Handling Supervision Scarcity in Chest X-ray Classification: Long-Tailed and Zero-Shot Learning
This addresses a critical issue in medical imaging for clinicians by improving classification of rare diseases, though it is incremental as it builds on existing methods for specific challenges.
The paper tackles the problem of imperfect supervision in chest X-ray classification due to long-tailed disease distributions and missing annotations for rare findings, achieving first-place ranking on a benchmark challenge with strong performance on both long-tailed and zero-shot tasks.
Chest X-Ray (CXR) classification in clinical practice is often limited by imperfect supervision, arising from (i) extreme long-tailed multi-label disease distributions and (ii) missing annotations for rare or previously unseen findings. The CXR-LT 2026 challenge addresses these issues on a PadChest-based benchmark with a 36-class label space split into 30 in-distribution classes for training and 6 out-of-distribution (OOD) classes for zero-shot evaluation. We present task-specific solutions tailored to the distinct supervision regimes. For Task 1 (long-tailed multi-label classification), we adopt an imbalance-aware multi-label learning strategy to improve recognition of tail classes while maintaining stable performance on frequent findings. For Task 2 (zero-shot OOD recognition), we propose a prediction approach that produces scores for unseen disease categories without using any supervised labels or examples from the OOD classes during training. Evaluated with macro-averaged mean Average Precision (mAP), our method achieves strong performance on both tasks, ranking first on the public leaderboard of the development phase. Code and pre-trained models are available at https://github.com/hieuphamha19/CXR_LT.