Joonas Ariva | Searcharxiv

arXiv2026

Weakly-supervised Kidney Tumor Classification from CT Scans with Multi-Instance Learning and Anatomical Filtering

Deep learning models for CT scan analysis are often limited by the scarcity of precise pixel-level annotations, which require significant radiologist effort to produce. Training on scan-level labels alone reduces annotation requirements but introduces challenges: low supervision ratios and large input volumes make models prone to overfitting and shortcut learning. In this work, we investigate two complementary methods to address these challenges: multi-instance learning (MIL) and anatomical filtering. MIL divides CT volumes into 2D slice instances, enabling efficient 2D architectures with ImageNet pretraining rather than computationally demanding 3D models. Anatomical filtering uses Compass, our self-supervised body part regression model, to crop scans to pathology-relevant subregions without requiring segmentation masks. We evaluate two MIL frameworks - Attention-based MIL (ABMIL) and FocusMIL - on kidney tumor classification across one internal dataset (TUH) and two external datasets (KiTS23 and TCGA-KiRC). Our best models achieve F1 = 0.83 on the internal test set using only scan-level labels. We further show that anatomical filtering with the Compass model is critical for the out-of-distribution generalization of embedding-based ABMIL, while instance-based FocusMIL demonstrates greater inherent robustness to distribution shift. While evaluated on kidney tumors, we consider this a proof-of-concept for a broader weakly supervised CT classification pipeline applicable to other organs and pathologies.

cs.CV↗

arXiv2024

COIN: Counterfactual inpainting for weakly supervised semantic segmentation for medical images

Deep learning is dramatically transforming the field of medical imaging and radiology, enabling the identification of pathologies in medical images, including computed tomography (CT) and X-ray scans. However, the performance of deep learning models, particularly in segmentation tasks, is often limited by the need for extensive annotated datasets. To address this challenge, the capabilities of weakly supervised semantic segmentation are explored through the lens of Explainable AI and the generation of counterfactual explanations. The scope of this research is development of a novel counterfactual inpainting approach (COIN) that flips the predicted classification label from abnormal to normal by using a generative model. For instance, if the classifier deems an input medical image X as abnormal, indicating the presence of a pathology, the generative model aims to inpaint the abnormal region, thus reversing the classifier's original prediction label. The approach enables us to produce precise segmentations for pathologies without depending on pre-existing segmentation masks. Crucially, image-level labels are utilized, which are substantially easier to acquire than creating detailed segmentation masks. The effectiveness of the method is demonstrated by segmenting synthetic targets and actual kidney tumors from CT images acquired from Tartu University Hospital in Estonia. The findings indicate that COIN greatly surpasses established attribution methods, such as RISE, ScoreCAM, and LayerCAM, as well as an alternative counterfactual explanation method introduced by Singla et al. This evidence suggests that COIN is a promising approach for semantic segmentation of tumors in CT images, and presents a step forward in making deep learning applications more accessible and effective in healthcare, where annotated data is scarce.

cs.CV↗