Biomedical Image Analysis Group, Department of Computing, Imperial College London
Abstract:Shifts in data distribution can substantially harm the performance of clinical AI models. Hence, various methods have been developed to detect the presence of such shifts at deployment time. However, root causes of dataset shifts are varied, and the choice of shift mitigation strategies is highly dependent on the precise type of shift encountered at test time. As such, detecting test-time dataset shift is not sufficient: precisely identifying which type of shift has occurred is critical. In this work, we propose the first unsupervised dataset shift identification framework, effectively distinguishing between prevalence shift (caused by a change in the label distribution), covariate shift (caused by a change in input characteristics) and mixed shifts (simultaneous prevalence and covariate shifts). We discuss the importance of self-supervised encoders for detecting subtle covariate shifts and propose a novel shift detector leveraging both self-supervised encoders and task model outputs for improved shift detection. We report promising results for the proposed shift identification framework across three different imaging modalities (chest radiography, digital mammography, and retinal fundus images) on five types of real-world dataset shifts, using four large publicly available datasets.
Abstract:We investigate the prominent class of fair representation learning methods for bias mitigation. Using causal reasoning to define and formalise different sources of dataset bias, we reveal important implicit assumptions inherent to these methods. We prove fundamental limitations on fair representation learning when evaluation data is drawn from the same distribution as training data and run experiments across a range of medical modalities to examine the performance of fair representation learning under distribution shifts. Our results explain apparent contradictions in the existing literature and reveal how rarely considered causal and statistical aspects of the underlying data affect the validity of fair representation learning. We raise doubts about current evaluation practices and the applicability of fair representation learning methods in performance-sensitive settings. We argue that fine-grained analysis of dataset biases should play a key role in the field moving forward.
Abstract:This study investigates the effects of radio-opaque artefacts, such as skin markers, breast implants, and pacemakers, on mammography classification models. After manually annotating 22,012 mammograms from the publicly available EMBED dataset, a robust multi-label artefact detector was developed to identify five distinct artefact types (circular and triangular skin markers, breast implants, support devices and spot compression structures). Subsequent experiments on two clinically relevant tasks $-$ breast density assessment and cancer screening $-$ revealed that these artefacts can significantly affect model performance, alter classification thresholds, and distort output distributions. These findings underscore the importance of accurate automatic artefact detection for developing reliable and robust classification models in digital mammography. To facilitate future research our annotations, code, and model predictions are made publicly available.
Abstract:Contrastive pretraining can substantially increase model generalisation and downstream performance. However, the quality of the learned representations is highly dependent on the data augmentation strategy applied to generate positive pairs. Positive contrastive pairs should preserve semantic meaning while discarding unwanted variations related to the data acquisition domain. Traditional contrastive pipelines attempt to simulate domain shifts through pre-defined generic image transformations. However, these do not always mimic realistic and relevant domain variations for medical imaging such as scanner differences. To tackle this issue, we herein introduce counterfactual contrastive learning, a novel framework leveraging recent advances in causal image synthesis to create contrastive positive pairs that faithfully capture relevant domain variations. Our method, evaluated across five datasets encompassing both chest radiography and mammography data, for two established contrastive objectives (SimCLR and DINO-v2), outperforms standard contrastive learning in terms of robustness to acquisition shift. Notably, counterfactual contrastive learning achieves superior downstream performance on both in-distribution and on external datasets, especially for images acquired with scanners under-represented in the training set. Further experiments show that the proposed framework extends beyond acquisition shifts, with models trained with counterfactual contrastive learning substantially improving subgroup performance across biological sex.
Abstract:The number of samples in structural brain MRI studies is often too small to properly train deep learning models. Generative models show promise in addressing this issue by effectively learning the data distribution and generating high-fidelity MRI. However, they struggle to produce diverse, high-quality data outside the distribution defined by the training data. One way to address the issue is using causal models developed for 3D volume counterfactuals. However, accurately modeling causality in high-dimensional spaces is a challenge so that these models generally generate 3D brain MRIS of lower quality. To address these challenges, we propose a two-stage method that constructs a Structural Causal Model (SCM) within the latent space. In the first stage, we employ a VQ-VAE to learn a compact embedding of the MRI volume. Subsequently, we integrate our causal model into this latent space and execute a three-step counterfactual procedure using a closed-form Generalized Linear Model (GLM). Our experiments conducted on real-world high-resolution MRI data (1mm) demonstrate that our method can generate high-quality 3D MRI counterfactuals.
Abstract:Deep learning-based medical image segmentation has seen tremendous progress over the last decade, but there is still relatively little transfer into clinical practice. One of the main barriers is the challenge of domain generalisation, which requires segmentation models to maintain high performance across a wide distribution of image data. This challenge is amplified by the many factors that contribute to the diverse appearance of medical images, such as acquisition conditions and patient characteristics. The impact of shifting patient characteristics such as age and sex on segmentation performance remains relatively under-studied, especially for abdominal organs, despite that this is crucial for ensuring the fairness of the segmentation model. We perform the first study to determine the impact of population shift with respect to age and sex on abdominal CT image segmentation, by leveraging two large public datasets, and introduce a novel metric to quantify the impact. We find that population shift is a challenge similar in magnitude to cross-dataset shift for abdominal organ segmentation, and that the effect is asymmetric and dataset-dependent. We conclude that dataset diversity in terms of known patient characteristics is not necessarily equivalent to dataset diversity in terms of image features. This implies that simple population matching to ensure good generalisation and fairness may be insufficient, and we recommend that fairness research should be directed towards better understanding and quantifying medical image dataset diversity in terms of performance-relevant characteristics such as organ morphology.
Abstract:Elasmobranchs (sharks and rays) can be important components of marine ecosystems but are experiencing global population declines. Effective monitoring of these populations is essential to their protection. Baited Remote Underwater Video Stations (BRUVS) have been a key tool for monitoring, but require time-consuming manual analysis. To address these challenges, we developed SharkTrack, an AI-enhanced BRUVS analysis software. SharkTrack uses Convolutional Neural Networks and Multi-Object Tracking to detect and track elasmobranchs and provides an annotation pipeline to manually classify elasmobranch species and compute MaxN, the standard metric of relative abundance. We tested SharkTrack on BRUVS footage from locations unseen by the model during training. SharkTrack computed MaxN with 89% accuracy over 207 hours of footage. The semi-automatic SharkTrack pipeline required two minutes of manual classification per hour of video, a 97% reduction of manual BRUVS analysis time compared to traditional methods, estimated conservatively at one hour per hour of video. Furthermore, we demonstrate SharkTrack application across diverse marine ecosystems and elasmobranch species, an advancement compared to previous models, which were limited to specific species or locations. SharkTrack applications extend beyond BRUVS analysis, facilitating rapid annotation of unlabeled videos, aiding the development of further models to classify elasmobranch species. We provide public access to the software and an unprecedentedly diverse dataset, facilitating future research in an important area of marine conservation.
Abstract:Learning modular object-centric representations is crucial for systematic generalization. Existing methods show promising object-binding capabilities empirically, but theoretical identifiability guarantees remain relatively underdeveloped. Understanding when object-centric representations can theoretically be identified is crucial for scaling slot-based methods to high-dimensional images with correctness guarantees. To that end, we propose a probabilistic slot-attention algorithm that imposes an aggregate mixture prior over object-centric slot representations, thereby providing slot identifiability guarantees without supervision, up to an equivalence relation. We provide empirical verification of our theoretical identifiability result using both simple 2-dimensional data and high-resolution imaging datasets.
Abstract:This study highlights the importance of conducting comprehensive model inspection as part of comparative performance analyses. Here, we investigate the effect of modelling choices on the feature learning characteristics of graph neural networks applied to a brain shape classification task. Specifically, we analyse the effect of using parameter-efficient, shared graph convolutional submodels compared to structure-specific, non-shared submodels. Further, we assess the effect of mesh registration as part of the data harmonisation pipeline. We find substantial differences in the feature embeddings at different layers of the models. Our results highlight that test accuracy alone is insufficient to identify important model characteristics such as encoded biases related to data source or potentially non-discriminative features learned in submodels. Our model inspection framework offers a valuable tool for practitioners to better understand performance characteristics of deep learning models in medical imaging.
Abstract:Causal generative modelling is gaining interest in medical imaging due to its ability to answer interventional and counterfactual queries. Most work focuses on generating counterfactual images that look plausible, using auxiliary classifiers to enforce effectiveness of simulated interventions. We investigate pitfalls in this approach, discovering the issue of attribute amplification, where unrelated attributes are spuriously affected during interventions, leading to biases across protected characteristics and disease status. We show that attribute amplification is caused by the use of hard labels in the counterfactual training process and propose soft counterfactual fine-tuning to mitigate this issue. Our method substantially reduces the amplification effect while maintaining effectiveness of generated images, demonstrated on a large chest X-ray dataset. Our work makes an important advancement towards more faithful and unbiased causal modelling in medical imaging.