Sebastian Gündel

Kai Packhäuser, Sebastian Gündel, Florian Thamm et al.

Robust and reliable anonymization of chest radiographs constitutes an essential step before publishing large datasets of such for research purposes. The conventional anonymization process is carried out by obscuring personal information in the images with black boxes and removing or replacing meta-information. However, such simple measures retain biometric information in the chest radiographs, allowing patients to be re-identified by a linkage attack. Therefore, there is an urgent need to obfuscate the biometric information appearing in the images. We propose the first deep learning-based approach (PriCheXy-Net) to targetedly anonymize chest radiographs while maintaining data utility for diagnostic and machine learning purposes. Our model architecture is a composition of three independent neural networks that, when collectively used, allow for learning a deformation field that is able to impede patient re-identification. Quantitative results on the ChestX-ray14 dataset show a reduction of patient re-identification from 81.8% to 57.7% (AUC) after re-training with little impact on the abnormality classification performance. This indicates the ability to preserve underlying abnormality patterns while increasing patient privacy. Lastly, we compare our proposed anonymization approach with two other obfuscation-based methods (Privacy-Net, DP-Pix) and demonstrate the superiority of our method towards resolving the privacy-utility trade-off for chest radiographs.

Sebastian Gündel, Arnaud A. A. Setio, Florin C. Ghesu et al.

Chest radiography is the most common radiographic examination performed in daily clinical practice for the detection of various heart and lung abnormalities. The large amount of data to be read and reported, with more than 100 studies per day for a single radiologist, poses a challenge in consistently maintaining high interpretation accuracy. The introduction of large-scale public datasets has led to a series of novel systems for automated abnormality classification. However, the labels of these datasets were obtained using natural language processed medical reports, yielding a large degree of label noise that can impact the performance. In this study, we propose novel training strategies that handle label noise from such suboptimal data. Prior label probabilities were measured on a subset of training data re-read by 4 board-certified radiologists and were used during training to increase the robustness of the training model to the label noise. Furthermore, we exploit the high comorbidity of abnormalities observed in chest radiography and incorporate this information to further reduce the impact of label noise. Additionally, anatomical knowledge is incorporated by training the system to predict lung and heart segmentation, as well as spatial knowledge labels. To deal with multiple datasets and images derived from various scanners that apply different post-processing techniques, we introduce a novel image normalization strategy. Experiments were performed on an extensive collection of 297,541 chest radiographs from 86,876 patients, leading to a state-of-the-art performance level for 17 abnormalities from 2 datasets. With an average AUC score of 0.880 across all abnormalities, our proposed training strategies can be used to significantly improve performance scores.

Kai Packhäuser, Sebastian Gündel, Nicolas Münster et al.

With the rise and ever-increasing potential of deep learning techniques in recent years, publicly available medical datasets became a key factor to enable reproducible development of diagnostic algorithms in the medical domain. Medical data contains sensitive patient-related information and is therefore usually anonymized by removing patient identifiers, e.g., patient names before publication. To the best of our knowledge, we are the first to show that a well-trained deep learning system is able to recover the patient identity from chest X-ray data. We demonstrate this using the publicly available large-scale ChestX-ray14 dataset, a collection of 112,120 frontal-view chest X-ray images from 30,805 unique patients. Our verification system is able to identify whether two frontal chest X-ray images are from the same person with an AUC of 0.9940 and a classification accuracy of 95.55%. We further highlight that the proposed system is able to reveal the same person even ten and more years after the initial scan. When pursuing a retrieval approach, we observe an mAP@R of 0.9748 and a precision@1 of 0.9963. Furthermore, we achieve an AUC of up to 0.9870 and a precision@1 of up to 0.9444 when evaluating our trained networks on external datasets such as CheXpert and the COVID-19 Image Data Collection. Based on this high identification rate, a potential attacker may leak patient-related information and additionally cross-reference images to obtain more information. Thus, there is a great risk of sensitive content falling into unauthorized hands or being disseminated against the will of the concerned patients. Especially during the COVID-19 pandemic, numerous chest X-ray datasets have been published to advance research. Therefore, such data may be vulnerable to potential attacks by deep learning-based re-identification algorithms.