用弱监督方法实现肾脏肿瘤分类,提升模型泛化能力。
Weakly-supervised Kidney Tumor Classification from CT Scans with Multi-Instance Learning and Anatomical Filtering

- 采用多实例学习与解剖过滤结合,减少标注依赖。
- 在内部数据集上达到F1=0.83,外数据集表现稳定。
- 适合医疗影像弱监督场景,可推广至其他器官疾病。
CT影像分析的深度学习模型常受限于像素级标注稀缺,此类标注需大量放射科医生投入。仅使用扫描级别标签虽降低标注需求,但低监督比例和大输入体积导致过拟合与捷径学习问题。本文研究两种互补方法:多实例学习(MIL)与解剖过滤。MIL将CT体积划分为2D切片实例,支持高效2D架构及ImageNet预训练,避免高计算成本的3D模型。解剖过滤利用自监督的Compass模型,无需分割掩码即可裁剪至病灶相关子区域。我们在两个外部数据集(KiTS23、TCGA-KiRC)和一个内部数据集(TUH)上评估了两种MIL框架——基于注意力的ABMIL与FocusMIL。最佳模型在内部测试集上达到F1=0.83,仅使用扫描级标签。结果表明,解剖过滤对基于嵌入的ABMIL的分布外泛化至关重要,而实例型FocusMIL对分布偏移具有更强内在鲁棒性。尽管聚焦于肾脏肿瘤,本工作为更广泛的弱监督CT分类流程提供了概念验证,适用于其他器官与病灶。
原文摘要 · Abstract (English)
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.
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