Tzu-Ming Harry Hsu

Yin-Chih Chelsea Wang, Tsao-Lun Chen, Shankeeth Vinayahalingam et al.

Dental panoramic radiographs (DPRs) are widely used in clinical practice for comprehensive oral assessment but present challenges due to overlapping structures and time constraints in interpretation. This study aimed to establish a solid baseline for the AI-automated assessment of findings in DPRs by developing, evaluating an AI system, and comparing its performance with that of human readers across multinational data sets. We analyzed 6,669 DPRs from three data sets (the Netherlands, Brazil, and Taiwan), focusing on 8 types of dental findings. The AI system combined object detection and semantic segmentation techniques for per-tooth finding identification. Performance metrics included sensitivity, specificity, and area under the receiver operating characteristic curve (AUC-ROC). AI generalizability was tested across data sets, and performance was compared with human dental practitioners. The AI system demonstrated comparable or superior performance to human readers, particularly +67.9% (95% CI: 54.0%-81.9%; p < .001) sensitivity for identifying periapical radiolucencies and +4.7% (95% CI: 1.4%-8.0%; p = .008) sensitivity for identifying missing teeth. The AI achieved a macro-averaged AUC-ROC of 96.2% (95% CI: 94.6%-97.8%) across 8 findings. AI agreements with the reference were comparable to inter-human agreements in 7 of 8 findings except for caries (p = .024). The AI system demonstrated robust generalization across diverse imaging and demographic settings and processed images 79 times faster (95% CI: 75-82) than human readers. The AI system effectively assessed findings in DPRs, achieving performance on par with or better than human experts while significantly reducing interpretation time. These results highlight the potential for integrating AI into clinical workflows to improve diagnostic efficiency and accuracy, and patient management.

Tzu-Ming Harry Hsu, Yin-Chih Chelsea Wang

Clinical finding summaries from an orthopantomogram, or a dental panoramic radiograph, have significant potential to improve patient communication and speed up clinical judgments. While orthopantomogram is a first-line tool for dental examinations, no existing work has explored the summarization of findings from it. A finding summary has to find teeth in the imaging study and label the teeth with several types of past treatments. To tackle the problem, we developDeepOPG that breaks the summarization process into functional segmentation and tooth localization, the latter of which is further refined by a novel dental coherence module. We also leverage weak supervision labels to improve detection results in a reinforcement learning scenario. Experiments show high efficacy of DeepOPG on finding summarization, achieving an overall AUC of 88.2% in detecting six types of findings. The proposed dental coherence and weak supervision both are shown to improve DeepOPG by adding 5.9% and 0.4% to AP@IoU=0.5.

Tzu-Ming Harry Hsu, Hang Qi, Matthew Brown

Federated Learning enables visual models to be trained on-device, bringing advantages for user privacy (data need never leave the device), but challenges in terms of data diversity and quality. Whilst typical models in the datacenter are trained using data that are independent and identically distributed (IID), data at source are typically far from IID. Furthermore, differing quantities of data are typically available at each device (imbalance). In this work, we characterize the effect these real-world data distributions have on distributed learning, using as a benchmark the standard Federated Averaging (FedAvg) algorithm. To do so, we introduce two new large-scale datasets for species and landmark classification, with realistic per-user data splits that simulate real-world edge learning scenarios. We also develop two new algorithms (FedVC, FedIR) that intelligently resample and reweight over the client pool, bringing large improvements in accuracy and stability in training. The datasets are made available online.

Tzu-Ming Harry Hsu, Hang Qi, Matthew Brown

Federated Learning enables visual models to be trained in a privacy-preserving way using real-world data from mobile devices. Given their distributed nature, the statistics of the data across these devices is likely to differ significantly. In this work, we look at the effect such non-identical data distributions has on visual classification via Federated Learning. We propose a way to synthesize datasets with a continuous range of identicalness and provide performance measures for the Federated Averaging algorithm. We show that performance degrades as distributions differ more, and propose a mitigation strategy via server momentum. Experiments on CIFAR-10 demonstrate improved classification performance over a range of non-identicalness, with classification accuracy improved from 30.1% to 76.9% in the most skewed settings.

Guanxiong Liu, Tzu-Ming Harry Hsu, Matthew McDermott et al.

The automatic generation of radiology reports given medical radiographs has significant potential to operationally and improve clinical patient care. A number of prior works have focused on this problem, employing advanced methods from computer vision and natural language generation to produce readable reports. However, these works often fail to account for the particular nuances of the radiology domain, and, in particular, the critical importance of clinical accuracy in the resulting generated reports. In this work, we present a domain-aware automatic chest X-ray radiology report generation system which first predicts what topics will be discussed in the report, then conditionally generates sentences corresponding to these topics. The resulting system is fine-tuned using reinforcement learning, considering both readability and clinical accuracy, as assessed by the proposed Clinically Coherent Reward. We verify this system on two datasets, Open-I and MIMIC-CXR, and demonstrate that our model offers marked improvements on both language generation metrics and CheXpert assessed accuracy over a variety of competitive baselines.

Tzu-Ming Harry Hsu, Wei-Hung Weng, Willie Boag et al.

Joint embeddings between medical imaging modalities and associated radiology reports have the potential to offer significant benefits to the clinical community, ranging from cross-domain retrieval to conditional generation of reports to the broader goals of multimodal representation learning. In this work, we establish baseline joint embedding results measured via both local and global retrieval methods on the soon to be released MIMIC-CXR dataset consisting of both chest X-ray images and the associated radiology reports. We examine both supervised and unsupervised methods on this task and show that for document retrieval tasks with the learned representations, only a limited amount of supervision is needed to yield results comparable to those of fully-supervised methods.