The high complexity of deep learning models is associated with the difficulty of explaining what evidence they recognize as correlating with specific disease labels. This information is critical for building trust in models and finding their biases. Until now, automated deep learning visualization solutions have identified regions of images used by classifiers, but these solutions are too coarse, too noisy, or have a limited representation of the way images can change. We propose a novel method for formulating and presenting spatial explanations of disease evidence, called deformation field interpretation with generative adversarial networks (DeFI-GAN). An adversarially trained generator produces deformation fields that modify images of diseased patients to resemble images of healthy patients. We validate the method studying chronic obstructive pulmonary disease (COPD) evidence in chest x-rays (CXRs) and Alzheimer's disease (AD) evidence in brain MRIs. When extracting disease evidence in longitudinal data, we show compelling results against a baseline producing difference maps. DeFI-GAN also highlights disease biomarkers not found by previous methods and potential biases that may help in investigations of the dataset and of the adopted learning methods.
Scientific Computing and Imaging Institute, University of Utah（犹他大学科学计算与成像研究所）；Department of Radiology and Imaging Sciences, University of Utah（犹他大学放射学与影像科学系）
Knowledge of what spatial elements of medical images deep learning methods use as evidence is important for model interpretability, trustiness, and validation. There is a lack of such techniques for models in regression tasks. We propose a method, called visualization for regression with a generative adversarial network (VR-GAN), for formulating adversarial training specifically for datasets containing regression target values characterizing disease severity. We use a conditional generative adversarial network where the generator attempts to learn to shift the output of a regressor through cre…
Medical imaging AI systems such as disease classification and segmentation are increasingly inspired and transformed from computer vision based AI systems. Although an array of adversarial training and/or loss function based defense techniques have been developed and proved to be effective in computer vision, defending against adversarial attacks on medical images remains largely an uncharted territory due to the following unique challenges: 1) label scarcity in medical images significantly limits adversarial generalizability of the AI system; 2) vastly similar and dominant fore- and backgroun…
Unlike natural images, medical images often have intrinsic characteristics that can be leveraged for neural network learning. For example, images that belong to different stages of a disease may continuously follow a certain progression pattern. In this paper, we propose a novel method that leverages disease progression learning for medical image recognition. In our method, sequences of images ordered by disease stages are learned by a neural network that consists of a shared vision model for feature extraction and a long short-term memory network for the learning of stage sequences. Auxiliary…
Semi-Supervised Disease Classification based on Limited Medical Image Data
School of Science, Minzu University of China（中央民族大学理学院）；Joint Research Center on Computational Mathematics and Control, Shenzhen MSU-BIT University（深圳北理莫斯科大学计算数学与控制联合研究中心）；Institute of Data Science, National University of Singapore（新加坡国立大学数据科学研究院）
Recently, medical report generation, which aims to automatically generate a long and coherent descriptive paragraph of a given medical image, has received growing research interests. Different from the general image captioning tasks, medical report generation is more challenging for data-driven neural models. This is mainly due to 1) the serious data bias: the normal visual regions dominate the dataset over the abnormal visual regions, and 2) the very long sequence. To alleviate above two problems, we propose an AlignTransformer framework, which includes the Align Hierarchical Attention (AHA) …
GLOMIA-Pro: A Generalizable Longitudinal Medical Image Analysis Framework for Disease Progression Prediction
School of Medical Technology, Beijing Institute of Technology（北京理工大学医学技术学院）；Department of Thoracic Surgery, Sun Yat-sen University Cancer Center（中山大学肿瘤医院胸外科部门）；Department of Radiology, The Fifth Affiliated Hospital of Sun Yat-sen University（中山大学第五附属医院放射科部门）；Beijing Duanliu Medical Technology Co., Ltd.（北京杜流医疗科技有限公司）
Beihang University（北京航空航天大学）；The University of Melbourne（墨尔本大学）；National Institute of Informatics（国立信息学研究所）；Shanghai Jiao Tong University（上海交通大学）；Chinese Academy of Sciences（中国科学院）
Deep neural networks (DNNs) have become popular for medical image analysis tasks like cancer diagnosis and lesion detection. However, a recent study demonstrates that medical deep learning systems can be compromised by carefully-engineered adversarial examples/attacks with small imperceptible perturbations. This raises safety concerns about the deployment of these systems in clinical settings. In this paper, we provide a deeper understanding of adversarial examples in the context of medical images. We find that medical DNN models can be more vulnerable to adversarial attacks compared to models…
Survey on Adversarial Attack and Defense for Medical Image Analysis: Methods and Challenges
School of Computer Science and Engineering, Sun Yat-sen University（中山大学计算机科学与工程学院）；Guangdong Province Key Laboratory of Information Security Technology（广东省信息安全技术重点实验室）；Division of Life Science, Hong Kong University of Science and Technology（香港科技大学生命科学部）
Shahid Beheshti University（沙希德·贝赫什提大学）；Shahid Beheshti University of Medical Sciences（沙希德·贝赫什提医科大学）；University of Leeds（利兹大学）；Royal Adelaide Hospital（阿德莱德皇家医院）；The University of Adelaide（阿德莱德大学）；Tehran University of Medical Sciences（德黑兰医科大学）
Coronavirus disease (COVID-19) is an infectious disease caused by a newly discovered coronavirus. The disease presents with symptoms such as shortness of breath, fever, dry cough, and chronic fatigue, amongst others. Sometimes the symptoms of the disease increase so much they lead to the death of the patients. The disease may be asymptomatic in some patients in the early stages, which can lead to increased transmission of the disease to others. Many studies have tried to use medical imaging for early diagnosis of COVID-19. This study attempts to review papers on automatic methods for medical i…
Universidad San Francisco de Quito（旧金山基多大学）；University of South Florida（南佛罗里达大学）
Deep learning models have obtained state-of-the-art results for medical image analysis. However, when these models are tested on an unseen domain there is a significant performance degradation. In this work, we present an unsupervised Cross-Modality Adversarial Domain Adaptation (C-MADA) framework for medical image segmentation. C-MADA implements an image- and feature-level adaptation method in a sequential manner. First, images from the source domain are translated to the target domain through an un-paired image-to-image adversarial translation with cycle-consistency loss. Then, a U-Net netwo…
Convolutional neural network-based medical image classifiers have been shown to be especially susceptible to adversarial examples. Such instabilities are likely to be unacceptable in the future of automated diagnoses. Though statistical adversarial example detection methods have proven to be effective defense mechanisms, additional research is necessary that investigates the fundamental vulnerabilities of deep-learning-based systems and how best to build models that jointly maximize traditional and robust accuracy. This paper presents the inclusion of attention mechanisms in CNN-based medical …
Technical University of Munich（慕尼黑工业大学）；Klinikum rechts der Isar（伊萨尔河畔医院）；IPM Institute For Research In Fundamental Sciences（基础科学研究所）
This paper presents a novel yet efficient defense framework for segmentation models against adversarial attacks in medical imaging. In contrary to the defense methods against adversarial attacks for classification models which widely are investigated, such defense methods for segmentation models has been less explored. Our proposed method can be used for any deep learning models without revising the target deep learning models, as well as can be independent of adversarial attacks. Our framework consists of a frequency domain converter, a detector, and a reformer. The frequency domain converter…
University of New South Wales（新南威尔士大学）；Stanford University（斯坦福大学）；Lehigh University（理海大学）
The shortage of annotated medical images is one of the biggest challenges in the field of medical image computing. Without a sufficient number of training samples, deep learning based models are very likely to suffer from over-fitting problem. The common solution is image manipulation such as image rotation, cropping, or resizing. Those methods can help relieve the over-fitting problem as more training samples are introduced. However, they do not really introduce new images with additional information and may lead to data leakage as the test set may contain similar samples which appear in the …
Princeton University（普林斯顿大学）；University of Science and Technology of China（中国科学技术大学）
Deep neural network based medical image systems are vulnerable to adversarial examples. Many defense mechanisms have been proposed in the literature, however, the existing defenses assume a passive attacker who knows little about the defense system and does not change the attack strategy according to the defense. Recent works have shown that a strong adaptive attack, where an attacker is assumed to have full knowledge about the defense system, can easily bypass the existing defenses. In this paper, we propose a novel adversarial example defense system called Medical Aegis. To the best of our k…
Indian Institute of Technology (IIT) Ropar（印度理工学院罗巴尔分校）；Monash University（莫纳什大学）；University of Canberra（堪培拉大学）；Inception Institute of Artificial Intelligence（因塞普申人工智能研究院）
We present a novel framework for explainable labeling and interpretation of medical images. Medical images require specialized professionals for interpretation, and are explained (typically) via elaborate textual reports. Different from prior methods that focus on medical report generation from images or vice-versa, we novelly generate congruent image--report pairs employing a cyclic-Generative Adversarial Network (cycleGAN); thereby, the generated report will adequately explain a medical image, while a report-generated image that effectively characterizes the text visually should (sufficientl…
École de Technologie Supérieure（高等技术学院）；Université de Sherbrooke（舍布鲁克大学）
This paper presents a client/server privacy-preserving network in the context of multicentric medical image analysis. Our approach is based on adversarial learning which encodes images to obfuscate the patient identity while preserving enough information for a target task. Our novel architecture is composed of three components: 1) an encoder network which removes identity-specific features from input medical images, 2) a discriminator network that attempts to identify the subject from the encoded images, 3) a medical image analysis network which analyzes the content of the encoded images (segm…
Numerous factors could lead to partial deteriorations of medical images. For example, metallic implants will lead to localized perturbations in MRI scans. This will affect further post-processing tasks such as attenuation correction in PET/MRI or radiation therapy planning. In this work, we propose the inpainting of medical images via Generative Adversarial Networks (GANs). The proposed framework incorporates two patch-based discriminator networks with additional style and perceptual losses for the inpainting of missing information in realistically detailed and contextually consistent manner. …
Arizona State University（亚利桑那州立大学）；Mayo Clinic（梅奥诊所）
Discriminative learning, restorative learning, and adversarial learning have proven beneficial for self-supervised learning schemes in computer vision and medical imaging. Existing efforts, however, omit their synergistic effects on each other in a ternary setup, which, we envision, can significantly benefit deep semantic representation learning. To realize this vision, we have developed DiRA, the first framework that unites discriminative, restorative, and adversarial learning in a unified manner to collaboratively glean complementary visual information from unlabeled medical images for fine-…
Harnessing the power of longitudinal medical imaging for eye disease prognosis using Transformer-based sequence modeling
Weill Cornell Medicine（威尔康奈尔医学院）；The University of Texas at Austin（德克萨斯大学奥斯汀分校）；Washington University School of Medicine（华盛顿大学医学院）；Columbia University（哥伦比亚大学）；National Eye Institute（国家眼科研究所）；National Institutes of Health (NIH)（美国国立卫生研究院）；National Center for Biotechnology Information (NCBI)（国家生物技术信息中心）；National Library of Medicine (NLM)（国家医学图书馆）
Case Western Reserve University（凯斯西储大学）；IBM Almaden Research Center（IBM阿尔马登研究中心）
We explore a solution for learning disease signatures from weakly, yet easily obtainable, annotated volumetric medical imaging data by analyzing 3D volumes as a sequence of 2D images. We demonstrate the performance of our solution in the detection of emphysema in lung cancer screening low-dose CT images. Our approach utilizes convolutional long short-term memory (LSTM) to "scan" sequentially through an imaging volume for the presence of disease in a portion of scanned region. This framework allowed effective learning given only volumetric images and binary disease labels, thus enabling trainin…
Shenzhen Institutes of Advanced Technology, Chinese Academy of Sciences（中国科学院深圳先进技术研究院）；Shenzhen University（深圳大学）；Renmin University of China（中国人民大学）；Central South University（中南大学）
Alzheimer's disease is characterized by alterations of the brain's structural and functional connectivity during its progressive degenerative processes. Existing auxiliary diagnostic methods have accomplished the classification task, but few of them can accurately evaluate the changing characteristics of brain connectivity. In this work, a prior guided adversarial representation learning and hypergraph perceptual network (PGARL-HPN) is proposed to predict abnormal brain connections using triple-modality medical images. Concretely, a prior distribution from the anatomical knowledge is estimated…
A Clinical-oriented Multi-level Contrastive Learning Method for Disease Diagnosis in Low-quality Medical Images
Northeastern University（东北大学）；Key Laboratory of Intelligent Computing in Medical Image of Ministry of Education（医学图像智能计算教育部重点实验室）；National Frontiers Science Center for Industrial Intelligence and Systems Optimization（工业智能与系统优化全国前沿科学中心）
Deep learning algorithms produces state-of-the-art results for different machine learning and computer vision tasks. To perform well on a given task, these algorithms require large dataset for training. However, deep learning algorithms lack generalization and suffer from over-fitting whenever trained on small dataset, especially when one is dealing with medical images. For supervised image analysis in medical imaging, having image data along with their corresponding annotated ground-truths is costly as well as time consuming since annotations of the data is done by medical experts manually. I…
Integrating Medical Imaging and Clinical Reports Using Multimodal Deep Learning for Advanced Disease Analysis
Penn State University（宾夕法尼亚州立大学）；Mississippi State University（密西西比州立大学）；Northwest Missouri State University（西北密苏里州立大学）；University of California, Los Angeles（加利福尼亚大学洛杉矶分校）；University of California, Berkeley（加利福尼亚大学伯克利分校）；Colorado State University（科罗拉多州立大学）
Adversarial Medical Image with Hierarchical Feature Hiding
University of Science and Technology of China（中国科学技术大学）；Institute of Computing Technology, Chinese Academy of Sciences（中国科学院计算技术研究所）；Tencent YouTu Lab（腾讯优图实验室）；Guangxi Medical University（广西医科大学）；The Hong Kong University of Science and Technology（香港科技大学）；Meta Reality Labs（Meta现实实验室）
Tencent Javis Lab（腾讯杰维斯实验室）；Tencent AI Lab（腾讯AI实验室）
Convolutional Neural Networks (CNNs) have advanced existing medical systems for automatic disease diagnosis. However, a threat to these systems arises that adversarial attacks make CNNs vulnerable. Inaccurate diagnosis results make a negative influence on human healthcare. There is a need to investigate potential adversarial attacks to robustify deep medical diagnosis systems. On the other side, there are several modalities of medical images (e.g., CT, fundus, and endoscopic image) of which each type is significantly different from others. It is more challenging to generate adversarial perturb…
ImageFlowNet: Forecasting Multiscale Image-Level Trajectories of Disease Progression with Irregularly-Sampled Longitudinal Medical Images
Yale University（耶鲁大学）；University of California, San Francisco（加州大学旧金山分校）；Mila - Quebec AI Institute（魁北克AI研究所）；Université de Montréal（蒙特利尔大学）；McGill University（麦吉尔大学）；Northern California Retina Vitreous Associates（北加州视网膜与玻璃体协会）
Multimodal, Multi-Disease Medical Imaging Foundation Model (MerMED-FM)
Institute of High Performance Computing (IHPC), A*STAR（高性能计算研究所 (IHPC)，A*STAR）；Singapore National Eye Centre（新加坡全国眼科中心）；Singapore Eye Research Institute（新加坡眼科研究所）；Singapore General Hospital（新加坡中央医院）；Duke-NUS Medical School（杜克-新加坡国立大学医学院）；Singapore Health Services（新加坡保健服务）
University of Edinburgh（爱丁堡大学）；The Alan Turing Institute（艾伦·图灵研究所）
Due to the limited availability of medical data, deep learning approaches for medical image analysis tend to generalise poorly to unseen data. Augmenting data during training with random transformations has been shown to help and became a ubiquitous technique for training neural networks. Here, we propose a novel adversarial counterfactual augmentation scheme that aims at finding the most \textit{effective} synthesised images to improve downstream tasks, given a pre-trained generative model. Specifically, we construct an adversarial game where we update the input \textit{conditional factor} of…
University of Georgia（佐治亚大学）；Zhongnan Hospital of Wuhan University（武汉大学中南医院）；Shanghai Jiao Tong University（上海交通大学）
In this paper we consider the problem of unsupervised anomaly segmentation in medical images, which has attracted increasing attention in recent years due to the expensive pixel-level annotations from experts and the existence of a large amount of unannotated normal and abnormal image scans. We introduce a segmentation network that utilizes adversarial learning to partition an image into two cuts, with one of them falling into a reference distribution provided by the user. This Adversarial-based Selective Cutting network (ASC-Net) bridges the two domains of cluster-based deep segmentation and …
Decoupling Disease, Covariates, and Individual Variability: A Unified Disentanglement Framework for Medical Image Classification
Shanghai Jiao Tong University School of Medicine（上海交通大学医学院）；Ruijin Hospital（瑞金医院）；Fudan University（复旦大学）；Shandong Provincial Hospital Affiliated to Shandong First Medical University（山东第一医科大学附属省立医院）；Air Force Medical University（空军军医大学）
University of Pittsburgh（匹兹堡大学）；Boston University（波士顿大学）
Large-scale volumetric medical images with annotation are rare, costly, and time prohibitive to acquire. Self-supervised learning (SSL) offers a promising pre-training and feature extraction solution for many downstream tasks, as it only uses unlabeled data. Recently, SSL methods based on instance discrimination have gained popularity in the medical imaging domain. However, SSL pre-trained encoders may use many clues in the image to discriminate an instance that are not necessarily disease-related. Moreover, pathological patterns are often subtle and heterogeneous, requiring the ability of the…
École de technologie Superieure (ETS)（高等技术学院（ETS））；IIT Kharagpur（印度理工学院卡拉格布尔分校）
We address the problem of segmenting 3D multi-modal medical images in scenarios where very few labeled examples are available for training. Leveraging the recent success of adversarial learning for semi-supervised segmentation, we propose a novel method based on Generative Adversarial Networks (GANs) to train a segmentation model with both labeled and unlabeled images. The proposed method prevents over-fitting by learning to discriminate between true and fake patches obtained by a generator network. Our work extends current adversarial learning approaches, which focus on 2D single-modality ima…
Technische Universität München（慕尼黑工业大学）；German Center for Neurodegenerative Diseases (DZNE)（德国神经退行性疾病中心（DZNE））；Johns Hopkins University（约翰斯·霍普金斯大学）
In this paper, for the first time, we propose an evaluation method for deep learning models that assesses the performance of a model not only in an unseen test scenario, but also in extreme cases of noise, outliers and ambiguous input data. To this end, we utilize adversarial examples, images that fool machine learning models, while looking imperceptibly different from original data, as a measure to evaluate the robustness of a variety of medical imaging models. Through extensive experiments on skin lesion classification and whole brain segmentation with state-of-the-art networks such as Incep…
Computational Imaging Research Lab (CIR)（计算成像研究实验室（CIR））；Department of Biomedical Imaging and Image-guided Therapy（生物医学成像与影像引导治疗系）；Medical University of Vienna（维也纳医科大学）
Predictive marker patterns in imaging data are a means to quantify disease and progression, but their identification is challenging, if the underlying biology is poorly understood. Here, we present a method to identify predictive texture patterns in medical images in an unsupervised way. Based on deep clustering networks, we simultaneously encode and cluster medical image patches in a low-dimensional latent space. The resulting clusters serve as features for disease staging, linking them to the underlying disease. We evaluate the method on 70 T1-weighted magnetic resonance images of patients w…
Frontotemporal dementia and Alzheimer's disease are two common forms of dementia and are easily misdiagnosed as each other due to their similar pattern of clinical symptoms. Differentiating between the two dementia types is crucial for determining disease-specific intervention and treatment. Recent development of Deep-learning-based approaches in the field of medical image computing are delivering some of the best performance for many binary classification tasks, although its application in differential diagnosis, such as neuroimage-based differentiation for multiple types of dementia, has not…
Ontology-based knowledge representation for bone disease diagnosis: a foundation for safe and sustainable medical artificial intelligence systems
University of Science, VNUHCM（胡志明市国家大学科学大学）；Viet Nam National University, Ho Chi Minh City（越南国家大学胡志明市分校）；Ho Chi Minh City Hospital for Traumatology and Orthopedics（胡志明市创伤与骨科医院）
Generative adversarial networks (GANs) are unsupervised Deep Learning approach in the computer vision community which has gained significant attention from the last few years in identifying the internal structure of multimodal medical imaging data. The adversarial network simultaneously generates realistic medical images and corresponding annotations, which proven to be useful in many cases such as image augmentation, image registration, medical image generation, image reconstruction, and image-to-image translation. These properties bring the attention of the researcher in the field of medical…
Arizona State University（亚利桑那州立大学）；Mila – Quebec Artificial Intelligence Institute（魁北克人工智能研究所（Mila））；Mayo Clinic（梅奥诊所）
Generative adversarial networks (GANs) have ushered in a revolution in image-to-image translation. The development and proliferation of GANs raises an interesting question: can we train a GAN to remove an object, if present, from an image while otherwise preserving the image? Specifically, can a GAN "virtually heal" anyone by turning his medical image, with an unknown health status (diseased or healthy), into a healthy one, so that diseased regions could be revealed by subtracting those two images? Such a task requires a GAN to identify a minimal subset of target pixels for domain translation,…
University of Central Florida（中佛罗里达大学）；Mayo Clinic Cancer Center（妙佑医疗国际癌症中心）
Adversarial learning has been proven to be effective for capturing long-range and high-level label consistencies in semantic segmentation. Unique to medical imaging, capturing 3D semantics in an effective yet computationally efficient way remains an open problem. In this study, we address this computational burden by proposing a novel projective adversarial network, called PAN, which incorporates high-level 3D information through 2D projections. Furthermore, we introduce an attention module into our framework that helps for a selective integration of global information directly from our segmen…
African Institute for Mathematical Sciences（非洲数学科学研究所）；Stanford University（斯坦福大学）
Deep learning models have become a popular choice for medical image analysis. However, the poor generalization performance of deep learning models limits them from being deployed in the real world as robustness is critical for medical applications. For instance, the state-of-the-art Convolutional Neural Networks (CNNs) fail to detect adversarial samples or samples drawn statistically far away from the training distribution. In this work, we experimentally evaluate the robustness of a Mahalanobis distance-based confidence score, a simple yet effective method for detecting abnormal input samples…
Chronic respiratory diseases, such as chronic obstructive pulmonary disease and asthma, are a serious health crisis, affecting a large number of people globally and inflicting major costs on the economy. Current methods for assessing the progression of respiratory symptoms are either subjective and inaccurate, or complex and cumbersome, and do not incorporate environmental factors. Lacking predictive assessments and early intervention, unexpected exacerbations can lead to hospitalizations and high medical costs. This work presents a multi-modal solution for predicting the exacerbation risks of…
Tsinghua University（清华大学）；Beijing National Research Center for Information Science and Technology（北京信息科学与技术国家研究中心）；Key Laboratory of Pervasive Computing, Ministry of Education（教育部普适计算重点实验室）；Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University（清华大学临床医学院北京清华长庚医院）；Peking Union Medical College Hospital（北京协和医院）
Segmentation is considered to be a very crucial task in medical image analysis. This task has been easier since deep learning models have taken over with its high performing behavior. However, deep learning models dependency on large data proves it to be an obstacle in medical image analysis because of insufficient data samples. Several data augmentation techniques have been used to mitigate this problem. We propose a new augmentation method by introducing adversarial learning attack techniques, specifically Fast Gradient Sign Method (FGSM). Furthermore, We have also introduced the concept of …
Centre for Medical Image Computing（医学图像计算中心）；Department of Computer Science, University College London（伦敦大学学院计算机科学系）
Simulating images representative of neurodegenerative diseases is important for predicting patient outcomes and for validation of computational models of disease progression. This capability is valuable for secondary prevention clinical trials where outcomes and screening criteria involve neuroimaging. Traditional computational methods are limited by imposing a parametric model for atrophy and are extremely resource-demanding. Recent advances in deep learning have yielded data-driven models for longitudinal studies (e.g., face ageing) that are capable of generating synthetic images in real-tim…
