score indicating the need for further invasive investigation our approach reaches an area under curve (AUC) of 0.923 and an AUC of 0.914 for determining whether the patient suffers from CAD. This level of performance enables our approach to be used in a fully-automated screening setup or to assist diagnostic CCTA reading, especially due to its neural architecture design -- which allows comprehensive predictions.