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Chest X-ray Image Classification: A Causal Perspective

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Medical Image Computing and Computer Assisted Intervention – MICCAI 2023 (MICCAI 2023)

Part of the book series: Lecture Notes in Computer Science ((LNCS,volume 14222))

Abstract

The chest X-ray (CXR) is a widely used and easily accessible medical test for diagnosing common chest diseases. Recently, there have been numerous advancements in deep learning-based methods capable of effectively classifying CXR. However, assessing whether these algorithms truly capture the cause-and-effect relationship between diseases and their underlying causes, or merely learn to map labels to images, remains a challenge. In this paper, we propose a causal approach to address the CXR classification problem, which involves constructing a structural causal model (SCM) and utilizing backdoor adjustment to select relevant visual information for CXR classification. Specifically, we design various probability optimization functions to eliminate the influence of confounding factors on the learning of genuine causality. Experimental results demonstrate that our proposed method surpasses the performance of two open-source datasets in terms of classification performance. To access the source code for our approach, please visit: https://github.com/zc2024/Causal_CXR.

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References

  1. Brady, A., Laoide, R.Ó., McCarthy, P., McDermott, R.: Discrepancy and error in radiology: concepts, causes and consequences. Ulster Med. J. 81(1), 3 (2012)

    Google Scholar 

  2. Glymour, M., Pearl, J., Jewell, N.P.: Causal Inference in Statistics: A Primer. Wiley, Hoboken (2016)

    Google Scholar 

  3. Gong, X., Xia, X., Zhu, W., Zhang, B., Doermann, D., Zhuo, L.: Deformable Gabor feature networks for biomedical image classification. In: Proceedings of the IEEE/CVF Winter Conference on Applications of Computer Vision, pp. 4004–4012 (2021)

    Google Scholar 

  4. Gündel, S., Grbic, S., Georgescu, B., Liu, S., Maier, A., Comaniciu, D.: Learning to recognize abnormalities in chest x-rays with location-aware dense networks. In: Vera-Rodriguez, R., Fierrez, J., Morales, A. (eds.) CIARP 2018. LNCS, vol. 11401, pp. 757–765. Springer, Cham (2019). https://doi.org/10.1007/978-3-030-13469-3_88

    Chapter  Google Scholar 

  5. He, K., Zhang, X., Ren, S., Sun, J.: Deep residual learning for image recognition. In: Proceedings of the IEEE Conference on Computer Vision and Pattern Recognition, pp. 770–778 (2016)

    Google Scholar 

  6. Irvin, J., et al.: Chexpert: a large chest radiograph dataset with uncertainty labels and expert comparison. In: Proceedings of the AAAI Conference on Artificial Intelligence, vol. 33, pp. 590–597 (2019)

    Google Scholar 

  7. Ke, A., Ellsworth, W., Banerjee, O., Ng, A.Y., Rajpurkar, P.: CheXtransfer: performance and parameter efficiency of ImageNet models for chest x-ray interpretation. In: Proceedings of the Conference on Health, Inference, and Learning, pp. 116–124 (2021)

    Google Scholar 

  8. Kingma, D.P., Ba, J.: Adam: a method for stochastic optimization. arXiv preprint arXiv:1412.6980 (2014)

  9. Liu, H., Wang, L., Nan, Y., Jin, F., Wang, Q., Pu, J.: SDFN: segmentation-based deep fusion network for thoracic disease classification in chest x-ray images. Comput. Med. Imaging Graph. 75, 66–73 (2019)

    Article  Google Scholar 

  10. Mao, C., Yao, L., Luo, Y.: ImageGCN: multi-relational image graph convolutional networks for disease identification with chest x-rays. IEEE Trans. Med. Imaging 41(8), 1990–2003 (2022)

    Article  Google Scholar 

  11. Ouyang, X., et al.: Learning hierarchical attention for weakly-supervised chest x-ray abnormality localization and diagnosis. IEEE Trans. Med. Imaging 40(10), 2698–2710 (2020)

    Article  Google Scholar 

  12. Pan, X., et al.: On the integration of self-attention and convolution. In: Proceedings of the IEEE/CVF Conference on Computer Vision and Pattern Recognition, pp. 815–825 (2022)

    Google Scholar 

  13. Pearl, J.: Interpretation and identification of causal mediation. Psychol. Methods 19(4), 459 (2014)

    Article  Google Scholar 

  14. Pearl, J., et al.: Models, reasoning and inference. Cambridge, UK: Cambridge University Press 19(2) (2000)

    Google Scholar 

  15. Pham, H.H., Le, T.T., Tran, D.Q., Ngo, D.T., Nguyen, H.Q.: Interpreting chest x-rays via CNNs that exploit hierarchical disease dependencies and uncertainty labels. Neurocomputing 437, 186–194 (2021)

    Article  Google Scholar 

  16. Rajaraman, S., Antani, S.: Training deep learning algorithms with weakly labeled pneumonia chest x-ray data for covid-19 detection. MedRxiv (2020)

    Google Scholar 

  17. Rocha, J., Pereira, S.C., Pedrosa, J., Campilho, A., Mendonça, A.M.: Attention-driven spatial transformer network for abnormality detection in chest x-ray images. In: 2022 IEEE 35th International Symposium on Computer-Based Medical Systems (CBMS), pp. 252–257. IEEE (2022)

    Google Scholar 

  18. Saleem, H.N., Sheikh, U.U., Khalid, S.A.: Classification of chest diseases from x-ray images on the CheXpert dataset. In: Mekhilef, S., Favorskaya, M., Pandey, R.K., Shaw, R.N. (eds.) Innovations in Electrical and Electronic Engineering. LNEE, vol. 756, pp. 837–850. Springer, Singapore (2021). https://doi.org/10.1007/978-981-16-0749-3_64

    Chapter  Google Scholar 

  19. Sui, Y., Wang, X., Wu, J., Lin, M., He, X., Chua, T.S.: Causal attention for interpretable and generalizable graph classification. In: Proceedings of the 28th ACM SIGKDD Conference on Knowledge Discovery and Data Mining, pp. 1696–1705 (2022)

    Google Scholar 

  20. Vaswani, A., et al.: Attention is all you need. In: Advances in Neural Information Processing Systems, vol. 30 (2017)

    Google Scholar 

  21. Wang, X., Peng, Y., Lu, L., Lu, Z., Bagheri, M., Summers, R.M.: Chestx-ray8: hospital-scale chest x-ray database and benchmarks on weakly-supervised classification and localization of common thorax diseases. In: Proceedings of the IEEE Conference on Computer Vision and Pattern Recognition, pp. 2097–2106 (2017)

    Google Scholar 

  22. Wu, J. et al.: SeATrans: learning segmentation-assisted diagnosis model via transformer. In: Wang, L., Dou, Q., Fletcher, P.T., Speidel, S., Li, S. (eds.) Medical Image Computing and Computer Assisted Intervention - MICCAI 2022. MICCAI 2022. LNCS, vol. 13432, pp 677–687. Springer, Cham (2022). https://doi.org/10.1007/978-3-031-16434-7_65

  23. Wu, J., et al.: Calibrate the inter-observer segmentation uncertainty via diagnosis-first principle. arXiv preprint arXiv:2208.03016 (2022)

  24. Wu, J. et al.: Opinions vary? Diagnosis first!. In: Wang, L., Dou, Q., Fletcher, P.T., Speidel, S., Li, S. (eds.) Medical Image Computing and Computer Assisted Intervention - MICCAI 2022. MICCAI 2022. LNCS, vol. 13432, pp. 604–613. Springer, Cham (2022). https://doi.org/10.1007/978-3-031-16434-7_58

  25. Wu, J., et al.: Leveraging undiagnosed data for glaucoma classification with teacher-student learning. In: Martel, A.L., et al. Medical Image Computing and Computer Assisted Intervention - MICCAI 2020. MICCAI 2020. LNCS, vol. 12261, pp. 731–740. Springer, Cham (2020). https://doi.org/10.1007/978-3-030-59710-8_71

  26. Zhang, Y., Kang, B., Hooi, B., Yan, S., Feng, J.: Deep long-tailed learning: a survey. arXiv preprint arXiv:2110.04596 (2021)

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Acknowledgement

This work was supported by the National Natural Science Foundation of China (62272337).

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Correspondence to Dan Song .

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Nie, W., Zhang, C., Song, D., Bai, Y., Xie, K., Liu, AA. (2023). Chest X-ray Image Classification: A Causal Perspective. In: Greenspan, H., et al. Medical Image Computing and Computer Assisted Intervention – MICCAI 2023. MICCAI 2023. Lecture Notes in Computer Science, vol 14222. Springer, Cham. https://doi.org/10.1007/978-3-031-43898-1_3

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  • DOI: https://doi.org/10.1007/978-3-031-43898-1_3

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