text: Accurate identification and localization of abnormalities from radiology images play an integral part in clinical diagnosis and treatment planning. Building a highly accurate prediction model for these tasks usually requires a large number of images manually annotated with labels and finding sites of abnormalities. In reality, however, such annotated data are expensive to acquire, especially the ones with location annotations. We need methods that can work well with only a small amount of location annotations. To address this challenge, we present a unified approach that simultaneously performs disease identification and localization through the same underlying model for all images. We demonstrate that our approach can effectively leverage both class information as well as limited location annotation, and significantly outperforms the comparative reference baseline in both classification and localization tasks.
  @cite_30: Recent advances of deep learning have achieved remarkable performances in various challenging computer vision tasks. Especially in object localization, deep convolutional neural networks outperform traditional approaches based on extraction of data task-driven features instead of hand-crafted features. Although location information of region-of-interests (ROIs) gives good prior for object localization, it requires heavy annotation efforts from human resources. Thus a weakly supervised framework for object localization is introduced. The term "weakly" means that this framework only uses image-level labeled datasets to train a network. With the help of transfer learning which adopts weight parameters of a pre-trained network, the weakly supervised learning framework for object localization performs well because the pre-trained network already has well-trained class-specific features. However, those approaches cannot be used for some applications which do not have pre-trained networks or well-localized large scale images. Medical image analysis is a representative among those applications because it is impossible to obtain such pre-trained networks. In this work, we present a "fully" weakly supervised framework for object localization ("semi"-weakly is the counterpart which uses pre-trained filters for weakly supervised localization) named as self-transfer learning (STL). It jointly optimizes both classification and localization networks simultaneously. By controlling a supervision level of the localization network, STL helps the localization network focus on correct ROIs without any types of priors. We evaluate the proposed STL framework using two medical image datasets, chest X-rays and mammograms, and achieve signiticantly better localization performance compared to previous weakly supervised approaches.
  @cite_14: The inability to interpret the model prediction in semantically and visually meaningful ways is a well-known shortcoming of most existing computer-aided diagnosis methods. In this paper, we propose MDNet to establish a direct multimodal mapping between medical images and diagnostic reports that can read images, generate diagnostic reports, retrieve images by symptom descriptions, and visualize attention, to provide justifications of the network diagnosis process. MDNet includes an image model and a language model. The image model is proposed to enhance multi-scale feature ensembles and utilization efficiency. The language model, integrated with our improved attention mechanism, aims to read and explore discriminative image feature descriptions from reports to learn a direct mapping from sentence words to image pixels. The overall network is trained end-to-end by using our developed optimization strategy. Based on a pathology bladder cancer images and its diagnostic reports (BCIDR) dataset, we conduct sufficient experiments to demonstrate that MDNet outperforms comparative baselines. The proposed image model obtains state-of-the-art performance on two CIFAR datasets as well.
  @cite_33: In this paper, we introduce the semantic knowledge of medical images from their diagnostic reports to provide an inspirational network training and an interpretable prediction mechanism with our proposed novel multimodal neural network, namely TandemNet. Inside TandemNet, a language model is used to represent report text, which cooperates with the image model in a tandem scheme. We propose a novel dual-attention model that facilitates high-level interactions between visual and semantic information and effectively distills useful features for prediction. In the testing stage, TandemNet can make accurate image prediction with an optional report text input. It also interprets its prediction by producing attention on the image and text informative feature pieces, and further generating diagnostic report paragraphs. Based on a pathological bladder cancer images and their diagnostic reports (BCIDR) dataset, sufficient experiments demonstrate that our method effectively learns and integrates knowledge from multimodalities and obtains significantly improved performance than comparing baselines.
  @cite_39: The chest X-ray is one of the most commonly accessible radiological examinations for screening and diagnosis of many lung diseases. A tremendous number of X-ray imaging studies accompanied by radiological reports are accumulated and stored in many modern hospitals Picture Archiving and Communication Systems (PACS). On the other side, it is still an open question how this type of hospital-size knowledge database containing invaluable imaging informatics (i.e., loosely labeled) can be used to facilitate the data-hungry deep learning paradigms in building truly large-scale high precision computer-aided diagnosis (CAD) systems. In this paper, we present a new chest X-ray database, namely ChestX-ray8, which comprises 108,948 frontal-view X-ray images of 32,717 unique patients with the text-mined eight disease image labels (where each image can have multi-labels), from the associated radiological reports using natural language processing. Importantly, we demonstrate that these commonly occurring thoracic diseases can be detected and even spatially-located via a unified weakly-supervised multi-label image classification and disease localization framework, which is validated using our proposed dataset. Although the initial quantitative results are promising as reported, deep convolutional neural network based reading chest X-rays (i.e., recognizing and locating the common disease patterns trained with only image-level labels) remains a strenuous task for fully-automated high precision CAD systems.
  @cite_19: 
  @cite_11: Large Convolutional Network models have recently demonstrated impressive classification performance on the ImageNet benchmark. However there is no clear understanding of why they perform so well, or how they might be improved. In this paper we address both issues. We introduce a novel visualization technique that gives insight into the function of intermediate feature layers and the operation of the classifier. We also perform an ablation study to discover the performance contribution from different model layers. This enables us to find model architectures that outperform Krizhevsky al on the ImageNet classification benchmark. We show our ImageNet model generalizes well to other datasets: when the softmax classifier is retrained, it convincingly beats the current state-of-the-art results on Caltech-101 and Caltech-256 datasets.
summary: Zhang al proposed a dual-attention model using images and optional texts to make accurate prediction @cite_33 . In @cite_14 , Zhang al proposed an image-to-text model to establish a direct mapping from medical images to diagnostic reports. Both models were evaluated on a dataset of bladder cancer images and corresponding diagnostic reports. Wang al took advantage of a large-scale chest X-ray dataset to formulate the disease diagnosis problem as multi-label classification, using class-specific image feature transformation @cite_39 . They also applied a thresholding method to the feature map visualization @cite_11 for each class and derived the bounding box for each disease. Their qualitative results showed that the model usually generated much larger bounding box than the ground-truth. Hwang al @cite_30 proposed a self-transfer learning framework to learn localization from the globally pooled class-specific feature maps supervised by image labels. These works have the same essence with class activation mapping @cite_19 which handles natural images. The location annotation information was not directly formulated into the loss function in the none of these works. Feature map pooling based localization did not effectively capture the precise disease regions.