Comparison of Deep Learning Approaches for Multi-Label Chest X-Ray Classification

The increased availability of X-ray image archives (e.g. the ChestX-ray14 dataset from the NIH Clinical Center) has triggered a growing interest in deep learning techniques. To provide better insight into the different approaches, and their applications to chest X-ray classification, we investigate a powerful network architecture in detail: the ResNet-50. Building on prior work in this domain, we consider transfer learning with and without fine-tuning as well as the training of a dedicated X-ray network from scratch. To leverage the high spatial resolutions of X-ray data, we also include an extended ResNet-50 architecture, and a network integrating non-image data (patient age, gender and acquisition type) in the classification process. In a systematic evaluation, using 5-fold re-sampling and a multi-label loss function, we evaluate the performance of the different approaches for pathology classification by ROC statistics and analyze differences between the classifiers using rank correlation. We observe a considerable spread in the achieved performance and conclude that the X-ray-specific ResNet-50, integrating non-image data yields the best overall results.