Progressive trajectory matching for medical dataset distillation

It is essential but challenging to share medical image datasets due to privacy issues, which prohibit building foundation models and knowledge transfer. In this paper, we propose a novel dataset distillation method to condense the original medical image datasets into a synthetic one that preserves useful information for building an analysis model without accessing the original datasets. Existing methods tackle only natural images by randomly matching parts of the training trajectories of the model parameters trained by the whole real datasets. However, through extensive experiments on medical image datasets, the training process is extremely unstable and achieves inferior distillation results. To solve these barriers, we propose to design a novel progressive trajectory matching strategy to improve the training stability for medical image dataset distillation. Additionally, it is observed that improved stability prevents the synthetic dataset diversity and final performance improvements. Therefore, we propose a dynamic overlap mitigation module that improves the synthetic dataset diversity by dynamically eliminating the overlap across different images and retraining parts of the synthetic images for better convergence. Finally, we propose a new medical image dataset distillation benchmark of various modalities and configurations to promote fair evaluations. It is validated that our proposed method achieves 8.33% improvement over previous state-of-the-art methods on average, and 11.7% improvement when ipc=2 (i.e., image per class is 2). Codes and benchmarks will be released.

Prompt-driven Latent Domain Generalization for Medical Image Classification

Deep learning models for medical image analysis easily suffer from distribution shifts caused by dataset artifacts bias, camera variations, differences in the imaging station, etc., leading to unreliable diagnoses in real-world clinical settings. Domain generalization (DG) methods, which aim to train models on multiple domains to perform well on unseen domains, offer a promising direction to solve the problem. However, existing DG methods assume domain labels of each image are available and accurate, which is typically feasible for only a limited number of medical datasets. To address these challenges, we propose a novel DG framework for medical image classification without relying on domain labels, called Prompt-driven Latent Domain Generalization (PLDG). PLDG consists of unsupervised domain discovery and prompt learning. This framework first discovers pseudo domain labels by clustering the bias-associated style features, then leverages collaborative domain prompts to guide a Vision Transformer to learn knowledge from discovered diverse domains. To facilitate cross-domain knowledge learning between different prompts, we introduce a domain prompt generator that enables knowledge sharing between domain prompts and a shared prompt. A domain mixup strategy is additionally employed for more flexible decision margins and mitigates the risk of incorrect domain assignments. Extensive experiments on three medical image classification tasks and one debiasing task demonstrate that our method can achieve comparable or even superior performance than conventional DG algorithms without relying on domain labels. Our code will be publicly available upon the paper is accepted.

EPVT: Environment-aware Prompt Vision Transformer for Domain Generalization in Skin Lesion Recognition

Skin lesion recognition using deep learning has made remarkable progress, and there is an increasing need for deploying these systems in real-world scenarios. However, recent research has revealed that deep neural networks for skin lesion recognition may overly depend on disease-irrelevant image artifacts (i.e. dark corners, dense hairs), leading to poor generalization in unseen environments. To address this issue, we propose a novel domain generalization method called EPVT, which involves embedding prompts into the vision transformer to collaboratively learn knowledge from diverse domains. Concretely, EPVT leverages a set of domain prompts, each of which plays as a domain expert, to capture domain-specific knowledge; and a shared prompt for general knowledge over the entire dataset. To facilitate knowledge sharing and the interaction of different prompts, we introduce a domain prompt generator that enables low-rank multiplicative updates between domain prompts and the shared prompt. A domain mixup strategy is additionally devised to reduce the co-occurring artifacts in each domain, which allows for more flexible decision margins and mitigates the issue of incorrectly assigned domain labels. Experiments on four out-of-distribution datasets and six different biased ISIC datasets demonstrate the superior generalization ability of EPVT in skin lesion recognition across various environments. Our code and dataset will be released at https://github.com/SiyuanYan1/EPVT.

Towards Open-Scenario Semi-supervised Medical Image Classification

Semi-supervised learning (SSL) has attracted much attention since it reduces the expensive costs of collecting adequate well-labeled training data, especially for deep learning methods. However, traditional SSL is built upon an assumption that labeled and unlabeled data should be from the same distribution e.g., classes and domains. However, in practical scenarios, unlabeled data would be from unseen classes or unseen domains, and it is still challenging to exploit them by existing SSL methods. Therefore, in this paper, we proposed a unified framework to leverage these unseen unlabeled data for open-scenario semi-supervised medical image classification. We first design a novel scoring mechanism, called dual-path outliers estimation, to identify samples from unseen classes. Meanwhile, to extract unseen-domain samples, we then apply an effective variational autoencoder (VAE) pre-training. After that, we conduct domain adaptation to fully exploit the value of the detected unseen-domain samples to boost semi-supervised training. We evaluated our proposed framework on dermatology and ophthalmology tasks. Extensive experiments demonstrate our model can achieve superior classification performance in various medical SSL scenarios.

Towards Trustable Skin Cancer Diagnosis via Rewriting Model's Decision

Deep neural networks have demonstrated promising performance on image recognition tasks. However, they may heavily rely on confounding factors, using irrelevant artifacts or bias within the dataset as the cue to improve performance. When a model performs decision-making based on these spurious correlations, it can become untrustable and lead to catastrophic outcomes when deployed in the real-world scene. In this paper, we explore and try to solve this problem in the context of skin cancer diagnosis. We introduce a human-in-the-loop framework in the model training process such that users can observe and correct the model's decision logic when confounding behaviors happen. Specifically, our method can automatically discover confounding factors by analyzing the co-occurrence behavior of the samples. It is capable of learning confounding concepts using easily obtained concept exemplars. By mapping the black-box model's feature representation onto an explainable concept space, human users can interpret the concept and intervene via first order-logic instruction. We systematically evaluate our method on our newly crafted, well-controlled skin lesion dataset and several public skin lesion datasets. Experiments show that our method can effectively detect and remove confounding factors from datasets without any prior knowledge about the category distribution and does not require fully annotated concept labels. We also show that our method enables the model to focus on clinical-related concepts, improving the model's performance and trustworthiness during model inference.

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.

Flexible Sampling for Long-tailed Skin Lesion Classification

Most of the medical tasks naturally exhibit a long-tailed distribution due to the complex patient-level conditions and the existence of rare diseases. Existing long-tailed learning methods usually treat each class equally to re-balance the long-tailed distribution. However, considering that some challenging classes may present diverse intra-class distributions, re-balancing all classes equally may lead to a significant performance drop. To address this, in this paper, we propose a curriculum learning-based framework called Flexible Sampling for the long-tailed skin lesion classification task. Specifically, we initially sample a subset of training data as anchor points based on the individual class prototypes. Then, these anchor points are used to pre-train an inference model to evaluate the per-class learning difficulty. Finally, we use a curriculum sampling module to dynamically query new samples from the rest training samples with the learning difficulty-aware sampling probability. We evaluated our model against several state-of-the-art methods on the ISIC dataset. The results with two long-tailed settings have demonstrated the superiority of our proposed training strategy, which achieves a new benchmark for long-tailed skin lesion classification.

Learning-based Hybrid Local Search for the Hard-label Textual Attack

Deep neural networks are vulnerable to adversarial examples in Natural Language Processing. However, existing textual adversarial attacks usually utilize the gradient or prediction confidence to generate adversarial examples, making it hard to be deployed in real-world applications. To this end, we consider a rarely investigated but more rigorous setting, namely hard-label attack, in which the attacker could only access the prediction label. In particular, we find that the changes on prediction label caused by word substitutions on the adversarial example could precisely reflect the importance of different words. Based on this observation, we propose a novel hard-label attack, called Learning-based Hybrid Local Search (LHLS) algorithm, which effectively estimates word importance with the prediction label from the attack history and integrate such information into hybrid local search algorithm to optimize the adversarial perturbation. Extensive evaluations for text classification and textual entailment using various datasets and models show that our LHLS significantly outperforms existing hard-label attacks regarding the attack performance as well as adversary quality.

Long-Tailed Multi-Label Retinal Diseases Recognition Using Hierarchical Information and Hybrid Knowledge Distillation

In the real world, medical datasets often exhibit a long-tailed data distribution (i.e., a few classes occupy most of the data, while most classes have rarely few samples), which results in a challenging imbalance learning scenario. For example, there are estimated more than 40 different kinds of retinal diseases with variable morbidity, however with more than 30+ conditions are very rare from the global patient cohorts, which results in a typical long-tailed learning problem for deep learning-based screening models. Moreover, there may exist more than one kind of disease on the retina, which results in a multi-label scenario and bring label co-occurrence issue for re-sampling strategy. In this work, we propose a novel framework that leverages the prior knowledge in retinal diseases for training a more robust representation of the model under a hierarchy-sensible constraint. Then, an instance-wise class-balanced sampling strategy and hybrid knowledge distillation manner are firstly introduced to learn from the long-tailed multi-label distribution. Our experiments training on the retinal dataset of more than one million samples demonstrate the superiority of our proposed methods which outperform all competitors and significantly improve the recognition accuracy of most diseases especially those rare diseases.