In the United States, skin cancer ranks as the most commonly diagnosed cancer, presenting a significant public health issue due to its high rates of occurrence and the risk of serious complications if not caught early. Recent advancements in dataset curation and deep learning have shown promise in quick and accurate detection of skin cancer. However, current open-source datasets have significant class imbalances which impedes the effectiveness of these deep learning models. In healthcare, generative artificial intelligence (AI) models have been employed to create synthetic data, addressing data imbalance in datasets by augmenting underrepresented classes and enhancing the overall quality and performance of machine learning models. In this paper, we build on top of previous work by leveraging new advancements in generative AI, notably Stable Diffusion and DreamBooth. We introduce Cancer-Net SCa-Synth, an open access synthetically generated 2D skin lesion dataset for skin cancer classification. Further analysis on the data effectiveness by comparing the ISIC 2020 test set performance for training with and without these synthetic images for a simple model highlights the benefits of leveraging synthetic data to improve performance. Cancer-Net SCa-Synth is publicly available at https://github.com/catai9/Cancer-Net-SCa-Synth as part of a global open-source initiative for accelerating machine learning for cancer care.
Skin cancer is a highly dangerous type of cancer that requires an accurate diagnosis from experienced physicians. To help physicians diagnose skin cancer more efficiently, a computer-aided diagnosis (CAD) system can be very helpful. In this paper, we propose a novel model, which uses a novel attention mechanism to pinpoint the differences in features across the spatial dimensions and symmetry of the lesion, thereby focusing on the dissimilarities of various classes based on symmetry, uniformity in texture and color, etc. Additionally, to take into account the variations in the boundaries of the lesions for different classes, we employ a gradient-based fusion of wavelet and soft attention-aided features to extract boundary information of skin lesions. We have tested our model on the multi-class and highly class-imbalanced dataset, called HAM10000, and achieved promising results, with a 91.17\% F1-score and 90.75\% accuracy. The code is made available at: https://github.com/AyushRoy2001/WAGF-Fusion.
Skin cancer is a treatable disease if discovered early. We provide a production-specific solution to the skin cancer classification problem that matches human performance in melanoma identification by training a vision transformer on melanoma medical images annotated by experts. Since inference cost, both time and memory wise is important in practice, we employ knowledge distillation to obtain a model that retains 98.33% of the teacher's balanced multi-class accuracy, at a fraction of the cost. Memory-wise, our model is 49.60% smaller than the teacher. Time-wise, our solution is 69.25% faster on GPU and 97.96% faster on CPU. By adding classification heads at each level of the transformer and employing a cascading distillation process, we improve the balanced multi-class accuracy of the base model by 2.1%, while creating a range of models of various sizes but comparable performance. We provide the code at https://github.com/Longman-Stan/SkinDistilVit.
Addressing fairness in lesion classification from dermatological images is crucial due to variations in how skin diseases manifest across skin tones. However, the absence of skin tone labels in public datasets hinders building a fair classifier. To date, such skin tone labels have been estimated prior to fairness analysis in independent studies using the Individual Typology Angle (ITA). Briefly, ITA calculates an angle based on pixels extracted from skin images taking into account the lightness and yellow-blue tints. These angles are then categorised into skin tones that are subsequently used to analyse fairness in skin cancer classification. In this work, we review and compare four ITA-based approaches of skin tone classification on the ISIC18 dataset, a common benchmark for assessing skin cancer classification fairness in the literature. Our analyses reveal a high disagreement among previously published studies demonstrating the risks of ITA-based skin tone estimation methods. Moreover, we investigate the causes of such large discrepancy among these approaches and find that the lack of diversity in the ISIC18 dataset limits its use as a testbed for fairness analysis. Finally, we recommend further research on robust ITA estimation and diverse dataset acquisition with skin tone annotation to facilitate conclusive fairness assessments of artificial intelligence tools in dermatology. Our code is available at https://github.com/tkalbl/RevisitingSkinToneFairness.
Convolutional Neural Networks have demonstrated dermatologist-level performance in the classification of melanoma from skin lesion images, but prediction irregularities due to biases seen within the training data are an issue that should be addressed before widespread deployment is possible. In this work, we robustly remove bias and spurious variation from an automated melanoma classification pipeline using two leading bias unlearning techniques. We show that the biases introduced by surgical markings and rulers presented in previous studies can be reasonably mitigated using these bias removal methods. We also demonstrate the generalisation benefits of unlearning spurious variation relating to the imaging instrument used to capture lesion images. Our experimental results provide evidence that the effects of each of the aforementioned biases are notably reduced, with different debiasing techniques excelling at different tasks.
In clinical applications, neural networks must focus on and highlight the most important parts of an input image. Soft-Attention mechanism enables a neural network toachieve this goal. This paper investigates the effectiveness of Soft-Attention in deep neural architectures. The central aim of Soft-Attention is to boost the value of important features and suppress the noise-inducing features. We compare the performance of VGG, ResNet, InceptionResNetv2 and DenseNet architectures with and without the Soft-Attention mechanism, while classifying skin lesions. The original network when coupled with Soft-Attention outperforms the baseline[16] by 4.7% while achieving a precision of 93.7% on HAM10000 dataset [25]. Additionally, Soft-Attention coupling improves the sensitivity score by 3.8% compared to baseline[31] and achieves 91.6% on ISIC-2017 dataset [2]. The code is publicly available at github.
Data augmentation has proved extremely useful by increasing training data variance to alleviate overfitting and improve deep neural networks' generalization performance. In medical image analysis, a well-designed augmentation policy usually requires much expert knowledge and is difficult to generalize to multiple tasks due to the vast discrepancies among pixel intensities, image appearances, and object shapes in different medical tasks. To automate medical data augmentation, we propose a regularized adversarial training framework via two min-max objectives and three differentiable augmentation models covering affine transformation, deformation, and appearance changes. Our method is more automatic and efficient than previous automatic augmentation methods, which still rely on pre-defined operations with human-specified ranges and costly bi-level optimization. Extensive experiments demonstrated that our approach, with less training overhead, achieves superior performance over state-of-the-art auto-augmentation methods on both tasks of 2D skin cancer classification and 3D organs-at-risk segmentation.
Globally, Skin carcinoma is among the most lethal diseases. Millions of people are diagnosed with this cancer every year. Sill, early detection can decrease the medication cost and mortality rate substantially. The recent improvement in automated cancer classification using deep learning methods has reached a human-level performance requiring a large amount of annotated data assembled in one location, yet, finding such conditions usually is not feasible. Recently, federated learning (FL) has been proposed to train decentralized models in a privacy-preserved fashion depending on labeled data at the client-side, which is usually not available and costly. To address this, we propose \verb!FedPerl!, a semi-supervised federated learning method. Our method is inspired by peer learning from educational psychology and ensemble averaging from committee machines. FedPerl builds communities based on clients' similarities. Then it encourages communities members to learn from each other to generate more accurate pseudo labels for the unlabeled data. We also proposed the peer anonymization (PA) technique to anonymize clients. As a core component of our method, PA is orthogonal to other methods without additional complexity and reduces the communication cost while enhancing performance. Finally, we propose a dynamic peer-learning policy that controls the learning stream to avoid any degradation in the performance, especially for individual clients. Our experimental setup consists of 71,000 skin lesion images collected from 5 publicly available datasets. We test our method in four different scenarios in SSFL. With few annotated data, FedPerl is on par with a state-of-the-art method in skin lesion classification in the standard setup while outperforming SSFLs and the baselines by 1.8% and 15.8%, respectively. Also, it generalizes better to unseen clients while being less sensitive to noisy ones.
Classifiers in machine learning are often brittle when deployed. Particularly concerning are models with inconsistent performance on specific subgroups of a class, e.g., exhibiting disparities in skin cancer classification in the presence or absence of a spurious bandage. To mitigate these performance differences, we introduce model patching, a two-stage framework for improving robustness that encourages the model to be invariant to subgroup differences, and focus on class information shared by subgroups. Model patching first models subgroup features within a class and learns semantic transformations between them, and then trains a classifier with data augmentations that deliberately manipulate subgroup features. We instantiate model patching with CAMEL, which (1) uses a CycleGAN to learn the intra-class, inter-subgroup augmentations, and (2) balances subgroup performance using a theoretically-motivated subgroup consistency regularizer, accompanied by a new robust objective. We demonstrate CAMEL's effectiveness on 3 benchmark datasets, with reductions in robust error of up to 33% relative to the best baseline. Lastly, CAMEL successfully patches a model that fails due to spurious features on a real-world skin cancer dataset.
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.
Deep learning techniques have proven high accuracy for identifying melanoma in digitised dermoscopic images. A strength is that these methods are not constrained by features that are pre-defined by human semantics. A down-side is that it is difficult to understand the rationale of the model predictions and to identify potential failure modes. This is a major barrier to adoption of deep learning in clinical practice. In this paper we ask if two existing local interpretability methods, Grad-CAM and Kernel SHAP, can shed light on convolutional neural networks trained in the context of melanoma detection. Our contributions are (i) we first explore the domain space via a reproducible, end-to-end learning framework that creates a suite of 30 models, all trained on a publicly available data set (HAM10000), (ii) we next explore the reliability of GradCAM and Kernel SHAP in this context via some basic sanity check experiments (iii) finally, we investigate a random selection of models from our suite using GradCAM and Kernel SHAP. We show that despite high accuracy, the models will occasionally assign importance to features that are not relevant to the diagnostic task. We also show that models of similar accuracy will produce different explanations as measured by these methods. This work represents first steps in bridging the gap between model accuracy and interpretability in the domain of skin cancer classification.
Skin cancer is by far the most common type of cancer. Early detection is the key to increase the chances for successful treatment significantly. Currently, Deep Neural Networks are the state-of-the-art results on automated skin cancer classification. To push the results further, we need to address the lack of annotated data, which is expensive and require much effort from specialists. To bypass this problem, we propose using Generative Adversarial Networks for generating realistic synthetic skin lesion images. To the best of our knowledge, our results are the first to show visually-appealing synthetic images that comprise clinically-meaningful information.
Deep learning models show remarkable results in automated skin lesion analysis. However, these models demand considerable amounts of data, while the availability of annotated skin lesion images is often limited. Data augmentation can expand the training dataset by transforming input images. In this work, we investigate the impact of 13 data augmentation scenarios for melanoma classification trained on three CNNs (Inception-v4, ResNet, and DenseNet). Scenarios include traditional color and geometric transforms, and more unusual augmentations such as elastic transforms, random erasing and a novel augmentation that mixes different lesions. We also explore the use of data augmentation at test-time and the impact of data augmentation on various dataset sizes. Our results confirm the importance of data augmentation in both training and testing and show that it can lead to more performance gains than obtaining new images. The best scenario results in an AUC of 0.882 for melanoma classification without using external data, outperforming the top-ranked submission (0.874) for the ISIC Challenge 2017, which was trained with additional data.