Adversarial Masked Image Inpainting for Robust Detection of Mpox and Non-Mpox

Due to the lack of efficient mpox diagnostic technology, mpox cases continue to increase. Recently, the great potential of deep learning models in detecting mpox and non-mpox has been proven. However, existing models learn image representations via image classification, which results in they may be easily susceptible to interference from real-world noise, require diverse non-mpox images, and fail to detect abnormal input. These drawbacks make classification models inapplicable in real-world settings. To address these challenges, we propose "Mask, Inpainting, and Measure" (MIM). In MIM's pipeline, a generative adversarial network only learns mpox image representations by inpainting the masked mpox images. Then, MIM determines whether the input belongs to mpox by measuring the similarity between the inpainted image and the original image. The underlying intuition is that since MIM solely models mpox images, it struggles to accurately inpaint non-mpox images in real-world settings. Without utilizing any non-mpox images, MIM cleverly detects mpox and non-mpox and can handle abnormal inputs. We used the recognized mpox dataset (MSLD) and images of eighteen non-mpox skin diseases to verify the effectiveness and robustness of MIM. Experimental results show that the average AUROC of MIM achieves 0.8237. In addition, we demonstrated the drawbacks of classification models and buttressed the potential of MIM through clinical validation. Finally, we developed an online smartphone app to provide free testing to the public in affected areas. This work first employs generative models to improve mpox detection and provides new insights into binary decision-making tasks in medical images.