Federated Learning (FL) emerged as a solution for collaborative medical image classification while preserving data privacy. However, label noise, which arises from inter-institutional data variability, can cause training instability and degrade model performance. Existing FL methods struggle with noise heterogeneity and the imbalance in medical data. Motivated by these challenges, we propose FedGSCA, a novel framework for enhancing robustness in noisy medical FL. FedGSCA introduces a Global Sample Selector that aggregates noise knowledge from all clients, effectively addressing noise heterogeneity and improving global model stability. Furthermore, we develop a Client Adaptive Adjustment (CAA) mechanism that combines adaptive threshold pseudo-label generation and Robust Credal Labeling Loss. CAA dynamically adjusts to class distributions, ensuring the inclusion of minority samples and carefully managing noisy labels by considering multiple plausible labels. This dual approach mitigates the impact of noisy data and prevents overfitting during local training, which improves the generalizability of the model. We evaluate FedGSCA on one real-world colon slides dataset and two synthetic medical datasets under various noise conditions, including symmetric, asymmetric, extreme, and heterogeneous types. The results show that FedGSCA outperforms the state-of-the-art methods, excelling in extreme and heterogeneous noise scenarios. Moreover, FedGSCA demonstrates significant advantages in improving model stability and handling complex noise, making it well-suited for real-world medical federated learning scenarios.
Deep neural networks are increasingly being used to detect and diagnose medical conditions using medical imaging. Despite their utility, these models are highly vulnerable to adversarial attacks and distribution shifts, which can affect diagnostic reliability and undermine trust among healthcare professionals. In this study, we propose a robust training algorithm with data augmentation (RTDA) to mitigate these vulnerabilities in medical image classification. We benchmark classifier robustness against adversarial perturbations and natural variations of RTDA and six competing baseline techniques, including adversarial training and data augmentation approaches in isolation and combination, using experimental data sets with three different imaging technologies (mammograms, X-rays, and ultrasound). We demonstrate that RTDA achieves superior robustness against adversarial attacks and improved generalization performance in the presence of distribution shift in each image classification task while maintaining high clean accuracy.
Kernel size selection in Convolutional Neural Networks (CNNs) is a critical but often overlooked design decision that affects receptive field, feature extraction, computational cost, and model accuracy. This paper proposes the Best Kernel Size Estimation Function (BKSEF), a mathematically grounded and empirically validated framework for optimal, layer-wise kernel size determination. BKSEF balances information gain, computational efficiency, and accuracy improvements by integrating principles from information theory, signal processing, and learning theory. Extensive experiments on CIFAR-10, CIFAR-100, ImageNet-lite, ChestX-ray14, and GTSRB datasets demonstrate that BKSEF-guided architectures achieve up to 3.1 percent accuracy improvement and 42.8 percent reduction in FLOPs compared to traditional models using uniform 3x3 kernels. Two real-world case studies further validate the approach: one for medical image classification in a cloud-based setup, and another for traffic sign recognition on edge devices. The former achieved enhanced interpretability and accuracy, while the latter reduced latency and model size significantly, with minimal accuracy trade-off. These results show that kernel size can be an active, optimizable parameter rather than a fixed heuristic. BKSEF provides practical heuristics and theoretical support for researchers and developers seeking efficient and application-aware CNN designs. It is suitable for integration into neural architecture search pipelines and real-time systems, offering a new perspective on CNN optimization.
This paper presents a comparison of the performance of Convolutional Neural Networks (CNNs) and Vision Transformers (ViTs) in the task of multi-classifying images containing lesions of psoriasis and diseases similar to it. Models pre-trained on ImageNet were adapted to a specific data set. Both achieved high predictive metrics, but the ViTs stood out for their superior performance with smaller models. Dual Attention Vision Transformer-Base (DaViT-B) obtained the best results, with an f1-score of 96.4%, and is recommended as the most efficient architecture for automated psoriasis detection. This article reinforces the potential of ViTs for medical image classification tasks.
Medical image classification is crucial for diagnosis and treatment, benefiting significantly from advancements in artificial intelligence. The paper reviews recent progress in the field, focusing on three levels of solutions: basic, specific, and applied. It highlights advances in traditional methods using deep learning models like Convolutional Neural Networks and Vision Transformers, as well as state-of-the-art approaches with Vision Language Models. These models tackle the issue of limited labeled data, and enhance and explain predictive results through Explainable Artificial Intelligence.
Deep models, such as convolutional neural networks (CNNs) and vision transformer (ViT), demonstrate remarkable performance in image classification. However, those deep models require large data to fine-tune, which is impractical in the medical domain due to the data privacy issue. Furthermore, despite the feasible performance of contrastive language image pre-training (CLIP) in the natural domain, the potential of CLIP has not been fully investigated in the medical field. To face these challenges, we considered three scenarios: 1) we introduce a novel CLIP variant using four CNNs and eight ViTs as image encoders for the classification of brain cancer and skin cancer, 2) we combine 12 deep models with two federated learning techniques to protect data privacy, and 3) we involve traditional machine learning (ML) methods to improve the generalization ability of those deep models in unseen domain data. The experimental results indicate that maxvit shows the highest averaged (AVG) test metrics (AVG = 87.03\%) in HAM10000 dataset with multimodal learning, while convnext\_l demonstrates remarkable test with an F1-score of 83.98\% compared to swin\_b with 81.33\% in FL model. Furthermore, the use of support vector machine (SVM) can improve the overall test metrics with AVG of $\sim 2\%$ for swin transformer series in ISIC2018. Our codes are available at https://github.com/AIPMLab/SkinCancerSimulation.
Bayesian neural networks (BNNs) treat neural network weights as random variables, which aim to provide posterior uncertainty estimates and avoid overfitting by performing inference on the posterior weights. However, the selection of appropriate prior distributions remains a challenging task, and BNNs may suffer from catastrophic inflated variance or poor predictive performance when poor choices are made for the priors. Existing BNN designs apply different priors to weights, while the behaviours of these priors make it difficult to sufficiently shrink noisy signals or they are prone to overshrinking important signals in the weights. To alleviate this problem, we propose a novel R2D2-Net, which imposes the R^2-induced Dirichlet Decomposition (R2D2) prior to the BNN weights. The R2D2-Net can effectively shrink irrelevant coefficients towards zero, while preventing key features from over-shrinkage. To approximate the posterior distribution of weights more accurately, we further propose a variational Gibbs inference algorithm that combines the Gibbs updating procedure and gradient-based optimization. This strategy enhances stability and consistency in estimation when the variational objective involving the shrinkage parameters is non-convex. We also analyze the evidence lower bound (ELBO) and the posterior concentration rates from a theoretical perspective. Experiments on both natural and medical image classification and uncertainty estimation tasks demonstrate satisfactory performance of our method.
Using massive datasets, foundation models are large-scale, pre-trained models that perform a wide range of tasks. These models have shown consistently improved results with the introduction of new methods. It is crucial to analyze how these trends impact the medical field and determine whether these advancements can drive meaningful change. This study investigates the application of recent state-of-the-art foundation models, DINOv2, MAE, VMamba, CoCa, SAM2, and AIMv2, for medical image classification. We explore their effectiveness on datasets including CBIS-DDSM for mammography, ISIC2019 for skin lesions, APTOS2019 for diabetic retinopathy, and CHEXPERT for chest radiographs. By fine-tuning these models and evaluating their configurations, we aim to understand the potential of these advancements in medical image classification. The results indicate that these advanced models significantly enhance classification outcomes, demonstrating robust performance despite limited labeled data. Based on our results, AIMv2, DINOv2, and SAM2 models outperformed others, demonstrating that progress in natural domain training has positively impacted the medical domain and improved classification outcomes. Our code is publicly available at: https://github.com/sajjad-sh33/Medical-Transfer-Learning.
Medical image classification is critical for clinical decision-making, yet demands for accuracy, interpretability, and generalizability remain challenging. This paper introduces EVM-Fusion, an Explainable Vision Mamba architecture featuring a novel Neural Algorithmic Fusion (NAF) mechanism for multi-organ medical image classification. EVM-Fusion leverages a multipath design, where DenseNet and U-Net based pathways, enhanced by Vision Mamba (Vim) modules, operate in parallel with a traditional feature pathway. These diverse features are dynamically integrated via a two-stage fusion process: cross-modal attention followed by the iterative NAF block, which learns an adaptive fusion algorithm. Intrinsic explainability is embedded through path-specific spatial attention, Vim {\Delta}-value maps, traditional feature SE-attention, and cross-modal attention weights. Experiments on a diverse 9-class multi-organ medical image dataset demonstrate EVM-Fusion's strong classification performance, achieving 99.75% test accuracy and provide multi-faceted insights into its decision-making process, highlighting its potential for trustworthy AI in medical diagnostics.
The pursuit of decision safety in clinical applications highlights the potential of concept-based methods in medical imaging. While these models offer active interpretability, they often suffer from concept leakages, where unintended information within soft concept representations undermines both interpretability and generalizability. Moreover, most concept-based models focus solely on local explanations (instance-level), neglecting the global decision logic (dataset-level). To address these limitations, we propose Concept Rule Learner (CRL), a novel framework to learn Boolean logical rules from binarized visual concepts. CRL employs logical layers to capture concept correlations and extract clinically meaningful rules, thereby providing both local and global interpretability. Experiments on two medical image classification tasks show that CRL achieves competitive performance with existing methods while significantly improving generalizability to out-of-distribution data. The code of our work is available at https://github.com/obiyoag/crl.
Efficient convolutional neural network (CNN) architecture designs have attracted growing research interests. However, they usually apply single receptive field (RF), small asymmetric RFs, or pyramid RFs to learn different feature representations, still encountering two significant challenges in medical image classification tasks: 1) They have limitations in capturing diverse lesion characteristics efficiently, e.g., tiny, coordination, small and salient, which have unique roles on results, especially imbalanced medical image classification. 2) The predictions generated by those CNNs are often unfair/biased, bringing a high risk by employing them to real-world medical diagnosis conditions. To tackle these issues, we develop a new concept, Expert-Like Reparameterization of Heterogeneous Pyramid Receptive Fields (ERoHPRF), to simultaneously boost medical image classification performance and fairness. This concept aims to mimic the multi-expert consultation mode by applying the well-designed heterogeneous pyramid RF bags to capture different lesion characteristics effectively via convolution operations with multiple heterogeneous kernel sizes. Additionally, ERoHPRF introduces an expert-like structural reparameterization technique to merge its parameters with the two-stage strategy, ensuring competitive computation cost and inference speed through comparisons to a single RF. To manifest the effectiveness and generalization ability of ERoHPRF, we incorporate it into mainstream efficient CNN architectures. The extensive experiments show that our method maintains a better trade-off than state-of-the-art methods in terms of medical image classification, fairness, and computation overhead. The codes of this paper will be released soon.
Kolmogorov-Arnold Networks (KAN) offer universal function approximation using univariate spline compositions without nonlinear activations. In this work, we integrate Error-Correcting Output Codes (ECOC) into the KAN framework to transform multi-class classification into multiple binary tasks, improving robustness via Hamming-distance decoding. Our proposed KAN with ECOC method outperforms vanilla KAN on a challenging blood cell classification dataset, achieving higher accuracy under diverse hyperparameter settings. Ablation studies further confirm that ECOC consistently enhances performance across FastKAN and FasterKAN variants. These results demonstrate that ECOC integration significantly boosts KAN generalizability in critical healthcare AI applications. To the best of our knowledge, this is the first integration of ECOC with KAN for enhancing multi-class medical image classification performance.
EfficientNet models are convolutional neural networks optimized for parameter allocation by jointly balancing network width, depth, and resolution. Renowned for their exceptional accuracy, these models have become a standard for image classification tasks across diverse computer vision benchmarks. While traditional neural networks learn correlations between feature channels during training, vector-valued neural networks inherently treat multidimensional data as coherent entities, taking for granted the inter-channel relationships. This paper introduces vector-valued EfficientNets (V-EfficientNets), a novel extension of EfficientNet designed to process arbitrary vector-valued data. The proposed models are evaluated on a medical image classification task, achieving an average accuracy of 99.46% on the ALL-IDB2 dataset for detecting acute lymphoblastic leukemia. V-EfficientNets demonstrate remarkable efficiency, significantly reducing parameters while outperforming state-of-the-art models, including the original EfficientNet. The source code is available at https://github.com/mevalle/v-nets.
Recent advancements in foundation models, such as the Segment Anything Model (SAM), have shown strong performance in various vision tasks, particularly image segmentation, due to their impressive zero-shot segmentation capabilities. However, effectively adapting such models for medical image classification is still a less explored topic. In this paper, we introduce a new framework to adapt SAM for medical image classification. First, we utilize the SAM image encoder as a feature extractor to capture segmentation-based features that convey important spatial and contextual details of the image, while freezing its weights to avoid unnecessary overhead during training. Next, we propose a novel Spatially Localized Channel Attention (SLCA) mechanism to compute spatially localized attention weights for the feature maps. The features extracted from SAM's image encoder are processed through SLCA to compute attention weights, which are then integrated into deep learning classification models to enhance their focus on spatially relevant or meaningful regions of the image, thus improving classification performance. Experimental results on three public medical image classification datasets demonstrate the effectiveness and data-efficiency of our approach.
The Computer_Aided Diagnosis (CAD) systems facilitate accurate diagnosis of diseases. The development of CADs by leveraging third generation neural network, namely, Spiking Neural Network (SNN), is essential to utilize of the benefits of SNNs, such as their event_driven processing, parallelism, low power consumption, and the ability to process sparse temporal_spatial information. However, Deep SNN as a deep learning model faces challenges with unreliability. To deal with unreliability challenges due to inability to quantify the uncertainty of the predictions, we proposed a deep Bayesian Convolutional Spiking Neural Network based_CADs with uncertainty_aware module. In this study, the Monte Carlo Dropout method as Bayesian approximation is used as an uncertainty quantification method. This method was applied to several medical image classification tasks. Our experimental results demonstrate that our proposed model is accurate and reliable and will be a proper alternative to conventional deep learning for medical image classification.
Curriculum learning strategies have been proven to be effective in various applications and have gained significant interest in the field of machine learning. It has the ability to improve the final model's performance and accelerate the training process. However, in the medical imaging domain, data irregularities can make the recognition task more challenging and usually result in misclassification between the different classes in the dataset. Class-decomposition approaches have shown promising results in solving such a problem by learning the boundaries within the classes of the data set. In this paper, we present a novel convolutional neural network (CNN) training method based on the curriculum learning strategy and the class decomposition approach, which we call CLOG-CD, to improve the performance of medical image classification. We evaluated our method on four different imbalanced medical image datasets, such as Chest X-ray (CXR), brain tumour, digital knee X-ray, and histopathology colorectal cancer (CRC). CLOG-CD utilises the learnt weights from the decomposition granularity of the classes, and the training is accomplished from descending to ascending order (i.e., anti-curriculum technique). We also investigated the classification performance of our proposed method based on different acceleration factors and pace function curricula. We used two pre-trained networks, ResNet-50 and DenseNet-121, as the backbone for CLOG-CD. The results with ResNet-50 show that CLOG-CD has the ability to improve classification performance with an accuracy of 96.08% for the CXR dataset, 96.91% for the brain tumour dataset, 79.76% for the digital knee X-ray, and 99.17% for the CRC dataset, compared to other training strategies. In addition, with DenseNet-121, CLOG-CD has achieved 94.86%, 94.63%, 76.19%, and 99.45% for CXR, brain tumour, digital knee X-ray, and CRC datasets, respectively
Humans can develop internal world models that encode common sense knowledge, telling them how the world works and predicting the consequences of their actions. This concept has emerged as a promising direction for establishing general-purpose machine-learning models in recent preliminary works, e.g., for visual representation learning. In this paper, we present CheXWorld, the first effort towards a self-supervised world model for radiographic images. Specifically, our work develops a unified framework that simultaneously models three aspects of medical knowledge essential for qualified radiologists, including 1) local anatomical structures describing the fine-grained characteristics of local tissues (e.g., architectures, shapes, and textures); 2) global anatomical layouts describing the global organization of the human body (e.g., layouts of organs and skeletons); and 3) domain variations that encourage CheXWorld to model the transitions across different appearance domains of radiographs (e.g., varying clarity, contrast, and exposure caused by collecting radiographs from different hospitals, devices, or patients). Empirically, we design tailored qualitative and quantitative analyses, revealing that CheXWorld successfully captures these three dimensions of medical knowledge. Furthermore, transfer learning experiments across eight medical image classification and segmentation benchmarks showcase that CheXWorld significantly outperforms existing SSL methods and large-scale medical foundation models. Code & pre-trained models are available at https://github.com/LeapLabTHU/CheXWorld.
Background: Deep learning has significantly advanced medical image analysis, with Vision Transformers (ViTs) offering a powerful alternative to convolutional models by modeling long-range dependencies through self-attention. However, ViTs are inherently data-intensive and lack domain-specific inductive biases, limiting their applicability in medical imaging. In contrast, radiomics provides interpretable, handcrafted descriptors of tissue heterogeneity but suffers from limited scalability and integration into end-to-end learning frameworks. In this work, we propose the Radiomics-Embedded Vision Transformer (RE-ViT) that combines radiomic features with data-driven visual embeddings within a ViT backbone. Purpose: To develop a hybrid RE-ViT framework that integrates radiomics and patch-wise ViT embeddings through early fusion, enhancing robustness and performance in medical image classification. Methods: Following the standard ViT pipeline, images were divided into patches. For each patch, handcrafted radiomic features were extracted and fused with linearly projected pixel embeddings. The fused representations were normalized, positionally encoded, and passed to the ViT encoder. A learnable [CLS] token aggregated patch-level information for classification. We evaluated RE-ViT on three public datasets (including BUSI, ChestXray2017, and Retinal OCT) using accuracy, macro AUC, sensitivity, and specificity. RE-ViT was benchmarked against CNN-based (VGG-16, ResNet) and hybrid (TransMed) models. Results: RE-ViT achieved state-of-the-art results: on BUSI, AUC=0.950+/-0.011; on ChestXray2017, AUC=0.989+/-0.004; on Retinal OCT, AUC=0.986+/-0.001, which outperforms other comparison models. Conclusions: The RE-ViT framework effectively integrates radiomics with ViT architectures, demonstrating improved performance and generalizability across multimodal medical image classification tasks.
In many medical imaging tasks, convolutional neural networks (CNNs) efficiently extract local features hierarchically. More recently, vision transformers (ViTs) have gained popularity, using self-attention mechanisms to capture global dependencies, but lacking the inherent spatial localization of convolutions. Therefore, hybrid models combining CNNs and ViTs have been developed to combine the strengths of both architectures. However, such hybrid CNN-ViT models are difficult to interpret, which hinders their application in medical imaging. In this work, we introduce an interpretable-by-design hybrid fully convolutional CNN-Transformer architecture for medical image classification. Unlike widely used post-hoc saliency methods for ViTs, our approach generates faithful and localized evidence maps that directly reflect the model's decision process. We evaluated our method on two medical image classification tasks using color fundus images. Our model not only achieves state-of-the-art predictive performance compared to both black-box and interpretable models but also provides class-specific sparse evidence maps in a single forward pass. The code is available at: https://anonymous.4open.science/r/Expl-CNN-Transformer/.
Deep neural networks for medical image classification often fail to generalize consistently in clinical practice due to violations of the i.i.d. assumption and opaque decision-making. This paper examines interpretability in deep neural networks fine-tuned for fracture detection by evaluating model performance against adversarial attack and comparing interpretability methods to fracture regions annotated by an orthopedic surgeon. Our findings prove that robust models yield explanations more aligned with clinically meaningful areas, indicating that robustness encourages anatomically relevant feature prioritization. We emphasize the value of interpretability for facilitating human-AI collaboration, in which models serve as assistants under a human-in-the-loop paradigm: clinically plausible explanations foster trust, enable error correction, and discourage reliance on AI for high-stakes decisions. This paper investigates robustness and interpretability as complementary benchmarks for bridging the gap between benchmark performance and safe, actionable clinical deployment.