Expert radiologists visually scan Chest X-Ray (CXR) images, sequentially fixating on anatomical structures to perform disease diagnosis. An automatic multi-label classifier of diseases in CXR images can benefit by incorporating aspects of the radiologists' approach. Recorded visual scanpaths of radiologists on CXR images can be used for the said purpose. But, such scanpaths are not available for most CXR images, which creates a gap even for modern deep learning based classifiers. This paper proposes to mitigate this gap by generating effective artificial visual scanpaths using a visual scanpath prediction model for CXR images. Further, a multi-class multi-label classifier framework is proposed that uses a generated scanpath and visual image features to classify diseases in CXR images. While the scanpath predictor is based on a recurrent neural network, the multi-label classifier involves a novel iterative sequential model with an attention module. We show that our scanpath predictor generates human-like visual scanpaths. We also demonstrate that the use of artificial visual scanpaths improves multi-class multi-label disease classification results on CXR images. The above observations are made from experiments involving around 0.2 million CXR images from 2 widely-used datasets considering the multi-label classification of 14 pathological findings. Code link: https://github.com/ashishverma03/SDC
Chest X-rays are widely used to diagnose thoracic diseases, but the lack of detailed information about these abnormalities makes it challenging to develop accurate automated diagnosis systems, which is crucial for early detection and effective treatment. To address this challenge, we employed deep learning techniques to identify patterns in chest X-rays that correspond to different diseases. We conducted experiments on the "ChestX-ray14" dataset using various pre-trained CNNs, transformers, hybrid(CNN+Transformer) models and classical models. The best individual model was the CoAtNet, which achieved an area under the receiver operating characteristic curve (AUROC) of 84.2%. By combining the predictions of all trained models using a weighted average ensemble where the weight of each model was determined using differential evolution, we further improved the AUROC to 85.4%, outperforming other state-of-the-art methods in this field. Our findings demonstrate the potential of deep learning techniques, particularly ensemble deep learning, for improving the accuracy of automatic diagnosis of thoracic diseases from chest X-rays. Code available at:https://github.com/syednabilashraf/SynthEnsemble
Performance degradation due to distribution discrepancy is a longstanding challenge in intelligent imaging, particularly for chest X-rays (CXRs). Recent studies have demonstrated that CNNs are biased toward styles (e.g., uninformative textures) rather than content (e.g., shape), in stark contrast to the human vision system. Radiologists tend to learn visual cues from CXRs and thus perform well across multiple domains. Motivated by this, we employ the novel on-the-fly style randomization modules at both image (SRM-IL) and feature (SRM-FL) levels to create rich style perturbed features while keeping the content intact for robust cross-domain performance. Previous methods simulate unseen domains by constructing new styles via interpolation or swapping styles from existing data, limiting them to available source domains during training. However, SRM-IL samples the style statistics from the possible value range of a CXR image instead of the training data to achieve more diversified augmentations. Moreover, we utilize pixel-wise learnable parameters in the SRM-FL compared to pre-defined channel-wise mean and standard deviations as style embeddings for capturing more representative style features. Additionally, we leverage consistency regularizations on global semantic features and predictive distributions from with and without style-perturbed versions of the same CXR to tweak the model's sensitivity toward content markers for accurate predictions. Our proposed method, trained on CheXpert and MIMIC-CXR datasets, achieves 77.32$\pm$0.35, 88.38$\pm$0.19, 82.63$\pm$0.13 AUCs(%) on the unseen domain test datasets, i.e., BRAX, VinDr-CXR, and NIH chest X-ray14, respectively, compared to 75.56$\pm$0.80, 87.57$\pm$0.46, 82.07$\pm$0.19 from state-of-the-art models on five-fold cross-validation with statistically significant results in thoracic disease classification.