We can achieve fast and consistent early skin cancer detection with recent developments in computer vision and deep learning techniques. However, the existing skin lesion segmentation and classification prediction models run independently, thus missing potential efficiencies from their integrated execution. To unify skin lesion analysis, our paper presents the Gaussian Splatting - Transformer UNet (GS-TransUNet), a novel approach that synergistically combines 2D Gaussian splatting with the Transformer UNet architecture for automated skin cancer diagnosis. Our unified deep learning model efficiently delivers dual-function skin lesion classification and segmentation for clinical diagnosis. Evaluated on ISIC-2017 and PH2 datasets, our network demonstrates superior performance compared to existing state-of-the-art models across multiple metrics through 5-fold cross-validation. Our findings illustrate significant advancements in the precision of segmentation and classification. This integration sets new benchmarks in the field and highlights the potential for further research into multi-task medical image analysis methodologies, promising enhancements in automated diagnostic systems.
The global outbreak of the Mpox virus, classified as a Public Health Emergency of International Concern (PHEIC) by the World Health Organization, presents significant diagnostic challenges due to its visual similarity to other skin lesion diseases. Traditional diagnostic methods for Mpox, which rely on clinical symptoms and laboratory tests, are slow and labor intensive. Deep learning-based approaches for skin lesion classification offer a promising alternative. However, developing a model that balances efficiency with accuracy is crucial to ensure reliable and timely diagnosis without compromising performance. This study introduces the Cascaded Atrous Group Attention (CAGA) framework to address these challenges, combining the Cascaded Atrous Attention module and the Cascaded Group Attention mechanism. The Cascaded Atrous Attention module utilizes dilated convolutions and cascades the outputs to enhance multi-scale representation. This is integrated into the Cascaded Group Attention mechanism, which reduces redundancy in Multi-Head Self-Attention. By integrating the Cascaded Atrous Group Attention module with EfficientViT-L1 as the backbone architecture, this approach achieves state-of-the-art performance, reaching an accuracy of 98% on the Mpox Close Skin Image (MCSI) dataset while reducing model parameters by 37.5% compared to the original EfficientViT-L1. The model's robustness is demonstrated through extensive validation on two additional benchmark datasets, where it consistently outperforms existing approaches.
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.
Concept-based models naturally lend themselves to the development of inherently interpretable skin lesion diagnosis, as medical experts make decisions based on a set of visual patterns of the lesion. Nevertheless, the development of these models depends on the existence of concept-annotated datasets, whose availability is scarce due to the specialized knowledge and expertise required in the annotation process. In this work, we show that vision-language models can be used to alleviate the dependence on a large number of concept-annotated samples. In particular, we propose an embedding learning strategy to adapt CLIP to the downstream task of skin lesion classification using concept-based descriptions as textual embeddings. Our experiments reveal that vision-language models not only attain better accuracy when using concepts as textual embeddings, but also require a smaller number of concept-annotated samples to attain comparable performance to approaches specifically devised for automatic concept generation.
The clinical diagnosis of skin lesion involves the analysis of dermoscopic and clinical modalities. Dermoscopic images provide a detailed view of the surface structures whereas clinical images offer a complementary macroscopic information. The visual diagnosis of melanoma is also based on seven-point checklist which involves identifying different visual attributes. Recently, supervised learning approaches such as convolutional neural networks (CNNs) have shown great performances using both dermoscopic and clinical modalities (Multi-modality). The seven different visual attributes in the checklist are also used to further improve the the diagnosis. The performances of these approaches, however, are still reliant on the availability of large-scaled labeled data. The acquisition of annotated dataset is an expensive and time-consuming task, more so with annotating multi-attributes. To overcome this limitation, we propose a self-supervised learning (SSL) algorithm for multi-modality skin lesion classification. Our algorithm enables the multi-modality learning by maximizing the similarities between paired dermoscopic and clinical images from different views. In addition, we generate surrogate pseudo-multi-labels that represent seven attributes via clustering analysis. We also propose a label-relation-aware module to refine each pseudo-label embedding and capture the interrelationships between pseudo-multi-labels. We validated the effectiveness of our algorithm using well-benchmarked seven-point skin lesion dataset. Our results show that our algorithm achieved better performances than other state-of-the-art SSL counterparts.
Deployment of Deep Neural Networks in medical imaging is hindered by distribution shift between training data and data processed after deployment, causing performance degradation. Post-Deployment Adaptation (PDA) addresses this by tailoring a pre-trained, deployed model to the target data distribution using limited labelled or entirely unlabelled target data, while assuming no access to source training data as they cannot be deployed with the model due to privacy concerns and their large size. This makes reliable adaptation challenging due to limited learning signal. This paper challenges this assumption and introduces FedPDA, a novel adaptation framework that brings the utility of learning from remote data from Federated Learning into PDA. FedPDA enables a deployed model to obtain information from source data via remote gradient exchange, while aiming to optimize the model specifically for the target domain. Tailored for FedPDA, we introduce a novel optimization method StarAlign (Source-Target Remote Gradient Alignment) that aligns gradients between source-target domain pairs by maximizing their inner product, to facilitate learning a target-specific model. We demonstrate the method's effectiveness using multi-center databases for the tasks of cancer metastases detection and skin lesion classification, where our method compares favourably to previous work. Code is available at: https://github.com/FelixWag/StarAlign
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.
Skin image datasets often suffer from imbalanced data distribution, exacerbating the difficulty of computer-aided skin disease diagnosis. Some recent works exploit supervised contrastive learning (SCL) for this long-tailed challenge. Despite achieving significant performance, these SCL-based methods focus more on head classes, yet ignoring the utilization of information in tail classes. In this paper, we propose class-Enhancement Contrastive Learning (ECL), which enriches the information of minority classes and treats different classes equally. For information enhancement, we design a hybrid-proxy model to generate class-dependent proxies and propose a cycle update strategy for parameters optimization. A balanced-hybrid-proxy loss is designed to exploit relations between samples and proxies with different classes treated equally. Taking both "imbalanced data" and "imbalanced diagnosis difficulty" into account, we further present a balanced-weighted cross-entropy loss following curriculum learning schedule. Experimental results on the classification of imbalanced skin lesion data have demonstrated the superiority and effectiveness of our method.
Representational transfer from publicly available models is a promising technique for improving medical image classification, especially in long-tailed datasets with rare diseases. However, existing methods often overlook the frequency-dependent behavior of these models, thereby limiting their effectiveness in transferring representations and generalizations to rare diseases. In this paper, we propose FoPro-KD, a novel framework that leverages the power of frequency patterns learned from frozen pre-trained models to enhance their transferability and compression, presenting a few unique insights: 1) We demonstrate that leveraging representations from publicly available pre-trained models can substantially improve performance, specifically for rare classes, even when utilizing representations from a smaller pre-trained model. 2) We observe that pre-trained models exhibit frequency preferences, which we explore using our proposed Fourier Prompt Generator (FPG), allowing us to manipulate specific frequencies in the input image, enhancing the discriminative representational transfer. 3) By amplifying or diminishing these frequencies in the input image, we enable Effective Knowledge Distillation (EKD). EKD facilitates the transfer of knowledge from pre-trained models to smaller models. Through extensive experiments in long-tailed gastrointestinal image recognition and skin lesion classification, where rare diseases are prevalent, our FoPro-KD framework outperforms existing methods, enabling more accessible medical models for rare disease classification. Code is available at https://github.com/xmed-lab/FoPro-KD.
Limited training data and severe class imbalance impose 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 data. However, the class imbalance problem persists due to inter-client class distribution variations. To overcome this, we propose federated classifier anchoring (FCA) by adding a personalized classifier at each client to guide and debias the federated model through consistency learning. Additionally, FCA debiases the federated classifier and each client's personalized classifier based on their respective class distributions, thus mitigating divergence. With FCA, the federated feature extractor effectively learns discriminative features suitably globally for federation as well as locally for all participants. In clinical practice, the federated model is expected to be both generalized, performing well across clients, and specialized, benefiting each individual client from collaboration. According to this, we propose a novel evaluation metric to assess models' generalization and specialization performance globally on an aggregated public test set and locally at each client. Through comprehensive comparison and evaluation, FCA outperforms the state-of-the-art methods with large margins for federated long-tailed skin lesion classification and intracranial hemorrhage classification, making it a more feasible solution in clinical settings.
Deep neural networks often rely on spurious correlations to make predictions, which hinders generalization beyond training environments. For instance, models that associate cats with bed backgrounds can fail to predict the existence of cats in other environments without beds. Mitigating spurious correlations is crucial in building trustworthy models. However, the existing works lack transparency to offer insights into the mitigation process. In this work, we propose an interpretable framework, Discover and Cure (DISC), to tackle the issue. With human-interpretable concepts, DISC iteratively 1) discovers unstable concepts across different environments as spurious attributes, then 2) intervenes on the training data using the discovered concepts to reduce spurious correlation. Across systematic experiments, DISC provides superior generalization ability and interpretability than the existing approaches. Specifically, it outperforms the state-of-the-art methods on an object recognition task and a skin-lesion classification task by 7.5% and 9.6%, respectively. Additionally, we offer theoretical analysis and guarantees to understand the benefits of models trained by DISC. Code and data are available at https://github.com/Wuyxin/DISC.
Early detection of melanoma is crucial for preventing severe complications and increasing the chances of successful treatment. Existing deep learning approaches for melanoma skin lesion diagnosis are deemed black-box models, as they omit the rationale behind the model prediction, compromising the trustworthiness and acceptability of these diagnostic methods. Attempts to provide concept-based explanations are based on post-hoc approaches, which depend on an additional model to derive interpretations. In this paper, we propose an inherently interpretable framework to improve the interpretability of concept-based models by incorporating a hard attention mechanism and a coherence loss term to assure the visual coherence of concept activations by the concept encoder, without requiring the supervision of additional annotations. The proposed framework explains its decision in terms of human-interpretable concepts and their respective contribution to the final prediction, as well as a visual interpretation of the locations where the concept is present in the image. Experiments on skin image datasets demonstrate that our method outperforms existing black-box and concept-based models for skin lesion classification.
Diffusion Probabilistic Models have recently shown remarkable performance in generative image modeling, attracting significant attention in the computer vision community. However, while a substantial amount of diffusion-based research has focused on generative tasks, few studies have applied diffusion models to general medical image classification. In this paper, we propose the first diffusion-based model (named DiffMIC) to address general medical image classification by eliminating unexpected noise and perturbations in medical images and robustly capturing semantic representation. To achieve this goal, we devise a dual conditional guidance strategy that conditions each diffusion step with multiple granularities to improve step-wise regional attention. Furthermore, we propose learning the mutual information in each granularity by enforcing Maximum-Mean Discrepancy regularization during the diffusion forward process. We evaluate the effectiveness of our DiffMIC on three medical classification tasks with different image modalities, including placental maturity grading on ultrasound images, skin lesion classification using dermatoscopic images, and diabetic retinopathy grading using fundus images. Our experimental results demonstrate that DiffMIC outperforms state-of-the-art methods by a significant margin, indicating the universality and effectiveness of the proposed model. Our code will be publicly available at https://github.com/scott-yjyang/DiffMIC.
Model pruning can enable the deployment of neural networks in environments with resource constraints. While pruning may have a small effect on the overall performance of the model, it can exacerbate existing biases into the model such that subsets of samples see significantly degraded performance. In this paper, we introduce the performance weighted loss function, a simple modified cross-entropy loss function that can be used to limit the introduction of biases during pruning. Experiments using the CelebA, Fitzpatrick17k and CIFAR-10 datasets demonstrate that the proposed method is a simple and effective tool that can enable existing pruning methods to be used in fairness sensitive contexts. Code used to produce all experiments contained in this paper can be found at https://github.com/robbiemeyer/pw_loss_pruning.
In this paper, we focus on multi-task classification, where related classification tasks share the same label space and are learned simultaneously. In particular, we tackle a new setting, which is more realistic than currently addressed in the literature, where categories shift from training to test data. Hence, individual tasks do not contain complete training data for the categories in the test set. To generalize to such test data, it is crucial for individual tasks to leverage knowledge from related tasks. To this end, we propose learning an association graph to transfer knowledge among tasks for missing classes. We construct the association graph with nodes representing tasks, classes and instances, and encode the relationships among the nodes in the edges to guide their mutual knowledge transfer. By message passing on the association graph, our model enhances the categorical information of each instance, making it more discriminative. To avoid spurious correlations between task and class nodes in the graph, we introduce an assignment entropy maximization that encourages each class node to balance its edge weights. This enables all tasks to fully utilize the categorical information from related tasks. An extensive evaluation on three general benchmarks and a medical dataset for skin lesion classification reveals that our method consistently performs better than representative baselines.
While deep learning based approaches have demonstrated expert-level performance in dermatological diagnosis tasks, they have also been shown to exhibit biases toward certain demographic attributes, particularly skin types (e.g., light versus dark), a fairness concern that must be addressed. We propose CIRCLe, a skin color invariant deep representation learning method for improving fairness in skin lesion classification. CIRCLe is trained to classify images by utilizing a regularization loss that encourages images with the same diagnosis but different skin types to have similar latent representations. Through extensive evaluation and ablation studies, we demonstrate CIRCLe's superior performance over the state-of-the-art when evaluated on 16k+ images spanning 6 Fitzpatrick skin types and 114 diseases, using classification accuracy, equal opportunity difference (for light versus dark groups), and normalized accuracy range, a new measure we propose to assess fairness on multiple skin type groups.
Deep learning models have achieved great success in automating skin lesion diagnosis. However, the ethnic disparity in these models' predictions, where lesions on darker skin types are usually underrepresented and have lower diagnosis accuracy, receives little attention. In this paper, we propose FairDisCo, a disentanglement deep learning framework with contrastive learning that utilizes an additional network branch to remove sensitive attributes, i.e. skin-type information from representations for fairness and another contrastive branch to enhance feature extraction. We compare FairDisCo to three fairness methods, namely, resampling, reweighting, and attribute-aware, on two newly released skin lesion datasets with different skin types: Fitzpatrick17k and Diverse Dermatology Images (DDI). We adapt two fairness-based metrics DPM and EOM for our multiple classes and sensitive attributes task, highlighting the skin-type bias in skin lesion classification. Extensive experimental evaluation demonstrates the effectiveness of FairDisCo, with fairer and superior performance on skin lesion classification tasks.
Recent years have witnessed a rapid development of automated methods for skin lesion diagnosis and classification. Due to an increasing deployment of such systems in clinics, it has become important to develop a more robust system towards various Out-of-Distribution(OOD) samples (unknown skin lesions and conditions). However, the current deep learning models trained for skin lesion classification tend to classify these OOD samples incorrectly into one of their learned skin lesion categories. To address this issue, we propose a simple yet strategic approach that improves the OOD detection performance while maintaining the multi-class classification accuracy for the known categories of skin lesion. To specify, this approach is built upon a realistic scenario of a long-tailed and fine-grained OOD detection task for skin lesion images. Through this approach, 1) First, we target the mixup amongst middle and tail classes to address the long-tail problem. 2) Later, we combine the above mixup strategy with prototype learning to address the fine-grained nature of the dataset. The unique contribution of this paper is two-fold, justified by extensive experiments. First, we present a realistic problem setting of OOD task for skin lesion. Second, we propose an approach to target the long-tailed and fine-grained aspects of the problem setting simultaneously to increase the OOD performance.
It is generally believed that the human visual system is biased towards the recognition of shapes rather than textures. This assumption has led to a growing body of work aiming to align deep models' decision-making processes with the fundamental properties of human vision. The reliance on shape features is primarily expected to improve the robustness of these models under covariate shift. In this paper, we revisit the significance of shape-biases for the classification of skin lesion images. Our analysis shows that different skin lesion datasets exhibit varying biases towards individual image features. Interestingly, despite deep feature extractors being inclined towards learning entangled features for skin lesion classification, individual features can still be decoded from this entangled representation. This indicates that these features are still represented in the learnt embedding spaces of the models, but not used for classification. In addition, the spectral analysis of different datasets shows that in contrast to common visual recognition, dermoscopic skin lesion classification, by nature, is reliant on complex feature combinations beyond shape-bias. As a natural consequence, shifting away from the prevalent desire of shape-biasing models can even improve skin lesion classifiers in some cases.