Generation of Anonymous Chest Radiographs Using Latent Diffusion Models for Training Thoracic Abnormality Classification Systems

The availability of large-scale chest X-ray datasets is a requirement for developing well-performing deep learning-based algorithms in thoracic abnormality detection and classification. However, biometric identifiers in chest radiographs hinder the public sharing of such data for research purposes due to the risk of patient re-identification. To counteract this issue, synthetic data generation offers a solution for anonymizing medical images. This work employs a latent diffusion model to synthesize an anonymous chest X-ray dataset of high-quality class-conditional images. We propose a privacy-enhancing sampling strategy to ensure the non-transference of biometric information during the image generation process. The quality of the generated images and the feasibility of serving as exclusive training data are evaluated on a thoracic abnormality classification task. Compared to a real classifier, we achieve competitive results with a performance gap of only 3.5% in the area under the receiver operating characteristic curve.

Deep Learning-based Anonymization of Chest Radiographs: A Utility-preserving Measure for Patient Privacy

Robust and reliable anonymization of chest radiographs constitutes an essential step before publishing large datasets of such for research purposes. The conventional anonymization process is carried out by obscuring personal information in the images with black boxes and removing or replacing meta-information. However, such simple measures retain biometric information in the chest radiographs, allowing patients to be re-identified by a linkage attack. Therefore, we see an urgent need to obfuscate the biometric information appearing in the images. To the best of our knowledge, we propose the first deep learning-based approach to targetedly anonymize chest radiographs while maintaining data utility for diagnostic and machine learning purposes. Our model architecture is a composition of three independent neural networks that, when collectively used, allow for learning a deformation field that is able to impede patient re-identification. The individual influence of each component is investigated with an ablation study. Quantitative results on the ChestX-ray14 dataset show a reduction of patient re-identification from 81.8% to 58.6% in the area under the receiver operating characteristic curve (AUC) with little impact on the abnormality classification performance. This indicates the ability to preserve underlying abnormality patterns while increasing patient privacy. Furthermore, we compare the proposed deep learning-based anonymization approach with differentially private image pixelization, and demonstrate the superiority of our method towards resolving the privacy-utility trade-off for chest radiographs.

Is Medical Chest X-ray Data Anonymous?

With the rise and ever-increasing potential of deep learning techniques in recent years, publicly available medical data sets became a key factor to enable reproducible development of diagnostic algorithms in the medical domain. Medical data contains sensitive patient-related information and is therefore usually anonymized by removing patient identifiers, e.g., patient names before publication. To the best of our knowledge, we are the first to show that a well-trained deep learning system is able to recover the patient identity from chest X-ray data. We demonstrate this using the publicly available large-scale ChestX-ray14 dataset, a collection of 112,120 frontal-view chest X-ray images from 30,805 unique patients. Our verification system is able to identify whether two frontal chest X-ray images are from the same person with an AUC of 0.9940 and a classification accuracy of 95.55%. We further highlight that the proposed system is able to reveal the same person even ten and more years after the initial scan. When pursuing a retrieval approach, we observe an mAP@R of 0.9748 and a precision@1 of 0.9963. Based on this high identification rate, a potential attacker may leak patient-related information and additionally cross-reference images to obtain more information. Thus, there is a great risk of sensitive content falling into unauthorized hands or being disseminated against the will of the concerned patients. Especially during the COVID-19 pandemic, numerous chest X-ray datasets have been published to advance research. Therefore, such data may be vulnerable to potential attacks by deep learning-based re-identification algorithms.