Revamping AI Models in Dermatology: Overcoming Critical Challenges for Enhanced Skin Lesion Diagnosis

The surge in developing deep learning models for diagnosing skin lesions through image analysis is notable, yet their clinical black faces challenges. Current dermatology AI models have limitations: limited number of possible diagnostic outputs, lack of real-world testing on uncommon skin lesions, inability to detect out-of-distribution images, and over-reliance on dermoscopic images. To address these, we present an All-In-One \textbf{H}ierarchical-\textbf{O}ut of Distribution-\textbf{C}linical Triage (HOT) model. For a clinical image, our model generates three outputs: a hierarchical prediction, an alert for out-of-distribution images, and a recommendation for dermoscopy if clinical image alone is insufficient for diagnosis. When the recommendation is pursued, it integrates both clinical and dermoscopic images to deliver final diagnosis. Extensive experiments on a representative cutaneous lesion dataset demonstrate the effectiveness and synergy of each component within our framework. Our versatile model provides valuable decision support for lesion diagnosis and sets a promising precedent for medical AI applications.

Skin Lesion Recognition with Class-Hierarchy Regularized Hyperbolic Embeddings

In practice, many medical datasets have an underlying taxonomy defined over the disease label space. However, existing classification algorithms for medical diagnoses often assume semantically independent labels. In this study, we aim to leverage class hierarchy with deep learning algorithms for more accurate and reliable skin lesion recognition. We propose a hyperbolic network to learn image embeddings and class prototypes jointly. The hyperbola provably provides a space for modeling hierarchical relations better than Euclidean geometry. Meanwhile, we restrict the distribution of hyperbolic prototypes with a distance matrix that is encoded from the class hierarchy. Accordingly, the learned prototypes preserve the semantic class relations in the embedding space and we can predict the label of an image by assigning its feature to the nearest hyperbolic class prototype. We use an in-house skin lesion dataset which consists of around 230k dermoscopic images on 65 skin diseases to verify our method. Extensive experiments provide evidence that our model can achieve higher accuracy with less severe classification errors than models without considering class relations.

Out-of-Distribution Detection for Long-tailed and Fine-grained Skin Lesion Images

Recent years have witnessed a rapid development of automated methods for skin lesion diagnosis and classification. Due to an increasing deployment of such systems in clinics, it has become important to develop a more robust system towards various Out-of-Distribution(OOD) samples (unknown skin lesions and conditions). However, the current deep learning models trained for skin lesion classification tend to classify these OOD samples incorrectly into one of their learned skin lesion categories. To address this issue, we propose a simple yet strategic approach that improves the OOD detection performance while maintaining the multi-class classification accuracy for the known categories of skin lesion. To specify, this approach is built upon a realistic scenario of a long-tailed and fine-grained OOD detection task for skin lesion images. Through this approach, 1) First, we target the mixup amongst middle and tail classes to address the long-tail problem. 2) Later, we combine the above mixup strategy with prototype learning to address the fine-grained nature of the dataset. The unique contribution of this paper is two-fold, justified by extensive experiments. First, we present a realistic problem setting of OOD task for skin lesion. Second, we propose an approach to target the long-tailed and fine-grained aspects of the problem setting simultaneously to increase the OOD performance.