arXiv:2607.04478cs.CVcs.AI2026-07

多视角注意力融合+梯度提升元学习,提升胸部X光片14类疾病诊断准确率与可解释性。

PulmoSight-XAI: An Explainable Multi-View Attention Ensemble with Gradient Boosting Meta-Learning for Multi-Label Chest X-Ray Classification

论文配图:PulmoSight-XAI: An Explainable Multi-View Attention Ensemble with Gradient Boosting Meta-Learning for Multi-Label Chest X-Ray Classification
图 1 · 摘自论文原文
  • 分前后位/侧位独立训练,用五种CNN ensemble + CBAM模块保留细粒度特征。
  • 采用混合损失函数,在严重类别不平衡下实现0.9319(前位)和0.9154(侧位)的AUROC。
  • 通过多层元学习融合增强预测,支持临床决策定位,适合医疗AI系统落地使用。

自动化胸部X光分类面临严重类别不平衡、病灶共现及传统架构丢失局部特征等问题。为此,我们提出一种可解释的分层多视角集成框架,用于14种胸腔疾病的稳健分类。该框架通过独立建模前后位与侧位放射影像,采用五个互补的卷积神经网络集合进行视图特定训练。以多尺度特征融合替代全局平均池化,并引入卷积块注意力模块(CBAM),在保留细粒度中间表示的同时强化高层病理特异性语义特征。为缓解正负样本不平衡及类间难度差异,模型采用结合非对称损失与自适应焦点损失的新型混合目标函数。在测试时,不采用简单概率平均,而是将测试时增强(TTA)预测与跨模型不确定性度量输入一级梯度提升元学习器(XGBoost、LightGBM、CatBoost),再经二级堆叠与优化α加权融合。在大规模CheXpert风格数据集上评估,框架在前后位和侧位放射影像上分别取得0.9319和0.9154的宏平均AUROC,达到当前最佳水平。通过七种后处理归因技术的综合可解释性分析,结果展现出强解剖一致性与临床意义的决策定位能力。该框架融合架构多样性、多尺度注意力、分层元学习与严格可解释性,提供透明、高精度且临床实用的胸腔疾病辅助诊断系统。

原文摘要 · Abstract (English)

Automated chest X-ray classification remains challenging due to severe class imbalance, co-occurring pathologies, and the loss of localized features in conventional architectures. To address these, we propose an explainable hierarchical multi-view ensemble framework for the robust classification of 14 thoracic pathologies. The framework employs view-specific training by independently modeling frontal and lateral radiographs using an ensemble of five complementary convolutional neural networks. Replacing global average pooling, a multi-scale feature fusion strategy augmented with Convolutional Block Attention Modules (CBAM) preserves fine-grained intermediate representations while emphasizing high-level pathology-specific semantic features. To mitigate positive-negative imbalance and varying inter-class difficulty, models are optimized using a novel hybrid objective combining Asymmetric Loss with Adaptive Focal Loss. Beyond simple probability averaging, the framework incorporates a hierarchical meta-learning strategy where test-time augmentation (TTA) predictions and cross-model uncertainty measures are integrated into Level-1 gradient-boosting meta-learners (XGBoost, LightGBM, and CatBoost), followed by Level-2 stacking with optimized alpha blending. Evaluated on a large-scale CheXpert-style dataset, the framework achieves state-of-the-art macro-average AUROC scores of 0.9319 for frontal and 0.9154 for lateral radiographs. Furthermore, comprehensive explainability analysis using seven post-hoc attribution techniques demonstrates strong anatomical consistency and clinically meaningful decision localization. By integrating architectural diversity, multi-scale attention, hierarchical meta-learning, and rigorous explainability, the proposed framework provides a transparent, highly accurate, and clinically practical computer-aided diagnosis system for thoracic disease classification.

医学影像多标签分类可解释性注意力机制

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