CVNov 7, 2024

Cross- and Intra-image Prototypical Learning for Multi-label Disease Diagnosis and Interpretation

arXiv:2411.04607v212 citationsh-index: 17IEEE Transactions on Medical Imaging
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This work addresses the problem of accurate and interpretable multi-label disease diagnosis for medical imaging, which is incremental by extending prototypical learning to a more complex multi-label setting.

The paper tackles the challenge of multi-label disease diagnosis in medical images, where existing prototypical learning models struggle due to disease entanglement, and presents a novel framework that achieves state-of-the-art classification accuracy on two public benchmarks and superior weakly-supervised localization.

Recent advances in prototypical learning have shown remarkable potential to provide useful decision interpretations associating activation maps and predictions with class-specific training prototypes. Such prototypical learning has been well-studied for various single-label diseases, but for quite relevant and more challenging multi-label diagnosis, where multiple diseases are often concurrent within an image, existing prototypical learning models struggle to obtain meaningful activation maps and effective class prototypes due to the entanglement of the multiple diseases. In this paper, we present a novel Cross- and Intra-image Prototypical Learning (CIPL) framework, for accurate multi-label disease diagnosis and interpretation from medical images. CIPL takes advantage of common cross-image semantics to disentangle the multiple diseases when learning the prototypes, allowing a comprehensive understanding of complicated pathological lesions. Furthermore, we propose a new two-level alignment-based regularisation strategy that effectively leverages consistent intra-image information to enhance interpretation robustness and predictive performance. Extensive experiments show that our CIPL attains the state-of-the-art (SOTA) classification accuracy in two public multi-label benchmarks of disease diagnosis: thoracic radiography and fundus images. Quantitative interpretability results show that CIPL also has superiority in weakly-supervised thoracic disease localisation over other leading saliency- and prototype-based explanation methods.

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