Advancing diagnostic performance and clinical usability of neural networks via adversarial training and dual batch normalization.

Journal: Nature communications
Published Date:

Abstract

Unmasking the decision making process of machine learning models is essential for implementing diagnostic support systems in clinical practice. Here, we demonstrate that adversarially trained models can significantly enhance the usability of pathology detection as compared to their standard counterparts. We let six experienced radiologists rate the interpretability of saliency maps in datasets of X-rays, computed tomography, and magnetic resonance imaging scans. Significant improvements are found for our adversarial models, which are further improved by the application of dual-batch normalization. Contrary to previous research on adversarially trained models, we find that accuracy of such models is equal to standard models, when sufficiently large datasets and dual batch norm training are used. To ensure transferability, we additionally validate our results on an external test set of 22,433 X-rays. These findings elucidate that different paths for adversarial and real images are needed during training to achieve state of the art results with superior clinical interpretability.

Authors

  • Tianyu Han
    Physics of Molecular Imaging Systems, Experimental Molecular Imaging, RWTH Aachen University, Aachen, Germany. tianyu.han@pmi.rwth-aachen.de.
  • Sven Nebelung
    Department of Diagnostic and Interventional Radiology, University Hospital Düsseldorf, Düsseldorf, Germany (J.S., D.B.A., S.N.); Institute of Computer Vision and Imaging, RWTH University Aachen, Pauwelsstrasse 30, 52072 Aachen, Germany (J.S., D.M.); Department of Diagnostic and Interventional Radiology, University Hospital Aachen, Aachen, Germany (D.T., M.P., F.M., C.K., S.N.); and Faculty of Mathematics and Natural Sciences, Institute of Informatics, Heinrich Heine University Düsseldorf, Düsseldorf, Germany (S.C.).
  • Federico Pedersoli
    Department of Diagnostic and Interventional Radiology, University Hospital Aachen, Aachen, Germany.
  • Markus Zimmermann
    Klinik für Chirurgie, Universitätsklinikum Schleswig-Holstein, Campus Lübeck, Deutschland.
  • Maximilian Schulze-Hagen
    Department of Diagnostic and Interventional Radiology, University Hospital Aachen, Aachen, Germany.
  • Michael Ho
    ARISTRA GmbH, Berlin, Germany.
  • Christoph Haarburger
    From the Departments of Diagnostic and Interventional Radiology (D.T., S.S., H.S., C.K.) and Institute of Imaging and Computer Vision (C.H., D.M.), RWTH Aachen University, Aachen, Pauwelsstr 30, 52074 Aachen, Germany.
  • Fabian Kiessling
    Fraunhofer Institute for Digital Medicine, MEVIS, Am Fallturm 1, 28359, Bremen, Germany. fkiessling@ukaachen.de.
  • Christiane Kuhl
    Department of Diagnostic and Interventional Radiology, University Hospital Düsseldorf, Düsseldorf, Germany (J.S., D.B.A., S.N.); Institute of Computer Vision and Imaging, RWTH University Aachen, Pauwelsstrasse 30, 52072 Aachen, Germany (J.S., D.M.); Department of Diagnostic and Interventional Radiology, University Hospital Aachen, Aachen, Germany (D.T., M.P., F.M., C.K., S.N.); and Faculty of Mathematics and Natural Sciences, Institute of Informatics, Heinrich Heine University Düsseldorf, Düsseldorf, Germany (S.C.).
  • Volkmar Schulz
    Physics of Molecular Imaging Systems, Experimental Molecular Imaging, RWTH Aachen University, Aachen, Germany. schulz@pmi.rwth-aachen.de.
  • Daniel Truhn
    Department of Diagnostic and Interventional Radiology, University Hospital Düsseldorf, Düsseldorf, Germany (J.S., D.B.A., S.N.); Institute of Computer Vision and Imaging, RWTH University Aachen, Pauwelsstrasse 30, 52072 Aachen, Germany (J.S., D.M.); Department of Diagnostic and Interventional Radiology, University Hospital Aachen, Aachen, Germany (D.T., M.P., F.M., C.K., S.N.); and Faculty of Mathematics and Natural Sciences, Institute of Informatics, Heinrich Heine University Düsseldorf, Düsseldorf, Germany (S.C.).