On Sensitivity and Robustness of Normalization Schemes to Input Distribution Shifts in Automatic MR Image Diagnosis

Magnetic Resonance Imaging (MRI) is considered the gold standard of medical imaging because of the excellent soft-tissue contrast exhibited in the images reconstructed by the MRI pipeline, which in-turn enables the human radiologist to discern many pathologies easily. More recently, Deep Learning (DL) models have also achieved state-of-the-art performance in diagnosing multiple diseases using these reconstructed images as input. However, the image reconstruction process within the MRI pipeline, which requires the use of complex hardware and adjustment of a large number of scanner parameters, is highly susceptible to noise of various forms, resulting in arbitrary artifacts within the images. Furthermore, the noise distribution is not stationary and varies within a machine, across machines, and patients, leading to varying artifacts within the images. Unfortunately, DL models are quite sensitive to these varying artifacts as it leads to changes in the input data distribution between the training and testing phases. The lack of robustness of these models against varying artifacts impedes their use in medical applications where safety is critical. In this work, we focus on improving the generalization performance of these models in the presence of multiple varying artifacts that manifest due to the complexity of the MR data acquisition. In our experiments, we observe that Batch Normalization, a widely used technique during the training of DL models for medical image analysis, is a significant cause of performance degradation in these changing environments. As a solution, we propose to use other normalization techniques, such as Group Normalization and Layer Normalization (LN), to inject robustness into model performance against varying image artifacts. Through a systematic set of experiments, we show that GN and LN provide better accuracy for various MR artifacts and distribution shifts.