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Georgios Kaissis

Publications and source records attributed to Georgios Kaissis.

At least 55 records · Page 3Linked to original sources

Private, fair and accurate: Training large-scale, privacy-preserving AI models in medical imaging

Artificial intelligence (AI) models are increasingly used in the medical domain. However, as medical data is highly sensitive, special precautions to ensure its protection are required. The gold standard for privacy preservation is the introduction of differential privacy (DP) to model training. Prior work indicates that DP has negative implications on model accuracy and fairness, which are unacceptable in medicine and represent a main barrier to the widespread use of privacy-preserving techniques. In this work, we evaluated the effect of privacy-preserving training of AI models regarding accuracy and fairness compared to non-private training. For this, we used two datasets: (1) A large dataset (N=193,311) of high quality clinical chest radiographs, and (2) a dataset (N=1,625) of 3D abdominal computed tomography (CT) images, with the task of classifying the presence of pancreatic ductal adenocarcinoma (PDAC). Both were retrospectively collected and manually labeled by experienced radiologists. We then compared non-private deep convolutional neural networks (CNNs) and privacy-preserving (DP) models with respect to privacy-utility trade-offs measured as area under the receiver-operator-characteristic curve (AUROC), and privacy-fairness trade-offs, measured as Pearson's r or Statistical Parity Difference. We found that, while the privacy-preserving trainings yielded lower accuracy, they did largely not amplify discrimination against age, sex or co-morbidity. Our study shows that -- under the challenging realistic circumstances of a real-life clinical dataset -- the privacy-preserving training of diagnostic deep learning models is possible with excellent diagnostic accuracy and fairness.

eess.IV↗

Kernel Normalized Convolutional Networks

Existing convolutional neural network architectures frequently rely upon batch normalization (BatchNorm) to effectively train the model. BatchNorm, however, performs poorly with small batch sizes, and is inapplicable to differential privacy. To address these limitations, we propose the kernel normalization (KernelNorm) and kernel normalized convolutional layers, and incorporate them into kernel normalized convolutional networks (KNConvNets) as the main building blocks. We implement KNConvNets corresponding to the state-of-the-art ResNets while forgoing the BatchNorm layers. Through extensive experiments, we illustrate that KNConvNets achieve higher or competitive performance compared to the BatchNorm counterparts in image classification and semantic segmentation. They also significantly outperform their batch-independent competitors including those based on layer and group normalization in non-private and differentially private training. Given that, KernelNorm combines the batch-independence property of layer and group normalization with the performance advantage of BatchNorm.

cs.LG↗

Weakly Supervised Object Detection in Chest X-Rays with Differentiable ROI Proposal Networks and Soft ROI Pooling

Weakly supervised object detection (WSup-OD) increases the usefulness and interpretability of image classification algorithms without requiring additional supervision. The successes of multiple instance learning in this task for natural images, however, do not translate well to medical images due to the very different characteristics of their objects (i.e. pathologies). In this work, we propose Weakly Supervised ROI Proposal Networks (WSRPN), a new method for generating bounding box proposals on the fly using a specialized region of interest-attention (ROI-attention) module. WSRPN integrates well with classic backbone-head classification algorithms and is end-to-end trainable with only image-label supervision. We experimentally demonstrate that our new method outperforms existing methods in the challenging task of disease localization in chest X-ray images. Code: https://github.com/philip-mueller/wsrpn

cs.CV↗

Preserving privacy in domain transfer of medical AI models comes at no performance costs: The integral role of differential privacy

Developing robust and effective artificial intelligence (AI) models in medicine requires access to large amounts of patient data. The use of AI models solely trained on large multi-institutional datasets can help with this, yet the imperative to ensure data privacy remains, particularly as membership inference risks breaching patient confidentiality. As a proposed remedy, we advocate for the integration of differential privacy (DP). We specifically investigate the performance of models trained with DP as compared to models trained without DP on data from institutions that the model had not seen during its training (i.e., external validation) - the situation that is reflective of the clinical use of AI models. By leveraging more than 590,000 chest radiographs from five institutions, we evaluated the efficacy of DP-enhanced domain transfer (DP-DT) in diagnosing cardiomegaly, pleural effusion, pneumonia, atelectasis, and in identifying healthy subjects. We juxtaposed DP-DT with non-DP-DT and examined diagnostic accuracy and demographic fairness using the area under the receiver operating characteristic curve (AUC) as the main metric, as well as accuracy, sensitivity, and specificity. Our results show that DP-DT, even with exceptionally high privacy levels (epsilon around 1), performs comparably to non-DP-DT (P>0.119 across all domains). Furthermore, DP-DT led to marginal AUC differences - less than 1% - for nearly all subgroups, relative to non-DP-DT. Despite consistent evidence suggesting that DP models induce significant performance degradation for on-domain applications, we show that off-domain performance is almost not affected. Therefore, we ardently advocate for the adoption of DP in training diagnostic medical AI models, given its minimal impact on performance.

cs.LG↗

Interpretable 2D Vision Models for 3D Medical Images

Training Artificial Intelligence (AI) models on 3D images presents unique challenges compared to the 2D case: Firstly, the demand for computational resources is significantly higher, and secondly, the availability of large datasets for pre-training is often limited, impeding training success. This study proposes a simple approach of adapting 2D networks with an intermediate feature representation for processing 3D images. Our method employs attention pooling to learn to assign each slice an importance weight and, by that, obtain a weighted average of all 2D slices. These weights directly quantify the contribution of each slice to the contribution and thus make the model prediction inspectable. We show on all 3D MedMNIST datasets as benchmark and two real-world datasets consisting of several hundred high-resolution CT or MRI scans that our approach performs on par with existing methods. Furthermore, we compare the in-built interpretability of our approach to HiResCam, a state-of-the-art retrospective interpretability approach.

eess.IV↗

Reconciling AI Performance and Data Reconstruction Resilience for Medical Imaging

Artificial Intelligence (AI) models are vulnerable to information leakage of their training data, which can be highly sensitive, for example in medical imaging. Privacy Enhancing Technologies (PETs), such as Differential Privacy (DP), aim to circumvent these susceptibilities. DP is the strongest possible protection for training models while bounding the risks of inferring the inclusion of training samples or reconstructing the original data. DP achieves this by setting a quantifiable privacy budget. Although a lower budget decreases the risk of information leakage, it typically also reduces the performance of such models. This imposes a trade-off between robust performance and stringent privacy. Additionally, the interpretation of a privacy budget remains abstract and challenging to contextualize. In this study, we contrast the performance of AI models at various privacy budgets against both, theoretical risk bounds and empirical success of reconstruction attacks. We show that using very large privacy budgets can render reconstruction attacks impossible, while drops in performance are negligible. We thus conclude that not using DP -- at all -- is negligent when applying AI models to sensitive data. We deem those results to lie a foundation for further debates on striking a balance between privacy risks and model performance.

cs.CR↗

SoK: Memorisation in machine learning

Quantifying the impact of individual data samples on machine learning models is an open research problem. This is particularly relevant when complex and high-dimensional relationships have to be learned from a limited sample of the data generating distribution, such as in deep learning. It was previously shown that, in these cases, models rely not only on extracting patterns which are helpful for generalisation, but also seem to be required to incorporate some of the training data more or less as is, in a process often termed memorisation. This raises the question: if some memorisation is a requirement for effective learning, what are its privacy implications? In this work we unify a broad range of previous definitions and perspectives on memorisation in ML, discuss their interplay with model generalisation and their implications of these phenomena on data privacy. Moreover, we systematise methods allowing practitioners to detect the occurrence of memorisation or quantify it and contextualise our findings in a broad range of ML learning settings. Finally, we discuss memorisation in the context of privacy attacks, differential privacy (DP) and adversarial actors.

cs.LG↗

Body Fat Estimation from Surface Meshes using Graph Neural Networks

Body fat volume and distribution can be a strong indication for a person's overall health and the risk for developing diseases like type 2 diabetes and cardiovascular diseases. Frequently used measures for fat estimation are the body mass index (BMI), waist circumference, or the waist-hip-ratio. However, those are rather imprecise measures that do not allow for a discrimination between different types of fat or between fat and muscle tissue. The estimation of visceral (VAT) and abdominal subcutaneous (ASAT) adipose tissue volume has shown to be a more accurate measure for named risk factors. In this work, we show that triangulated body surface meshes can be used to accurately predict VAT and ASAT volumes using graph neural networks. Our methods achieve high performance while reducing training time and required resources compared to state-of-the-art convolutional neural networks in this area. We furthermore envision this method to be applicable to cheaper and easily accessible medical surface scans instead of expensive medical images.

eess.IV↗

Propagation and Attribution of Uncertainty in Medical Imaging Pipelines

Uncertainty estimation, which provides a means of building explainable neural networks for medical imaging applications, have mostly been studied for single deep learning models that focus on a specific task. In this paper, we propose a method to propagate uncertainty through cascades of deep learning models in medical imaging pipelines. This allows us to aggregate the uncertainty in later stages of the pipeline and to obtain a joint uncertainty measure for the predictions of later models. Additionally, we can separately report contributions of the aleatoric, data-based, uncertainty of every component in the pipeline. We demonstrate the utility of our method on a realistic imaging pipeline that reconstructs undersampled brain and knee magnetic resonance (MR) images and subsequently predicts quantitative information from the images, such as the brain volume, or knee side or patient's sex. We quantitatively show that the propagated uncertainty is correlated with input uncertainty and compare the proportions of contributions of pipeline stages to the joint uncertainty measure.

cs.CV↗

Label Noise-Robust Learning using a Confidence-Based Sieving Strategy

In learning tasks with label noise, improving model robustness against overfitting is a pivotal challenge because the model eventually memorizes labels, including the noisy ones. Identifying the samples with noisy labels and preventing the model from learning them is a promising approach to address this challenge. When training with noisy labels, the per-class confidence scores of the model, represented by the class probabilities, can be reliable criteria for assessing whether the input label is the true label or the corrupted one. In this work, we exploit this observation and propose a novel discriminator metric called confidence error and a sieving strategy called CONFES to differentiate between the clean and noisy samples effectively. We provide theoretical guarantees on the probability of error for our proposed metric. Then, we experimentally illustrate the superior performance of our proposed approach compared to recent studies on various settings, such as synthetic and real-world label noise. Moreover, we show CONFES can be combined with other state-of-the-art approaches, such as Co-teaching and DivideMix to further improve model performance.

cs.LG↗

(Predictable) Performance Bias in Unsupervised Anomaly Detection

Background: With the ever-increasing amount of medical imaging data, the demand for algorithms to assist clinicians has amplified. Unsupervised anomaly detection (UAD) models promise to aid in the crucial first step of disease detection. While previous studies have thoroughly explored fairness in supervised models in healthcare, for UAD, this has so far been unexplored. Methods: In this study, we evaluated how dataset composition regarding subgroups manifests in disparate performance of UAD models along multiple protected variables on three large-scale publicly available chest X-ray datasets. Our experiments were validated using two state-of-the-art UAD models for medical images. Finally, we introduced a novel subgroup-AUROC (sAUROC) metric, which aids in quantifying fairness in machine learning. Findings: Our experiments revealed empirical "fairness laws" (similar to "scaling laws" for Transformers) for training-dataset composition: Linear relationships between anomaly detection performance within a subpopulation and its representation in the training data. Our study further revealed performance disparities, even in the case of balanced training data, and compound effects that exacerbate the drop in performance for subjects associated with multiple adversely affected groups. Interpretation: Our study quantified the disparate performance of UAD models against certain demographic subgroups. Importantly, we showed that this unfairness cannot be mitigated by balanced representation alone. Instead, the representation of some subgroups seems harder to learn by UAD models than that of others. The empirical fairness laws discovered in our study make disparate performance in UAD models easier to estimate and aid in determining the most desirable dataset composition.

cs.LG↗

Extended Graph Assessment Metrics for Graph Neural Networks

When re-structuring patient cohorts into so-called population graphs, initially independent data points can be incorporated into one interconnected graph structure. This population graph can then be used for medical downstream tasks using graph neural networks (GNNs). The construction of a suitable graph structure is a challenging step in the learning pipeline that can have severe impact on model performance. To this end, different graph assessment metrics have been introduced to evaluate graph structures. However, these metrics are limited to classification tasks and discrete adjacency matrices, only covering a small subset of real-world applications. In this work, we introduce extended graph assessment metrics (GAMs) for regression tasks and continuous adjacency matrices. We focus on two GAMs in specific: \textit{homophily} and \textit{cross-class neighbourhood similarity} (CCNS). We extend the notion of GAMs to more than one hop, define homophily for regression tasks, as well as continuous adjacency matrices, and propose a light-weight CCNS distance for discrete and continuous adjacency matrices. We show the correlation of these metrics with model performance on different medical population graphs and under different learning settings.

cs.SI↗

MAD: Modality Agnostic Distance Measure for Image Registration

Multi-modal image registration is a crucial pre-processing step in many medical applications. However, it is a challenging task due to the complex intensity relationships between different imaging modalities, which can result in large discrepancy in image appearance. The success of multi-modal image registration, whether it is conventional or learning based, is predicated upon the choice of an appropriate distance (or similarity) measure. Particularly, deep learning registration algorithms lack in accuracy or even fail completely when attempting to register data from an "unseen" modality. In this work, we present Modality Agnostic Distance (MAD), a deep image distance}] measure that utilises random convolutions to learn the inherent geometry of the images while being robust to large appearance changes. Random convolutions are geometry-preserving modules which we use to simulate an infinite number of synthetic modalities alleviating the need for aligned paired data during training. We can therefore train MAD on a mono-modal dataset and successfully apply it to a multi-modal dataset. We demonstrate that not only can MAD affinely register multi-modal images successfully, but it has also a larger capture range than traditional measures such as Mutual Information and Normalised Gradient Fields.

cs.CV↗

Anatomy-Driven Pathology Detection on Chest X-rays

Pathology detection and delineation enables the automatic interpretation of medical scans such as chest X-rays while providing a high level of explainability to support radiologists in making informed decisions. However, annotating pathology bounding boxes is a time-consuming task such that large public datasets for this purpose are scarce. Current approaches thus use weakly supervised object detection to learn the (rough) localization of pathologies from image-level annotations, which is however limited in performance due to the lack of bounding box supervision. We therefore propose anatomy-driven pathology detection (ADPD), which uses easy-to-annotate bounding boxes of anatomical regions as proxies for pathologies. We study two training approaches: supervised training using anatomy-level pathology labels and multiple instance learning (MIL) with image-level pathology labels. Our results show that our anatomy-level training approach outperforms weakly supervised methods and fully supervised detection with limited training samples, and our MIL approach is competitive with both baseline approaches, therefore demonstrating the potential of our approach.

cs.CV↗

Bias-Aware Minimisation: Understanding and Mitigating Estimator Bias in Private SGD

Differentially private SGD (DP-SGD) holds the promise of enabling the safe and responsible application of machine learning to sensitive datasets. However, DP-SGD only provides a biased, noisy estimate of a mini-batch gradient. This renders optimisation steps less effective and limits model utility as a result. With this work, we show a connection between per-sample gradient norms and the estimation bias of the private gradient oracle used in DP-SGD. Here, we propose Bias-Aware Minimisation (BAM) that allows for the provable reduction of private gradient estimator bias. We show how to efficiently compute quantities needed for BAM to scale to large neural networks and highlight similarities to closely related methods such as Sharpness-Aware Minimisation. Finally, we provide empirical evidence that BAM not only reduces bias but also substantially improves privacy-utility trade-offs on the CIFAR-10, CIFAR-100, and ImageNet-32 datasets.

cs.LG↗

Unsupervised Pathology Detection: A Deep Dive Into the State of the Art

Deep unsupervised approaches are gathering increased attention for applications such as pathology detection and segmentation in medical images since they promise to alleviate the need for large labeled datasets and are more generalizable than their supervised counterparts in detecting any kind of rare pathology. As the Unsupervised Anomaly Detection (UAD) literature continuously grows and new paradigms emerge, it is vital to continuously evaluate and benchmark new methods in a common framework, in order to reassess the state-of-the-art (SOTA) and identify promising research directions. To this end, we evaluate a diverse selection of cutting-edge UAD methods on multiple medical datasets, comparing them against the established SOTA in UAD for brain MRI. Our experiments demonstrate that newly developed feature-modeling methods from the industrial and medical literature achieve increased performance compared to previous work and set the new SOTA in a variety of modalities and datasets. Additionally, we show that such methods are capable of benefiting from recently developed self-supervised pre-training algorithms, further increasing their performance. Finally, we perform a series of experiments in order to gain further insights into some unique characteristics of selected models and datasets. Our code can be found under https://github.com/iolag/UPD_study/.

cs.CV↗

Privacy-Utility Trade-offs in Neural Networks for Medical Population Graphs: Insights from Differential Privacy and Graph Structure

We initiate an empirical investigation into differentially private graph neural networks on population graphs from the medical domain by examining privacy-utility trade-offs at different privacy levels on both real-world and synthetic datasets and performing auditing through membership inference attacks. Our findings highlight the potential and the challenges of this specific DP application area. Moreover, we find evidence that the underlying graph structure constitutes a potential factor for larger performance gaps by showing a correlation between the degree of graph homophily and the accuracy of the trained model.

cs.LG↗

Bounding data reconstruction attacks with the hypothesis testing interpretation of differential privacy

We explore Reconstruction Robustness (ReRo), which was recently proposed as an upper bound on the success of data reconstruction attacks against machine learning models. Previous research has demonstrated that differential privacy (DP) mechanisms also provide ReRo, but so far, only asymptotic Monte Carlo estimates of a tight ReRo bound have been shown. Directly computable ReRo bounds for general DP mechanisms are thus desirable. In this work, we establish a connection between hypothesis testing DP and ReRo and derive closed-form, analytic or numerical ReRo bounds for the Laplace and Gaussian mechanisms and their subsampled variants.

cs.CR↗