Accurate identification and localization of abnormalities from radiology images play an integral part in clinical diagnosis and treatment planning. Building a highly accurate prediction model for these tasks usually requires a large number of images manually annotated with labels and finding sites of abnormalities. In reality, however, such annotated data are expensive to acquire, especially the ones with location annotations. We need methods that can work well with only a small amount of location annotations. To address this challenge, we present a unified approach that simultaneously performs disease identification and localization through the same underlying model for all images. We demonstrate that our approach can effectively leverage both class information as well as limited location annotation, and significantly outperforms the comparative reference baseline in both classification and localization tasks.
Zhang al proposed a dual-attention model using images and optional texts to make accurate prediction @cite_33 . In @cite_14 , Zhang al proposed an image-to-text model to establish a direct mapping from medical images to diagnostic reports. Both models were evaluated on a dataset of bladder cancer images and corresponding diagnostic reports. Wang al took advantage of a large-scale chest X-ray dataset to formulate the disease diagnosis problem as multi-label classification, using class-specific image feature transformation @cite_39 . They also applied a thresholding method to the feature map visualization @cite_11 for each class and derived the bounding box for each disease. Their qualitative results showed that the model usually generated much larger bounding box than the ground-truth. Hwang al @cite_30 proposed a self-transfer learning framework to learn localization from the globally pooled class-specific feature maps supervised by image labels. These works have the same essence with class activation mapping @cite_19 which handles natural images. The location annotation information was not directly formulated into the loss function in the none of these works. Feature map pooling based localization did not effectively capture the precise disease regions.
@cite_30 @cite_14 @cite_33 @cite_39 @cite_19 @cite_11
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The inability to interpret the model prediction in semantically and visually meaningful ways is a well-known shortcoming of most existing computer-aided diagnosis methods. In this paper, we propose MDNet to establish a direct multimodal mapping between medical images and diagnostic reports that can read images, generate diagnostic reports, retrieve images by symptom descriptions, and visualize attention, to provide justifications of the network diagnosis process. MDNet includes an image model and a language model. The image model is proposed to enhance multi-scale feature ensembles and utilization efficiency. The language model, integrated with our improved attention mechanism, aims to read and explore discriminative image feature descriptions from reports to learn a direct mapping from sentence words to image pixels. The overall network is trained end-to-end by using our developed optimization strategy. Based on a pathology bladder cancer images and its diagnostic reports (BCIDR) dataset, we conduct sufficient experiments to demonstrate that MDNet outperforms comparative baselines. The proposed image model obtains state-of-the-art performance on two CIFAR datasets as well. The inability to interpret the model prediction in semantically and visually meaningful ways is a well-known shortcoming of most existing computer-aided diagnosis methods. In this paper, we propose MDNet to establish a direct multimodal mapping between medical images and diagnostic reports that can read images, generate diagnostic reports, retrieve images by symptom descriptions, and visualize attention, to provide justifications of the network diagnosis process. MDNet includes an image model and a language model. The image model is proposed to enhance multi-scale feature ensembles and utilization efficiency. The language model, integrated with our improved attention mechanism, aims to read and explore discriminative image feature descriptions from reports to learn a direct mapping from sentence words to image pixels. The overall network is trained end-to-end by using our developed optimization strategy. Based on a pathology bladder cancer images and its diagnostic reports (BCIDR) dataset, we conduct sufficient experiments to demonstrate that MDNet outperforms comparative baselines. The proposed image model obtains state-of-the-art performance on two CIFAR datasets as well. In this work, we exploit the task of joint classification and weakly supervised localization of thoracic diseases from chest radiographs, with only image-level disease labels coupled with disease severity-level (DSL) information of a subset. A convolutional neural network (CNN) based attention-guided curriculum learning (AGCL) framework is presented, which leverages the severity-level attributes mined from radiology reports. Images in order of difficulty (grouped by different severity-levels) are fed to CNN to boost the learning gradually. In addition, highly confident samples (measured by classification probabilities) and their corresponding class-conditional heatmaps (generated by the CNN) are extracted and further fed into the AGCL framework to guide the learning of more distinctive convolutional features in the next iteration. A two-path network architecture is designed to regress the heatmaps from selected seed samples in addition to the original classification task. The joint learning scheme can improve the classification and localization performance along with more seed samples for the next iteration. We demonstrate the effectiveness of this iterative refinement framework via extensive experimental evaluations on the publicly available ChestXray14 dataset. AGCL achieves over 5.7 (averaged over 14 diseases) increase in classification AUC and 7 11 increases in Recall Precision for the localization task compared to the state of the art. We present an adversarial domain adaptation based deep learning approach for automatic tumor segmentation from T2-weighted MRI. Our approach is composed of two steps: (i) a tumor-aware unsupervised cross-domain adaptation (CT to MRI), followed by (ii) semi-supervised tumor segmentation using Unet trained with synthesized and limited number of original MRIs. We introduced a novel target specific loss, called tumor-aware loss, for unsupervised cross-domain adaptation that helps to preserve tumors on synthesized MRIs produced from CT images. In comparison, state-of-the art adversarial networks trained without our tumor-aware loss produced MRIs with ill-preserved or missing tumors. All networks were trained using labeled CT images from 377 patients with non-small cell lung cancer obtained from the Cancer Imaging Archive and unlabeled T2w MRIs from a completely unrelated cohort of 6 patients with pre-treatment and 36 on-treatment scans. Next, we combined 6 labeled pre-treatment MRI scans with the synthesized MRIs to boost tumor segmentation accuracy through semi-supervised learning. Semi-supervised training of cycle-GAN produced a segmentation accuracy of 0.66 computed using Dice Score Coefficient (DSC). Our method trained with only synthesized MRIs produced an accuracy of 0.74 while the same method trained in semi-supervised setting produced the best accuracy of 0.80 on test. Our results show that tumor-aware adversarial domain adaptation helps to achieve reasonably accurate cancer segmentation from limited MRI data by leveraging large CT datasets.