Gall Bladder Cancer Detection from US Images with Only Image Level Labels

Automated detection of Gallbladder Cancer (GBC) from Ultrasound (US) images is an important problem, which has drawn increased interest from researchers. However, most of these works use difficult-to-acquire information such as bounding box annotations or additional US videos. In this paper, we focus on GBC detection using only image-level labels. Such annotation is usually available based on the diagnostic report of a patient, and do not require additional annotation effort from the physicians. However, our analysis reveals that it is difficult to train a standard image classification model for GBC detection. This is due to the low inter-class variance (a malignant region usually occupies only a small portion of a US image), high intra-class variance (due to the US sensor capturing a 2D slice of a 3D object leading to large viewpoint variations), and low training data availability. We posit that even when we have only the image level label, still formulating the problem as object detection (with bounding box output) helps a deep neural network (DNN) model focus on the relevant region of interest. Since no bounding box annotations is available for training, we pose the problem as weakly supervised object detection (WSOD). Motivated by the recent success of transformer models in object detection, we train one such model, DETR, using multi-instance-learning (MIL) with self-supervised instance selection to suit the WSOD task. Our proposed method demonstrates an improvement of AP and detection sensitivity over the SOTA transformer-based and CNN-based WSOD methods. Project page is at https://gbc-iitd.github.io/wsod-gbc