Privacy-Aware Federated nnU-Net for ECG Page Digitization
This addresses privacy constraints in multi-institution medical imaging analysis, though it appears incremental as it combines existing federated learning methods with standard privacy mechanisms.
The paper tackles the problem of converting ECG page images to analyzable waveforms while preserving privacy across institutions, presenting a federated learning framework that trains a nnU-Net segmentation model without sharing images. The approach achieves competitive accuracy approaching centralized performance while providing formal differential privacy guarantees.
Deep neural networks can convert ECG page images into analyzable waveforms, yet centralized training often conflicts with cross-institutional privacy and deployment constraints. A cross-silo federated digitization framework is presented that trains a full-model nnU-Net segmentation backbone without sharing images and aggregates updates across sites under realistic non-IID heterogeneity (layout, grid style, scanner profile, noise). The protocol integrates three standard server-side aggregators--FedAvg, FedProx, and FedAdam--and couples secure aggregation with central, user-level differential privacy to align utility with formal guarantees. Key features include: (i) end-to-end full-model training and synchronization across clients; (ii) secure aggregation so the server only observes a clipped, weighted sum once a participation threshold is met; (iii) central Gaussian DP with Renyi accounting applied post-aggregation for auditable user-level privacy; and (iv) a calibration-aware digitization pipeline comprising page normalization, trace segmentation, grid-leakage suppression, and vectorization to twelve-lead signals. Experiments on ECG pages rendered from PTB-XL show consistently faster convergence and higher late-round plateaus with adaptive server updates (FedAdam) relative to FedAvg and FedProx, while approaching centralized performance. The privacy mechanism maintains competitive accuracy while preventing exposure of raw images or per-client updates, yielding deployable, auditable guarantees suitable for multi-institution settings.