arXiv subjects

Ian Selby

Publications and source records attributed to Ian Selby.

7 recordsLinked to original sources

arXiv2026

Rethinking Clinical Relevance in Chest X-ray Machine Learning: How Evaluation References Define Performance

Chest X-ray (CXR) machine learning relies heavily on automated evaluation using reference standards that aim to approximate clinical judgment. However, commonly used report-derived labels for pathology classification or generic image quality metrics for reconstruction may not reliably reflect clinical judgment. We systematically investigate how evaluation-reference choices affect model performance and ranking in both pathology classification and image quality assessment (IQA). To enable controlled comparison across evaluation references, we collected paired expert image- and report-derived labels for thoracic findings from a clinical cohort at Cambridge University Hospitals (CUH) and curated a subset of the public MIMIC-CXR dataset, along with expert ratings of diagnostic image quality. We show that for supervised image classifiers (ResNet, DenseNet), several zero-shot and fine-tuned vision-language models (e.g., MedKLIP, GLoRIA, and ConVIRT), changing the label source leads to substantial differences not only in performance estimates but also in model rankings. In parallel, alignment of IQA measures with expert judgment depends heavily on the choice of measure, and commonly used IQA metrics such as SSIM and PSNR often fail to align with expert assessments of diagnostic usability. Our results demonstrate that evaluation choices are crucial: they can determine which models and methods appear best and are therefore selected for further development or deployment. The selection of evaluation references should therefore be treated as a central component of clinical validity in CXR machine learning, and justified with respect to the pathology, imaging task, and intended downstream clinical use.

eess.IV↗

arXiv2025

PhotIQA: A photoacoustic image data set with image quality ratings

Image quality assessment (IQA) is crucial in the evaluation stage of novel algorithms operating on images, including traditional and machine learning based methods. Due to the lack of available quality-rated medical images, most commonly used full-reference IQA measures have been developed and tested for natural images. Reported pitfalls and inconsistencies arising when applying such measures for medical images are not surprising, as they rely on different properties than natural images. In photoacoustic imaging (PAI), especially, standard benchmarking approaches for assessing the quality of image reconstructions are lacking. PAI is a multi-physics imaging modality, in which two inverse problems have to be solved, which makes the application of IQA measures uniquely challenging due to both, acoustic and optical, artifacts. To support the development and testing of IQA measures we assembled PhotIQA, a data set consisting of 1134 photoacoustic images. The images were rated by five experts across five quality properties in a full-reference setting, where the detailed rating enables usage beyond PAI. The data set with the images and corresponding ratings is publicly available on Zenodo.

eess.IV↗

arXiv2024

Parameter choices in HaarPSI for IQA with medical images

When developing machine learning models, image quality assessment (IQA) measures are a crucial component for the evaluation of obtained output images. However, commonly used full-reference IQA (FR-IQA) measures have been primarily developed and optimized for natural images. In many specialized settings, such as medical images, this poses an often overlooked problem regarding suitability. In previous studies, the FR-IQA measure HaarPSI showed promising behavior regarding generalizability. The measure is based on Haar wavelet representations and the framework allows optimization of two parameters. So far, these parameters have been aligned for natural images. Here, we optimize these parameters for two medical image data sets, a photoacoustic and a chest X-ray data set, with IQA expert ratings. We observe that they lead to similar parameter values, different to the natural image data, and are more sensitive to parameter changes. We denote the novel optimized setting as HaarPSI$_{MED}$, which improves the performance of the employed medical images significantly (p<0.05). Additionally, we include an independent CT test data set that illustrates the generalizability of HaarPSI$_{MED}$, as well as visual examples that qualitatively demonstrate the improvement. The results suggest that adapting common IQA measures within their frameworks for medical images can provide a valuable, generalizable addition to employment of more specific task-based measures.

eess.IV↗

arXiv2024

Can Rule-Based Insights Enhance LLMs for Radiology Report Classification? Introducing the RadPrompt Methodology

Developing imaging models capable of detecting pathologies from chest X-rays can be cost and time-prohibitive for large datasets as it requires supervision to attain state-of-the-art performance. Instead, labels extracted from radiology reports may serve as distant supervision since these are routinely generated as part of clinical practice. Despite their widespread use, current rule-based methods for label extraction rely on extensive rule sets that are limited in their robustness to syntactic variability. To alleviate these limitations, we introduce RadPert, a rule-based system that integrates an uncertainty-aware information schema with a streamlined set of rules, enhancing performance. Additionally, we have developed RadPrompt, a multi-turn prompting strategy that leverages RadPert to bolster the zero-shot predictive capabilities of large language models, achieving a statistically significant improvement in weighted average F1 score over GPT-4 Turbo. Most notably, RadPrompt surpasses both its underlying models, showcasing the synergistic potential of LLMs with rule-based models. We have evaluated our methods on two English Corpora: the MIMIC-CXR gold-standard test set and a gold-standard dataset collected from the Cambridge University Hospitals.

cs.CL↗

arXiv2024

A study on the adequacy of common IQA measures for medical images

Image quality assessment (IQA) is standard practice in the development stage of novel machine learning algorithms that operate on images. The most commonly used IQA measures have been developed and tested for natural images, but not in the medical setting. Reported inconsistencies arising in medical images are not surprising, as they have different properties than natural images. In this study, we test the applicability of common IQA measures for medical image data by comparing their assessment to manually rated chest X-ray (5 experts) and photoacoustic image data (2 experts). Moreover, we include supplementary studies on grayscale natural images and accelerated brain MRI data. The results of all experiments show a similar outcome in line with previous findings for medical images: PSNR and SSIM in the default setting are in the lower range of the result list and HaarPSI outperforms the other tested measures in the overall performance. Also among the top performers in our experiments are the full reference measures FSIM, LPIPS and MS-SSIM. Generally, the results on natural images yield considerably higher correlations, suggesting that additional employment of tailored IQA measures for medical imaging algorithms is needed.

eess.IV↗

arXiv2024

A study of why we need to reassess full reference image quality assessment with medical images

Image quality assessment (IQA) is indispensable in clinical practice to ensure high standards, as well as in the development stage of machine learning algorithms that operate on medical images. The popular full reference (FR) IQA measures PSNR and SSIM are known and tested for working successfully in many natural imaging tasks, but discrepancies in medical scenarios have been reported in the literature, highlighting the gap between development and actual clinical application. Such inconsistencies are not surprising, as medical images have very different properties than natural images, and PSNR and SSIM have neither been targeted nor properly tested for medical images. This may cause unforeseen problems in clinical applications due to wrong judgment of novel methods. This paper provides a structured and comprehensive overview of examples where PSNR and SSIM prove to be unsuitable for the assessment of novel algorithms using different kinds of medical images, including real-world MRI, CT, OCT, X-Ray, digital pathology and photoacoustic imaging data. Therefore, improvement is urgently needed in particular in this era of AI to increase reliability and explainability in machine learning for medical imaging and beyond. Lastly, we will provide ideas for future research as well as suggesting guidelines for the usage of FR-IQA measures applied to medical images.

eess.IV↗

arXiv2022

Data Harmonisation for Information Fusion in Digital Healthcare: A State-of-the-Art Systematic Review, Meta-Analysis and Future Research Directions

Removing the bias and variance of multicentre data has always been a challenge in large scale digital healthcare studies, which requires the ability to integrate clinical features extracted from data acquired by different scanners and protocols to improve stability and robustness. Previous studies have described various computational approaches to fuse single modality multicentre datasets. However, these surveys rarely focused on evaluation metrics and lacked a checklist for computational data harmonisation studies. In this systematic review, we summarise the computational data harmonisation approaches for multi-modality data in the digital healthcare field, including harmonisation strategies and evaluation metrics based on different theories. In addition, a comprehensive checklist that summarises common practices for data harmonisation studies is proposed to guide researchers to report their research findings more effectively. Last but not least, flowcharts presenting possible ways for methodology and metric selection are proposed and the limitations of different methods have been surveyed for future research.

cs.AI↗