text: We investigate the effectiveness of a simple solution to the common problem of deep learning in medical image analysis with limited quantities of labeled training data. The underlying idea is to assign artificial labels to abundantly available unlabeled medical images and, through a process known as surrogate supervision, pre-train a deep neural network model for the target medical image analysis task lacking sufficient labeled training data. In particular, we employ 3 surrogate supervision schemes, namely rotation, reconstruction, and colorization, in 4 different medical imaging applications representing classification and segmentation for both 2D and 3D medical images. 3 key findings emerge from our research: 1) pre-training with surrogate supervision is effective for small training sets; 2) deep models trained from initial weights pre-trained through surrogate supervision outperform the same models when trained from scratch, suggesting that pre-training with surrogate supervision should be considered prior to training any deep 3D models; 3) pre-training models in the medical domain with surrogate supervision is more effective than transfer learning from an unrelated domain (e.g., natural images), indicating the practical value of abundant unlabeled medical image data.
  @cite_5: A significant proportion of patients scanned in a clinical setting have follow-up scans. We show in this work that such longitudinal scans alone can be used as a form of “free” self-supervision for training a deep network. We demonstrate this self-supervised learning for the case of T2-weighted sagittal lumbar Magnetic Resonance Images (MRIs). A Siamese convolutional neural network (CNN) is trained using two losses: (i) a contrastive loss on whether the scan is of the same person (i.e. longitudinal) or not, together with (ii) a classification loss on predicting the level of vertebral bodies. The performance of this pre-trained network is then assessed on a grading classification task. We experiment on a dataset of 1016 subjects, 423 possessing follow-up scans, with the end goal of learning the disc degeneration radiological gradings attached to the intervertebral discs. We show that the performance of the pre-trained CNN on the supervised classification task is (i) superior to that of a network trained from scratch; and (ii) requires far fewer annotated training samples to reach an equivalent performance to that of the network trained from scratch.
  @cite_18: Purpose Surgical data science is a new research field that aims to observe all aspects of the patient treatment process in order to provide the right assistance at the right time. Due to the breakthrough successes of deep learning-based solutions for automatic image annotation, the availability of reference annotations for algorithm training is becoming a major bottleneck in the field. The purpose of this paper was to investigate the concept of self-supervised learning to address this issue.
  @cite_4: The work explores the use of denoising autoencoders (DAEs) for brain lesion detection, segmentation, and false-positive reduction. Stacked denoising autoencoders (SDAEs) were pretrained using a large number of unlabeled patient volumes and fine-tuned with patches drawn from a limited number of patients (n=20, 40, 65). The results show negligible loss in performance even when SDAE was fine-tuned using 20 labeled patients. Low grade glioma (LGG) segmentation was achieved using a transfer learning approach in which a network pretrained with high grade glioma data was fine-tuned using LGG image patches. The networks were also shown to generalize well and provide good segmentation on unseen BraTS 2013 and BraTS 2015 test data. The manuscript also includes the use of a single layer DAE, referred to as novelty detector (ND). ND was trained to accurately reconstruct nonlesion patches. The reconstruction error maps of test data were used to localize lesions. The error maps were shown to assign unique error distributions to various constituents of the glioma, enabling localization. The ND learns the nonlesion brain accurately as it was also shown to provide good segmentation performance on ischemic brain lesions in images from a different database.
summary: Self-supervised learning with surrogate supervision is a relatively new trend in computer vision, with promising schemes appearing only in recent years. Consequently, the literature on the effectiveness of surrogate supervision in medical imaging is meager. @cite_5 proposed longitudinal relationships between medical images as the surrogate task to pre-train model weights. To generate surrogate supervision, they assign a label of 1 if two longitudinal studies belong to the same patient and 0 otherwise. @cite_4 used noise removal in small image patches as the surrogate task, wherein the surrogate supervision was created by mapping the patches with user-injected noise to the original clean image patches. @cite_18 used image colorization as the surrogate task, wherein color colonoscopy images are converted to gray-scale and then recovered using a conditional Generative Adversarial Network (GAN).