Given sufficient data from multiple edge devices, federated learning (FL) enables training a shared model without transmitting private data to a central server. However, FL is generally vulnerable to Byzantine attacks from compromised edge devices, which can significantly degrade the model performance. In this paper, we propose a intuitive plugin that can be integrated into existing FL techniques to achieve Byzantine-Resilience. Key idea is to generate virtual data samples and evaluate model consistency scores across local updates to effectively filter out compromised edge devices. By utilizing this scoring mechanism before the aggregation phase, the proposed plugin enables existing FL techniques to become robust against Byzantine attacks while maintaining their original benefits. Numerical results on medical image classification task validate that plugging the proposed approach into representative FL algorithms, effectively achieves Byzantine resilience. Furthermore, the proposed plugin maintains the original convergence properties of the base FL algorithms when no Byzantine attacks are present.
Federated learning (FL) has emerged as a promising approach to medical image analysis that allows deep model training using decentralized data while ensuring data privacy. However, in the field of FL, communication cost plays a critical role in evaluating the performance of the model. Thus, transferring vision foundation models can be particularly challenging due to the significant resource costs involved. In this paper, we introduce a federated adaptive Contrastive Language Image Pretraining CLIP model designed for classification tasks. We employ a light-weight and efficient feature attention module for CLIP that selects suitable features for each client's data. Additionally, we propose a domain adaptation technique to reduce differences in data distribution between clients. Experimental results on four publicly available datasets demonstrate the superior performance of FACMIC in dealing with real-world and multisource medical imaging data. Our codes are available at https://github.com/AIPMLab/FACMIC.
Medical image classification is crucial for supporting healthcare professionals in decision-making and training. While Convolutional Neural Networks (CNNs) have traditionally dominated this field, Transformer-based models are gaining attention. In this study, we apply explainable AI (XAI) techniques to assess the performance of various models on real-world medical data and identify areas for improvement. We compare CNN models such as VGG-16, ResNet-50, and EfficientNetV2L with a Transformer model: ViT-Base-16. Our results show that data augmentation has little impact, but hyperparameter tuning and advanced modeling improve performance. CNNs, particularly VGG-16 and ResNet-50, outperform ViT-Base-16 and EfficientNetV2L, likely due to underfitting from limited data. XAI methods like LIME and SHAP further reveal that better-performing models visualize tumors more effectively. These findings suggest that CNNs with shallower architectures are more effective for small datasets and can support medical decision-making.
Long-tailed learning is considered to be an extremely challenging problem in data imbalance learning. It aims to train well-generalized models from a large number of images that follow a long-tailed class distribution. In the medical field, many diagnostic imaging exams such as dermoscopy and chest radiography yield a long-tailed distribution of complex clinical findings. Recently, long-tailed learning in medical image analysis has garnered significant attention. However, the field currently lacks a unified, strictly formulated, and comprehensive benchmark, which often leads to unfair comparisons and inconclusive results. To help the community improve the evaluation and advance, we build a unified, well-structured codebase called Medical OpeN-source Long-taIled ClassifiCAtion (MONICA), which implements over 30 methods developed in relevant fields and evaluated on 12 long-tailed medical datasets covering 6 medical domains. Our work provides valuable practical guidance and insights for the field, offering detailed analysis and discussion on the effectiveness of individual components within the inbuilt state-of-the-art methodologies. We hope this codebase serves as a comprehensive and reproducible benchmark, encouraging further advancements in long-tailed medical image learning. The codebase is publicly available on https://github.com/PyJulie/MONICA.
The widespread adoption of large-scale pre-training techniques has significantly advanced the development of medical foundation models, enabling them to serve as versatile tools across a broad range of medical tasks. However, despite their strong generalization capabilities, medical foundation models pre-trained on large-scale datasets tend to suffer from domain gaps between heterogeneous data, leading to suboptimal performance on specific tasks compared to specialist models, as evidenced by previous studies. In this paper, we explore a new perspective called "Knowledge Decomposition" to improve the performance on specific medical tasks, which deconstructs the foundation model into multiple lightweight expert models, each dedicated to a particular anatomical region, with the aim of enhancing specialization and simultaneously reducing resource consumption. To accomplish the above objective, we propose a novel framework named Low-Rank Knowledge Decomposition (LoRKD), which explicitly separates gradients from different tasks by incorporating low-rank expert modules and efficient knowledge separation convolution. The low-rank expert modules resolve gradient conflicts between heterogeneous data from different anatomical regions, providing strong specialization at lower costs. The efficient knowledge separation convolution significantly improves algorithm efficiency by achieving knowledge separation within a single forward propagation. Extensive experimental results on segmentation and classification tasks demonstrate that our decomposed models not only achieve state-of-the-art performance but also exhibit superior transferability on downstream tasks, even surpassing the original foundation models in task-specific evaluations. The code is available at here.
A fundamental challenge in federated learning lies in mixing heterogeneous datasets and classification tasks while minimizing the high communication cost caused by clients as well as the exchange of weight updates with the server over a fixed number of rounds. This results in divergent model convergence rates and performance, which may hinder their deployment in precision medicine. In real-world scenarios, client data is collected from different hospitals with extremely varying components (e.g., imaging modality, organ type, etc). Previous studies often overlooked the convoluted heterogeneity during the training stage where the target learning tasks vary across clients as well as the dataset type and their distributions. To address such limitations, we unprecedentedly introduce UniFed, a universal federated learning paradigm that aims to classify any disease from any imaging modality. UniFed also handles the issue of varying convergence times in the client-specific optimization based on the complexity of their learning tasks. Specifically, by dynamically adjusting both local and global models, UniFed considers the varying task complexities of clients and the server, enhancing its adaptability to real-world scenarios, thereby mitigating issues related to overtraining and excessive communication. Furthermore, our framework incorporates a sequential model transfer mechanism that takes into account the diverse tasks among hospitals and a dynamic task-complexity based ordering. We demonstrate the superiority of our framework in terms of accuracy, communication cost, and convergence time over relevant benchmarks in diagnosing retina, histopathology, and liver tumour diseases under federated learning. Our UniFed code is available at https://github.com/basiralab/UniFed.
Deep learning models used for medical image classification tasks are often constrained by the limited amount of training data along with severe class imbalance. Despite these problems, models should be explainable to enable human trust in the models' decisions to ensure wider adoption in high-risk situations. In this paper, we propose PRECISe, an explainable-by-design model meticulously constructed to concurrently address all three challenges. Evaluation on 2 imbalanced medical image datasets reveals that PRECISe outperforms the current state-of-the-art methods on data efficient generalization to minority classes, achieving an accuracy of ~87% in detecting pneumonia in chest x-rays upon training on <60 images only. Additionally, a case study is presented to highlight the model's ability to produce easily interpretable predictions, reinforcing its practical utility and reliability for medical imaging tasks.
The success of large-scale pre-trained models has established fine-tuning as a standard method for achieving significant improvements in downstream tasks. However, fine-tuning the entire parameter set of a pre-trained model is costly. Parameter-efficient transfer learning (PETL) has recently emerged as a cost-effective alternative for adapting pre-trained models to downstream tasks. Despite its advantages, the increasing model size and input resolution present challenges for PETL, as the training memory consumption is not reduced as effectively as the parameter usage. In this paper, we introduce Fine-grained Prompt Tuning plus (FPT+), a PETL method designed for high-resolution medical image classification, which significantly reduces the training memory consumption compared to other PETL methods. FPT+ performs transfer learning by training a lightweight side network and accessing pre-trained knowledge from a large pre-trained model (LPM) through fine-grained prompts and fusion modules. Specifically, we freeze the LPM of interest and construct a learnable lightweight side network. The frozen LPM processes high-resolution images to extract fine-grained features, while the side network employs corresponding down-sampled low-resolution images to minimize the memory usage. To enable the side network to leverage pre-trained knowledge, we propose fine-grained prompts and fusion modules, which collaborate to summarize information through the LPM's intermediate activations. We evaluate FPT+ on eight medical image datasets of varying sizes, modalities, and complexities. Experimental results demonstrate that FPT+ outperforms other PETL methods, using only 1.03% of the learnable parameters and 3.18% of the memory required for fine-tuning an entire ViT-B model. Our code is available https://github.com/YijinHuang/FPT.
Counterfactual explanations (CEs) aim to enhance the interpretability of machine learning models by illustrating how alterations in input features would affect the resulting predictions. Common CE approaches require an additional model and are typically constrained to binary counterfactuals. In contrast, we propose a novel method that operates directly on the latent space of a generative model, specifically a Diffusion Autoencoder (DAE). This approach offers inherent interpretability by enabling the generation of CEs and the continuous visualization of the model's internal representation across decision boundaries. Our method leverages the DAE's ability to encode images into a semantically rich latent space in an unsupervised manner, eliminating the need for labeled data or separate feature extraction models. We show that these latent representations are helpful for medical condition classification and the ordinal regression of severity pathologies, such as vertebral compression fractures (VCF) and diabetic retinopathy (DR). Beyond binary CEs, our method supports the visualization of ordinal CEs using a linear model, providing deeper insights into the model's decision-making process and enhancing interpretability. Experiments across various medical imaging datasets demonstrate the method's advantages in interpretability and versatility. The linear manifold of the DAE's latent space allows for meaningful interpolation and manipulation, making it a powerful tool for exploring medical image properties. Our code is available at https://doi.org/10.5281/zenodo.13859266.
Recent studies have underscored the capabilities of natural imaging foundation models to serve as powerful feature extractors, even in a zero-shot setting for medical imaging data. Most commonly, a shallow multi-layer perceptron (MLP) is appended to the feature extractor to facilitate end-to-end learning and downstream prediction tasks such as classification, thus representing the de facto standard. However, as graph neural networks (GNNs) have become a practicable choice for various tasks in medical research in the recent past, we direct attention to the question of how effective GNNs are compared to MLP prediction heads for the task of 3D medical image classification, proposing them as a potential alternative. In our experiments, we devise a subject-level graph for each volumetric dataset instance. Therein latent representations of all slices in the volume, encoded through a DINOv2 pretrained vision transformer (ViT), constitute the nodes and their respective node features. We use public datasets to compare the classification heads numerically and evaluate various graph construction and graph convolution methods in our experiments. Our findings show enhancements of the GNN in classification performance and substantial improvements in runtime compared to an MLP prediction head. Additional robustness evaluations further validate the promising performance of the GNN, promoting them as a suitable alternative to traditional MLP classification heads. Our code is publicly available at: https://github.com/compai-lab/2024-miccai-grail-kiechle
Limited training data and severe class imbalance pose significant challenges to developing clinically robust deep learning models. Federated learning (FL) addresses the former by enabling different medical clients to collaboratively train a deep model without sharing privacy-sensitive data. However, class imbalance worsens due to variation in inter-client class distribution. We propose federated learning with non-parametric regularization (FedNPR and FedNPR-Per, a personalized version of FedNPR) to regularize the feature extractor and enhance useful and discriminative signal in the feature space. Our extensive experiments show that FedNPR outperform the existing state-of-the art FL approaches in class imbalance skin lesion classification and intracranial hemorrhage identification. Additionally, the non-parametric regularization module consistently improves the performance of existing state-of-the-art FL approaches. We believe that NPR is a valuable tool in FL under clinical settings.
Continual Learning (CL) is crucial for enabling networks to dynamically adapt as they learn new tasks sequentially, accommodating new data and classes without catastrophic forgetting. Diverging from conventional perspectives on CL, our paper introduces a new perspective wherein forgetting could actually benefit the sequential learning paradigm. Specifically, we present BiasPruner, a CL framework that intentionally forgets spurious correlations in the training data that could lead to shortcut learning. Utilizing a new bias score that measures the contribution of each unit in the network to learning spurious features, BiasPruner prunes those units with the highest bias scores to form a debiased subnetwork preserved for a given task. As BiasPruner learns a new task, it constructs a new debiased subnetwork, potentially incorporating units from previous subnetworks, which improves adaptation and performance on the new task. During inference, BiasPruner employs a simple task-agnostic approach to select the best debiased subnetwork for predictions. We conduct experiments on three medical datasets for skin lesion classification and chest X-Ray classification and demonstrate that BiasPruner consistently outperforms SOTA CL methods in terms of classification performance and fairness. Our code is available here.
Vision Transformers (ViTs) have achieved significant advancement in computer vision tasks due to their powerful modeling capacity. However, their performance notably degrades when trained with insufficient data due to lack of inherent inductive biases. Distilling knowledge and inductive biases from a Convolutional Neural Network (CNN) teacher has emerged as an effective strategy for enhancing the generalization of ViTs on limited datasets. Previous approaches to Knowledge Distillation (KD) have pursued two primary paths: some focused solely on distilling the logit distribution from CNN teacher to ViT student, neglecting the rich semantic information present in intermediate features due to the structural differences between them. Others integrated feature distillation along with logit distillation, yet this introduced alignment operations that limits the amount of knowledge transferred due to mismatched architectures and increased the computational overhead. To this end, this paper presents Hybrid Data-efficient Knowledge Distillation (HDKD) paradigm which employs a CNN teacher and a hybrid student. The choice of hybrid student serves two main aspects. First, it leverages the strengths of both convolutions and transformers while sharing the convolutional structure with the teacher model. Second, this shared structure enables the direct application of feature distillation without any information loss or additional computational overhead. Additionally, we propose an efficient light-weight convolutional block named Mobile Channel-Spatial Attention (MBCSA), which serves as the primary convolutional block in both teacher and student models. Extensive experiments on two medical public datasets showcase the superiority of HDKD over other state-of-the-art models and its computational efficiency. Source code at: https://github.com/omarsherif200/HDKD
The robustness of supervised deep learning-based medical image classification is significantly undermined by label noise. Although several methods have been proposed to enhance classification performance in the presence of noisy labels, they face some challenges: 1) a struggle with class-imbalanced datasets, leading to the frequent overlooking of minority classes as noisy samples; 2) a singular focus on maximizing performance using noisy datasets, without incorporating experts-in-the-loop for actively cleaning the noisy labels. To mitigate these challenges, we propose a two-phase approach that combines Learning with Noisy Labels (LNL) and active learning. This approach not only improves the robustness of medical image classification in the presence of noisy labels, but also iteratively improves the quality of the dataset by relabeling the important incorrect labels, under a limited annotation budget. Furthermore, we introduce a novel Variance of Gradients approach in LNL phase, which complements the loss-based sample selection by also sampling under-represented samples. Using two imbalanced noisy medical classification datasets, we demonstrate that that our proposed technique is superior to its predecessors at handling class imbalance by not misidentifying clean samples from minority classes as mostly noisy samples.
Malaria parasites pose a significant global health burden, causing widespread suffering and mortality. Detecting malaria infection accurately is crucial for effective treatment and control. However, existing automated detection techniques have shown limitations in terms of accuracy and generalizability. Many studies have focused on specific features without exploring more comprehensive approaches. In our case, we formulate a deep learning technique for malaria infected cell classification using traditional CNNs and transfer learning models notably VGG19, InceptionV3, and Xception. The models were trained using NIH datasets and tested using different performance metrics such as accuracy, precision, re- call, and F1-score. The test results showed that deep CNNs achieved the highest accuracy - 97%, followed by Xception with an accuracy of 95%. A machine learning model SVM achieved an accuracy of 83%, while an Inception-V3 achieved an accuracy of 94%. Furthermore, the system can be accessed through a web interface, where users can upload blood smear images for malaria detection
Cross-silo federated learning (FL) enables decentralized organizations to collaboratively train models while preserving data privacy and has made significant progress in medical image classification. One common assumption is task homogeneity where each client has access to all classes during training. However, in clinical practice, given a multi-label classification task, constrained by the level of medical knowledge and the prevalence of diseases, each institution may diagnose only partial categories, resulting in task heterogeneity. How to pursue effective multi-label medical image classification under task heterogeneity is under-explored. In this paper, we first formulate such a realistic label missing setting in the multi-label FL domain and propose a two-stage method FedMLP to combat class missing from two aspects: pseudo label tagging and global knowledge learning. The former utilizes a warmed-up model to generate class prototypes and select samples with high confidence to supplement missing labels, while the latter uses a global model as a teacher for consistency regularization to prevent forgetting missing class knowledge. Experiments on two publicly-available medical datasets validate the superiority of FedMLP against the state-of-the-art both federated semi-supervised and noisy label learning approaches under task heterogeneity. Code is available at https://github.com/szbonaldo/FedMLP.
Test-time augmentation (TTA) is a well-known technique employed during the testing phase of computer vision tasks. It involves aggregating multiple augmented versions of input data. Combining predictions using a simple average formulation is a common and straightforward approach after performing TTA. This paper introduces a novel framework for optimizing TTA, called BayTTA (Bayesian-based TTA), which is based on Bayesian Model Averaging (BMA). First, we generate a prediction list associated with different variations of the input data created through TTA. Then, we use BMA to combine predictions weighted by the respective posterior probabilities. Such an approach allows one to take into account model uncertainty, and thus to enhance the predictive performance of the related machine learning or deep learning model. We evaluate the performance of BayTTA on various public data, including three medical image datasets comprising skin cancer, breast cancer, and chest X-ray images and two well-known gene editing datasets, CRISPOR and GUIDE-seq. Our experimental results indicate that BayTTA can be effectively integrated into state-of-the-art deep learning models used in medical image analysis as well as into some popular pre-trained CNN models such as VGG-16, MobileNetV2, DenseNet201, ResNet152V2, and InceptionRes-NetV2, leading to the enhancement in their accuracy and robustness performance. The source code of the proposed BayTTA method is freely available at: \underline {https://github.com/Z-Sherkat/BayTTA}.
Differential privacy upper-bounds the information leakage of machine learning models, yet providing meaningful privacy guarantees has proven to be challenging in practice. The private prediction setting where model outputs are privatized is being investigated as an alternate way to provide formal guarantees at prediction time. Most current private prediction algorithms, however, rely on global sensitivity for noise calibration, which often results in large amounts of noise being added to the predictions. Data-specific noise calibration, such as smooth sensitivity, could significantly reduce the amount of noise added, but were so far infeasible to compute exactly for modern machine learning models. In this work we provide a novel and practical approach based on convex relaxation and bound propagation to compute a provable upper-bound for the local and smooth sensitivity of a prediction. This bound allows us to reduce the magnitude of noise added or improve privacy accounting in the private prediction setting. We validate our framework on datasets from financial services, medical image classification, and natural language processing and across models and find our approach to reduce the noise added by up to order of magnitude.
Deep learning has enabled breakthroughs in automated diagnosis from medical imaging, with many successful applications in ophthalmology. However, standard medical image classification approaches only assess disease presence at the time of acquisition, neglecting the common clinical setting of longitudinal imaging. For slow, progressive eye diseases like age-related macular degeneration (AMD) and primary open-angle glaucoma (POAG), patients undergo repeated imaging over time to track disease progression and forecasting the future risk of developing disease is critical to properly plan treatment. Our proposed Longitudinal Transformer for Survival Analysis (LTSA) enables dynamic disease prognosis from longitudinal medical imaging, modeling the time to disease from sequences of fundus photography images captured over long, irregular time periods. Using longitudinal imaging data from the Age-Related Eye Disease Study (AREDS) and Ocular Hypertension Treatment Study (OHTS), LTSA significantly outperformed a single-image baseline in 19/20 head-to-head comparisons on late AMD prognosis and 18/20 comparisons on POAG prognosis. A temporal attention analysis also suggested that, while the most recent image is typically the most influential, prior imaging still provides additional prognostic value.
Numerous studies have revealed that deep learning-based medical image classification models may exhibit bias towards specific demographic attributes, such as race, gender, and age. Existing bias mitigation methods often achieve high level of fairness at the cost of significant accuracy degradation. In response to this challenge, we propose an innovative and adaptable Soft Nearest Neighbor Loss-based channel pruning framework, which achieves fairness through channel pruning. Traditionally, channel pruning is utilized to accelerate neural network inference. However, our work demonstrates that pruning can also be a potent tool for achieving fairness. Our key insight is that different channels in a layer contribute differently to the accuracy of different groups. By selectively pruning critical channels that lead to the accuracy difference between the privileged and unprivileged groups, we can effectively improve fairness without sacrificing accuracy significantly. Experiments conducted on two skin lesion diagnosis datasets across multiple sensitive attributes validate the effectiveness of our method in achieving state-of-the-art trade-off between accuracy and fairness. Our code is available at https://github.com/Kqp1227/Sensitive-Channel-Pruning.