Adam Wang

Son Nguyen, Adam Wang, Albert Montillo

Traditional deep learning (DL) models have two ubiquitous limitations. First, they assume training samples are independent and identically distributed (i.i.d), an assumption often violated in real-world datasets where samples have additional correlation due to repeat measurements (e.g., on the same participants in a longitudinal study or cells from the same sequencer). This leads to performance degradation, limited generalization, and covariate confounding, which induces Type I and Type II errors. Second, DL models typically prioritize overall accuracy, favoring accuracy on the majority while sacrificing performance for underrepresented subpopulations, leading to unfair, biased models. This is critical to remediate, particularly in models which influence decisions regarding loan approvals and healthcare. To address these issues, we propose the Fair Mixed Effects Deep Learning (Fair MEDL) framework. This framework quantifies cluster-invariant fixed effects (FE) and cluster-specific random effects (RE) through: 1) a cluster adversary for learning invariant FE, 2) a Bayesian neural network for RE, and 3) a mixing function combining FE and RE for final predictions. Fairness is enhanced through architectural and loss function changes introduced by an adversarial debiasing network. We formally define and demonstrate improved fairness across three metrics: equalized odds, demographic parity, and counterfactual fairness, for both classification and regression tasks. Our method also identifies and de-weights confounded covariates, mitigating Type I and II errors. The framework is comprehensively evaluated across three datasets spanning two industries, including finance and healthcare. The Fair MEDL framework improves fairness by 86.4% for Age, 64.9% for Race, 57.8% for Sex, and 36.2% for Marital status, while maintaining robust predictive performance.

Attiano Purpura-Pontoniere, Demetri Terzopoulos, Adam Wang et al.

Disease diagnosis from medical images via supervised learning is usually dependent on tedious, error-prone, and costly image labeling by medical experts. Alternatively, semi-supervised learning and self-supervised learning offer effectiveness through the acquisition of valuable insights from readily available unlabeled images. We present Semi-Supervised Relational Contrastive Learning (SRCL), a novel semi-supervised learning model that leverages self-supervised contrastive loss and sample relation consistency for the more meaningful and effective exploitation of unlabeled data. Our experimentation with the SRCL model explores both pre-train/fine-tune and joint learning of the pretext (contrastive learning) and downstream (diagnostic classification) tasks. We validate against the ISIC 2018 Challenge benchmark skin lesion classification dataset and demonstrate the effectiveness of our semi-supervised method on varying amounts of labeled data.

Sun-Young Jeon, Sen Wang, Adam S. Wang et al.

Fluoroscopy is critical for real-time X-ray visualization in medical imaging. However, low-dose images are compromised by noise, potentially affecting diagnostic accuracy. Noise reduction is crucial for maintaining image quality, especially given such challenges as motion artifacts and the limited availability of clean data in medical imaging. To address these issues, we propose an unsupervised training framework for dynamic context-aware denoising of fluoroscopy image sequences. First, we train the multi-scale recurrent attention U-Net (MSR2AU-Net) without requiring clean data to address the initial noise. Second, we incorporate a knowledge distillation-based uncorrelated noise suppression module and a recursive filtering-based correlated noise suppression module enhanced with motion compensation to further improve motion compensation and achieve superior denoising performance. Finally, we introduce a novel approach by combining these modules with a pixel-wise dynamic object motion cross-fusion matrix, designed to adapt to motion, and an edge-preserving loss for precise detail retention. To validate the proposed method, we conducted extensive numerical experiments on medical image datasets, including 3500 fluoroscopy images from dynamic phantoms (2,400 images for training, 1,100 for testing) and 350 clinical images from a spinal surgery patient. Moreover, we demonstrated the robustness of our approach across different imaging modalities by testing it on the publicly available 2016 Low Dose CT Grand Challenge dataset, using 4,800 images for training and 1,136 for testing. The results demonstrate that the proposed approach outperforms state-of-the-art unsupervised algorithms in both visual quality and quantitative evaluation while achieving comparable performance to well-established supervised learning methods across low-dose fluoroscopy and CT imaging.

Abdullah-Al-Zubaer Imran, Sen Wang, Debashish Pal et al.

Purpose: Estimation of patient-specific organ doses is required for more comprehensive dose metrics, such as effective dose. Currently, available methods are performed retrospectively using the CT images themselves, which can only be done after the scan. To optimize CT acquisitions before scanning, rapid prediction of patient-specific organ dose is needed prospectively, using available scout images. We, therefore, devise an end-to-end, fully-automated deep learning solution to perform real-time, patient-specific, organ-level dosimetric estimation of CT scans. Approach: We propose the Scout-Net model for CT dose prediction at six different organs as well as for the overall patient body, leveraging the routinely obtained frontal and lateral scout images of patients, before their CT scans. To obtain reference values of the organ doses, we used Monte Carlo simulation and 3D segmentation methods on the corresponding CT images of the patients. Results: We validate our proposed Scout-Net model against real patient CT data and demonstrate the effectiveness in estimating organ doses in real-time (only 27 ms on average per scan). Additionally, we demonstrate the efficiency (real-time execution), sufficiency (reasonable error rates), and robustness (consistent across varying patient sizes) of the Scout-Net model. Conclusions: An effective, efficient, and robust Scout-Net model, once incorporated into the CT acquisition plan, could potentially guide the automatic exposure control for balanced image quality and radiation dose.

Ayaan Haque, Abdullah-Al-Zubaer Imran, Adam Wang et al.

Deep learning-based models, when trained in a fully-supervised manner, can be effective in performing complex image analysis tasks, although contingent upon the availability of large labeled datasets. Especially in the medical imaging domain, however, expert image annotation is expensive, time-consuming, and prone to variability. Semi-supervised learning from limited quantities of labeled data has shown promise as an alternative. Maximizing knowledge gains from copious unlabeled data benefits semi-supervised learning models. Moreover, learning multiple tasks within the same model further improves its generalizability. We propose MultiMix, a new multi-task learning model that jointly learns disease classification and anatomical segmentation in a semi-supervised manner, while preserving explainability through a novel saliency bridge between the two tasks. Our experiments with varying quantities of multi-source labeled data in the training sets confirm the effectiveness of MultiMix in the simultaneous classification of pneumonia and segmentation of the lungs in chest X-ray images. Moreover, both in-domain and cross-domain evaluations across these tasks further showcase the potential of our model to adapt to challenging generalization scenarios.

Ayaan Haque, Adam Wang, Abdullah-Al-Zubaer Imran

CT image quality is heavily reliant on radiation dose, which causes a trade-off between radiation dose and image quality that affects the subsequent image-based diagnostic performance. However, high radiation can be harmful to both patients and operators. Several (deep learning-based) approaches have been attempted to denoise low dose images. However, those approaches require access to large training sets, specifically the full dose CT images for reference, which can often be difficult to obtain. Self-supervised learning is an emerging alternative for lowering the reference data requirement facilitating unsupervised learning. Currently available self-supervised CT denoising works are either dependent on foreign domain or pretexts are not very task-relevant. To tackle the aforementioned challenges, we propose a novel self-supervised learning approach, namely Self-Supervised Window-Leveling for Image DeNoising (SSWL-IDN), leveraging an innovative, task-relevant, simple, yet effective surrogate -- prediction of the window-leveled equivalent. SSWL-IDN leverages residual learning and a hybrid loss combining perceptual loss and MSE, all incorporated in a VAE framework. Our extensive (in- and cross-domain) experimentation demonstrates the effectiveness of SSWL-IDN in aggressive denoising of CT (abdomen and chest) images acquired at 5\% dose level only.

Ayaan Haque, Abdullah-Al-Zubaer Imran, Adam Wang et al.

Semi-supervised learning via learning from limited quantities of labeled data has been investigated as an alternative to supervised counterparts. Maximizing knowledge gains from copious unlabeled data benefit semi-supervised learning settings. Moreover, learning multiple tasks within the same model further improves model generalizability. We propose a novel multitask learning model, namely MultiMix, which jointly learns disease classification and anatomical segmentation in a sparingly supervised manner, while preserving explainability through bridge saliency between the two tasks. Our extensive experimentation with varied quantities of labeled data in the training sets justify the effectiveness of our multitasking model for the classification of pneumonia and segmentation of lungs from chest X-ray images. Moreover, both in-domain and cross-domain evaluations across the tasks further showcase the potential of our model to adapt to challenging generalization scenarios.

Sarah M. Hooper, Jared A. Dunnmon, Matthew P. Lungren et al.

Automated medical image classification with convolutional neural networks (CNNs) has great potential to impact healthcare, particularly in resource-constrained healthcare systems where fewer trained radiologists are available. However, little is known about how well a trained CNN can perform on images with the increased noise levels, different acquisition protocols, or additional artifacts that may arise when using low-cost scanners, which can be underrepresented in datasets collected from well-funded hospitals. In this work, we investigate how a model trained to triage head computed tomography (CT) scans performs on images acquired with reduced x-ray tube current, fewer projections per gantry rotation, and limited angle scans. These changes can reduce the cost of the scanner and demands on electrical power but come at the expense of increased image noise and artifacts. We first develop a model to triage head CTs and report an area under the receiver operating characteristic curve (AUROC) of 0.77. We then show that the trained model is robust to reduced tube current and fewer projections, with the AUROC dropping only 0.65% for images acquired with a 16x reduction in tube current and 0.22% for images acquired with 8x fewer projections. Finally, for significantly degraded images acquired by a limited angle scan, we show that a model trained specifically to classify such images can overcome the technological limitations to reconstruction and maintain an AUROC within 0.09% of the original model.

Adam Wang, Steve Chang, John Wilson

Mobile applications and on-body devices are becoming increasingly ubiquitous tools for physical activity tracking. We propose utilizing a self-tracker's habits to support continuous prediction of whether they will reach their daily step goal, thus enabling a variety of potential persuasive interventions. Our aim is to improve the prediction by leveraging historical data and other qualitative (motivation for using the systems, location, gender) and, quantitative (age) features. We have collected datasets from two activity tracking platforms (Moves and Fitbit) and aim to check if the model we derive from one is generalizable over the other. In the following paper we establish a pipeline for extracting the data and formatting it for modeling. We discuss the approach we took and our findings while selecting the features and classification models for the dataset. We further discuss the notion of generalizability of the model across different types of dataset and the probable inclusion of non standard features to further improve the model's accuracy.