Data-driven models are now deployed in a plethora of real-world applications - including automated diagnosis - but models learned from data risk learning biases from that same data. When models learn spurious correlations not found in real-world situations, their deployment for critical tasks, such as medical decisions, can be catastrophic. In this work we address this issue for skin-lesion classification models, with two objectives: finding out what are the spurious correlations exploited by biased networks, and debiasing the models by removing such spurious correlations from them. We perform a systematic integrated analysis of 7 visual artifacts (which are possible sources of biases exploitable by networks), employ a state-of-the-art technique to prevent the models from learning spurious correlations, and propose datasets to test models for the presence of bias. We find out that, despite interesting results that point to promising future research, current debiasing methods are not ready to solve the bias issue for skin-lesion models.
Skin lesion datasets consist predominantly of normal samples with only a small percentage of abnormal ones, giving rise to the class imbalance problem. Also, skin lesion images are largely similar in overall appearance owing to the low inter-class variability. In this paper, we propose a two-stage framework for automatic classification of skin lesion images using adversarial training and transfer learning toward melanoma detection. In the first stage, we leverage the inter-class variation of the data distribution for the task of conditional image synthesis by learning the inter-class mapping and synthesizing under-represented class samples from the over-represented ones using unpaired image-to-image translation. In the second stage, we train a deep convolutional neural network for skin lesion classification using the original training set combined with the newly synthesized under-represented class samples. The training of this classifier is carried out by minimizing the focal loss function, which assists the model in learning from hard examples, while down-weighting the easy ones. Experiments conducted on a dermatology image benchmark demonstrate the superiority of our proposed approach over several standard baseline methods, achieving significant performance improvements. Interestingly, we show through feature visualization and analysis that our method leads to context based lesion assessment that can reach an expert dermatologist level.
Towards automated retinal screening, this paper makes an endeavor to simultaneously achieve pixel-level retinal lesion segmentation and image-level disease classification. Such a multi-task approach is crucial for accurate and clinically interpretable disease diagnosis. Prior art is insufficient due to three challenges, i.e., lesions lacking objective boundaries, clinical importance of lesions irrelevant to their size, and the lack of one-to-one correspondence between lesion and disease classes. This paper attacks the three challenges in the context of diabetic retinopathy (DR) grading. We propose Lesion-Net, a new variant of fully convolutional networks, with its expansive path re-designed to tackle the first challenge. A dual Dice loss that leverages both semantic segmentation and image classification losses is introduced to resolve the second challenge. Lastly, we build a multi-task network that employs Lesion-Net as a side-attention branch for both DR grading and result interpretation. A set of 12K fundus images is manually segmented by 45 ophthalmologists for 8 DR-related lesions, resulting in 290K manual segments in total. Extensive experiments on this large-scale dataset show that our proposed approach surpasses the prior art for multiple tasks including lesion segmentation, lesion classification and DR grading
Automated skin lesion analysis is very crucial in clinical practice, as skin cancer is among the most common human malignancy. Existing approaches with deep learning have achieved remarkable performance on this challenging task, however, heavily relying on large-scale labelled datasets. In this paper, we present a novel active learning framework for cost-effective skin lesion analysis. The goal is to effectively select and utilize much fewer labelled samples, while the network can still achieve state-of-the-art performance. Our sample selection criteria complementarily consider both informativeness and representativeness, derived from decoupled aspects of measuring model certainty and covering sample diversity. To make wise use of the selected samples, we further design a simple yet effective strategy to aggregate intra-class images in pixel space, as a new form of data augmentation. We validate our proposed method on data of ISIC 2017 Skin Lesion Classification Challenge for two tasks. Using only up to 50% of samples, our approach can achieve state-of-the-art performances on both tasks, which are comparable or exceeding the accuracies with full-data training, and outperform other well-known active learning methods by a large margin.
In this work, we explore the issue of the inter-annotator agreement for training and evaluating automated segmentation of skin lesions. We explore what different degrees of agreement represent, and how they affect different use cases for segmentation. We also evaluate how conditioning the ground truths using different (but very simple) algorithms may help to enhance agreement and may be appropriate for some use cases. The segmentation of skin lesions is a cornerstone task for automated skin lesion analysis, useful both as an end-result to locate/detect the lesions and as an ancillary task for lesion classification. Lesion segmentation, however, is a very challenging task, due not only to the challenge of image segmentation itself but also to the difficulty in obtaining properly annotated data. Detecting accurately the borders of lesions is challenging even for trained humans, since, for many lesions, those borders are fuzzy and ill-defined. Using lesions and annotations from the ISIC Archive, we estimate inter-annotator agreement for skin-lesion segmentation and propose several simple procedures that may help to improve inter-annotator agreement if used to condition the ground truths.
Objective: This work addresses two key problems of skin lesion classification. The first problem is the effective use of high-resolution images with pretrained standard architectures for image classification. The second problem is the high class imbalance encountered in real-world multi-class datasets. Methods: To use high-resolution images, we propose a novel patch-based attention architecture that provides global context between small, high-resolution patches. We modify three pretrained architectures and study the performance of patch-based attention. To counter class imbalance problems, we compare oversampling, balanced batch sampling, and class-specific loss weighting. Additionally, we propose a novel diagnosis-guided loss weighting method which takes the method used for ground-truth annotation into account. Results: Our patch-based attention mechanism outperforms previous methods and improves the mean sensitivity by 7%. Class balancing significantly improves the mean sensitivity and we show that our diagnosis-guided loss weighting method improves the mean sensitivity by 3% over normal loss balancing. Conclusion: The novel patch-based attention mechanism can be integrated into pretrained architectures and provides global context between local patches while outperforming other patch-based methods. Hence, pretrained architectures can be readily used with high-resolution images without downsampling. The new diagnosis-guided loss weighting method outperforms other methods and allows for effective training when facing class imbalance. Significance: The proposed methods improve automatic skin lesion classification. They can be extended to other clinical applications where high-resolution image data and class imbalance are relevant.
Automated skin lesion segmentation and classification are two most essential and related tasks in the computer-aided diagnosis of skin cancer. Despite their prevalence, deep learning models are usually designed for only one task, ignoring the potential benefits in jointly performing both tasks. In this paper, we propose the mutual bootstrapping deep convolutional neural networks (MB-DCNN) model for simultaneous skin lesion segmentation and classification. This model consists of a coarse segmentation network (coarse-SN), a mask-guided classification network (mask-CN), and an enhanced segmentation network (enhanced-SN). On one hand, the coarse-SN generates coarse lesion masks that provide a prior bootstrapping for mask-CN to help it locate and classify skin lesions accurately. On the other hand, the lesion localization maps produced by mask-CN are then fed into enhanced-SN, aiming to transfer the localization information learned by mask-CN to enhanced-SN for accurate lesion segmentation. In this way, both segmentation and classification networks mutually transfer knowledge between each other and facilitate each other in a bootstrapping way. Meanwhile, we also design a novel rank loss and jointly use it with the Dice loss in segmentation networks to address the issues caused by class imbalance and hard-easy pixel imbalance. We evaluate the proposed MB-DCNN model on the ISIC-2017 and PH2 datasets, and achieve a Jaccard index of 80.4% and 89.4% in skin lesion segmentation and an average AUC of 93.8% and 97.7% in skin lesion classification, which are superior to the performance of representative state-of-the-art skin lesion segmentation and classification methods. Our results suggest that it is possible to boost the performance of skin lesion segmentation and classification simultaneously via training a unified model to perform both tasks in a mutual bootstrapping way.
In this paper, we studied extensively on different deep learning based methods to detect melanoma and skin lesion cancers. Melanoma, a form of malignant skin cancer is very threatening to health. Proper diagnosis of melanoma at an earlier stage is crucial for the success rate of complete cure. Dermoscopic images with Benign and malignant forms of skin cancer can be analyzed by computer vision system to streamline the process of skin cancer detection. In this study, we experimented with various neural networks which employ recent deep learning based models like PNASNet-5-Large, InceptionResNetV2, SENet154, InceptionV4. Dermoscopic images are properly processed and augmented before feeding them into the network. We tested our methods on International Skin Imaging Collaboration (ISIC) 2018 challenge dataset. Our system has achieved best validation score of 0.76 for PNASNet-5-Large model. Further improvement and optimization of the proposed methods with a bigger training dataset and carefully chosen hyper-parameter could improve the performances. The code available for download at https://github.com/miltonbd/ISIC_2018_classification
As skin cancer is one of the most frequent cancers globally, accurate, non-invasive dermoscopy-based diagnosis becomes essential and promising. A task of the Part 3 of the ISIC Skin Image Analysis Challenge at MICCAI 2018 is to predict seven disease classes with skin lesion images, including melanoma (MEL), melanocytic nevus (NV), basal cell carcinoma (BCC), actinic keratosis / Bowen's disease (intraepithelial carcinoma) (AKIEC), benign keratosis (solar lentigo / seborrheic keratosis / lichen planus-like keratosis) (BKL), dermatofibroma (DF) and vascular lesion (VASC) as defined by the International Dermatology Society. In this work, we design the WonDerM pipeline, that resamples the preprocessed skin lesion images, builds neural network architecture fine-tuned with segmentation task data (the Part 1), and uses an ensemble method to classify the seven skin diseases. Our model achieved an accuracy of 0.899 and 0.785 in the validation set and test set, respectively.
This report describes our submission to the ISIC 2017 Challenge in Skin Lesion Analysis Towards Melanoma Detection. We have participated in the Part 3: Lesion Classification with a system for automatic diagnosis of nevus, melanoma and seborrheic keratosis. Our approach aims to incorporate the expert knowledge of dermatologists into the well known framework of Convolutional Neural Networks (CNN), which have shown impressive performance in many visual recognition tasks. In particular, we have designed several networks providing lesion area identification, lesion segmentation into structural patterns and final diagnosis of clinical cases. Furthermore, novel blocks for CNNs have been designed to integrate this information with the diagnosis processing pipeline.