Depending on the application, radiological diagnoses can be associated with high inter- and intra-rater variabilities. Most computer-aided diagnosis (CAD) solutions treat such data as incontrovertible, exposing learning algorithms to considerable and possibly contradictory label noise and biases. Thus, managing subjectivity in labels is a fundamental problem in medical imaging analysis. To address this challenge, we introduce auto-decoded deep latent embeddings (ADDLE), which explicitly models the tendencies of each rater using an auto-decoder framework. After a simple linear transformation, the latent variables can be injected into any backbone at any and multiple points, allowing the model to account for rater-specific effects on the diagnosis. Importantly, ADDLE does not expect multiple raters per image in training, meaning it can readily learn from data mined from hospital archives. Moreover, the complexity of training ADDLE does not increase as more raters are added. During inference each rater can be simulated and a 'mean' or 'greedy' virtual rating can be produced. We test ADDLE on the problem of liver steatosis diagnosis from 2D ultrasound (US) by collecting 46 084 studies along with clinical US diagnoses originating from 65 different raters. We evaluated diagnostic performance using a separate dataset with gold-standard biopsy diagnoses. ADDLE can improve the partial areas under the curve (AUCs) for diagnosing severe steatosis by 10.5% over standard classifiers while outperforming other annotator-noise approaches, including those requiring 65 times the parameters.
3D delineation of anatomical structures is a cardinal goal in medical imaging analysis. Prior to deep learning, statistical shape models that imposed anatomical constraints and produced high quality surfaces were a core technology. Prior to deep learning, statistical shape models that imposed anatomical constraints and produced high quality surfaces were a core technology. Today fully-convolutional networks (FCNs), while dominant, do not offer these capabilities. We present deep implicit statistical shape models (DISSMs), a new approach to delineation that marries the representation power of convolutional neural networks (CNNs) with the robustness of SSMs. DISSMs use a deep implicit surface representation to produce a compact and descriptive shape latent space that permits statistical models of anatomical variance. To reliably fit anatomically plausible shapes to an image, we introduce a novel rigid and non-rigid pose estimation pipeline that is modelled as a Markov decision process(MDP). We outline a training regime that includes inverted episodic training and a deep realization of marginal space learning (MSL). Intra-dataset experiments on the task of pathological liver segmentation demonstrate that DISSMs can perform more robustly than three leading FCN models, including nnU-Net: reducing the mean Hausdorff distance (HD) by 7.7-14.3mm and improving the worst case Dice-Sorensen coefficient (DSC) by 1.2-2.3%. More critically, cross-dataset experiments on a dataset directly reflecting clinical deployment scenarios demonstrate that DISSMs improve the mean DSC and HD by 3.5-5.9% and 12.3-24.5mm, respectively, and the worst-case DSC by 5.4-7.3%. These improvements are over and above any benefits from representing delineations with high-quality surface.
Osteoporosis is a common chronic metabolic bone disease that is often under-diagnosed and under-treated due to the limited access to bone mineral density (BMD) examinations, Dual-energy X-ray Absorptiometry (DXA). In this paper, we propose a method to predict BMD from Chest X-ray (CXR), one of the most common, accessible, and low-cost medical image examinations. Our method first automatically detects Regions of Interest (ROIs) of local and global bone structures from the CXR. Then a multi-ROI model is developed to exploit both local and global information in the chest X-ray image for accurate BMD estimation. Our method is evaluated on 329 CXR cases with ground truth BMD measured by DXA. The model predicted BMD has a strong correlation with the gold standard DXA BMD (Pearson correlation coefficient 0.840). When applied for osteoporosis screening, it achieves a high classification performance (AUC 0.936). As the first effort in the field to use CXR scans to predict the spine BMD, the proposed algorithm holds strong potential in enabling early osteoporosis screening through routine chest X-rays and contributing to the enhancement of public health.
Bone mineral density (BMD) is a clinically critical indicator of osteoporosis, usually measured by dual-energy X-ray absorptiometry (DEXA). Due to the limited accessibility of DEXA machines and examinations, osteoporosis is often under-diagnosed and under-treated, leading to increased fragility fracture risks. Thus it is highly desirable to obtain BMDs with alternative cost-effective and more accessible medical imaging examinations such as X-ray plain films. In this work, we formulate the BMD estimation from plain hip X-ray images as a regression problem. Specifically, we propose a new semi-supervised self-training algorithm to train the BMD regression model using images coupled with DEXA measured BMDs and unlabeled images with pseudo BMDs. Pseudo BMDs are generated and refined iteratively for unlabeled images during self-training. We also present a novel adaptive triplet loss to improve the model's regression accuracy. On an in-house dataset of 1,090 images (819 unique patients), our BMD estimation method achieves a high Pearson correlation coefficient of 0.8805 to ground-truth BMDs. It offers good feasibility to use the more accessible and cheaper X-ray imaging for opportunistic osteoporosis screening.
Lesion detection serves a critical role in early diagnosis and has been well explored in recent years due to methodological advancesand increased data availability. However, the high costs of annotations hinder the collection of large and completely labeled datasets, motivating semi-supervised detection approaches. In this paper, we introduce mean teacher hetero-modal detection (MTHD), which addresses two important gaps in current semi-supervised detection. First, it is not obvious how to enforce unlabeled consistency constraints across the very different outputs of various detectors, which has resulted in various compromises being used in the state of the art. Using an anchor-free framework, MTHD formulates a mean teacher approach without such compromises, enforcing consistency on the soft-output of object centers and size. Second, multi-sequence data is often critical, e.g., for abdominal lesion detection, but unlabeled data is often missing sequences. To deal with this, MTHD incorporates hetero-modal learning in its framework. Unlike prior art, MTHD is able to incorporate an expansive set of consistency constraints that include geometric transforms and random sequence combinations. We train and evaluate MTHD on liver lesion detection using the largest MR lesion dataset to date (1099 patients with >5000 volumes). MTHD surpasses the best fully-supervised and semi-supervised competitors by 10.1% and 3.5%, respectively, in average sensitivity.
The boundary of tumors (hepatocellular carcinoma, or HCC) contains rich semantics: capsular invasion, visibility, smoothness, folding and protuberance, etc. Capsular invasion on tumor boundary has proven to be clinically correlated with the prognostic indicator, microvascular invasion (MVI). Investigating tumor boundary semantics has tremendous clinical values. In this paper, we propose the first and novel computational framework that disentangles the task into two components: spatial vertex localization and sequential semantic classification. (1) A HCC tumor segmentor is built for tumor mask boundary extraction, followed by polar transform representing the boundary with radius and angle. Vertex generator is used to produce fixed-length boundary vertices where vertex features are sampled on the corresponding spatial locations. (2) The sampled deep vertex features with positional embedding are mapped into a sequential space and decoded by a multilayer perceptron (MLP) for semantic classification. Extensive experiments on tumor capsule semantics demonstrate the effectiveness of our framework. Mining the correlation between the boundary semantics and MVI status proves the feasibility to integrate this boundary semantics as a valid HCC prognostic biomarker.
In federated learning (FL), fair and accurate measurement of the contribution of each federated participant is of great significance. The level of contribution not only provides a rational metric for distributing financial benefits among federated participants, but also helps to discover malicious participants that try to poison the FL framework. Previous methods for contribution measurement were based on enumeration over possible combination of federated participants. Their computation costs increase drastically with the number of participants or feature dimensions, making them inapplicable in practical situations. In this paper an efficient method is proposed to evaluate the contributions of federated participants. This paper focuses on the horizontal FL framework, where client servers calculate parameter gradients over their local data, and upload the gradients to the central server. Before aggregating the client gradients, the central server train a data value estimator of the gradients using reinforcement learning techniques. As shown by experimental results, the proposed method consistently outperforms the conventional leave-one-out method in terms of valuation authenticity as well as time complexity.
In the federated learning system, parameter gradients are shared among participants and the central modulator, while the original data never leave their protected source domain. However, the gradient itself might carry enough information for precise inference of the original data. By reporting their parameter gradients to the central server, client datasets are exposed to inference attacks from adversaries. In this paper, we propose a quantitative metric based on mutual information for clients to evaluate the potential risk of information leakage in their gradients. Mutual information has received increasing attention in the machine learning and data mining community over the past few years. However, existing mutual information estimation methods cannot handle high-dimensional variables. In this paper, we propose a novel method to approximate the mutual information between the high-dimensional gradients and batched input data. Experimental results show that the proposed metric reliably reflect the extent of information leakage in federated learning. In addition, using the proposed metric, we investigate the influential factors of risk level. It is proven that, the risk of information leakage is related to the status of the task model, as well as the inherent data distribution.
Knowledge distillation refers to a technique of transferring the knowledge from a large learned model or an ensemble of learned models to a small model. This method relies on access to the original training set, which might not always be available. A possible solution is a data-free adversarial distillation framework, which deploys a generative network to transfer the teacher model's knowledge to the student model. However, the data generation efficiency is low in the data-free adversarial distillation. We add an activation regularizer and a virtual interpolation method to improve the data generation efficiency. The activation regularizer enables the students to match the teacher's predictions close to activation boundaries and decision boundaries. The virtual interpolation method can generate virtual samples and labels in-between decision boundaries. Our experiments show that our approach surpasses state-of-the-art data-free distillation methods. The student model can achieve 95.42% accuracy on CIFAR-10 and 77.05% accuracy on CIFAR-100 without any original training data. Our model's accuracy is 13.8% higher than the state-of-the-art data-free method on CIFAR-100.
Self-attention models have been successfully applied in end-to-end speech recognition systems, which greatly improve the performance of recognition accuracy. However, such attention-based models cannot be used in online speech recognition, because these models usually have to utilize a whole acoustic sequences as inputs. A common method is restricting the field of attention sights by a fixed left and right window, which makes the computation costs manageable yet also introduces performance degradation. In this paper, we propose Memory-Self-Attention (MSA), which adds history information into the Restricted-Self-Attention unit. MSA only needs localtime features as inputs, and efficiently models long temporal contexts by attending memory states. Meanwhile, recurrent neural network transducer (RNN-T) has proved to be a great approach for online ASR tasks, because the alignments of RNN-T are local and monotonic. We propose a novel network structure, called Memory-Self-Attention (MSA) Transducer. Both encoder and decoder of the MSA Transducer contain the proposed MSA unit. The experiments demonstrate that our proposed models improve WER results than Restricted-Self-Attention models by $13.5 on WSJ and $7.1 on SWBD datasets relatively, and without much computation costs increase.