Shantanu Ghosh

Ke Yu, Shantanu Ghosh, Zhexiong Liu et al. · amazon-science, cmu

Creating a large-scale dataset of abnormality annotation on medical images is a labor-intensive and costly task. Leveraging weak supervision from readily available data such as radiology reports can compensate lack of large-scale data for anomaly detection methods. However, most of the current methods only use image-level pathological observations, failing to utilize the relevant anatomy mentions in reports. Furthermore, Natural Language Processing (NLP)-mined weak labels are noisy due to label sparsity and linguistic ambiguity. We propose an Anatomy-Guided chest X-ray Network (AGXNet) to address these issues of weak annotation. Our framework consists of a cascade of two networks, one responsible for identifying anatomical abnormalities and the second responsible for pathological observations. The critical component in our framework is an anatomy-guided attention module that aids the downstream observation network in focusing on the relevant anatomical regions generated by the anatomy network. We use Positive Unlabeled (PU) learning to account for the fact that lack of mention does not necessarily mean a negative label. Our quantitative and qualitative results on the MIMIC-CXR dataset demonstrate the effectiveness of AGXNet in disease and anatomical abnormality localization. Experiments on the NIH Chest X-ray dataset show that the learned feature representations are transferable and can achieve the state-of-the-art performances in disease classification and competitive disease localization results. Our code is available at https://github.com/batmanlab/AGXNet

Shantanu Ghosh, Ke Yu, Forough Arabshahi et al. · amazon-science, cmu

ML model design either starts with an interpretable model or a Blackbox and explains it post hoc. Blackbox models are flexible but difficult to explain, while interpretable models are inherently explainable. Yet, interpretable models require extensive ML knowledge and tend to be less flexible and underperforming than their Blackbox variants. This paper aims to blur the distinction between a post hoc explanation of a Blackbox and constructing interpretable models. Beginning with a Blackbox, we iteratively carve out a mixture of interpretable experts (MoIE) and a residual network. Each interpretable model specializes in a subset of samples and explains them using First Order Logic (FOL), providing basic reasoning on concepts from the Blackbox. We route the remaining samples through a flexible residual. We repeat the method on the residual network until all the interpretable models explain the desired proportion of data. Our extensive experiments show that our route, interpret, and repeat approach (1) identifies a diverse set of instance-specific concepts with high concept completeness via MoIE without compromising in performance, (2) identifies the relatively ``harder'' samples to explain via residuals, (3) outperforms the interpretable by-design models by significant margins during test-time interventions, and (4) fixes the shortcut learned by the original Blackbox. The code for MoIE is publicly available at: \url{https://github.com/batmanlab/ICML-2023-Route-interpret-repeat}

Shantanu Ghosh, Zheng Feng, Jiang Bian et al. · amazon-science, cmu

Determining causal effects of interventions onto outcomes from real-world, observational (non-randomized) data, e.g., treatment repurposing using electronic health records, is challenging due to underlying bias. Causal deep learning has improved over traditional techniques for estimating individualized treatment effects (ITE). We present the Doubly Robust Variational Information-theoretic Deep Adversarial Learning (DR-VIDAL), a novel generative framework that combines two joint models of treatment and outcome, ensuring an unbiased ITE estimation even when one of the two is misspecified. DR-VIDAL integrates: (i) a variational autoencoder (VAE) to factorize confounders into latent variables according to causal assumptions; (ii) an information-theoretic generative adversarial network (Info-GAN) to generate counterfactuals; (iii) a doubly robust block incorporating treatment propensities for outcome predictions. On synthetic and real-world datasets (Infant Health and Development Program, Twin Birth Registry, and National Supported Work Program), DR-VIDAL achieves better performance than other non-generative and generative methods. In conclusion, DR-VIDAL uniquely fuses causal assumptions, VAE, Info-GAN, and doubly robustness into a comprehensive, performant framework. Code is available at: https://github.com/Shantanu48114860/DR-VIDAL-AMIA-22 under MIT license.

Shantanu Ghosh, Ke Yu, Forough Arabshahi et al. · amazon-science, cmu

We use concept-based interpretable models to mitigate shortcut learning. Existing methods lack interpretability. Beginning with a Blackbox, we iteratively carve out a mixture of interpretable experts (MoIE) and a residual network. Each expert explains a subset of data using First Order Logic (FOL). While explaining a sample, the FOL from biased BB-derived MoIE detects the shortcut effectively. Finetuning the BB with Metadata Normalization (MDN) eliminates the shortcut. The FOLs from the finetuned-BB-derived MoIE verify the elimination of the shortcut. Our experiments show that MoIE does not hurt the accuracy of the original BB and eliminates shortcuts effectively.

Shantanu Ghosh, Kayhan Batmanghelich · amazon-science, cmu

Discovering a high-performing sparse network within a massive neural network is advantageous for deploying them on devices with limited storage, such as mobile phones. Additionally, model explainability is essential to fostering trust in AI. The Lottery Ticket Hypothesis (LTH) finds a network within a deep network with comparable or superior performance to the original model. However, limited study has been conducted on the success or failure of LTH in terms of explainability. In this work, we examine why the performance of the pruned networks gradually increases or decreases. Using Grad-CAM and Post-hoc concept bottleneck models (PCBMs), respectively, we investigate the explainability of pruned networks in terms of pixels and high-level concepts. We perform extensive experiments across vision and medical imaging datasets. As more weights are pruned, the performance of the network degrades. The discovered concepts and pixels from the pruned networks are inconsistent with the original network -- a possible reason for the drop in performance.

Weicheng Dai, Chenyu Wang, Andy Li et al.

Generative models for volumetric medical images have found many applications in medical imaging, ranging from data augmentation to serving as priors for inverse problems. For these applications, generating high-resolution 3D images with strong controllability is essential but remains highly challenging. Existing approaches typically control generation either through radiology reports used as text prompts or through full image segmentation. While text-based prompting is flexible, it provides limited spatial control over the location, shape, and boundary of abnormalities. In contrast, segmentation-based methods receive precise spatial guidance but are restrictive in requiring full-organ annotations. In this work, we propose a flexible multimodal framework for controllable volumetric image generation that supports input from radiology reports and segmentation prompts (both optional). Our approach allows users to provide segmentation of a specific anatomy or abnormality without requiring full-organ annotations. The semantic meaning of the segmentation mask is specified through an accompanying text description, resulting in a highly flexible and scalable conditioning mechanism. We develop a memory-efficient architecture based on a modified diffusion transformer that jointly processes image and segmentation tokens. The model further incorporates gated attention to effectively attend to long radiology reports. Experiments demonstrate that our method achieves state-of-the-art perceptual and semantic scores (e.g., 24% relative improvement in mean FID), generates high-resolution anatomically consistent CT volumes, and improves data efficiency when used for data augmentation. Radiologists' evaluation further confirms strong alignment between generated and real medical images.

Shantanu Ghosh, Rayan Syed, Chenyu Wang et al. · amazon-science, cmu

Error slice discovery is crucial to diagnose and mitigate model errors. Current clustering or discrete attribute-based slice discovery methods face key limitations: 1) clustering results in incoherent slices, while assigning discrete attributes to slices leads to incomplete coverage of error patterns due to missing or insufficient attributes; 2) these methods lack complex reasoning, preventing them from fully explaining model biases; 3) they fail to integrate \textit{domain knowledge}, limiting their usage in specialized fields \eg radiology. We propose\ladder (\underline{La}nguage-\underline{D}riven \underline{D}iscovery and \underline{E}rror \underline{R}ectification), to address the limitations by: (1) leveraging the flexibility of natural language to address incompleteness, (2) employing LLM's latent \textit{domain knowledge} and advanced reasoning to analyze sentences and derive testable hypotheses directly, identifying biased attributes, and form coherent error slices without clustering. Existing mitigation methods typically address only the worst-performing group, often amplifying errors in other subgroups. In contrast,\ladder generates pseudo attributes from the discovered hypotheses to mitigate errors across all biases without explicit attribute annotations or prior knowledge of bias. Rigorous evaluations on 6 datasets spanning natural and medical images -- comparing 200+ classifiers with diverse architectures, pretraining strategies, and LLMs -- show that\ladder consistently outperforms existing baselines in discovering and mitigating biases.

Shantanu Ghosh, Clare B. Poynton, Shyam Visweswaran et al. · amazon-science, cmu

The lack of large and diverse training data on Computer-Aided Diagnosis (CAD) in breast cancer detection has been one of the concerns that impedes the adoption of the system. Recently, pre-training with large-scale image text datasets via Vision-Language models (VLM) (\eg CLIP) partially addresses the issue of robustness and data efficiency in computer vision (CV). This paper proposes Mammo-CLIP, the first VLM pre-trained on a substantial amount of screening mammogram-report pairs, addressing the challenges of dataset diversity and size. Our experiments on two public datasets demonstrate strong performance in classifying and localizing various mammographic attributes crucial for breast cancer detection, showcasing data efficiency and robustness similar to CLIP in CV. We also propose Mammo-FActOR, a novel feature attribution method, to provide spatial interpretation of representation with sentence-level granularity within mammography reports. Code is available publicly: \url{https://github.com/batmanlab/Mammo-CLIP}.

Chenyu Wang, Weichao Zhou, Shantanu Ghosh et al. · amazon-science, cmu

Radiology report generation (RRG) has shown great potential in assisting radiologists by automating the labor-intensive task of report writing. While recent advancements have improved the quality and coherence of generated reports, ensuring their factual correctness remains a critical challenge. Although generative medical Vision Large Language Models (VLLMs) have been proposed to address this issue, these models are prone to hallucinations and can produce inaccurate diagnostic information. To address these concerns, we introduce a novel Semantic Consistency-Based Uncertainty Quantification framework that provides both report-level and sentence-level uncertainties. Unlike existing approaches, our method does not require modifications to the underlying model or access to its inner state, such as output token logits, thus serving as a plug-and-play module that can be seamlessly integrated with state-of-the-art models. Extensive experiments demonstrate the efficacy of our method in detecting hallucinations and enhancing the factual accuracy of automatically generated radiology reports. By abstaining from high-uncertainty reports, our approach improves factuality scores by $10$\%, achieved by rejecting $20$\% of reports using the \texttt{Radialog} model on the MIMIC-CXR dataset. Furthermore, sentence-level uncertainty flags the lowest-precision sentence in each report with an $82.9$\% success rate. Our implementation is open-source and available at https://github.com/BU-DEPEND-Lab/SCUQ-RRG.

Shantanu Ghosh, Tiankang Xie, Mikhail Kuznetsov · amazon-science, cmu

Machine learning (ML) models trained using Empirical Risk Minimization (ERM) often exhibit systematic errors on specific subpopulations of tabular data, known as error slices. Learning robust representation in presence of error slices is challenging, especially in self-supervised settings during the feature reconstruction phase, due to high cardinality features and the complexity of constructing error sets. Traditional robust representation learning methods are largely focused on improving worst group performance in supervised setting in computer vision, leaving a gap in approaches tailored for tabular data. We address this gap by developing a framework to learn robust representation in tabular data during self-supervised pre-training. Our approach utilizes an encoder-decoder model trained with Masked Language Modeling (MLM) loss to learn robust latent representations. This paper applies the Just Train Twice (JTT) and Deep Feature Reweighting (DFR) methods during the pre-training phase for tabular data. These methods fine-tune the ERM pre-trained model by up-weighting error-prone samples or creating balanced datasets for specific categorical features. This results in specialized models for each feature, which are then used in an ensemble approach to enhance downstream classification performance. This methodology improves robustness across slices, thus enhancing overall generalization performance. Extensive experiments across various datasets demonstrate the efficacy of our approach. The code is available: https://github.com/amazon-science/distributionally-robust-self-supervised-learning-for-tabular-data.

Shantanu Ghosh, Ke Yu, Kayhan Batmanghelich

Building generalizable AI models is one of the primary challenges in the healthcare domain. While radiologists rely on generalizable descriptive rules of abnormality, Neural Network (NN) models suffer even with a slight shift in input distribution (e.g., scanner type). Fine-tuning a model to transfer knowledge from one domain to another requires a significant amount of labeled data in the target domain. In this paper, we develop an interpretable model that can be efficiently fine-tuned to an unseen target domain with minimal computational cost. We assume the interpretable component of NN to be approximately domain-invariant. However, interpretable models typically underperform compared to their Blackbox (BB) variants. We start with a BB in the source domain and distill it into a \emph{mixture} of shallow interpretable models using human-understandable concepts. As each interpretable model covers a subset of data, a mixture of interpretable models achieves comparable performance as BB. Further, we use the pseudo-labeling technique from semi-supervised learning (SSL) to learn the concept classifier in the target domain, followed by fine-tuning the interpretable models in the target domain. We evaluate our model using a real-life large-scale chest-X-ray (CXR) classification dataset. The code is available at: \url{https://github.com/batmanlab/MICCAI-2023-Route-interpret-repeat-CXRs}.

Shantanu Ghosh, Vedant Parthesh Joshi, Rayan Syed et al.

Breast cancer is one of the leading causes of death among women worldwide. We introduce Mammo-FM, the first foundation model specifically for mammography, pretrained on the largest and most diverse dataset to date - 140,677 patients (821,326 mammograms) across four U.S. institutions. Mammo-FM provides a unified foundation for core clinical tasks in breast imaging, including cancer diagnosis, pathology localization, structured report generation, and cancer risk prognosis within a single framework. Its alignment between images and text enables both visual and textual interpretability, improving transparency and clinical auditability, which are essential for real-world adoption. We rigorously evaluate Mammo-FM across diagnosis, prognosis, and report-generation tasks in in- and out-of-distribution datasets. Despite operating on native-resolution mammograms and using only one-third of the parameters of state-of-the-art generalist FMs, Mammo-FM consistently outperforms them across multiple public and private benchmarks. These results highlight the efficiency and value of domain-specific foundation models designed around the full spectrum of tasks within a clinical domain and emphasize the importance of rigorous, domain-aligned evaluation.

R. Prashanth, Sumantra Dutta Roy, Pravat K. Mandal et al.

Early and accurate identification of parkinsonian syndromes (PS) involving presynaptic degeneration from non-degenerative variants such as Scans Without Evidence of Dopaminergic Deficit (SWEDD) and tremor disorders, is important for effective patient management as the course, therapy and prognosis differ substantially between the two groups. In this study, we use Single Photon Emission Computed Tomography (SPECT) images from healthy normal, early PD and SWEDD subjects, as obtained from the Parkinson's Progression Markers Initiative (PPMI) database, and process them to compute shape- and surface fitting-based features for the three groups. We use these features to develop and compare various classification models that can discriminate between scans showing dopaminergic deficit, as in PD, from scans without the deficit, as in healthy normal or SWEDD. Along with it, we also compare these features with Striatal Binding Ratio (SBR)-based features, which are well-established and clinically used, by computing a feature importance score using Random forests technique. We observe that the Support Vector Machine (SVM) classifier gave the best performance with an accuracy of 97.29%. These features also showed higher importance than the SBR-based features. We infer from the study that shape analysis and surface fitting are useful and promising methods for extracting discriminatory features that can be used to develop diagnostic models that might have the potential to help clinicians in the diagnostic process.